Staff – student relationships and their impact on nursing students' belongingness and learning

Title. Staff – student relationships and their impact on nursing students’ belongingness and learning . Aim. This paper is a report of selected findings from a study exploring the relationship between belongingness and placement experiences of preregistration nursing students. Background. Staff‐student relationships are an important influence on students’ experiences of belongingness and their clinical learning. The need to belong is universal and pervasive, exerting a powerful influence on thought processes, emotions, behaviour, health and happiness. People deprived of belongingness are more likely to experience diminished self‐esteem, increased stress and anxiety, depression and a decrease in general well‐being. Nursing students’ motivation and capacity to learn, self‐concept, confidence, the extent to which they are willing to question or conform to poor practice and their future career decisions are influenced by the extent to which they experience belongingness. Method. During 2006, 18 third year students from two Australian universities and one United Kingdom university participated in in‐depth semi‐structured interviews. Data were analysed thematically. Findings. Participants described placement experiences spanning a continuum from those promoting a high degree of belongingness to those provoking intense feelings of alienation. Staff‐student relationships (including receptiveness, inclusion/exclusion, legitimization of the student role, recognition and appreciation, challenge and support) were the most important influence on students’ sense of belonging and learning. Similarities between sites were remarkable, despite the differences in healthcare and higher education systems. Conclusion. Staff‐student relationships are key to students’ experience of belongingness. Understanding the types of interactions and behaviours that facilitate or impede students’ belongingness and learning are essential to the creation of positive clinical experiences.     

Graduating nursing students' perceived preparedness for working in critical care areas

halcomb e.j., salamonson y., raymond d. & knox n. (2012)?Graduating nursing students perceived preparedness for working in critical care areas. Journal of Advanced Nursing68(10), 2229-2236. ABSTRACT: Aims. This article reports a study examining the relationships between undergraduate students' demographics, educational preparation and clinical experience and their self reported preparedness for employment in critical care. Background. Increasing demand for critical care services internationally, creates a need to grow the critical care nursing workforce. Limited data are available on factors affecting new graduate nurses' career choices. Methods. Final year nursing students from a multi-campus Australian university were surveyed during 2009. Results. Over half of the participants were interested in seeking employment in critical care following graduation. Main reasons for choosing critical care nursing were: (i) like varied and challenging work; (ii) opportunities for professional development; and (iii) like working one-on-one with patients. The main barriers identified by participants were related to the lack of knowledge and clinical skills required to work in critical care. Using the 9-item Confidence and Interest in Critical Care Nursing scale, the study revealed that male participants and those who spent more than 1 week clinical placement in critical care were significantly more likely to report greater confidence and interest in seeking employment in critical care areas. Conclusions. The value of placing nursing students in critical care areas for more than 1 week during undergraduate clinical placements is affirmed. Whilst most final year students report feeling prepared to work in critical care areas, the next step is to explore the transition of students as new graduates in critical care to identify professional and educational issues that impact on their retention.     

A study of nurses' knowledge of a palliative approach in residential aged care facilities

Aim. To identify residential aged care nurses’ current knowledge of palliative care for older residents in need of end‐of‐life care. Background. Recently, there has been a growing interest in the delivery of palliative care in residential aged care facilities. While it is recognized that aged care nurses do possess palliative care knowledge the actual level of their knowledge has not been well documented. Design/method. An analytical study using a validated questionnaire tool – Palliative Care Quiz for Nursing, developed by Ross et al. [Journal of Advanced Nursing 23 (1996) 126–137] , combined with a demographic survey of Registered Nurses and assistants in nursing working in five high care residential aged care facilities in inner city region of Sydney, Australia. Results. The total Palliative Care Quiz for Nursing score possible was 20. The mean score for Registered Nurses was 11.7 (SD 3.1) and for AINs 5.8 (SD 3.3), the difference between scores being significant (t = 8.7, df 95, P = 0.000). Misconceptions in palliative care were identified for both the groups of carers. Conclusion. This research has highlighted the need for ongoing palliative care education for both the groups of primary carers. Relevance to clinical practice. The findings of this research highlight the existing palliative care knowledge of residential aged care nurses and provides evidence for education programmes.     

Developing palliative care practice in nursing and residential care homes: the role of the clinical nurse specialist

The development of practice is but one aspect of Clinical Nurse Specialists' (CNSs) work, and a number of factors act to shape the extent to which CNSs are able to work with and develop practice with nursing and residential care homes. A postal survey of 730 community CNSs in palliative care working in the UK was undertaken to explore the involvement of these nurses with nursing and residential care homes. Much of the focus of the involvement was reactive work meeting the direct clinical needs of residents, primarily with cancer. Although the CNSs perceived that there were some educational and care deficits in these care settings, the amount of proactive work undertaken to improve practice was limited. The development work undertaken was focused on educational initiatives and establishing link nurse systems. There is potential to develop palliative care practice in nursing and residential care homes through practice development initiatives.     

Communities of practice in residential aged care: A rapid review

Background

Communities of practice (CoPs) have the potential to help address the residential aged care system's need for continuing education and quality improvement. CoPs have been used in healthcare to improve clinical practice; however, little is known about their application to the unique residential aged care context.

Objectives

This rapid review of CoPs for residential aged care was conducted to summarise the features of CoPs, how they are developed and maintained, and assess their effectiveness.

