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1.
Loretto Quinney Trudy Dwyer Ysanne Chapman 《Collegian (Royal College of Nursing, Australia)》2018,25(3):263-269
Background
The incidence of chronic illness is growing globally and nurses within the family circle often fulfil a caring role for relatives who are chronically ill. Registered nurses who are also carers have a unique vantage point to evaluate healthcare provision.Aim
This study aimed to develop insights into healthcare provision from understanding the lived experience of participants who were family carer and professional nurse.Methods
This paper is drawn from a larger phenomenological study that explored the lived experience of fifteen registered nurses who cared for family who had a chronic illness. Unstructured interviews of one hour duration were used as the method of data collection to enable thematic analysis of the findings within the context of Heideggerian philosophy.Findings
The research identified that participants held three distinctive ways of being a nurse and family carer while at the bedside of their chronically ill family member. During the critical times of exacerbation and hospitalisation, the carer who is also a nurse, has professional and personal insights which enable them to; navigate healthcare systems to access care, progress through hospital safely and build pathways towards discharge.Discussion and conclusion
In contrast to much of the previous literature, which has focused upon the needs of nurses who are family carers, this paper focuses upon the contributions that participants can make to the nursing profession and the wider health industry. Understanding the contribution that carers can make to patient safety and improved health outcomes may bring focus and purpose to the implementation of care for the chronically ill. Participants developed insights into healthcare provision from repeated exposure through multiple admissions and this repository of knowledge may have previously been overlooked. 相似文献2.
3.
Robin Digby Susan Lee Allison Williams 《Collegian (Royal College of Nursing, Australia)》2018,25(4):377-383
Background
The number of people presenting to hospital with dementia is escalating worldwide. Hospitals are inadequately prepared leading to a poor patient experience.Aim
To explore the perspectives of nurses caring for people with dementia to critically evaluate the reasons behind the widely reported poor care received by such patients. The study examined what was privileged in the care of patients with dementia in geriatric rehabilitation facilities.Method
The study used critical ethnography. Data were obtained from interviews with 29 nurses working with patients with dementia in geriatric rehabilitation hospitals. The interviews were audio-recorded and transcribed verbatim.Findings
The theme of the ‘unworthy’ patient was supported by sub-themes of people with dementia and hospital performance targets, risk, nurse workload and acute care issues.Discussion
Hospitals have increasing pressure to conform to tight budgets and must justify all expenditure, increase patient throughput and minimise risk. Patients with dementia can have a longer hospital stay complicated by frailty, complications and social problems. The focus on rapid discharge influences the mind-set of nurses and nurse habitus. Patients with multiple chronic co-morbidities are unpopular and considered low priority and less worthy of resources. Privileging care for certain patients and tasks is supported by organisational cultural beliefs. Nurses require support to maintain empathetic caring practices in the face of managerial priorities.Conclusion
The research found that patients with dementia were considered unworthy in the geriatric rehabilitation hospital setting. The difficulties caring for patients with dementia are considerable. Nurses need education and support to improve practice. 相似文献4.
Melanie Birks Lea M. Budden Narelle Biedermann Tanya Park Ysanne Chapman 《Collegian (Royal College of Nursing, Australia)》2018,25(1):45-50
Background
Bullying in nursing remains an unacceptable international phenomenon and one that is widely reported in the literature. Recently, reports of bullying and harassment of nursing students have been increasing.Aim
This paper aims to describe bullying and harassment experienced by Australian nursing students while on clinical placement, as told by the participants.Methods
As part of a larger study, 884 Australian baccalaureate nursing students were surveyed to identify the nature and extent of their experiences of bullying and/or harassment during clinical placement. Almost half of the students (430) provided open-ended comments. These textual data were explored using a content analysis approach.Findings
The major themes derived from the analysis consisted of: manifestations of bullying and harassment; the perpetrators, consequences and impacts. Bullying behaviours included various forms of verbal, racial, physical and sexual abuse. Perpetrators of bullying included other nurses, medical professionals, administrative and support staff. Students reported anxiety, panic attacks, physical symptoms of distress and loss of confidence and self-esteem from their experience of bullying during clinical placement.Discussion
Bullying in nursing is a widespread yet poorly understood phenomenon that impacts negatively on the learning experience of vulnerable nursing students, effecting them physically, mentally and emotionally. The potential implications of the bullying of nursing students on patient care reinforces the need for the culture of bullying that exists amongst the nursing profession to be addressed.Conclusion
The findings of this research have implications for nursing educators and clinicians. Recommendations include ensuring adequate preparation of students, clinical instructors and registered nurses who work with students in the practice environment. 相似文献5.
