Nursing home employment for nursing students: valuable experience or a harsh deterrent?

AIM OF THE STUDY: The primary aim of the study was to examine the attitudes of undergraduate nursing students at the both the beginning and end of their nursing course. BACKGROUND: Throughout Australia there is increasing awareness of the ageing of the population and the widespread implications this will have for the future. The ramifications for the health system are expected to be wide and far-reaching. For the nursing profession the increase in the number of aged people will increase the demand for nurses to practice within the aged care area. This raises serious concerns in light of the negative attitudes that Registered Nurses and undergraduate nursing students hold towards working with older people. METHODS: This paper reports the results of a longitudinal study of undergraduate nursing students at the start (n = 793) and at the end (n = 524) of their nursing education programme. FINDINGS: The findings support the literature in demonstrating that working with older people is the least preferred area of practice for students, and that its popularity actually declines during the education process. One interesting finding from this research suggests that part-time employment of student nurses in nursing homes can further influence students' negative attitudes. CONCLUSIONS: If nursing students are to continue working in aged care, strategies to address the potential detrimental impact need to be identified and developed as a matter of urgency.     

Patient safety: where is nursing education?

Patient safety is receiving unprecedented attention among clinicians, researchers, and managers in health care systems. In particular, the focus is on the magnitude of systems-based errors and the urgency to identify and prevent these errors. In this new era of patient safety, attending to errors, adverse events, and near misses warrants consideration of both active (individual) and latent (system) errors. However, it is the exclusive focus on individual errors, and not system errors, that is of concern regarding nursing education and patient safety. Educators are encouraged to engage in a culture shift whereby student error is considered from an education systems perspective. Educators and schools are challenged to look within and systematically review how program structures and processes may be contributing to student error and undermining patient safety. Under the rubric of patient safety, the authors also encourage educators to address discontinuities between the educational and practice sectors.     

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.     

Professional nursing education: what is its purpose?

Rogers (1970, p. 88) has written "The purpose of professional education is to provide the knowledge and tools whereby an individual may become an artist in his field. It is not to prepare the skilled practitioner." This statement is used to provide a basis for discussion of some issues involved in relation to nursing and nursing education. The problem area is first clarified before discussion moves on to show the relevance of conceptual models and theory to professional nursing education and to look at the kinds of knowledge and tools which could be provided to promote artistry in nursing.     

Can education make a difference to undergraduate nursing students' attitudes to psychiatric nursing?

The introduction of undergraduate nursing education throughout Australia has had serious implications for the position of psychiatric nursing in attracting graduates into this field. There is some evidence from the results of limited research that a more positive view of psychiatric nursing can emerge as the result of education. However, such a relationship has not been found to be strong. This paper reports the findings of a quasi-experimental research study, which compared student nurses' attitudes towards psychiatric nursing as a career option both before and after completing the psychiatric nursing component of the course. The post-test results demonstrate a strong and statistically significant increase in the popularity of psychiatric nursing. Analysis of the open-ended responses suggests that exposure to the theory and practice of psychiatric nursing has dispelled many myths regarding this area of practice. The possible impact of problem-based learning on these results is discussed.     

Hands-free communication technology: a benefit for nursing?

The introduction of mobile communication devices (MCDs) has dramatically altered how nurses communicate. It is critical to assess whether these technologies contribute to stress and complicate the work of the nurse or if the devices are perceived as assisting in the provision of efficient and higher-quality patient care. The authors discuss a study that assessed the perceptions of nurses on a medical unit after MCDs were implemented.     

Comprehensive nursing education in Victoria: rhetoric or reality?

Significant and widespread changes to the education of the psychiatric nursing workforce in Victoria, Australia are resulting in serious problems in the recruitment of new nursing staff. In reviewing the available literature, it is evident that undergraduate nursing students do not commence their educational program with a strong interest in pursuing a career in psychiatric nursing. In light of this knowledge, the role of education in providing a comprehensive view of the nursing profession becomes paramount. Research investigating the impact of education on the attitudes of students to psychiatric nursing as a career option has produced mixed and often inconclusive results. A longitudinal study was undertaken in Victoria, Australia. Students of the majority of universities in which undergraduate nursing programs were operating participated in this study. The participants were asked to rank nine areas of nursing specialty in order of preference at the commencement and immediately prior to the completion of the nursing program. Despite a significant improvement in the popularity of psychiatric nursing as a career choice, this area was ranked at number 8 at both pre- and post-program test. The analysis of open-ended questions demonstrated a marked change in the overall attitudes towards the mentally ill and psychiatric nursing.     

Does nursing education have a future?

This paper analyses the relationship between government and nurse education policy using the current changes in England as a case study. It argues that there are times when ideologies of governments and professions coalesce, signifying the most opportune times for advancement. It also illustrates times when policy shifts are made because nursing is perceived as relatively insignificant in the order of health policies and politics. It goes on to argue that nursing leaders need to be aware of the political and policy context in order to select the most effective methods of moving the agenda forward. Using UK reforms, particularly the English strategy document Making a Difference (Department of Health 1999d) as a case study, the paper analyses recent events in nurse education to illustrate the key points. The paper concludes by suggesting that the nursing profession must recognize promoters and barriers for change and commit itself to the transformation of nursing practice through the realization of a new educational agenda that embraces the principles of new democracy. Namely, these are equality, mutual responsibility, autonomy, negotiated decision-making, inclusivity, collaboration and celebrating diversity.     

Academic and clinical dissonance in nursing education: are we guilty of failure to rescue?

The experience of cognitive dissonance in novice clinical nursing students is examined. These students often confront an incongruity between the rule-bound academic ideal of nursing with which they have been prepared and the more flexible, intuition-driven clinical reality they encounter. Without insightful guidance from clinical faculty, the students' response to this dissonance could include disillusionment with clinical nursing practice or devaluation of the academic ideal of nursing. Cognitive Dissonance Theory, the Novice to Expert Model, and the Neuman Systems Model provide insight into this phenomenon and serve as a theoretical foundation for recommended strategies and interventions for optimal response to dissonance between academic ideal and clinical reality in nursing students.     

Psychiatric nursing education: can it make a difference?

A review of the literature clearly indicates that psychiatric nursing is not a popular career choice for undergraduate nursing students. While it appears from the literature that exposure to the theory and practice of psychiatric nursing can influence the attitudes of student nurses towards the mentally ill, no clear picture emerges from the research. Furthermore, the design of previous research does not address the relationship between improved attitudes towards the mentally ill and an increase in the popularity of psychiatric nursing. This paper discusses the results of a quasi-experimental study, which compared the attitudes of student nurses towards psychiatric nursing as a career option prior to and following completion of the psychiatric nursing component of the course. The post-test results suggest a strong and statistically significant increase in the popularity of psychiatric nursing. The possible impact of problem based learning in influencing these results is discussed.