Abstract: Although there is a sizeable body of evidence regarding the nature of hostile behaviours among clinicians in the nursing workplace, what is less clear is the nature of the relationship between these behaviours and patient care. To inform the development of appropriate intervention strategies we examine the level of evidence detailing the relationships between hostile clinician behaviours and patient care.
Abstract: AIMS: To explore nursing students' perceptions of how their profession is portrayed on medical television programmes. BACKGROUND: Recruitment and retention in nursing have been linked to the image of the profession in society. Images of nursing in popular media frequently draw on stereotypes that may damage the appeal of nursing for potential students and denigrate the value and status of the profession. A growing body of work analyses how nursing is portrayed in popular media, but less research asks nursing students themselves to reflect on this area. DESIGN: Convergent parallel mixed methods. METHODS: Data were collected in 2011 from surveys of 484 undergraduate nursing students at a large university in New South Wales, Australia, that included demographic data, their viewing habits of medical television programmes and their opinions of how the shows handled nursing ethics and professionalism and the image of nursing on television and nursing role models. RESULTS: Most students watch medical television programmes. Students who do not speak English at home watched fewer programmes but were more positive about the depictions of professionalism. The qualitative data showed students were concerned that television can have a negative influence on the image of nursing, but they also recognized some educational and recruitment value in television programmes. CONCLUSIONS: It is important for nurses, educators and students to be critically engaged with the image of their profession in society. There is value in engaging more closely with contemporary media portrayals of nursing for students and educators alike.
Abstract: Abstract This paper arises from the analysis of data from a large Singapore-based survey and a complementary qualitative series of 17 individual interviews. Some results from both arms of the research have been previously analysed and are reported elsewhere. Answers to a series of questions within the questionnaire and the structured interviews have been drawn together under the umbrella of investigating of recent Singaporean graduates' views about the characteristics of a good nurse, a good day at work, and how they uphold ethical standards. Overall five themes emerged, these are: caring for others; respectful interpersonal interaction; rational clinical decision-making; the harsh reality of the workplace; and personal qualities (not easily influenced by formal education). Interviewees believed that potential nursing students should be made aware of the harsh realities they will face on graduation, which may seem counter-intuitive. However, graduates recalled their own struggles and perseverance and toughness to simply survive the early months as a key component of transition shock, indicating that an earlier awareness may be beneficial.
Abstract: As health professionals, nurses are responsible for staying abreast of current professional knowledge and managing their own career, professional growth and development, and ideally, practices to support these activities should start during their student years. Interest in electronic or eportfolios is gathering momentum as educationalists explore their potential as a strategy for fostering lifelong learning and enhancing on-going personal and professional development. In this paper, we present an overview of e-portfolios and their application to nurse education, highlighting potential benefits and considerations of useage. We argue that the e-portfolio can represent an authentic means of assessing cognitive, reflective and affective skills. Furthermore, the e-portfolio provides a means through which nurses can record and provide evidence of skills, achievements, experience, professional development and on-going learning, not only for themselves, but for the information and scrutiny of registration boards, employers, managers and peers.
Abstract: Abstract Nurses and midwives commonly face a variety of challenges and difficulties in their everyday work. Stress, pressure, fatigue and anxiety are acknowledged sources of workplace adversity, which causes decreased perceptions of health and wellbeing. This study reports the effects of a work-based, educational intervention to promote personal resilience in a group of fourteen nurses and midwives working in a busy clinical environment. The intervention encouraged participants to focus on the key characteristics of a resilient person and the elements that assisted them in their maintenance of personal resilience. The intervention also explored potential strategies for the future. Opportunities were provided for experiential learning, creative self-expression and exposure to new ideas. Primary effects of the intervention were found to benefit the participants in personal and professional areas; by enhanced confidence, self-awareness, assertiveness and self-care. This intervention had implications for the education and practice of nurses and midwives in terms of building and maintaining their personal resilience, especially those exposed to workplace adversity.
Abstract: To describe the challenges related to being an 'insider' researcher in a study that uses a feminist-informed storytelling research design and to discuss practical strategies to manage these challenges.