Tamsin H.T. Thomas Jacqueline G. Bloomfield Christopher J. Gordon Christina Aggar 《Collegian (Royal College of Nursing, Australia)》2018,25(2):201-208
Background
In Australia, there is an increasing demand for registered nurses in primary health care. Registered nurses graduating from university typically enter the workforce via supported transition to professional practice programs in acute-care hospital settings. A prospective strategy to create a sustainable primary health care workforce is to develop comparable transition programs in primary health care settings, such as general practice. We developed, implemented, and evaluated Australia’s first transition to professional practice in primary care program.Aim
To explore the experiences and perceptions of graduate registered nurses and practice nurses participating in a novel transition to professional practice in primary care program.Methods
Thematic analysis of semi-structured interviews with graduate registered nurses (n = 4) and their preceptors (practice nurses, n = 5) on completion of the program.Findings
Three themes emerged from the graduate registered nurse interviews: opportunities for education and clinical development, job satisfaction, and career progression opportunities. Graduate registered nurses were satisfied with the available learning opportunities, indicated a career in primary health care could be potentially rewarding, and anticipated moderate career progression opportunities within general practice. Preceptor themes included program positivity and early career opportunities. The preceptors were positive about the program and believed it supported the graduate registered nurses to become confident and competent. However, both the graduate registered nurses and preceptors perceived an acute-care hospital transition to professional practice program was necessary to gain adequate nursing skills, even if they intended to have a future career in primary health care. Furthermore, they appeared to believe that a career in general practice is more appropriate for “older nurses”.Discussion
These beliefs may be a barrier for transition to professional practice in primary care programs to develop and support a sustainable primary health care workforce.Conclusions
Improved primary health care transition programs, policy, and educational strategies are required. 相似文献6.
7.
Helen Hall Caragh Brosnan Jane Frawley Jon Wardle Melissa Collins Matthew Leach 《Collegian (Royal College of Nursing, Australia)》2018,25(3):285-291
Background
: Many people integrate complementary and alternative medicine (CAM) into their health care. Nurses potentially play a significant role in communicating with patients about their CAM utilisation.Aim
: The study aimed to explore whether, how and why nurses working in Australia communicate about patients’ CAM use.Methods
: This paper reports on phase one of a mixed methods study. Qualitative data was obtained, via interviews, with nineteen registered nurses who work in a wide variety of clinical environments across all states of Australia.Findings
: Four themes related to nurses’ communication with patients about CAM, were developed from the qualitative data; engaging with patients about CAM, communication with doctors about patients’ use of CAM, connecting with CAM practitioners and barriers to CAM communication.Discussion
: Despite their positive attitudes, nurses are often not comfortable discussing or documenting patients’ CAM use. Furthermore, nurses perceive that patients may be apprehensive about disclosing their use. CAM communication with colleagues is moderated by the workplace culture and the perceived attitude of co-workers. There is very little evidence of nurses referring or collaborating with CAM practitioners. Professional expectation, time restraints and the nurses’ lack of relevant CAM knowledge all have a powerful effect on limiting CAM communication.Conclusion
: Communication about patients’ use of CAM is imperative to support safe therapeutic decisions. Currently, this is limited in the Australian healthcare workplace. The nursing professional needs to consider introducing basic CAM education and flexible guidelines to enable nurses’ to respond appropriately to the patient driven demand for CAM. 相似文献8.
9.
Background
Caring for older people can be a burden for the family that led to mistreatment.Objective
To determine the relationship between the levels of family burden in caring for older people with the occurrence of mistreatment incidence. Design and participants: A cross sectional study design was conducted with 135 older people who live with their family as respondents.Setting
135 families with older people at Kelurahan/Village of Harjamukti area, Kecamatan/ District of Cimanggis, Depok city.Method
This study applied probability sampling technique with multistage cluster sampling.Results
Family characteristics show that almost half of older people were caring by family members (caregivers) who were aged 20-39 years, nearly all caregivers were women, family income mostly less than UMK, families mostly monosyllabic nation Betawi and caregivers mostly were their own child. Most of the families stated that no expense in caring for the older people (89.6%), but there are still families who feel the burden of caring. The highest type of mistreatmet of the older people is psychological mistreatments.Conclusions
From the statistical test obtained by p value equals to 0.553, it was concluded there was no correlation between the incidences of any family burden with mistreatment. 相似文献10.
