Contracting for nurse education: nurse leader experiences and future visions.

The integration of nurse education into higher education establishments following Working for Patients, Working Paper 10 (DOH 1989a) has seen changes to the funding and delivery of nurse education. The introduction of contracting for education initiated a business culture which subsumed previous relationships, affecting collaborative partnerships and shared understanding. Discourse between the providers and purchasers of nurse education is vital to achieve proactive curriculum planning, which supports the development of nursing practitioners who are fit for award and fit for purpose. Research employed philosophical hermeneutics to guide the interviewing of seven nurse leaders within one region. Data analysis occurred within a hermeneutic circle and was refined using NUDIST. Two key themes were seen as impacting on the development of an effective educational strategy. Firstly, the development of collaborative working was thought to have been impeded by communication difficulties between the Trusts and higher education provider. Secondly, there was concern that curriculum developments would support the future evolution of nursing, acknowledging the professional issues impacting on nursing roles. The research findings suggest purchasers and providers of nurse education must move towards achieving mutual understanding and collaborate in developing a curriculum which will prepare nurses for practice and for award.     

Learning from abroad: the benefits for nursing

Contemporary curriculum guidelines for nurse education advocate the development of a broader European or international perspective. This is enhanced by curriculum changes which now enable student nurses to undertake clinical experience overseas, either for observation or direct participation in health care. Such initiatives are to be welcomed, given the implications of the Maastricht Treaty and the transition to a single European market. Furthermore, changes within Europe and further afield may have an impact on nursing practice at a time when those involved in health care may be facing similar challenges in the UK in terms of diminishing health resources and demographic trends. If nurses are to adapt to these socio-economic challenges and develop pro-active nursing practice they need to be tolerant of cultural issues, and have an understanding of health care in the wider European and international context. The aim of this paper is to discuss the evidence for incorporating a European dimension into nurse education, before examining the benefits for nurses with reference to activities within one department of nursing.     

Recommendations for educating nurses in genetics

With the ongoing and increasingly rapid pace of genetic discoveries, nurses must be able to incorporate genetic knowledge into their everyday practices of promoting the genetic health of individuals, families, and communities. Although development of genetic health knowledge is in its infancy, nurses are currently expected to integrate information about genetic risks, testing, and treatments for clients throughout the clients' entire lifespan. All nurses must have an understanding of the relationship between genetics and health to appropriately identify and address genetic concerns in their clients. To fulfill these roles, nurses need to improve their knowledge base in genetics. This article provides recommendations for genetics curriculum in continuing and entry-level nursing education programs. These recommendations are outcomes of a research project involving genetics nurse experts as well as nurses new to the area of genetics, and a consensus workshop of nursing faculty involved in curriculum changes subsequent to an intensive genetics continuing education program. Nursing educators are beginning to recognize the importance of education of all nurses about genetics. If, however, all educators do not accept this responsibility, nurses will be left behind in designing and offering health care for the 21st century.     

Some important limitations of competency-based education with respect to nurse education: an Australian perspective.

Issues concerning competency-based education (CBE) have recently promoted much discussion and debate throughout most developed countries. This paper provides an Australian perspective and adds to the wider debate about CBE by deliberating on the part professional competency standards should play in a university curriculum, specifically the undergraduate nurse education curriculum. A position is developed by addressing the following thesis statement: the competency-based approach to nursing education is an indisputable reality but nursing competencies must not be allowed to control the curriculum. Some background material is briefly reviewed in order to situate CBE, nurse education, and nursing competencies in their Australian economic and sociopolitical context. The position is then explicated through an examination of some intersections between nursing competencies and aspects of undergraduate nurse curriculum making.     

Nurse practitioner: redefining the role of the community nurse?