Abstract: There is a scarcity of research published on clinical scholarship. Much of the conceptualisation has been conducted in the academy. Nurse academics espouse that the practice of nursing must be built within a framework of clinical scholarship. A key concept of clinical scholarship emerging from discussions in the literature is that it is an essential component of enabling evidence--based nursing and the development of best practice standards to provide for the needs of patients/clients. However, there is no comprehensive definition of clinical scholarship from the practicing nurses. The aim of this study was to contribute to this definitional discussion on the nature of clinical scholarship in nursing.
Abstract: Abstract The performance-driven culture of universities challenges faculty to meet workplace expectations. In this paper, we draw on the literature to identify key aspects of, and requirements for, promoting integrity in the academic workplace. Integrity is a crucial personal characteristic that can exert a powerful influence in any setting. Any threat to integrity in the workplace can result in a toxic and corrupt environment that may be deleterious to faculty and students. Such an environment can act to prevent faculty from speaking up about ethical issues or workplace concerns, which can result in failure to identify areas for improvement, continuation of suboptimal practices, and problematic professional relationships. The aim of this paper, therefore, is to present an overview of the concept of integrity in the academic workforce and to discuss some of the issues and dimensions, in the hope of creating greater awareness. This is essential if health professional faculties are to recruit and retain staff and create optimal working environments conducive to facilitating high quality outcomes.
Abstract: Abstract Nurses have a crucial role in play in supporting parents and in delivering and referring parents to family-support services. In this editorial, we reflect on papers recently published in Contemporary Nurse. We sought to consider data-based papers on parenting published between 2008 and 2012 and elucidate the role/s and potential roles of nurses in enhancing and supporting parenting. Parenting is recognised as a crucial variable for achieving positive outcomes for children (Dawson et al 2012). Poor, inconsistent or abusive parenting is linked to poor outcomes (Griffin et al. 2000, Holt et al.2008, Patterson et al.1989), while consistent and effective parenting is associated with enhanced child outcomes (Lamb 2012, Landry et al.2001). In addition to being important to outcomes for children, perceived parenting quality is also important to parents themselves. Disrupted relationships between parents and their children have been identified as distressing and potentially damaging to both parties (Jackson 2000; East 2006, 2007; Power 2012).
Abstract: Lesbian mothers share mainstream existence with other mothers by virtue of their motherhood, but remain marginalised by their non-heterosexual identity. This paper will draw on the qualitative findings of a recent Australian study that examined the experiences of lesbian mothers. Using a story-sharing method, data were collected using three methods; a demographic data sheet, in-depth semi-structured interviews and journaling. The findings demonstrated that participants experienced various forms of homophobia when interfacing with healthcare services and providers and included exclusion, heterosexual assumption, inappropriate questioning and refusal of services. Strategies used to avoid homophobia included screening and crusading.
Abstract: Foster carers have a significant responsibility in caring for vulnerable children. In order to support and facilitate foster carers it is important to understand how they perceive and fulfil this responsibility. A qualitative story-telling study, informed by feminist perspectives, was used to conduct in-depth, semi-structured interviews with 20 women providing long-term foster care in Australia. Thematic analysis revealed these women characterised themselves as mothers, rather than paid carers, to the long-term foster children in their care. Using this maternal self-perception as the starting point, this paper reveals some of the challenges and difficulties participants encountered when mothering within the confines of the child protection system. Implications for nursing practice are discussed. These implications focus on ways that nurses can effectively support foster carers, thus optimising the health and well-being of the vulnerable children in their care.
Abstract: Abstract Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.
Abstract: Relatively little is known about the experiences of those bereaved by suicide, particularly in the weeks leading to the death of a loved one. This study used a qualitative methodology to explore the perspectives of close survivors of a completed suicide. Ten people who were bereaved by suicide participated in face-to-face interviews that were digitally recorded, transcribed verbatim, and thematically analysed. Analysis revealed the following three themes: He Tried to Hang Himself: Purposeful indications of the intent to end life; They Still Ignored It: Disappointment with health services; and Nobody Talked to Me: Exclusion of family members from treatment information. Prior to the suicide of their loved one, participants had identified that the loved one was at risk and perceived they were unable to acquire appropriate assistance from services. Rather, services were perceived by participants as unsupportive and inadequate. Health and social service professionals could benefit from further specialised education concerning suicide and its sequelae to ensure more effective and sensitive care delivery to suicide survivors.
