Transforming nursing curricula for a global community

With nurses and midwives providing the majority of health care globally, nursing education in all countries must prepare students for broader responsibilities to move the agenda forward for equitable care and universal health coverage. Columbia University School of Nursing developed and implemented a vibrant approach to curriculum transformation that included a new didactic course followed by a program of global clinical experiences to expand students' learning environments in global health. Program planning included defining learning objectives, mobilizing support within the school, establishing new sites, recruiting and preparing students, overseeing of students with host institutions, and evaluating the program. A total of twenty-four students were placed over five sites for a six-week credit-bearing global clinical experience. Students had varied clinical experiences with new understandings of the reality of health disparities. Host sites expressed a commitment to have students return in the next year, and all students stated that they would chose a global experience again. This innovation provides a transformative addition to nursing education with a deepened understanding of health disparities and nursing roles in different health systems. It strengthens the school's network of nursing and midwifery educators and opens doors for new exchanges.     

Nursing and midwifery advocacy to lead the United Nations Sustainable Development Agenda

The United Nations 2030 Agenda for Sustainable Development was implemented on January 1, 2016 and is composed of 17 Sustainable Development Goals (SDGs) and further delineated by 169 targets. This article offers background information on the 2030 Agenda as it relates to nursing and midwifery, professional organizational initiatives currently advancing the SDGs, the ethos of global citizenship, the urgency to respond to dwindling planetary health, the salience of nursing and midwifery advocacy in SDG attainment, and the myriad opportunities for nurses to lead and collaborate toward realizing these Global Goals. A US-based perspective is employed to underscore the Agenda's relevance to the US nursing workforce and healthcare system. The SDGs, with their holistic bio-psycho-social-environmental approach to health, present enormous opportunities for nurses and midwives. The SDG framework is naturally aligned with the foundational philosophy and purpose of our professions.     

Evaluating the funding and capacity of research in Scotland

This paper will discuss the results of a scoping exercise carried out as part of a strategy to inform subsequent models of infrastructure funding. The exercise showed that Scotland has less research capacity in nursing and midwifery than the UK as a whole. Following the publication of a nursing and midwifery research strategy for Scotland, initiatives are being put in place to fund an increase in research capacity and capability in the nursing and midwifery professions.     

Promoting nursing and midwifery as a potential career for school leavers

Changes to nurse education and the shortage of nurses and midwives in the NHS are likely to affect recruitment to nursing and midwifery professions in Jersey. The Health and Social Services Department in Jersey will face a significant challenge in recruiting experienced nurses and midwives in the future. In an attempt to address the problem, an innovative approach has been developed to encourage school leavers to consider a career in nursing or midwifery. The aim is to increase students' understanding of the diverse roles that exist in this field. Students are offered the opportunity to meet and interact with practitioners from a variety of nursing and midwifery roles.     

A review of evidence for the practice learning environment: enhancing the context for nursing and midwifery care in Scotland

This paper considers the issues which will ensure practice learning excellence in the future and in particular how these will impact on the delivery of high quality nursing and midwifery care in Scotland in the United Kingdom (UK). This will include the inter-dependency of learning in practice for undergraduate pre-registration students and qualified practitioners, in particular continuing professional development as a lifelong experience and its link to quality care provision. We contend that the practice learning environment is the whole of an organisation which values and supports the development of its workforce through education. Partnership working between education and service providers is central to ensuring an educated and professionally prepared workforce. Both nursing and midwifery are practice-based professions which are accountable for, and charged with assuring, effective public health and safety. The initial paper which established the key issues discussed here was initially written as one of the key background papers for a consensus conference to inform NHS Education for Scotland’s nursing and midwifery workforce development over the next five years (NES 2009).     

Global and planetary health: teaching as if the future matters

If nursing, along with other health professions, is to be able to critique national and international health policy and be equipped to address the global and planetary dimensions of health, the conceptual horizons of our educational and research enterprises will need to be expanded. Not only are nursing curricula needed that address such concepts as "health for all" and "environmental sustainability," but new pedagogies are required that engage students deeply and call them to socially and globally responsible ways-of-being. This article describes teaching and learning in a course that situates health in a global and environmental context and calls forth new personal and professional meanings.     

Government chief nursing officers: a study of the key issues they face and the knowledge and skills required by their roles

The first Government Chief Nursing Officer (CNO) position was created in New Zealand over a century ago. Over the ensuing decades, the roles of these national nurse leaders have evolved and become a focal point for global nursing and midwifery development. Despite the important actual and potential roles of CNOs, very little work has been done to systematically study the key issues that they face and the skill sets needed to address them. Now, in the face of global cost-driven health reform, the position of CNO is even more important than ever. This paper describes the only global systematic study of CNOs conducted since the beginning of health reform and lays a substantive foundation for the development of these key leaders and their positions. In addition, the research reported provides important groundwork for future studies and enhancement of the global literature relating to national nursing and midwifery leadership.     

