Mental health issues within the general health care system: the challenge for nursing education in Australia

The mental health content of undergraduate nursing programs has consistently been identified as inadequate in preparing graduate nurses with the knowledge and skills for, and interest in, a career in mental health nursing. Since the introduction of generic nursing education, undergraduate programs have become primarily focused on the development of generalist skills, with specialisation occurring at postgraduate level. The integration of mental health services within the broader health care system in Australia has led to a significant increase in the prevalence of mental health problems within the general health care setting. The relevant literature suggests that nurses are not well prepared to meet the mental health care needs of this population. The aim of this paper is to briefly outline the incidence of mental health problems within the general health care system, the implications for nursing, and the potential role which nursing could play in recognising, and providing appropriate care for the treatment of mental health problems. The implications for nursing education, and the need for mental health nursing skills to be considered essential for all nurses will be discussed.     

Making a case for integration of disaster-preparedness content in associate degree nursing programs

Catastrophic events such as 9/11 and Hurricane Katrina have identified the need for nurses to be trained in disaster preparedness. Government and regulatory agencies are calling for this content to be included in nursing education at all levels. Associate degree nursing programs can take a leading role in preparing students to manage disaster events in a variety of health care settings. This article will provide resources for associate degree programs wishing to incorporate this content in their curriculum.     

Staff Nurses' Perception of Their Role in a Dedicated Education Unit Within the Intensive Care Unit

The dedicated education unit (DEU), a model for clinical nursing education, is a partnership in which professional nurses are trained to participate in the clinical education of nursing students. This study evaluated the perceptions of staff nurses who acted as clinical teaching associates to senior nursing students in an intensive care unit setting using the DEU model. Other nursing programs may benefit from the outcomes experienced in this application of the DEU model.     

Genomics in Nursing Education

PURPOSE: To review international efforts to incorporate genetics content into nursing education curricula. ORGANIZING FRAMEWORK: A discussion of the progress in nursing education programs in selected countries to educate students for genomics-based health care. Information is based on review of the literature and curriculum change efforts by the authors. CONCLUSIONS: The lack of agreed-upon minimum competencies impedes efforts to educate nurses for genomics-based health care. Nationally and internationally recognized documents are useful for collaborative efforts to establish minimal competencies in knowledge, skills, and attitudes for nurses with basic and advanced education. Curriculum change that incorporates minimum competencies will require nursing faculty to improve their knowledge base in genomics-based health care. Partnerships among nurses in different countries are needed for successful genomics education programs for faculty.     

Health communications: nursing education for increased visibility and effectiveness.

The media play an influential role in American society. The challenge for health professionals, including nurses, is to translate and transmit complex health information for the public through many channels. Although nurses are trained to be effective communicators in practice, a recent study demonstrates that nurses are virtually invisible in the media. This lack of visibility limits nursing's ability to communicate important health information, impedes nursing's ability to define its role and contributions in the health care delivery system, and restricts nursing's ability to advocate for health policy. One option to improve nurses' ability to communicate effectively in all media venues is to integrate health communications content into nursing programs, which would provide nurses with the opportunity to develop advanced communication skills, media expertise, and new strategies for educating the public. Health communications programs exist in several colleges and universities, but not within nursing programs. Because nursing curricula are in a period of transition as changes in the health care environment are accommodated, health communications courses could be integrated into nursing programs as elective courses, graduate certificate programs, or a field of graduate study. Without creative educational strategies, nursing will remain invisible to the public and ineffective in its ability to influence the health care environment.     

A national survey of nursing education and practice of newly licensed nurses

The Institute of Medicine recommended establishing evidence-based teaching methods and curricula in health professions' education to meet the needs of the changing healthcare system. In an attempt to provide evidence-based information for nursing education, this study was designed to identify educational elements that best prepare nurses for practice. The study employed a two-tiered survey process for collecting and combining data from programs of nursing education and the graduates of those programs. Administrators of 410 nursing programs responded to questions related to elements of education in their programs (response rate = 51%), whereas 7,497 RN (76.5%) and LPN (23.5%) graduates of respondent programs answered questions related to the adequacy of educational preparation for practice, difficulty with current client care assignments, and other professional and practice issues (response rate = 45.4%). The majority of the nurses reported that their education had adequately prepared them to perform many, but not all, essential areas of the nursing functions examined. Nearly 20% of the RNs and 18% of the LPNs reported having difficulty with client care assignments. Inadequate preparation of several nursing functions were identified as predictive of difficulty with patient care assignments. These areas include working effectively within the healthcare team, administering medications to groups of patients, analyzing multiple types of data when making client-related decisions, delegating tasks to others, and understanding the pathophysiology underlying a client's conditions. In addition, it was found that the graduates were more likely to feel adequately prepared when nursing programs taught them use of information technology and evidence-based practice; integrated pathophysiology and critical thinking throughout the curriculum; taught content related to the care of client populations as independent courses; and had a higher percentage of faculty teaching both didactic and clinical components of the curriculum. The findings of this study are significant in broadening our understanding of the relationships between educational elements and preparedness of new nurses for practice.     