Methods

MEDLINE and CINAHL databases were searched for studies published from January 1991 to November 2022 about CoPs in residential aged care. Data were extracted regarding the CoPs' three key features of ‘domain’, ‘community’ and ‘practice’ as described by Wenger and colleagues. Kirkpatrick's four levels of evaluation (members' reactions, learning, behaviour and results) was used to examine studies on the effectiveness of CoPs. The Mixed Methods Appraisal Tool was used for quality appraisal.

Results

Nineteen articles reported on 13 residential aged care CoPs. Most CoPs aimed to improve care quality (n = 9, 69%) while others aimed to educate members (n = 3, 23%). Membership was often multidisciplinary (n = 8, 62%), and interactions were in-person (n = 6, 46%), online (n = 3, 23%) or both (n = 4, 31%). Some CoPs were developed with the aid of a planning group (n = 4, 31%) or as part of a larger collaborative (n = 4, 31%), and were maintained using a facilitator (n = 7, 54%) or adapted to member feedback (n = 2, 15%). Thirteen (81%) studies evaluated members' reactions, and three (24%) studies assessed members' behaviour. The heterogeneity of studies and levels of reporting made it difficult to synthesise findings.

Conclusions

This review revealed the variation in why, and how, CoPs have been used in residential aged care, which is consistent with previous reviews of CoPs in healthcare. While these findings can inform the development of CoPs in this context, further research is needed to understand how CoPs, including the membership makeup, delivery mode, facilitator type and frequency of meetings, impact quality of care.     

Mentorship in contemporary practice: the experiences of nursing students and practice mentors

Aim. This paper explores the role of the mentor in contemporary nursing practice in the UK. It presents findings from a recent study which investigated the impact of a locality‐based nursing education initiative on students, practice mentors and academic staff and draws on another study, conducted in the same setting and two Australian sites, to examine the perceptions of nursing students and mentors. Background. Within nursing, mentorship is integral to students’ clinical placement experiences and has attracted increasing interest among researchers. Despite a plethora of studies focussing on mentoring and its nature and application within the practice setting, limited attention has been paid to the extent to which guidelines provided by regulatory bodies for nursing inform and influence the practice of mentoring in contemporary health‐care settings. Design. The study used a two‐phased design with data on mentorship being focussed on the second phase. Method. Data were collected using an online survey questionnaire of pre‐qualifying students and a postal questionnaire for practice mentors. Findings. The findings highlight the importance of mentorship for prequalifying students and emphasise the need to provide mentors with adequate preparation and support. They confirm previous research, but also highlight improvements in bridging the gap between rhetoric and reality for mentorship. Results are further strengthened when compared with those of the second study. Conclusions. Findings provide new evidence of a narrowing of the gap between the theory and practice of mentoring and for the continuing implementation of national standards to clarify the roles and responsibilities of the mentor. They also suggest the benefits of developing such standards in countries with similar systems of support for nursing students. Relevance to clinical practice. Mentorship is pivotal to students’ clinical experiences and is instrumental in preparing them for their role as confident and competent practitioners.     

Demonstration of the usefulness of a theoretical framework for humanising care with reference to a residential aged care service in Australia

Aims and objectives. To demonstrate the usefulness of a theoretical framework for humanising care of dementia patients. Background. The term humanisation of care has been increasingly used to describe an approach to health care that is informed by core dimensions of what it means to be human. Recent developments in dementia care highlight the importance of maintaining personhood in people with dementia. Design. A conceptual framework is proposed by which the humanisation of care can be understood and applied. Eight dimensions that articulate core features of what needs to be attended to in order for a person to feel more deeply ‘met’ as a human being are discussed. Evidence from an evaluative study of a dementia outreach service is used to illustrate the usefulness of the humanising framework. Methods. Case study examples demonstrate the value of this framework by describing how a dementia outreach service enables care staff in residential aged care facilities to change their focus in the provision of care to residents with dementia. Each of the eight dimensions of humanisation/dehumanisation is used to illustrate how the dementia outreach service team have led to the improvements in resident care. Results. Positive outcomes can be achieved by providing humanised care to residents with dementia. Conclusion. The paper highlights the potential for the humanising framework to be used in dementia care and shows how the framework can be helpfully translated into practice so that carers are supported to adopt an inclusive view of care delivery. Relevance to clinical practice. A comprehensive framework, grounded in a strong philosophical foundation, can name a breadth of criteria for humanly sensitive care and can be translated into practice in such a way as to potentially transform the provision of care to residents in residential aged care facilities.     

冠心病同型半胱氨酸血症患者的护理健康教育研究

目的探讨护理健康教育在提高老年冠心病患者对Hcy、叶酸、B族维生素等知识水平．减少冠心病不良事件发生中的作用。方法选择住院老年冠心病患者98例为观察对象,按护理程序对其实施健康教育,主要内容为Hcy、叶酸、B族维生素与冠心病的关系。结果患者在教育后的知识评分比教育前明显提高,教育后伴随其认识的明显提高,患者冠心病不良事件明显减少。结论对老年冠心病患者进行护理健康教育能提高病人Hcy、叶酸、B族维生素的知识水平,建立科学饮食习惯。对减少老年冠心病不良事件的发生具有重要的意义。