Currently there is considerable uncertainty regarding the future for community nurses in the United Kingdom (UK). Within the present social and political context the development of the nurse practitioner is examined as one possible means of redefining the role of some community nurses. The historical development of the nurse practitioner in the United States of America (USA) and the UK reveals that such a role has, previously, been a response to changing health trends and to deficits in the provision of care to communities. The evolution of an independent nurse practitioner role is suggested as a way forward for different groups of community nurses and should enable them to meet the health demands of people in a variety of settings. The 'needs' of patients and clients and a multidisciplinary approach are emphasized as being important to the redefinition of community nursing roles. The preparation of community nurses as nurse practitioners would have obvious implications for community education; this matter is briefly discussed. The future of nursing as a whole is set to change; it is imperative that all nurses delivering patient care in this arena should examine the changing needs of society in the context of political reform, and consider how their roles may be developed and redefined.     

Public health and nursing practice: seizing the receptive moment

Both nursing and government policy indicate the crucial role that all nurses have in the public health arena and yet it would seem that the role of the nurse in general within public health is open to debate and criticism. The author has a responsibility for the development of public health across the undergraduate curriculum within a university. This paper presents a discussion of some of the issues raised from student nurses, nurse lecturers and nurse managers. These discussions are as a result of both a 5 year PhD study undertaken by the author and a revalidation the undergraduate nursing programme within the author's organisation. The aim of the paper being to consider what is needed to put public health at the core of all and every nurse's practice across the UK. It takes the approach of lessons learned as it discusses some of the changes made to the author's own organisations undergraduate nurse curriculum, and those changes which still need to happen in order for nursing to identify its public health capacity. Such changes it may be suggested are easily transferable across all UK nursing curricula.     

Miracles take a little longer: Project 2000 and the health-promoting nurse

This paper suggests that the new paradigm for nurse education is being prevented from fulfilling itself because of factors operating within the taught, hidden and wider curriculum. Firstly it is argued that the theoretical components relating to social science, health education/promotion and nursing need to be clearly integrated for nursing students. This integration is demonstrated through the analysis of two nursing models. Secondly it is argued that the taught curriculum needs to be supported by a suitable hidden curriculum both within the educational and clinical setting. Role models which demonstrate integrated theory occurring in practice are a vital component of this. Thirdly it is argued that without the wider social and political context supporting the aims of the ‘new’ nurse education, meaningful success will be very difficult to achieve.     

Nurse educators and the future of nursing

Calls for transformation in nursing education and practice abound. Nurses are part of a trusted profession, but they have been under-represented in conversations about health care compared with other, more vocal professionals. Nurses may not consider that they already have many leadership skills, and nurse educators in staff development roles are positioned to foster growth in other nurses. The relationship between nurse educators and their constituents provides the context for support that can motivate staff nurses to move beyond their concerns and accept challenges that may cause them some discomfort, such as writing for publication or public speaking. The leadership of nurse educators is essential to support colleagues who will shape the future of nursing.     

The captive market in nurse education and the displacement of nursing knowledge

This paper develops a framework of empowerment within which to examine the commissioning process for nurse education arising from market reform of the British National Health Service (NHS). The paper argues that an imbalance in this commissioning process favours theoretical products, such as the diploma-level nursing curricula (Project 2000). Also, the university setting of nurse education is seen as clinically de-skilling both nurse teachers and student nurses as well as influencing the discourses on clinical skills. The paper further argues that the effects of such trends are a captive market in nurse education contracting and a displacement of nursing knowledge. An approach to commissioning nurse education is described which may counter such trends and positively impact on NHS organizational development and quality. Further reform of the commissioning process is described in context of pragmatic health legislation.     

Curriculum as environment: a focus group study

Curricula development is critical for the advancement and evolution of holistic nursing education. Although the American Holistic Nurses Association offers advanced practice board certification for graduate nurses, there is a scarcity of available graduate holistic nursing courses and curricula. The researchers developed a curriculum for an advanced holistic nursing program at a university college of nursing in South Florida. The curriculum and process of development were presented at a workshop during a national holistic nursing conference. A portion of the workshop included an opportunity for attendees to voluntarily participate in a focus group research study. The specific aim of the research was to determine the best approaches for the development of curricula for the promotion of graduate holistic nurse education based on the insights of holistic nurses, nurse educators, nurse practitioners, and scholars. A content analysis identified 3 themes that addressed holistic nursing curriculum: (1) consider curriculum as an evolving blueprint for personal and professional growth; (2) embrace the uniqueness of students; and (3) encourage faculty to co-create the learning environment.     