Abstract: BACKGROUND: Clinical scholarship has been conceptualised and theorised in the nursing literature for over 30 years but no research has captured nurses' clinicians' views on how it differs or is the same as clinical expertise and clinical leadership. The aim of this study was to determine clinical nurses' understanding of the differences and similarities between the clinical expert, clinical leader and clinical scholar. METHODS: A descriptive interpretative qualitative approach using semi-structured interviews with 18 practising nurses from Australia, Canada and England. The audio-taped interviews were transcribed and the text coded for emerging themes. The themes were sorted into categories of clinical expert, clinical leader and clinical scholarship as described by the participants. These themes were then compared and contrasted and the essential elements that characterise the nursing roles of the clinical expert, clinical leader and clinical scholar were identified. RESULTS: Clinical experts were seen as linking knowledge to practice with some displaying clinical leadership and scholarship. Clinical leadership is seen as a positional construct with a management emphasis. For the clinical scholar they linked theory and practice and encouraged research and dissemination of knowledge. CONCLUSION: There are distinct markers for the roles of clinical expert, clinical leader and clinical scholar. Nurses working in one or more of these roles need to work together to improve patient care. An 'ideal nurse' may be a blending of all three constructs. As nursing is a practice discipline its scholarship should be predominantly based on clinical scholarship. Nurses need to be encouraged to go beyond their roles as clinical leaders and experts to use their position to challenge and change through the propagation of knowledge to their community.
Abstract: Homeless youth are a growing, vulnerable population with specific primary health care (PHC) requirements. There are no systematic reviews of evidence to guide the delivery of PHC interventions to best address the needs of homeless youth in Australia. We present a narrative synthesis of peer reviewed research designed to determine: (1) the PHC services homeless youth access; (2) experiences of services, reported outcomes and barriers to use; and, (3) the PHC service needs of homeless youth. Findings show that homeless youth access a variety of services and delivery approaches. Increased PHC use is associated with youth who recognise they need help. Street-based clinic linked services and therapy and case management alongside improved housing can positively impact upon mental health and substance use outcomes. Barriers to service use include knowledge; provider attitudes, financial constraints and inappropriate environments. Findings support targetted, co-ordinated networks of PHC and housing services with nurses working alongside community workers.
Abstract: AIMS AND OBJECTIVES: To assess recent nurse graduates of a large university and seeks their views of university preparation, requisite nursing skills and qualities, workplace transition, supports received, nurse leadership and role models, and career development and retention. BACKGROUND: Concern about attracting and retaining registered nurses is a continuing workforce issue in parts of Asia and throughout the world. DESIGN: Qualitative interviews with recent nursing graduates. METHODS: Seventeen face-to-face interviews took place using a structured schedule of 23 questions. Data were coded and analysed by hand to determine clusters of interest and develop themes. RESULTS: Four broad topics emerged: (1) skills and qualities graduates consider central to nursing; (2) the support they received during the transition from graduate to novice practitioner and that which continues; (3) elements they value in nursing role models and leaders; and (4) the ward characteristics that will encourage them to remain in nursing and develop a career. Interviewees expressed concerns about retention-related issues, making suggestions for improvements. Unique findings focus on the blaming culture that many respondents consider they are working in, and the system whereby they are not free to access postgraduate studies until a specific time frame has elapsed, and when they do pursue further studies, they are bonded to the auspicing hospital/health service. CONCLUSIONS: Responses unique to this research are the explicit concerns about a blaming culture, and complaints about rigid rules (bonding system) that virtually prevent an individual from accessing postgraduate studies independent of the hospital system. Interviewees strongly resent the bonding system that indentures them to that place of work. RELEVANCE TO CLINICAL PRACTICE: Quality health care is dependent on a well-educated, sustainable and skilled nursing workforce. Recognition of the concerns of newly graduated nurses in relation to nursing skill acquisition, workplace support issues and career concerns can assist in ensuring these issues are adequately addressed and in turn contribute to a stronger, more stable and competent nursing workforce.
