Undergraduate psychiatric nursing education at the crossroads in Ireland. The generalist vs. specialist approach: towards a common foundation

This paper provides a critical overview of undergraduate educational preparation for psychiatric nursing and proposes the use of a model, which may equip psychiatric nurses to adapt to current and future directions in psychiatric nursing practice. It contends that mental health nursing is a distinct scope of practice and as such requires specialty undergraduate education. A major difference between educational preparation for psychiatric nursing in the Republic of Ireland and the UK, and distinct from most other developed countries, is the existence of separate, specialized pre-registration programmes that, upon graduation, allow the nurse to register as a psychiatric nurse. In other countries such as, Australia, the integration of pre-registration nurse education into the university sector resulted in the wide-scale adoption of a generalist approach to nurse education. In light of the recent changes in pre-registration nursing education in Ireland, and the integration of nursing into higher-level education, this paper examines the generalist vs. specialist approach to nurse education. It contends that neither the generalist nor the specialist model best serve the nursing profession in preparing safe and competent practitioners. Rather, it argues that the use of a model which incorporates both generalist and specialist perspectives will help to redress the imbalance inherent in both of the existing approaches and promote a sense of unity in the profession without sacrificing the real strengths of specialization. Such a model will also facilitate psychiatric nurses to adapt to current and future directions in psychiatric nursing practice.     

护理本科生实习前临床护理职业态度调查分析及对策

目的了解实习前护理本科生对临床护理工作的认可情况,并提出教育对策。方珐设计问卷,对即将进入临床实习的80名2000级护理本科生进行问卷调查。结果发出问卷80份,回收76份,对临床护理工作职业态度分别为喜欢者9．2％（7／76）,不喜欢者30．3％（23／76）,一般者60．5％（46／76）。不喜欢从事临床护理工作的主要原因有学历、职称、知识水平与实际工作不相称;社会期望值低;社会地位低;社会福利待遇低;临床护理工作不能发挥自己的知识才能、无成就感等。结论实习之前护理本科生喜欢从事临床护理工作者很少,针对具体原因从护理教学管理、带教老师、学生和社会等方面提出对策,帮助培养护理本科生的职业认同感。     

The emergence of liberal education in nursing education, 1893 to 1923

This is a study of the liberal education theme in nursing education as articulated in nursing literature from 1893 to 1923. The major questions addressed are: What did nurse educators believe to be the nature of liberal education? What did they believe would be the effect of a liberal education on the profession of nursing? To what extent did the articulation of the beliefs regarding liberal education parallel the development of collegiate-level nursing programs? The resources for this study are viewed in a historical and philosophical context, relating education beliefs, beliefs about professions, and the development of nursing education. The materials used for research include literature published in the major nursing journals of the time, proceedings of the national professional organizations for nursing practice and education, and major studies of nursing by various committees and commissions. The writings of nurse educators were examined for central themes. The study concludes that nurse educators believed the purposes of a liberal education for nurses were to foster the development of the individual, to prepare the individual for citizenship, to provide the individual with a broad knowledge base, and to develop the individual's critical thinking and judgment skills. Practitioners of nursing with these attributes would increase the credibility of nursing's claim to professional status. Although nurse educators believed that institutions of higher education were the logical sites for professional nursing education, the development of collegiate-level educational programs that incorporated a general education as part of the program of study for nursing lagged behind the articulation of beliefs.     

A model to guide development and application of multiple nursing theories

Over the past decade there has been an explosion of interest and activity in the nursing profession directed toward the development of a theory base for nursing education and practice. Although we support the overall thrust of nursing theory development, we have concerns about its utility, scope and stated purposes. We are especially sensitive to the plight of the practising nurse who might attempt to use the current nursing theories to guide and explain choices made in daily practice. In this paper we examine current use of the word 'theory' and describe problems inherent in nursing's efforts to apply educationally derived conceptual frameworks to nursing practice. We identify a need for the development and use of many theories for nursing and argue that there is a logical need for a 'meta-model' which will guide the use of multiple theories in practice. A model is presented which allows the practising nurse to examine the various theories in terms of their applicability to a given client situation. We believe the model is also useful to nurse educators and researchers who may be attempting to use nursing theories for educational purposes or develop nursing's knowledge base through empirical work.     

