Integrating what is taught with what is practised in the nursing curriculum: a multi-dimensional model

The discrepancy between nursing as it is taught in the classroom (theory) and nursing as it is experienced by students in the clinical setting (practice) has long been a source of concern to teachers, practitioners and learners This paper provides an overview of the literature on the theory-practice gap, exploring some of the many reasons cited for its existence as well as suggested ways of bridging the gap Drawing upon the findings, a comprehensive and multidimensional model designed to integrate theory and practice of nursing is proposed for use by curriculum planners Fundamental to the model is the notion of collaboration between education and service staff at all stages of the curriculum process The model highlights eight key areas for the curriculum team to consider the curriculum model to be used, sequencing of taught content and clinical practice, the content of the course, teaching methods to be used, assessment criteria, the role of tutors in the learning process, the contribution of service staff, and the influence of the hidden curriculum It is argued that only through such a comprehensive model can integration of theory and practice within the curriculum be achieved Adoption of the model, however, will require considerable individual and organizational commitment     

Evidence-based mental health nursing in Australia: our history and our future

This paper will develop a discussion related to evidence-based knowledge for mental health nursing, arguing for a historical component to be included in the comprehensive degree programme that will offer significant insights into mental health nursing knowledge from historical information and constructing implications for contemporary practice. Our understanding of the present is clearer by this looking back and forth and by adding meaning (and what the meanings mean) to what historically preceded. It allows the history of psychiatry to be a much more productive, useful, and a continual source of wisdom for the here and now. This blending of past knowledge with contemporary inquiry can offer depth in mental health nursing practices by forming a context for practice for the beginning nurse practitioner.     

Childcare health and health consultation curriculum: trends and future directions in nursing education

Purpose. The purpose of this study was to identify graduate and undergraduate nursing courses in health and health consultation in childcare and early education, and faculty awareness and interest in federal resources. Design and Methods. A questionnaire was sent electronically to 140 faculty in 45 schools of nursing. Results. Fifty‐nine faculty from 45 schools (42%) participated, and 80% reported at least one course related to childcare health and safety. Most faculty were not aware of federal initiatives to support childcare health and safety, and the role of nurse childcare health consultants; however, many were interested in receiving instructional materials. Practice Implications. Utilizing federal resources to augment nursing education in childcare health and safety curriculum may strengthen the workforce of nurses providing health consultation to early childhood programs.     

Occupational health nursing practice in Australia: what occupational health nurses say they do and what they actually do

This study investigated current activities of occupational health nurses (OHN) in Australia related to the applicability of and their involvement in emergent role, wellness-based practices and traditional role and illness-based practices. A questionnaire encompassing the eight Areas of Practice as articulated by the Australian College of Occupational Health Nursing (ACOHN) competency standards was used to obtain data from 93 OHNs affiliated with ACOHN. More traditional role Areas of Practice such as treatment services, health assessment and rehabilitation services were seen as more applicable to their practice and a substantial amount of time was spent on them. Managing occupational health and safety (OH&S) service' was the only emergent area that was a substantial part of the OHN's role. Less time was devoted to other emergent and pro-active areas of OHN practice, such as illness and injury prevention, health promotion, health education and research into OH&S. While less time was allocated to emergent Areas of Practice, and they were ranked more lowly they were considered to be applicable to practice. The findings of this study suggest that OHNs in Australia may not be engaging fully in all Areas of Practice that have been articulated by the ACOHN, particularly emergent role activities. Although Australian OHNs perform all the activities articulated in the ACOHN Areas of Practice, their focus is still primarily illness and injury based, and also management. While the profession is supportive of emergent role activities, there is a need to debate possibilities, undertake research into barriers and supports for emergent role activities, more clearly articulate future directions for the OHN role, and develop strategies to support OHNs as they develop their professional role.     