Moving towards integrated working in health and social care in Scotland: from maze to matrix

This paper explores evidence-based practice (EBP) in health and social care in the UK from the individual perspectives of professionals in physiotherapy, midwifery, nursing and social care. The present interest in EBP emerges as a natural derivative of contemporary economic, social and political trends and concerns. There is optimism and broad acceptance of the overall philosophy of EBP and each profession demonstrates a concerted organisational attempt to bridge the research--practice divide. This includes the interpretation of research outcomes in the form of practice guidelines, protocols and standards. However, adherence to these is poor and resistance to EBP is growing. This is attributed to practical and philosophical tensions common to all of the professions. These include the continued dominance of randomised controlled trials (RCTs) in the hierarchy of evidence. RCTs often fail to capture the multi-faceted individualistic nature of health and social care interactions or the development of qualitative methodologies within the professions. Concern is expressed that professional autonomy and the art of practice will be eroded by the enforcement of guidelines and protocols. EBP is currently located within individual professions rather than the broader context of interprofessional practice. The future of EBP is dependent, at least in part, on educational initiatives, organisational commitment and support, patient/client involvement and the development of a broader interprofessional perspective.     

A critical review of the nursing shortage in Malaysia

BARNETT T., NAMASIVAYAM P. & NARUDIN D.A.A. (2010) A critical review of the nursing shortage in Malaysia. International Nursing Review 57 , 32–39
Objective:  This paper describes and critically reviews steps taken to address the nursing workforce shortage in Malaysia.
Background:  To address the shortage and to build health care capacity, Malaysia has more than doubled its nursing workforce over the past decade, primarily through an increase in the domestic supply of new graduates.
Methods:  Government reports, policy documents and ministerial statements were sourced from the Ministry of Health Malaysia website and reviewed and analysed in the context of the scholarly literature published about the health care workforce in Malaysia and more generally about the global nursing shortage.
Results:  An escalation in student numbers and the unprecedented number of new graduates entering the workforce has been associated with other impacts that have been responded to symptomatically rather than through workplace reform. Whilst growing the domestic supply of nurses is a critical key strategy to address workforce shortages, steps should also be taken to address structural and other problems of the workplace to support both new graduates and the retention of more experienced staff.
Conclusion:  Nursing shortages should not be tackled by increasing the supply of new graduates alone. The creation of a safe and supportive work environment is important to the long-term success of current measures taken to grow the workforce and retain nurses within the Malaysian health care system.     

Iranian nursing staff's self-reported general and mental health related to working conditions and family situation

ARSALANI N., FALLAHI‐KHOSHKNAB M., JOSEPHSON M. & LAGERSTROM M. (2012) Iranian nursing staff's self‐reported general and mental health related to working conditions and family situation. International Nursing Review 59 , 416–423 Background: There is increasing global evidence that today's work environment results in higher risk of adverse health among nursing staff than among other professions. Aim: To investigate self‐reported general and mental health among Iranian nursing staff, and associations with organizational, physical and psychosocial working conditions and family situation. Methods: 520 nursing personnel from 10 university hospitals in Tehran participated in this cross‐sectional study. Data were collected using a validated questionnaire in the Persian language, containing the Copenhagen Psychosocial Questionnaire, physical items from the Nurse Early eXit Study and two scales relating to general health and mental health from the Short Form‐36. The Chi‐square test with P < 0.05 and logistic regression were used to analyse data. Results: Three out of four nursing staff reported overtime work. The self‐reported general and mental health rates of participants were poor/fair (38%, 41%), good (44%, 39%) and very good/excellent (18%, 20%), respectively. Family demands were associated with general health but were not associated with mental health. Adverse physical and psychosocial work conditions gave an elevated odds ratio for poor health. Conclusion: Poor general and mental health was associated with adverse working conditions and family demands. Physical and psychosocial working conditions of nursing personnel should be improved. Social facilities such as daycare for children and care for the elderly should be available during work shifts to help Iranian nurses play their family roles.     

An international exploration of blended learning use in pre-registration nursing and midwifery education

AimTo explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy.BackgroundThe global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere.DesignCross-sectional, sequential, mixed methods studyParticipants/settingsNursing/nurse education leaders from across International Council of Nurses regionsMethodsExploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants’ knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes.ResultsParticipants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation.ConclusionsBlended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact.Tweetable abstractBlended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.     

Children's nursing education: 'the future characterised by paradoxes'

According to Healthcare Futures 2010 (Warner et al 1998) the future for the nursing and midwifery professions will be characterised by a series of paradoxes. There will be 'a growing emphasis on prevention, yet a great demand for cure and palliation; public reliance upon professionalism within the workforce, yet greater lay assertiveness; a greater demand for technical competence and scientific rationality among nurses and midwives, yet a continuing need for traditional nursing qualities and the time to express them' (Warner et al 1998). If these projections hold true there are significant implications for nursing and midwifery education. This article provides a summary of the development of nurse education and uses the three paradoxes identified to reflect on the past and the present and explore the future of children's nursing education.     