Abstract: Abstract Nurses and midwives commonly face a variety of challenges and difficulties in their everyday work. Stress, pressure, fatigue and anxiety are acknowledged sources of workplace adversity, which causes decreased perceptions of health and wellbeing. This study reports the effects of a work-based, educational intervention to promote personal resilience in a group of 14 nurses and midwives working in a busy clinical environment. The intervention encouraged participants to focus on the key characteristics of a resilient person and the elements that assisted them in their maintenance of personal resilience. The intervention also explored potential strategies for the future. Opportunities were provided for experiential learning, creative self-expression and exposure to new ideas. Primary effects of the intervention were found to benefit the participants in personal and professional areas; by enhanced confidence, self-awareness, assertiveness and self-care. This intervention had implications for the education and practice of nurses and midwives in terms of building and maintaining their personal resilience, especially those exposed to workplace adversity.
Abstract: Abstract Currently many nursing faculties and schools employ high numbers of sessional teachers to meet the demands of teaching. Sessional teachers are a source for future continuing academic staff; however, there is little exploration on the experiences of sessional teachers as they transition into the full-time nurse academic role. A qualitative study of 14 registered nurse participants used a story-telling approach to explore the experiences of sessional teachers as they transitioned into full-time and continuing academic roles. Findings revealed that participants had only a very limited understanding of the requirements of the academic role when appointed to it. Thematic analysis revealed two major themes. These were: 'Uncertainty: Dealing with role expectation' and 'Mitigating lack of confidence'. The implications of this paper contributes to and enhances knowledge of the transition experiences of sessional teachers and provides new evidence to suggest that adequate support processes are essential for sessional staff transitioning into permanent, full-time academic positions.
Abstract: Effective nurse leadership is positioned as an essential factor in achieving optimal patient outcomes and workplace enhancement. Over the last two decades, writing and research on nursing leadership has been dominated by one conceptual theory, that of transformational leadership. This theoretical framework has provided insight into various leader characteristics, with research findings presented as persuasive evidence. While elsewhere there has been robust debate on the merits of the transformational model of leadership, in the nursing literature, there has been little critical review of the model and the commonly used assessment instruments. In this article, we critically review more than a decade of nursing scholarship on the transformational model of leadership and its empirical evidence. Applying a critical lens to the literature, the conceptual and methodological weaknesses of much nursing research on this topic, we question whether the uncritical adoption of the transformational model has resulted in a limited interpretation of nursing leadership. Given the limitations of the model, we advocate embracing new ways of thinking about nursing leadership.
Abstract: Abstract Lesbian mothers share mainstream existence with other mothers by virtue of their motherhood, but remain marginalised by their non-heterosexual identity. This paper will draw on the qualitative findings of a recent Australian study that examined the experiences of lesbian mothers. Using a story-sharing method, data were collected using three methods; a demographic data sheet, in-depth semi-structured interviews and journaling. The findings demonstrated that participants experienced various forms of homophobia when interfacing with healthcare services and providers and included exclusion, heterosexual assumption, inappropriate questioning and refusal of services. Strategies used to avoid homophobia included screening and crusading.
Abstract: There has been increasing emphasis on evidence-based approaches to improve patient outcomes through rigorous, standardised and well-validated approaches. Clinical guidelines drive this process and are largely developed based on the findings of systematic reviews (SRs). This paper presents a discussion of the SR process in providing decisive information to shape and guide clinical practice, using a purpose-built review database: the Cochrane reviews; and focussing on a highly prevalent medical condition: hypertension.
Abstract: Aim  To illuminate ways that avoidant leadership can be enacted in contemporary clinical settings. Background  Avoidance is identified in relation to laissez-faire leadership and passive avoidant leadership. However, the nature and characteristics of avoidance and how it can be enacted in a clinical environment are not detailed. Methods  This paper applied secondary analysis to data from two qualitative studies. Results  We have identified three forms of avoidant leader response: placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant. Conclusions  Through secondary analysis of two existing sets of data, we have shed new light on avoidant leaderships and how it can be enacted in contemporary clinical settings. Further work needs to be undertaken to better understand this leadership style. Implications for nursing management  We recommend that organizations ensure that all nurse leaders are aware of how best to respond to concerns of wrongdoing and that mechanisms are created to ensure timely feedback is provided about the actions taken.