An audit of health education services within UK hospitals

Rationale, aims and objective  UK public health policy requires hospitals to deliver health promotion services to patients for healthy lifestyles (i.e. health education), but there are currently few data on the health education delivered within hospitals. This audit aimed to collect data on the routine health education activities delivered to hospitalized patients to assess whether the following standards were met: 100% of hospitalized patients screened for smoking, alcohol use and obesity, 70% of smokers offered health education for smoking cessation and 50% of patients identified as misusing alcohol, obese, consuming an unhealthy diet and/or physically inactive delivered the appropriate health education.
Methods  An audit of data contained in hospitalized patients' written medical case notes for evidence that the above standards were met. Nine hospitals in Greater Manchester in England participated.
Results  Four hospitals screened all patients for smoking. None of the hospitals met the standards for screening alcohol or obesity. For health education delivery, all hospitals met the standard for diet, four for alcohol misuse and four for physical activity. None of the hospitals met the standards for smoking or obesity.
Conclusions  Improvements in practice for screening of alcohol and obesity are required. While some hospitals appeared to meet standards for health education delivery for alcohol, diet and physical activity, given the poor screening procedures for these risk factors, we can not conclude that health education delivery was adequate.     

Rapid tranquilization: An audit of Irish mental health nursing practice

Rapid tranquillization is a pharmacological intervention sometimes employed in mental health care for the management of acute behavioural disturbance. It is a form of restrictive practice, which, along with seclusion and restraint, is a conventional and controversial intervention in the therapeutic management of risk in mental health settings. This study surveyed mental health nurses practice in rapid tranquillization. A self‐report questionnaire was utilized which addressed aspects such as definitions of rapid tranquillization, presence of rapid tranquillization policy, types of incidents where it is used and postintervention monitoring. The results demonstrate that rapid tranquillization is an intervention used in the management of acute behavioural disturbance in various mental health settings in Ireland. Respondents showed a basic understanding of rapid tranquillization as an intervention; however, some areas reported not having a specific rapid tranquillization policy. There was some evidence of a variation in postrapid tranquillization monitoring of psychiatric/mental health and physical health. Service user debriefing following rapid tranquillization was reported to be common; however, the content of this was not elaborated on. In the light of variations in practice, specific training and the development of rapid tranquillization policies are recommended.     

Attitudes towards disability in an undergraduate nursing curriculum: the effects of a curriculum change

Through improved technology and treatment and ongoing de-institutionalisation, nurses will encounter growing numbers of people with disabilities in the New Zealand community and hospitals. Quality of nursing care is influenced by attitude and this study was to evaluate the effect of a curriculum change on the attitudes of two different streams of student nurses towards people with disabilities. During the year 2002 a focused disability unit was introduced to the revised undergraduate nursing curriculum of a major educational institution in New Zealand. The opportunity arose to consider student nurses' attitudes toward disabled people, comparing two streams of students undertaking two different curricula. A convenience sample of students completed the attitudes toward disabled persons questionnaire form B (Yuker, H.E., Block, J.R., Younng, J.H., 1970. The Measurement of Attitudes Toward Disabled Persons. INA Mend Institute, New York), prior to and on completion of their relevant disability unit. No statistically significant difference in scores was demonstrated. A number of possible reasons for this are suggested.     

The shortage of nurses and nursing faculty: what critical care nurses can do

Nurses are needed more than ever to support the healthcare needs of every American. Nurses make up the greatest single component of hospital staff. In 2004, of the almost 3 million nurses in the United States, 83% were employed in nursing, and 58% of those were employed full-time. However, a severe shortage of nurses exists nationwide, putting the safe, effective healthcare of Americans in jeopardy. The concurrent shortage of nursing faculty has significant impact on the potential for admitting and graduating sufficient numbers of nursing students to address the shortage of prepared nurses. A close examination of the demographics of the 3 million nurses provides a context for an in-depth discussion of strategies that critical care nurses can employ to help alleviate the nursing and nurse faculty shortages.     

Lecturers' accounts of facilitating clinical supervision groups within a pre-registration mental health nursing curriculum

In 1994 the Department of Health recommended that nurses be introduced to the process of clinical supervision during pre-registration training. Since then a body of literature has emerged, largely focusing on students' experiences of a variety of training initiatives in supervision. There is however a paucity of literature exploring the experiences of nursing lecturers engaged in such initiatives. This paper reports the findings from one part of a three-year prospective longitudinal study examining mental health students' and lecturers' experiences of group clinical supervision undertaken as part of a pre-registration course. In this part of the study eight mental health nursing lecturers participated in semi-structured individual interviews in which they discussed their experiences of facilitating student supervision groups. Content analysis of the interview data produced eight major categories: 'attitudes to supervision'; 'perceptions of the student experience'; 'preparation and support'; 'approaches to supervision'; 'the "good" supervisor'; 'the lecturer as supervisor'; 'the structure and process of sessions; and 'the content of supervision'. The findings suggest that the idea of undertaking supervision for students is attractive to lecturers. However, several issues need to be addressed if this type of initiative is to be successful in preparing students for their future role as supervisee.     