Preparation of academic nurse educators

Nursing practice is diverse, with nurses serving in both direct and indirect patient care roles. For nurse educators, the realm of nursing practice extends beyond direct patient care to include preparing students for nursing practice. Academic nurse educators must be prepared to serve as educators, researchers, and to have experience in a clinical specialty area. For many nurse educators, advanced academic preparation often relates to a clinical area of practice rather than pedagogical practice. Graduate-level knowledge of evidence-based research and practice, teaching methods, and curriculum design and development form the foundation for academic practice. Because education and nursing are two distinctive disciplines, clinical expertise does not naturally result in teaching expertise. Lack of consensus regarding the educational preparation of nurse educators adds to the complexity of the nursing profession. The purpose of this article is to advocate for pedagogical preparation for academic nurse educators. Additionally, this article contains recommendations for pedagogical competencies indicative of academic nurse educator preparation.     

Nurse education in higher education: understanding cultural barriers to progress

Nurse education is established in higher education but nurse academics remain concerned about nursing's lack of equal status within the academy. This paper reports findings of a small study of nurse lecturers' views which support other published studies. It argues that cultural factors which contribute to nursing's problems gaining equal status include anti-intellectualism within nursing and academic denigration of practice. These cultural factors are linked to the history of women in higher education, the separation between intellectual education and practical, skill-based training, the low status of caring courses and the resulting mutual denigration of culturally opposed groups. Anti-intellectualism in nursing can be seen as a defensive reaction against an academic culture that defines practical activity as inferior to abstract thinking skills. This can lead to limited educational opportunities to examine the structural and cultural context of nursing. In Freire's view, this is a necessary part of education for freedom. Current cultural change, in nursing and higher education, including an emphasis on learning outcomes and transferable skills, provides new opportunities for nursing to contribute to educational change. Removing cultural barriers to the educated nurse is a responsibility shared by universities and by the nursing profession.     

Australian clinicians and educators identify gaps in specialist cardiac nursing practice.

Change is endemic in both the health care and higher education sectors in Australia. Consequently professional roles and educational pathways must also evolve and adapt, often catalysed by those in leadership positions. Two national Delphi panels, one of cardiac nurse educators and the other of cardiac nurses, were convened to answer the question 'What knowledge, skills and attitudes are required for an expert nurse practising in the highly technological cardiac care environment?' Respondents indicated on a Likert scale the importance of 107 items to the nurse's role in both the 'real' and 'ideal' worlds of practice. Overall there was very strong agreement between the two panels with results indicating that Australian nurses perform close to their ideal in many areas of practice. For 31 of the items, both panels identified that the reality of practice is quite far from their ideal. Both panels agree that 10 of the behaviours are carried out or valued very little in practice. Reasons why nurses are not carrying out these elements of the role to their satisfaction are discussed and remediation strategies suggested. The findings can inform both curriculum development and clinical practice. In the dynamic health care arena, the nursing profession continues to respond to community and professional needs, seeking to establish sound research-based practice and maintain a high quality of clinical care and nursing management. The development of competencies by the Confederation of Critical Care Nurses (1996) is a good example of professional groups taking the initiative both in defining the practice role and providing tools that assist educational bodies to develop programs appropriate for a practice based discipline. Specialty nursing practice is 'under the microscope' in Australia as the profession seeks the best methods to weight nursing activities, measure nursing outcomes and recruit, retain and justify the use of specialist practitioners.     