Elizabeth Halcomb Elizabeth Smyth Lorna Moxham Victoria Traynor Ritin Fernandez 《Collegian (Royal College of Nursing, Australia)》2018,25(4):429-434
Background
To prepare nurses for a role in knowledge generation they need to engage in research training. Bachelor of Nursing (Honours) programs are a first step in this training. Developing a better understanding of current programs, their challenges and outcomes will provide an evidence base to inform curriculum development and policy making.Aim
The aim of this study was to explore current Australian Bachelor of Nursing (Honours) programs in terms of their composition, delivery and number of enrolments/graduates.Methods
Bachelor of Nursing Honours Coordinators or Heads of Schools of Nursing and Midwifery at Australian Universities were emailed an invitation to participate in an online survey.Findings
Of the 19 academics who responded to the survey, 15 (78.9%) reported currently offering a Bachelor of Nursing (Honours) program in their institution. A steady decline in mean enrolments was evident over recent years. There were clear differences in course delivery and assessment tasks between courses.Conclusion
This paper highlights the need to further explore Bachelor of Nursing (Honours) programs across Australia to ensure consistency in outcomes and to explore innovations in course delivery and project development. Such changes should incorporate feedback from students, supervisors, curriculum developers and professional stakeholders to ensure that programs address their various needs. 相似文献11.
Background
Demands on the health care system, a growing ageing population and the age profile within the current nursing workforce have placed Australia in a position to expect a future shortage of nurses. One solution to this shortage could be to attract overseas trained nurses, who may provide a readymade and experienced addition to the workforce.Aim
This study aimed to investigate similarities found in the individual and unique migration journeys of 21 registered nurses. Each of the nurses in this study migrated from the United Kingdom to Perth in Western Australia.Methods
The research methodology chosen was Heuristic inquiry. Participants were recruited using purposive sampling, and snowballing was utilised to provide ease of access to eligible participants. Data was collected through a focus group, individual semi-structured interviews, and a journal.Findings
In this study, three main coping strategies were identified: (a) developing resilience; (b) finding a new professional identity; and (c) having the ability to adapt to a new life. It was found that feelings of belonging were necessary to make the move a success. Participants placed the need to develop new friendships and a replacement family as a high priority.Discussion
Migration offers a unique experience. Success during the complex migration process depended on the migrant RNs’ ability to adapt to a new country and to develop strategies that assist in dealing with the new and unfamiliar.Conclusion
This study highlighted many of the issues that need to be considered by future nurses migrating to Western Australia from United Kingdom. Learning from the experiences of past migrants can assist future nurses to “live the dream” that Australia offers, both professionally and personally. 相似文献12.
13.
Objective
To identify a correlation between family support and maternal self-efficacy of adolescent mothers.Method
This cross-sectional study applied a consecutive sampling technique. The sample was 100 primiparous adolescent mothers. Instruments utilized were structured questionnaires, including a demographic questionnaire, Maternal Efficacy Questionnaire (MEQ), Postpartum Support System, Edinburgh Postnatal Depression Scale (EPDS), and Infant Characteristics Questionnaire (ICQ). The correlation of family support and maternal self-efficacy was analyzed using chi-square and logistic regression.Results
The results showed a significant correlation between family support and maternal self-efficacy of adolescent mothers. The family support that most influenced maternal self-efficacy of adolescent mothers was family instrument support, with Wald value of 34.720.Conclusions
Instrument support most affects maternal self-efficacy of adolescent mothers and encourages adolescents performing nurturing and mothering roles. 相似文献14.
The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study
Background
Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges. However little is known about the care of these patients in intensive care.Objective
To explore medical and nursing practices and attitudes in intensive care when caring for critically ill morbidly obese patients.Methods
A focused ethnographic approach was adopted. Participant observation of care practices and interviews with intensive care doctors and nurses were undertaken over a four month period. Qualitative analysis was conducted using constant comparison.Setting
An 18 bedded tertiary intensive care unit in New Zealand.Participants
Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40 kg/m2.Findings
Morbidly obese patients present significant physical and language challenges for intensive care practice. The physical shape of morbidly obese patients did not appropriately fit the different equipment used. Staff used specific knowledge of the patient’s body size and shape to adapt care practices and keep patients safe and comfortable. There were also specific language challenges where staff expressed concern about what words were most appropriate to use to describe body mass when in the presence of morbidly obese patients.Conclusions
Bariatric care pathways need to be developed that use more suitable body measurements to inform the use of bariatric equipment. Intensive care staff need to engage in debate about what is acceptable, respectful, and appropriate language in the delivery of bariatric patient care. 相似文献15.