Nurses' knowledge of pain in the elderly

The purpose of this study was to investigate nurses' knowledge of pain and pain management with respect to elderly persons. Registered nurses at several general hospitals and nursing homes were surveyed by questionnaire concerning their knowledge of pain management in the elderly. The findings indicated a significant knowledge deficit in this area. There were also significant differences in knowledge levels between general hospital nurses and those working in nursing homes. We conclude that more education about pain management in elderly patients is needed for nurses. This deficit needs to be addressed in both undergraduate nursing programs and hospital in-service courses. Presently, the majority of patients entering hospitals are aged 65 years and over. Hence, nurses in all areas of care, not just specifically those working in aged care facilities, need a sound knowledge of pain management of the elderly to facilitate compassionate and effective nursing care.     

Public Health Nursing Education for Primary Health Care

This article examines several issues relevant to the education of nurses for roles in primary health care. The basic premises of education for community-based public health practice are put forth. The World Health Organization's seven key principles for primary health care and their cur-ricular implications for various levels of nursing programs are discussed. Examples are given of nursing education programs in which aspects of primary health care are used; finally, the continuing education needs of nurses are explored.     

Case management curriculum in nursing education

Case management has been viewed as an essential function within the current healthcare environment. While the importance of case management in providing quality patient care is documented in the literature and in statements by national nursing and healthcare organizations, there is limited identification and documentation of case management content in nursing education programs. The purpose of this study was to identify the current case management content taught in nursing education programs and to determine the essential concepts and skills of case management relevant to associate, baccalaureate, and graduate nursing education. Using the results of this study, one baccalaureate nursing program revised a chronic illness course to expand the classroom presentation and clinical experience associated with case management content.     

Case management education in nursing

In Taiwan, few articles have been published that describe case management education for nurses. This article reviews case management literature and aims to introduce case management definitions, a comparison between the nursing process and the case management process, current case management educational programs and core content for case management education. Finally, suggestions identified from the literature review for Taiwanese nursing education will be discussed. On the basis of evidence of case management's effectiveness in saving health costs and providing better quality of care, case management strategies are currently being implemented in a variety of settings with different populations under a range of conditions. Case management services are assisted by knowledgeable and skilled healthcare professionals called case managers. With their background of professional knowledge and skills and their familiarity with the nursing process, nurses have been the main case managers. A case manager's educational preparation is the key to successful case management. In other countries, many formal and informal case management educational programs have become available to prepare the nursing profession for the demands of the job market. Six essential knowledge areas and three categories of skills are identified for case management education. Developing a formal case management education program in nursing schools and offering continuing professional education for nurse case managers are suggested for Taiwanese nursing education to prepare nurses for case management. Collaboration between nursing academia and nursing practice might be considered an effective strategy to promote the development of case management practice in nursing.     

Graduate education in geropsychiatric nursing: findings from a national survey

By 2030, the numbers of older adults with mental illness will strain our health care system. Sufficient advanced practice nurses (APNs) with specialized knowledge to provide care will be critical. All 339 graduate nursing programs in the US were surveyed regarding the extent and nature of geropsychiatric nursing (GPN) content in their curricula. Of 206 schools responding, 15 reported having a GPN subspecialty. Regarding the 60 schools with a psychiatric/mental health nursing (PMHN) graduate program, only one third (n = 23) included some GPN content, while more than half (n = 116) of all schools reported integration of GPN content in a non-psychiatric nurse practitioner program. Thus, currently, the greatest numbers of APNs receiving education on mental health needs of older adults are prepared in non-psychiatric nurse practitioner programs. This article discusses the implications for nursing education and practice.     

The impact of an aging population on curriculum development in Canadian undergraduate nursing education

The rise in numbers of persons 65 years of age and older due to increased life expectancy is necessitating a revision in undergraduate nursing education. Since additional qualified nurses will be required to care for this expanding population, nursing programs must include sufficient relevant gerontological content delivered by competent faculty to prepare these practitioners. The authors review pertinent literature, present several surveys outlining the current status of gerontology content in nursing and other allied health programs, and argue for gerontological nursing to be a core component of undergraduate programs.     

Addressing the need for education: curriculum development for nurses about intellectual and developmental disabilities

People with disabilities and national and international agencies are voicing their views, forcing health care providers to look at how people with disabilities are treated in the health care system and to find ways to help them achieve equal access to quality care. Education about nursing care of patients with I/DD is limited in basic nursing education programs and for nurses who are in practice. A number of developmental disabilities nursing projects are addressing this need with curriculum development that has validated the need for education and has begun testing the various methods of instruction. As the curriculum is disseminated in written or Internet-accessible formats, nurses in education and practice will be able to find resources that target a specific topic area or a set of comprehensive instructions to acquire a better understanding of the comprehensive needs of people with I/DD and better ways to provide care. There is a need for a greater integration of curriculum about nursing care of people with developmental disabilities into basic nursing education at all levels and further evaluation of the impact of this curriculum on nursing care for people with I/DD. The hope is that these efforts can improve the education of nurses and other health care providers for the direct benefit of individuals with intellectual disabilities.     