男性护士教育培养现状与对策

南丁格尔创立现代护理以来,护理一直以女性为主导,男性在护理队伍中所占比例很小。人们的健康需求需要男性护士提供护理服务,所以,教育培养一定数量的男性护士势在必行。在培养男性护士的过程中面临生源少且专业思想不端正、心理状况较差、角色适应难度大等问题。提出解决对策:教育者和学习者应该认清护理发展史上男性护士曾经扮演的重要角色,从社会需求和人类健康需要的角度认识男性护士在健康服务中的必须性,认清男性护士在护理职业中的优势,加强对男性护士的宣传,并针对男性护生的学习特点和社会需求开展教育培养。     

Evidence-based nursing education: myth or reality?

This article explores the concept of evidence-based nursing education. Because nurse educators incorporate evidence-based practice as a basic tenet of their programs, they assume nursing education itself is evidence based. Nursing education has a body of knowledge on which nurse educators base teaching, educational strategies, and curricular designs, but most of this knowledge is tacit, experiential, and based on practice. This knowledge relates to the art of teaching in nursing and can warrant the practice of nurse educators. However, research is also necessary to demonstrate the effectiveness of teaching approaches and strategies. Nurse educators need to develop the science of nursing education through qualitative and quantitative research, to add to the tacit knowledge underpinning nursing education strategies. When the science of nursing education is adequately developed through rigorous research, we will truly be able to say that nursing education is evidence based. Until then, it may be only a myth.     

Clinical practice/education exchange: bridging the theory-practice gap

Nursing education is directed toward development of nursing practitioners competent to nurse effectively in the reality of our present society. A major challenge to the nursing profession is to find ways of merging theory and practice in the delivery of nursing education and patient care. One option for achieving this goal is for nurse educators to spend time in clinical practice updating their clinical skills and re-experiencing the realities of practice. Joint appointments with practice, intermittent periods of clinical update in practice and work role exchanges have all been utilized by the profession. However clinical practice/education exchange (CPEE) involving two people--one in clinical practice and the other in education--who exchange jobs for a fixed period of time is a relatively new concept. Central to a CPEE is the aim of enhancing student learning and facilitating meaningful links between theory and practice for them. Hence the exchange occurs between the education institute and the service area where students are placed. This article positions the CPEE within nursing literature and presents narrative accounts from a nurse educator and clinician who exchanged jobs for one year.     

Educational achievement of nurses who completed the nursing education and the nursing administration certificate courses of the Department of Nursing Studies, University of Edinburgh, 1958–1975

This paper describes the educational activity of a group of 149 nurse teachers and administrators following completion of the nursing education and nursing administration certificate courses of the University of Edinburgh (1958-1975). The data were obtained by a postal questionnaire and three particular types of courses reported by the respondents are discussed. Emphasis is given to the analysis involving degree courses as this was a prominent educational activity, especially among nurse teachers. The conclusion discusses the potential of an all graduate nurse teacher group and suggests some implications for the nursing profession.     

Integration of theory and practice in learning mental health nursing

This article describes an action research project that aimed at a better integration of theory and practice in the education of mental health nursing students. Two partners, an institute of nursing and health care and a university hospital, collaborated to develop a new educational programme for mental health nursing. The blocks of theoretical studies were implemented simultaneously with practical training, and the theory content was taught by nursing teachers as well as by nurse practitioners who worked on the teaching wards. In addition, the students had their own personal nurse-preceptors on the wards. The nurse managers were responsible for the educational level of the teaching wards and the director of nursing planned the teaching arrangements together with the nursing teachers. In all, the project involved over 50 different actors and several researchers. The results are encouraging: all the participants - students, preceptors, nurse managers and nursing teachers - found the project rewarding and they want to continue to develop and improve the level of teaching and learning in mental health nursing education. All the participants grew and developed professionally during the project.     