Nursing practice environment: A strategy for mental health nurse retention?

Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required.     

男性护士教育培养现状与对策

南丁格尔创立现代护理以来,护理一直以女性为主导,男性在护理队伍中所占比例很小。人们的健康需求需要男性护士提供护理服务,所以,教育培养一定数量的男性护士势在必行。在培养男性护士的过程中面临生源少且专业思想不端正、心理状况较差、角色适应难度大等问题。提出解决对策:教育者和学习者应该认清护理发展史上男性护士曾经扮演的重要角色,从社会需求和人类健康需要的角度认识男性护士在健康服务中的必须性,认清男性护士在护理职业中的优势,加强对男性护士的宣传,并针对男性护生的学习特点和社会需求开展教育培养。     

Nursing education in China: past, present and future

wong f.k.y. & zhao y. (2012) Journal of Nursing Management 20, 38–44
Nursing education in China: past, present and future Aim To describe the development of nursing education in the past, present and future in China. Background The development of nursing education in China is closely tied with the country’s wider context, including the social, political and economic environment. Evaluation The source of information includes published materials accessible to the public and the authors’ knowledge as content experts of the nursing situation in China. Key issues Nursing in China is developing rapidly particularly in the last decade in quantity and quality terms. The education development of nursing is in line with the service development which aims at client-centred care adopting a holistic approach caring for clients at the preventive, curative and rehabilitative levels. Conclusions Nursing education in China, both at the pre-registration and post-registration level, plays a key role in building a strong team of nurses to fulfil the health mission of the country. Implications for nursing management Managers in nursing education need to continuously revise the curriculum to produce nurses who meet societal needs at present and for the future. At the same time, nurse managers in the service need to make best use of these nursing talents according to the nurses’ competence and educational levels.     

临床护理专家的角色功能及发展趋势

临床护理专家是指在某专科或专病具有较高水平的护理人才,其主要角色功能包括临床实践、护理研究、护理教学、护理会诊以及护理管理五大基本职能和社会心理治疗以及高级医疗、护理技能等方面的特殊职能。为了适应患、患家属、医疗机构及社区需求的复杂化和变化性, 临床护理专家与护理开业的角色进行合并进未来发展的必然趋势。     

Graduate education for advanced practice public health nursing: at the crossroads

The complexity of public health problems and advancement of science framing public health demand an expansion of traditional educational approaches and curriculum to prepare a futuristic advanced practice public health nursing (APPHN) workforce. This position paper sponsored by the Association of Community Health Nursing Educators challenges nurse educators to apply innovative strategies in preparing public health nursing (PHN) professionals and to expand curriculum paradigms to promote PHN's ecological approach to solving problems. To meet the challenges of ensuring public health in the 21st century, advanced practice public health nurses must have greater foundational knowledge in critical content areas discussed in this document. Competence in these areas will enable advanced practice public health nurses to address future health care challenges such as rapidly changing social structures, escalating knowledge explosion, globalization, and growth of new technologies. This education will prepare nurses to forge new knowledge and establish health care teams to create effective solutions.     

Conversations in context: cultural safety and reflexivity in child and family health nursing

Over 10 years, a number of nurse educators at the Waikato Institute of Technology (WINTEC) have worked collaboratively across primary health, cultural safety, and child and family health domains of the nursing curriculum. They share a common philosophy underpinned by notions of diversity and health equity. The philosophy informs their theoretical inquiry, practice and research interests, and pedagogical concerns. This article outlines some key aspects of their practice as nurse educators and researchers committed to the needs of their specific region in the central North Island of Aotearoa New Zealand. They begin by situating themselves within the region, its people, and influences before moving into a consideration of the wider political and policy environment. They consider the destabilizing effects of cultural safety education and the tension between biculturalism and multiculturalism in their context. Finally, they reflect on how these ideas inform their work with postgraduate child and family nurses.     