Clinical major option: a model for implementing critical care nursing into baccalaureate preparation

What was initiated as a directive from a provincial government in an attempt to increase the number of critical care nurses has evolved into an exciting educational opportunity for many nurses and student nurses in the year 2000. Between 1993 and 1997 there has been significant downsizing of acute care beds across Canada (Code Blue: Critical Care Nursing in Nova Scotia, 1998). At the same time patient acuity has increased, due to shorter hospital stays, and the number of nurses working full-time has decreased with the increased use of casual nurses. Several studies at both the provincial and national levels report current and future shortages of specialized nurses (emergency, critical care and perioperative). It is expected that this shortage will continue into the future, a shortage that is driven by technological advances, as well as an aging general and nursing population. Continued shortages of these acute care nurses will result in fierce competition for skilled nurses as well as aggressive recruitment and retention strategies (Code Blue: Critical Care Nursing in Nova Scotia, 1998). It is generally agreed within the nursing community that specialty nurses in critical care require a unique body of knowledge that is not acquired in a basic undergraduate nursing program (Fitzsimmons, Hadley, & Shively, 1999). This specialized knowledge can be gained informally through experience; however, it is largely developed in additional formal education programs. The purpose of this article is to outline a strategy for the delivery of specialty education at three educational levels in acute care nursing with three streams: emergency, critical care and perioperative nursing. This clinical major option is to be delivered in partnership among the Queen Elizabeth Hospital II, the Health Science Centre and Dalhousie University School of Nursing, Halifax, Nova Scotia, Canada. This model of offering specialty education in university preparation could be a template for preparing nurses in the new millennium.     

Mentorship: a key to retention and recruitment.

Currently there is renewed interest in the selection of nursing as a career. As nursing education programs graduate more new nurses, the challenge is passed to the clinical agencies to provide an environment in which these novice nurses can flourish and remain engaged in providing quality nursing care. Mentorship programs are essential strategies to retain them in clinical practice as they begin their evolution as professional nurses.     

International collaboration on genomics education for nurses

The International Society of Nurses in Genetics began in 1988 as a venue for nurses around the world to advance their knowledge and practice related to genomics. This article discusses how the organization has conducted an annual international nursing conference, promoted the incorporation of genomics topics into continuing education programs and professional nursing journals, assisted with the incorporation of genomics content into undergraduate and graduate nursing curricula, and defined genetics as a clinical nursing specialty. Genomics education is relevant to nursing practice in all specialty areas and significant to the future of health care.     

Assessment of nurses' continuing education needs in Jordan.

This study assessed the learning needs of hospital nurses in northern Jordan to develop programming recommendations for future continuing education (CE) efforts. Although few CE programs exist, a response rate of 85% (n = 171) suggested these nurses have important learning needs. Nurses identified eight priority content areas: critical care, management of cardiac arrest, emergency room nursing, delegation and accountability, power and authority, teaching innovations, seminar management, and patient education. The findings showed that almost two thirds of subjects (n = 110) had not attended a CE program in the previous year, and very few (n = 8) had read nursing journals to supplement their nursing knowledge. Although data suggested lack of motivation to participate in CE programs was a frequent problem, they also indicated CE participation would increase if participants could earn some type of credit for this additional education.     

Incorporating critical care oncology nursing in a baccalaureate of science in nursing curriculum

Undergraduate nursing curricula traditionally provide a superficial overview of oncology with only a passing mention of critical care oncology concepts. With an unprecedented nursing shortage predicted in the coming decade and acute care facilities likely to overflow with an elderly, chronically ill patient population, nursing education programs must strive to assure that nursing curriculum remains relevant in the face of these future challenges and changes in health care. Rather than require employers to provide the oncology education needed by the nursing staff during the orientation period, undergraduate nursing programs must accept the commitment to provide a stronger oncology and critical care nursing knowledge base in the basic nursing curriculum. This article describes how the baccalaureate degree nursing program at Houston Baptist University accepted this challenge and incorporated content on the management of oncologic emergencies within an existing critical care nursing course. Discussion of the development of the oncology content and the benefits of incorporating the content within a critical care nursing framework are also provided.     

The learning process of recently graduated nurses in professional situations--experiences of an introduction program

An increased theoretical focus and decreased clinical training have resulted in sharp criticism from health care institutions of the content of the nursing education program. As a consequence of this criticism, employers offer introduction programs to recently graduated nurses after they have completed their nursing education. This study is part one of a larger research study. The aim of the present study was to analyze and describe how recently graduated nurses learn at the place of work and how they seek a meaning in their encounter with that environment. The research method was ethnographic, and the empirical material was based upon data from participant observations, interviews and field notes. The results disclosed that workplaces using the master-apprentice system as a model for supervising recently graduated nurses during the introduction program. The results also showed that the novices have acquired theoretical knowledge and know what action to take, but may have trouble assessing which part of their knowledge to use. The introduction program constitutes an obstacle in the professional development of the novices.