Clint Douglas Diana Schmalkuche Debra Nizette Patsy Yates Ann Bonner 《Collegian (Royal College of Nursing, Australia)》2018,25(4):363-370
Background
Nurse-led services are expanding in Australia, yet current information about the scope and nature of these services is lacking. The need for more coordinated service planning and systematic evaluation prompted a scoping study to inform future development.Aim
To provide a comprehensive profile of nurse-led services in the Queensland public health system.Methods
A scoping study of 257 nurse-led services was conducted using an online survey distributed through each Hospital and Health Service in Queensland. Service level data were collected on structure, process and outcome evaluation, as well as enablers and barriers to sustainability of care delivery models.Findings
There is a diverse and growing range of nurse-led services across the state that have evolved to meet the dynamic needs of their communities. Increasingly, registered nurses are rising to the challenge of providing equitable and accessible healthcare in ways that transcend traditional professional or care setting boundaries. The major challenges for sustainability were funding and resource limitations, particularly for developing service capacity to meet growing demands. There were also tensions around the need for ongoing negotiation and review of nurse-led services with medical and administrative stakeholders.Discussion
Findings underscore the need for a modernised regulatory and policy framework to support sustainable nurse-led services and allow nurses to work to their full potential to optimise outcomes for the community.Conclusion
Nurse-led services are the sleeping giant of healthcare reform in Australia. Now is the time for policy and practice changes that will realise the transformative potential of nurse-led care. 相似文献16.
Pei-Lan Hsu Hsiu-Hung Wang Cheng-Joo Eng Mei-Sang Yang 《Collegian (Royal College of Nursing, Australia)》2018,25(4):435-440
Background
The global nursing shortage has highlighted the role of the clinical practicum in nurses’ training. Studies have indicated that student nurses suffer from high stress levels during clinical practicums. However, few studies have evaluated how student nurses effectively cope with these stressors to adapt to their surroundings.Aim
To obtain a comprehensive understanding of the transformation process of student nurses during clinical practicums, including stressful encounters, interactions in their interpersonal relationships, coping strategies, and the relationship between self-identity and challenges.Methods
Eight Taiwanese student nurses in the second year of a two-year bachelor’s program served as study subjects. A qualitative research design was adopted.Findings
Three theme clusters were identified: challenges, reactions, and transformation. The student nurses struggled with challenges in interpersonal relationships, improving their professional knowledge and skills, and adapting to negative learning environments. The student nurses became more confident in their abilities by improving interpersonal interaction abilities, professional knowledge and skills, and professional ethics as well as by preserving family bonds.Discussion
The student nurses’ clinical practicum experiences present severe challenges. Negative learning environments may influence a student’s professional identity. The student nurses recognized this issue and developed their self-identity through interactions nurses recognized this issue and developed their self-identity based on interactions between themselves with others. Conclusion The results demonstrate the key aspects of student nurses’ transformation that facilitate the development of self-identity and enable students to evolve into mature individuals. The findings may help new student nurses prepare for the challenges of practicum experiences. 相似文献17.
Karen Missen Lisa McKenna Alison Beauchamp 《Collegian (Royal College of Nursing, Australia)》2018,25(2):227-230
Background
This paper reports on one aspect of a larger doctoral project which investigated the perceptions of qualified nurses on the abilities of newly registered nursing graduates.Aims
To explore qualified nurses’ perceptions on national examinations for registration in Australia. 相似文献18.
Kay Cooper Llinos M. Jehu Susan Klein Blair H. Smith Patricia Schofield 《Physiotherapy》2018,104(2):239-247
Objective
To determine the feasibility and acceptability of a training programme for peer volunteers to support older adults with chronic low back pain (CLBP) following discharge from physiotherapy.Design
Feasibility study.Setting
Community-based.Participants
17 adults (4 male, 13 female) with CLBP or experience of supporting someone with CLBP enrolled and 12 (2 male, 10 female) completed the volunteer training.Intervention
Volunteers took part in a face-to-face or blended delivery peer support training programme based on the Mental Health Foundation’s “Principles into Practice” and adapted for CLBP by the study team.Main outcome measures
Recruitment/retention rates; demographics; time & resources used to deliver training; training evaluation (questionnaire); knowledge questionnaire, and self-efficacy questionnaire.Results
17 participants enrolled on the training programme (11 face-to-face, 6 blended delivery). 12 (71%) completed the training (73% face-to-face, 67% blended delivery). The training was positively evaluated. All but two participants passed the knowledge quiz at the end of the training, and the majority of self-efficacy scores (90%) were high.Conclusions
It is feasible to develop, implement and evaluate a peer support training programme for the facilitation of CLBP self-management in older adults following discharge from physiotherapy. Blended delivery of training may facilitate the recruitment of greater numbers of peer support volunteers in future studies. Supported self-management of CLBP pain is widely recommended but can be difficult to achieve. Peer support might be a promising method of facilitating CLBP self-management without additional burden to health services, and should be further evaluated in a larger study. 相似文献19.
20.
Anna Maria Bosco Natalie Williams Jacqueline Marie Graham Dianne Lorraine Malagas Yvonne Hauck 《Collegian (Royal College of Nursing, Australia)》2018,25(1):73-80