Faculty for the millennium: changes needed to attract the emerging workforce into nursing

The twenty-something generation wants educators who nurture, motivate, and listen. Personal attention is important to these students who are entering nursing education programs that are under great pressure to produce more nurses. To compete with other career options and address the global nursing shortage, nursing education must be considered a collaborator, rather than a barrier. Aging faculty and declining faculty numbers increase the challenges related to recruiting and retaining the emerging workforce in nursing professions. This study explored what young students want in their faculty and new options for increasing the number of nursing graduates.     

Advanced care planning for paediatrics - the role of the NP

Nurse Practitioners have a very special role to play in leadership and development of the nursing and midwifery professions, and must have the confidence to participate in health service planning at the highest level whilst still participating in health service delivery at the coal face. It is a careful balance of priorities that requires understanding, determination and courage to progress but is essential for targeted, holistic health service planning and delivery that meets the needs and     

Nursing and midwifery research in Scotland: from partnership to collaboration

Nurses and midwives form the workforce that provides the greatest proportion of direct care to service users. They have the ability to make a significant impact not only on the quality and outcomes of patient care, but also on service users' and carers' perceptions of the care experience. It is therefore vital that nursing and midwifery practice has a robust knowledge and evidence base. The Scottish Executive Health Department, in partnership with other key stakeholders, launched in 2004 an 8 million pounds funding package for research and development capacity and capability initiatives for nursing, midwifery and the allied health professions. This article seeks to describe the process of engagement and partnership building that enabled this scheme to be developed. It will attempt to illustrate how the convergence of political, policy and professional agendas has provided the opportunity for nurses and midwives to set a direction of travel for research and development that will enable them to become key players within multidisciplinary research at United Kingdom and international levels.     

Achievements in child health over the first half of the 20th century

This article will reflect upon the gains made in the health and welfare of children in the UK over the first half of this century. It will discuss how government reforms covering health, welfare and education have improved all aspects of children's lives and the contribution made by the relatively new professions of nursing, midwifery and health visiting. Finally, it will show how changing attitudes towards children and the two World Wars culminated in international recognition of children's rights. A future article will highlight the increasing rate of change seen in the second half of this century.     

Anthropology, nursing and midwifery: a natural alliance?

Anthropology, and its supposed operationalisation within transcultural nursing, is becoming increasingly prominent in educational curricula in the U.K. This increase in interest is driven both by governmental pressure to provide more culturally appropriate care, and an intuitive notion that anthropology, nursing and other related professions such as midwifery have a common basis of mutually overlapping and re-enforcing theory and practice. This paper explores the question of whether there is a natural alliance between anthropology, and the applied aspects of health care disciplines such as nursing and midwifery, by examining some of the concepts underlying each discipline, and the ways in which these concepts are applied in practice. Anthropology is the study of culture, and it is suggested that a more complete understanding of this central concept is essential if it is to be utilised in the applied disciplines encompassed by the practice of nursing and midwifery.     

The Welsh Nursing Academy: a focus for excellence

This article traces the development of the Welsh Nursing Academy (WNA) and links this to other changes that have occurred within the professions of nursing, midwifery and heath visiting, as well as the political landscape of Wales. The mission of the WNA is to serve the people of Wales by promoting excellence in nursing and health care through the generation, synthesis and dissemination of nursing knowledge. How this will be translated into practice through the activities of its membership will be shown in relation to each of the academy's five purposes. This is the first nursing academy to be established in the UK and it is likely that others will follow in England, Scotland and Northern Ireland. As the article concludes, this may lead to a federation of academies across the UK which will collaborate and support each other and link up with existing nursing academies in other countries.     

Divergence and convergence in nursing and health care among six countries participating in ICN's 2010 Global Nursing Leadership Institute

ZITTEL B., EZZEDDINE S.H., MAKATJANE M., GRAHAM I., LUANGAMORNLERT S. & PEMO T. (2011) Divergence and convergence in nursing and health care among six countries participating in ICN's 2010 Global Nursing Leadership Institute. International Nursing Review 59 , 48–54 In 2009 the International Council of Nursing (ICN) launched, with support from Pfizer External Medical Affairs, a Global Nursing Leadership Institute (GNLI) which was again repeated in the fall of 2010. The programme, provided in English, at a location near ICN headquarters in Geneva, Switzerland, provided the opportunity for senior and executive level nursing leaders throughout the world to acquire new knowledge and skills about national and global leadership within a supportive and stimulating learning environment. Once selected for participation, GNLI members are requested to complete a country profile – a two to three page précis providing information regarding health and nursing specific to their respective country encompassing the following: the country's health system and how it is funded; identification of current or proposed changes in the health system; national demographic data such as population, gross national income, average life expectancy, number of nurses and physicians, and the top three causes of deaths; and key issues facing the health system and nursing in the country. On arrival at the Institute, participants were divided into leadership development teams, small groups of six persons each, which met throughout the week to discuss the ways in which health challenges and nursing in their respective countries both converged and diverged. Shared insights learned are presented from one such 2010 GNLI team representing nursing leaders from the countries of Australia, Bhutan, Lebanon, Lesotho, Thailand and the USA. A comparative analysis of the health profiles of their respective countries is also provided.