Abstract: Abstract Currently many nursing faculties and schools employ high numbers of sessional teachers to meet the demands of teaching. Sessional teachers are a source for future continuing academic staff; however, there is little exploration on the experiences of sessional teachers as they transition into the full-time nurse academic role. A qualitative study of 14 Registered nurse participants used a storytelling approach to explore the experiences of sessional teachers as they transitioned into full-time and continuing academic roles. Findings revealed that participants had only a very limited understanding of the requirements of the academic role when appointed to it. Thematic analysis revealed two major themes. These were: 'Uncertainty: Dealing with role expectation', and 'Mitigating lack of confidence'. The implications of this paper contributes to and enhances knowledge of the transition experiences of sessional teachers and provides new evidence to suggest that adequate support processes are essential for sessional staff transitioning into permanent, full-time academic positions.
Abstract: To examine and critique how the phases of the 4D cycle (Discovery, Dream, Design, and Destiny) of appreciative inquiry are implemented in a healthcare context.
Abstract: AIMS: To report observational data collected as part of a multi-phased study examining violence in the health sector. The findings presented detail the nature of verbal abuse experienced by nurses during their everyday interactions with patient, their families, or companions. BACKGROUND: Nurses have unacceptably high levels of exposure to violence, which commonly includes verbal abuse. However, relatively little is known about the nature of verbal abuse against nurses. DESIGN: Observational design. METHODS: During 2010, 1150Â hours of observation resulted in data on 220 patients displaying cues for physical violence and 210 qualitative observational notes. These observational notes constitute the data for this paper and reveal the nature of verbal abuse experienced by nurses in their everyday work. RESULTS: A mosaic of abuse was revealed through three major categories: a discourse of gendered verbal abuse that was largely: sexual; insults, ridicule, and unreasonable demands; and hostility, threats, and menacing language. CONCLUSIONS: For the nurses observed in this study, everyday nursing practice occurred in a backdrop of verbal abuse and hostility, which had a strong theme of gendered and sexualized overtones. We recommend that interventions that target verbal abuse should address the gendered and sexualized nature of the abuse experienced by nurses.
Abstract: Abstract Nurses and midwives commonly face a variety of challenges and difficulties in their everyday work. Stress, pressure, fatigue and anxiety are acknowledged sources of workplace adversity, which causes decreased perceptions of health and wellbeing. This study reports the effects of a work-based, educational intervention to promote personal resilience in a group of fourteen nurses and midwives working in a busy clinical environment. The intervention encouraged participants to focus on the key characteristics of a resilient person and the elements that assisted them in their maintenance of personal resilience. The intervention also explored potential strategies for the future. Opportunities were provided for experiential learning, creative self-expression and exposure to new ideas. Primary effects of the intervention were found to benefit the participants in personal and professional areas; by enhanced confidence, self-awareness, assertiveness and self-care. This intervention had implications for the education and practice of nurses and midwives in terms of building and maintaining their personal resilience, especially those exposed to workplace adversity.
Abstract: Stigma is a powerful social phenomenon with insidious health implications. Understanding stigma as it applies to various populations is imperative for nurses as it enables nurses to enhance individual patient care and nurses are well positioned to influence both social and health care policies which may exacerbate the experience of stigma. This article is a report of a study to explore the experiences of women who provide long-term foster care. Interviews were conducted with 20 women who provided long-term foster care in Australia. Data were coded according to the components of stigma described by Link and Phelan (2001). Findings reveal participants rejected the label of foster carer to avoid the negative stereotype. When unable to conceal their foster carer label, participants experienced social isolation and status loss. Moreover, participants felt marginalized and disempowered within the governing systems.
Abstract: This article synthesises principles and ideas from relevant literature on professional boundaries and applies them to higher education settings with the intention of contributing to contemporary debates on appropriate, respectful, and ethical conduct in academia. This is against a background of structural changes and growing complexity of academic institutions in concert with decreasing adherence to rules of conduct and established privileges historically handed down from traditional universities. The professional and personal conduct of nurse academics is increasingly unfettered in association with 'market' forces and simultaneously more available for scrutiny in association with a greater awareness of and institutionalisation of human rights and protections across all sectors of society.