Making us what we are: Noteworthy people and achievements in Queensland mental health nursing

Understanding mental health nursing's past is an important way to preserve our cultural heritage. By exploring and then disseminating the insights gained through examination of the past, students and practicing mental health nurses may become more aware of the social and intellectual origins of the profession. They may also have their professional connections and commitment to mental health nursing clarified and reconfirmed. This paper presents the results of a survey conducted in Queensland in 2009. Members of the Australian College of Mental Health Nurses were invited to identify mental health nurses who they perceived had made a noteworthy contribution to the profession. Twenty mental health nurses were identified from the 38 surveys received. The reasons underlying the nominations revealed two main themes: achievements and qualities. Achievements included the subthemes: practice pioneer; career longevity; and far reach of influence. Qualities included: inspirational role model; and passion, dedication and/or commitment. The study provides a beginning conversation on the preservation of heritage and recommends deeper exploration of the history of mental health nursing within Australia, and specifically Queensland.     

Looking backward toward our future: creating the nexus between community health nursing and palliative care

Palliative care literature and practice have historically been dominated by end-of-life discussion, with palliative care often seen as the prequel to hospice care. As the population ages and previously fatal illnesses convert to chronic illnesses, the medically modeled, institutionally based care model is changing. Community health nurses (CHNs) are well equipped to play a role in this arena of care. They have a population-focused practice, experience with care in the community, an orientation to health, and skills related to advocacy and social justice. The authors outline salient issues in palliative care, exemplars of community-based palliative care programs, and the contributions CHNs can make toward development of an integrated model of care. A course of action is outlined for CHNs to pursue in this rapidly developing field and they are urged to participate in the next iteration of palliative care.     

Exploring pedagogies used in undergraduate mental health nursing curriculum: An Integrative Literature Review

The growing demand of mental health services among the population and the stigma associated with mental health conditions have resulted in a shortage of skilled nurses competent in delivering quality care to persons experiencing mental health conditions. This suggests the need to develop a systematic and comprehensive curriculum to prepare nursing students for a career in mental health nursing. An integrative review on empirical studies was conducted based on Cooper’s five‐stage integrative review framework to investigate the different pedagogies and to highlight the elements of an effective curriculum for teaching mental health nursing. All quantitative, qualitative, and mixed‐method studies published between 2009 and 2019 that examined pedagogies in mental health nursing for nursing undergraduates were included in this review. Databases of interest included PubMed, Cochrane, PsycINFO, Embase, Scopus, Web of Science, and ProQuest Dissertations and Theses. To ensure methodological rigour and validity, the 23 included studies were independently evaluated by two authors through critical appraisal tools developed by Joanna Briggs Institute for quantitative and qualitative studies. Results from this review were categorized into three themes: (i) the deployment of simulation; (ii) pedagogies in enhancing critical thinking; and (iii) importance of consumer‐oriented educational experiences. These results suggested that students would benefit substantially from in‐depth discussions, critical reflections, and real‐life experiences. Mental health nursing curricula should incorporate simulations, pedagogies for critical thinking, and consumers’ lived experience to supplement the clinical rotations.     

COVID‐19: The future of nursing will determine the fate of our health services

Preparing the world to manage future pandemics must take priority. It is clear that we were not prepared for the COVID‐19 pandemic which continues to cause great suffering around the world. Nurses and other health professionals everywhere must be involved in health policy planning and implementation of public health measures to combat this and future pandemics. Such preparation needs community policy involvement at grassroots levels and needs to be collaboratively instigated at international levels. The death so far of over 2000 nurses is unacceptable in this pandemic, and we need to better protect and sustain the workforce. The International Council of Nurses has been instrumental in data gathering of nurses' experiences during COVID‐19. Key points from analysis of this data have been included in Second Progress Report of the World Health Organization's Independent Panel for Pandemic Preparedness and Response. This paper summarises the key messages from this report, as well as the nursing shortage. The International Council of Nurses resounds the call for massive investment in nursing education, leadership and jobs, as well as protection for our nurses on the frontlines of the pandemic.     

Advance directives: curriculum content and preparation of nursing students.

The amount of didactic content on advance directives in nursing curricula is addressed. Conclusions have relevance to the limited knowledge of practicing nurses on the subject of advance directives.