Is the humanistic view of the nurse role still alive – in spite of an academic education?

AIM: This paper is a report of a study exploring what 'being a good nurse' means by following nursing students during their pre-registration education and for some years after graduation. BACKGROUND: There have been few studies focusing on the nurse role in the transition from student to experienced nurse. Studies with a qualitative design, in particular, are limited in number. METHODS: A longitudinal survey design was adopted, using an open-ended questionnaire at the beginning of education (n = 164), just before graduation (n = 123), and 3-5 years after graduation (n = 77). The participants were students in the nursing programme at a Swedish university. The data were collected during the period 1993-2002. Latent and manifest content analyses were used. FINDINGS: Four categories were identified in the data. 'To do good for others', with the sub-category 'to care for others', was most frequent over time and quite stable. The category 'to be competent and skilled' was frequent and increased over time. 'To have professional courage and pride' and 'to seek professional development' were mentioned to lesser extent and showed a slight increase over time. The meaning of being a good nurse grew in complexity over time and informants' professional awareness seemed to increase, especially concerning 'to be competent and skilled'. CONCLUSION: Attention needs to be paid both to nursing education and practice. Clinical supervision given by nurses with Master's degrees is suggested in order to convey positive attitudes towards nursing development and research into practice. Further studies are needed to compare what 'a good nurse' means to graduate nurses and how they actually behave when performing good nursing care.     

Assessing the critical thinking skills of faculty: What do the findings mean for nursing education?

The purpose of this study was twofold: to determine the critical thinking skills of nurse faculty and to examine the relationship between epistemological position and critical thinking. Most participants reported having no education on critical thinking. Data were collected using the California Critical Thinking Skills Test (CCTST) and the Learning Environment Preferences (LEP). Findings from the CCTST indicated that faculty varied considerably in their ability to think critically; LEP findings suggested that participants had not reached the intellectual level needed for critical thinking. In addition, 12 faculty participated in one-hour telephone interviews in which they described experiences in which students demonstrated critical thinking. Despite a lack of clarity on the definition of critical thinking, faculty described clinical examples where students engaged in analysis, inference, and evaluation. Based on these findings, it is recommended that faculty transfer their ability to engage students in critical thinking in the clinical setting to the classroom setting. Benchmarks can be established based on the ability of faculty to engage in critical thinking.     

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.     

Does the use of reflective models restrict critical thinking and therefore learning in nurse education? What have we done?

This article will explore relevant publications relating to practices involving the use of reflective models in UK nurse education. This will then be critically analysed in terms of my personal experiences as a nurse educator. Sch?n's seminal work (1987) on reflection never intended for the process of reflection to become so structured that it actually restricted thinking. Sadly however, it is my personal belief that this is the case within some aspects of nurse education, primarily due to the introduction and overuse of structured models of reflection. A large part of written assessment in nurse education utilises reflective writing, this may not be helpful in terms of learning and exploration of practice experiences. Indeed these models are now being seen by both students and some nurse educators as compulsory. The number of these models available to students within nurse education is phenomenal (Rolfe et al., 2001) and they appear to be a requirement for educators to support their learners in constructing ways of thinking. Further consideration needs to be given by nurses educators to the underpinning philosophy and concepts relating to reflection.     

A case in point? A parasuicide patient's recollections of being nursed: a discourse analysis

This paper highlights the recollections of being nursed from the perspective of a patient (Gabby) admitted to a general medical ward after attempting suicide. A discourse analysis was used to discuss the way in which Gabby was nursed, enabling identification of the social structure which supports the nurse-patient relationship. This research evolved with the realisation that the point of view of parasuicide patients was primarily absent within nursing literature. Inattention within the literature was later replicated by Gabby's expressions of inadequate interaction between nurses and parasuicide patients.     

A broken promise? Exploring the lack of evidence for the benefits of comprehensive nursing education

Over the past approximately 25 years, Australia has undergone significant changes in the educational preparation of nurses. Australia has moved away from specialization in areas, such as mental health nursing at undergraduate level, in favour of a comprehensive model, an approach that remains controversial. The aim of this paper is to identify and critique the three main arguments advanced in support of comprehensive nursing education, which we argue are not supported by existing evidence. The purported wide skill and knowledge base does not appear to have brought about identifiable improvements in consumer outcomes. The evidence regarding stigma suggests comprehensive nursing education has not impacted favourably on nurses' attitudes towards working with people with mental health problems. There is no evidence to support the notion that graduates will be able to better deal with and meet the physiological needs of those people diagnosed with mental illness. From the arguments articulated in this paper, we conclude that comprehensive nursing education has not met its promises or expectations, and as a result, specialist entry-level preparation for nurses ought to be reintroduced as a matter of urgency in Australia.     

Population health as a ‘platform’ for nurse education: A qualitative study of nursing leaders

BackgroundChallenges to the sustainability of global healthcare systems are prompting a shift towards more population-focused models of care. Nurse educators need to develop courses that prepare students for population health practice. However, the educational approaches that can support this shift are poorly understood. Publication of new standards for nurse education by the United Kingdom's (UK) Nursing and Midwifery Council that place greater emphasis on population health presented an opportunity to seek nursing leaders' views on population health in nurse education.ObjectivesTo assess the views of nursing leaders within a Scottish context on the connection between nurse education and population health for all students, evaluate what student nurses need to know to support population health practice, and draw insights from the UK for pre-registration programmes internationally.DesignQualitative interview study.ParticipantsTwenty-four nursing leaders from academic (n = 15), practice (n = 4) and regulatory (n = 5) sectors.MethodsSemi-structured interviews were conducted face-to-face (n = 21), by telephone (n = 2) or Skype (n = 1). Interviews were transcribed and analysed, using interview questions as structural themes, followed by thematic and content analyses.ResultsNursing leaders encouraged rebalancing nurse education towards population health, suggesting that population health concepts should sit at the core of spiral curricula to enable students to (re)view learning through a population health lens. Seven outcomes were identified to equip student nurses for practice in any setting. These formed the mnemonic FULCRUM: Find and interpret evidence; Understand the psychology of behavior and change; Link epidemiology to population health; Consider others and themselves in context; Recognise social determinants of health; Understand the impact of policy and politics on health; Motivate to encourage behaviour change.ConclusionsFULCRUM can guide nurse educators globally to support preparation of graduate nurses for the significant shifts in healthcare delivery and service organisation towards improving population outcomes.     

Alternative,complementary or concurrent health care? A critical analysis of the use of the concept of complementary therapy

In this paper I critically address what is becoming the wholesale adoption of the concept of complementary medicine in researchers' analyses of lay participation in alternative therapies. This paper emerged out of a qualitative study of 21 Canadians who use and/or practice alternative therapies. I found that only seven informants used the term 'complementary' in describing their use of alternative therapies. Of those seven who did, five were alternative practitioners. I discuss the variability of meaning of the concept of 'complementary' and I argue that alternative practitioners have a professional interest in using the concept to avoid seeming in competition with medical professionals and to reduce the likelihood of being labelled 'quacks'. I conclude with a plea for researchers to define their terms in analyses of individuals' use of alternative and/or their dual use of alternative and allopathic health care.