Abstract: Undergraduate nurses are employed as assistants in nursing (AIN) in inpatient mental health settings; however, there is a paucity of published research exploring registered nurses' (RN) views about the AIN role in these settings. This qualitative study documents the views and experiences of RN working with undergraduate AIN. Fifty structured face-to-face interviews were analysed, and the results are discussed in three sections. The first section outlines RN perceptions of qualities and skills required of AIN in mental health, and the responses primarily focus on communication skills, initiative, and willingness to learn. The second section targets factors in the workplace that might enhance the interest of AIN in a mental health nursing career; the responses emphasize their need to work with experienced staff. The last section outlines RN expectations of AIN, most of which are met and involve physical observations and technical tasks; less fulfilled activities primarily cluster around interactions with patients. Findings highlight the advantages and disadvantages of drawing on undergraduate nursing students as AIN in mental health settings. Communication skills, personal initiative, safety training to prevent violence, and education to increase knowledge and awareness about mental illness, diagnosis, and mental status-related skills were all important concerns articulated by RN.
Abstract: To identify the challenges associated with using journaling as a method of data collection and to offer strategies for effectively managing those challenges.
Abstract: Sexually transmitted infections have long been associated with stigma and stereotypes due to their very nature. Throughout history sexually transmitted infections have been associated with female prostitution and deviant immoral behaviour making women who contract these infections particularly vulnerable to being stigmatised and stereotyped. Although the stigma attached to such infections has previously been documented in the literature, the aim of this research was to gain in depth insight into young Australian women's experiences of having a sexually transmitted infection from a feminist perspective. Findings from this study provide insight into the onerous effects stigma can have on women with these infections and sheds light on how these effects can influence self-perceptions, fear of rejection and feelings of unworthiness. These findings can provide nurses with greater understanding and insight into the effects of stigma on women's experiences of having a sexually transmitted infection. Having this understanding and insight has the potential to promote therapeutic care and minimise the stigma that may be felt among women who have contracted this type of infection.
Abstract: A work-based educational programme was the intervention used in a collective case study aiming to develop, strengthen and maintain personal resilience amongst fourteen nurses and midwives. The participants attended six, monthly workshops and formed a participatory learning group. Post-intervention, participants reported positive personal and professional outcomes, including enhanced self-confidence, self-awareness, communication and conflict resolution skills. They strengthened relationships with their colleagues, enabling them to build helpful support networks in the workplace. The intervention used new and innovative ways of engaging nurses and midwives exhibiting the effects of workplace adversity - fatigue, pressure, stress and emotional labour. Participants were removed from their usual workplace environment and brought together to engage in critical reflection, experiential learning and creativity whilst also learning about the key characteristics and strategies of personal resilience. Participants' experiences and skills were valued and respected; honest airing of the differences within the group regarding common workplace issues and concerns was encouraged. The new contribution of this intervention for nursing and midwifery education was supporting the learning experience with complementary therapies to improve participants' wellbeing and reduce stress.
Abstract: This paper is concerned with the use of published literary autobiographies that contain first-hand accounts of illness narratives, to explore their usefulness as a form of qualitative data to generate knowledge that can inform nursing practice. There is increasing realisation that the experiences of patients and families should be used to guide health care service delivery, and autobiographical accounts are a valuable resource, providing first-hand accounts of the ways illness, disability, and health care, are experienced by patients and their families.
Abstract: The aim of this study is to explore neonatal nurses' perspectives of their role in facilitating family centred care in the neonatal intensive care unit.
Abstract: In workforces that are traditionally mobile and have long lead times for new supply, such as health, effective global indicators of tertiary education are increasingly essential. Difficulties with transportability of qualifications and cross-accreditation are now recognised as key barriers to meeting the rapidly shifting international demands for health care providers. The plethora of mixed education and service arrangements poses challenges for employers and regulators, let alone patients; in determining equivalence of training and competency between individuals, institutions and geographical locations.
Abstract: A wide range of statutory and non-statutory child protection and family support services exist to prevent the occurrence or re-occurrence of maltreatment. They may be oriented towards primary, secondary or tertiary levels of prevention, employ various types of professional and/or paraprofessional workers, and target a diverse range of groups. The purpose of this study was to examine the experiences of parents who were directed by child protection authorities to attend a tertiary level child protection and family enhancement program. In depth unstructured interviews were used to gather data about these parents' experience. Thematic content analysis of these transcripts identified four major themes as follows: 1) It's a good place to be: Participation as an affordable social outlet; 2) Learning about kids: Participation as a source of learning; 3) They are there for me: Participation as a source of practical help and support; and, 4) I am a good mother: Participation as a source of tension and conflict. Participants' perceptions of friendship with workers emerged as the most significant and valued aspect of their experience. These feelings of friendship were tested when staff undertook their mandatory reporting role. Feelings of betrayal arose that challenged the women's previous unconditional feelings of trust, and jeopardized the therapeutic relationships that had been established.