A critical exploration of "Working Together,Learning Together"--does it meet the learning needs of nurses?

Recent government educational initiatives have emphasised the need for lifelong learning to facilitate and equip nurses with the appropriate knowledge and skills to operate in a dynamic healthcare delivery system. In this paper I will critically explore a recent educational framework from an educational ideology and curriculum design perspective. It is recognised that any educational program cannot be devised or constructed in a socio-political vacuum and any developments must acknowledge this influence on the context in which nurse education operates. The framework is debated from an ideological perspective and I surmise that an ideological change from Romanticism to Revisionism will facilitate change in curriculum design that is in keeping with the realties of healthcare needs. The educational initiative is explored from a curriculum design perspective utilising Beattie's Fourfold Model. I further surmise that the educational initiative fails to acknowledge the uniqueness of nursing knowledge and the integral learning processes such as reflection thus marginalising nursing as a profession. In this paper I suggest that any educational initiative must recognise the evolving role of nursing, the profession and the realties of healthcare systems to ensure the present and future workforce is skilled and empowered to aspire to these multifaceted demands.     

Collegiality, adaptation and nursing faculty

Many nurse educators in the United Kingdom are currently faced with the challenge of change, of leaving the culture of the British National Health Service and integrating into the culture of tertiary education This paper reports on a study of the process of developing collegial relationships in the context of a new collaboration to develop a combined curriculum for nurses within a tertiary institution The aims of the study were to analyse this process of integration and to identify the conditions that enhanced the development of collegiality between members of the nursing group The case study centred on the analysis of data collected on video during unstructured interviews with the five members of the group Data were analysed using Burnard's method of thematic content analysis The paper argues that during the transition from the National Health Service to tertiary education, individual nurse educators and their managers must address problems related to issues such as 'ingroupism', nursing the students, perceived difference between nurse academics and other academics, and expectations of power-relationships     

Nursing colonialism in America: Implications for nursing leadership

The purpose of this paper is to explore the nurse leader's role in understanding the impact of American colonialism – specifically racism, a product of colonialism – as a key determinant in shaping the education of nursing students and its influence on practicing nurses. American values have been grounded in its colonialism and continue to be influential in shaping beliefs, attitudes, behaviors, and policies within the United States. Like racism, American colonialism depends on its perceived death for its survival – this is its paradox. Historic roots of the nursing profession evolved within this context of American colonialism which has shaped the lens of individuals who are the leaders and practitioners in our profession. Therefore, it is important to examine strategies that challenge and decolonize the nursing profession and to become an accomplice, clarifying and addressing inclusion/exclusion in our profession's leadership machine including: hiring/promotion practices, confrontation of White silence, critiquing design and dissemination of knowledge development, and fostering widespread change in nursing education/curriculum. Understanding the invisible internalization and manifestation of racism within our profession must be addressed if we are to advance the integrity and quality of education and practice in the nursing profession and to promote equity of healthcare among all individuals in the United States.     

Implementing change in nursing education

Nursing education faces a period of change within the next decade. Blueprints for educational change have been developed in the United Kingdom, Australia and Canada. Change in education needs to be planned rather than a reaction to internal or external pressures. Blueprints for education should extend beyond the entry to practice level and include specialisation, baccalaureate and graduate education. A plan for practice for the future should encompass both hospital and community based health care. Nursing practitioners as well as nurse educators need to be involved in educational planning. In light of the changing student body and societal needs, consideration must be given to the development of a variety of models for nursing education. Prior to instituting wholesale change, pilot projects need to be developed and tested. Plans for preparing adult educators competent in the use of modern technology, are a necessary adjunct to new programme development. Education also needs to be available to the practising nurse to enable professional growth. Professional associations must play a role in educating nurses, other professionals and consumers of nursing care on the changing roles and functions of the nurse, as movement is made toward the goal of 'Health For All By The Year 2000'.