The chemically dependent nurse

Although exact numbers are not known, it is recognized that addiction to alcohol and other drugs occurs in nurses as it does in other occupations. There is some indication that nurses may be at greater risk for the development of addictive disease because of factors present in the profession. The nursing profession is recognizing the problem impaired practice presents and is working to develop programs to ensure that the issue of the impaired nurse is no longer denied by institutions, administrators, and individual nurses. There is a need for education of the profession in regard to the nature of addictive disease and the identification of the nurse whose practice has become impaired because of the use of alcohol or other drugs. Nurses also need to know more about intervention, treatment, and monitoring of recovery. It is the responsibility of the entire profession to see that programs designed to accomplish these tasks are in place in all states. The goals of programs for the impaired nurse are to protect the safety of individual patients, to safeguard the integrity of the profession, and to facilitate treatment and rehabilitation for the chemically dependent nurse.     

Promoting leadership and management in Australian general practice nursing: what will it take?

Aim This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Background Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. Conclusions The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. Implications for nursing management There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.     

Assessment of learning in contemporary nurse education: Do we need standardised examination for nurse registration?

In Australia and Norway final examinations to determine eligibility for registration as a nurse were discontinued during the period when nurse education moved into the higher education sector. In response to recent calls for the reintroduction of final examinations we explore the range of knowledge needs for the practice of nursing. These various forms of knowledge demand different forms of mediation and acquisition as well as assessment. There are numerous problems identified in the literature about the shortcomings of examinations as the foundation of assessing clinically based professions. There is a need to develop systems of appropriate assessment to ensure that graduates of nursing demonstrate adequate knowledge and competence to enter their profession.     

培养护理创新人才的社会系统观

21世纪中围护理事业的发展需要培养和造就大批护理创新人才．培养护理创新人才是护理创新教育的系统工程。从学校内部来看，护理创新教育需要护理教育创新和先进的大学化。护理教育创新是通过建立和实施护理创新人才的培养目标及教学计划来完成的。要求在师生互动的基础上，开展课堂教学内容、方法、手段和评价体系等方面的教育创新；把课外活动的目的定位在培养学生创新的人格品质、化修养等综合素质方面；把在校期间的社会实践作为培养和检验学生智力、知识、思维方法．个性、动机和环境适应等5个创新要素的重要途径。从学校外部来看，护理创新人才的评价标准应与社会评价标准相一致。     

护理专业学生实习前专业承诺状况及其影响因素

目的了解护理本科生及大专生实习前的专业承诺状况,并分析其影响因素。方法应用护理专业承诺量表对371名护理本科生及541名护理专科生进行问卷调查。结果实习前护理大专生总体专业承诺得分为(2.91±0.34)分,本科生为(2.79±0.35)分;不同性别、学历、成绩、专业兴趣、护理角色感觉、就读原因的学生,专业承诺水平差异有统计学意义。结论实习前护理专业学生专业承诺总体水平处于中等偏上,大专生的专业承诺水平高于本科生;性别、成绩、专业兴趣、角色感觉、就读原因对专业承诺有一定影响。     

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.     

Undergraduate nursing education reform in France: from vocational to academic programmes

DEBOUT C., CHEVALLIER‐DARCHEN F., PETIT DIT DARIEL O. & ROTHAN‐TONDEUR M. (2012) Undergraduate nursing education reform in France: from vocational to academic programmes. International Nursing Review Background: France is currently implementing a number of reforms to the healthcare and education systems. Within this context, a comprehensive reform of undergraduate nurse education was launched in 2009, bringing nurse education closer to the higher education environment. It is likely in future to move from being vocational towards becoming an academic educational programme. Aim: In this paper, the 2009 reform of the French pre‐registration nursing curriculum will be analysed in light of the European framework. Process: The pedagogical approach, methods and content of nursing education in France are undergoing an in‐depth reorganization. The main innovation that the reforms introduce is a competency‐based approach. France is joining the group of countries that require first degree‐level entry to the nursing profession. Conclusion: There are still many unanswered questions regarding the competencies and qualifications required by both the academic and clinical educators many of whom have not been previously involved in research or publications. The future status of nursing science is unclear, as is the way in which the nursing profession will be able to retain control over its educational mechanisms.