Abstract: Abstract Foster carers have a significant responsibility in caring for vulnerable children. In order to support and facilitate foster carers it is important to understand how they perceive and fulfil this responsibility. A qualitative story-telling study, informed by feminist perspectives, was used to conduct in-depth, semi-structured interviews with twenty women providing long-term foster care in Australia. Thematic analysis revealed these women characterised themselves as mothers, rather than paid carers, to the long-term foster children in their care. Using this maternal self-perception as the starting point, this paper reveals some of the challenges and difficulties participants encountered when mothering within the confines of the child protection system. Implications for nursing practice are discussed. These implications focus on ways that nurses can effectively support foster carers, thus optimising the health and wellbeing of the vulnerable children in their care.
Abstract: Over the past two decades, the number of clinical trials conducted globally has increased thereby increasing demand for nurses working as Clinical Trial Nurses (CTNs), sometimes known as Clinical Research Nurses. The role and professional issues for these nurses in Australia has not been empirically formulated. Sixty-seven clinical trial nurses were surveyed nationally using a modified version of the Clinical Trials Nursing Questionnaire (CTNQ). Findings revealed the complex CTN role can include the coordination of the trials on one or more sites. This involves all domains listed in the questionnaire from protocol development, ethics approval applications, recruitment and consenting of participants in trials, to administering or assisting with treatments within the bounds of their practice code and the evaluation of protocols. Professional issues documented were: being undervalued in the nursing workforce, having no formal educational preparation for the role and minimal recognition in publications emanating from research in which they were involved. These nurses bring their practice knowledge to benefit research outcomes that may contribute to improving patient/client care.
Abstract: Abstract Homeless youth are a growing, vulnerable population with specific primary health care (PHC) requirements. There are no systematic reviews of evidence to guide the delivery of PHC interventions to best address the needs of homeless youth in Australia. We present a narrative synthesis of peer reviewed research designed to determine: 1) the PHC services homeless youth access; 2) experiences of services, reported outcomes and barriers to use; and, 3) the PHC service needs of homeless youth. Findings show that homeless youth access a variety of services and delivery approaches. Increased PHC use is associated with youth who recognise they need help. Street-based clinic linked services and therapy and case management alongside improved housing can positively impact upon mental health and substance use outcomes. Barriers to service use include knowledge; provider attitudes, financial constraints and inappropriate environments. Findings support targeted, co-ordinated networks of PHC and housing services with nurses working alongside community workers.
Abstract: In the present study, we interviewed 40 patients in acute inpatient mental health settings regarding their experience of, and views about, receiving pro re nata (PRN) medication. Patient requests for PRN were primarily to relieve anxiety or to aid sleep, and the majority of the participants (80%) could describe a situation where this medication was very helpful. From the perspective of patients, interactions surrounding the immediate administration of PRN medication were inadequate, in that half of the interviewees were simply told to take the medication, and three-quarters said that, in their experience, formal consent was not commonly sought. Three-quarters of respondents came up with alternatives to PRN, and half wanted more information about the medication itself. These findings could contribute to improved nursing assessment for PRN medication need, administration, and monitoring.
Abstract: To describe the experiences of women who have had an emergency hysterectomy following a severe postpartum haemorrhage and the impact on their early mothering experiences.
Abstract: There is an abundance of literature documenting the shortage of nurse faculty, both in Australia and internationally. This shortage has repercussions for the next generation of nurses, contributes to the overall nursing workforce shortage, and holds implications for the development of nursing research and continued practice development. The literature suggests a multitude of factors contributing to the shortage, including the ageing of current nurse faculty, and an undersupply of doctorally prepared nurses to take their place. To date, most nurse academics come from a clinical background with little preparation for the complex faculty role; despite this there is little exploration of their experiences transitioning to academia. The limited available evidence suggests that this new role may be accompanied by feelings of uncertainty, anxiety and isolation associated with changed responsibilities, an emphasis on scholarly activities and teaching, and the unique culture of the academic environment. The aim of this paper is to provide a critical review of the literature, identify issues relevant to the nurse faculty shortage and provide direction for further research.
Abstract: Abstract A wide range of statutory and non- statutory child protection and family support services exist to prevent the occurrence or re-occurrence of maltreatment. They may be oriented towards primary, secondary or tertiary levels of prevention, employ various types of professional and/or paraprofessional workers, and target a diverse range of groups. The purpose of this study was to examine the experiences of parents who were directed by child protection authorities to attend a tertiary level child protection and family enhancement program. In depth unstructured interviews were used to gather data about these parents experience. Thematic content analysis of these transcripts identified four major themes as follows: 1) It's a good place to be: Participation as an affordable social outlet; 2) Learning about kids: Participation as a source of learning; 3) They are there for me: Participation as a source of practical help and support; and, 4) I am a good mother: Participation as a source of tension and conflict. Participants' perceptions of friendship with workers emerged as the most significant and valued aspect of their experience. These feelings of friendship were tested when staff undertook their mandatory reporting role. Feelings of betrayal arose that challenged the women's previous unconditional feelings of trust, and jeopardized the therapeutic relationships that had been established.
Abstract: Frequently, research and conference papers explore difficult or problematic areas of practice that can inadvertently render daily nursing accomplishments invisible and create the perception of a discipline in crisis. In this qualitative study, we explore the views of registered nurses about achievements in the workplace and good nursing work in an acute inpatient mental health setting in Sydney, Australia. Mental health nurses were asked a series of questions about their experiences and understanding of what constitutes good nursing work as well as their sense of optimism about their work. A total of 40 structured face-to-face interviews were completed. Among the responses to questions about achievements and good nursing practice, five broad themes were identified: i) teamwork; (ii) interpersonal interactions with patients; (iii) providing practical and holistic support to patients; (iv) patients' mental health improvements; and (v) optimism-pessimism continuum. Findings contribute to a discussion of good nursing work in acute mental health settings, as well as self-perceptions of optimism and hopefulness, which are important contributors to positive, supportive health-care settings and patient recovery.
Abstract: Settling in a new country exposes immigrants to various health risk factors, and the existing literature alludes to immigrant women being more vulnerable than men. This article highlights some of the difficulties faced by West African women while settling into life in Australia. A qualitative DESIGN: beginning again and experiencing loneliness and isolation. Participants encountered difficulties in developing social networks and obtaining employment, and as a result, they felt lonely and isolated. Therefore, nurses and health care professionals need to incorporate screening for precursors of emotional and social well-being issues when caring for this population.
Abstract: This paper is a report of a study of sexually active young women's experiences of negotiating condom use both before and after diagnosis of a sexually transmitted infection.
Abstract: Nurses involved in whistleblowing often face economic and emotional retaliation, victimization and abuse. Yet for many nurses, one major part of their whistleblowing experience is the negative impact it has on their families. This paper reports findings from a qualitative study pertaining to the effects of whistleblowing on family life from the perspective of the nurses. Using a narrative inquiry approach, fourteen nurses were interviewed who were directly involved in whistleblowing complaints. Data analysis drew out three themes: strained relationships with family members, dislocation of family life, and exposing family to public scrutiny. The harm caused to the nurses involved in a whistleblowing event is not restricted to one party but to all those involved, as the harrowing experience and its consequences are echoed in the family life as well. It is important for organizations to seek strategies that will minimize the harmful effects on nurses' families during whistleblowing events.
Abstract: Analysis of Australian nursing research output is becoming more important as academic institutions move into implementing quality programs of research output. Notable in determining research quality is the publication of research papers in journals with a high ranking within the Institute for Scientific Information (ISI) or Excellence in Research for Australia (ERA). This paper reports an analysis of Australian nurse researcher output in journals highly ranked by the ISI and ERA. Research abstracts were analysed for topic, sources of data, location of research and methodological paradigm. A total of 530 articles from five Australian and from five USA and UK journals were analysed. There was an increase in output from the period of prior analyses in 2000. Practice issues are the most common topic followed closely by nurse education. While most studies used nurses as sources of data there were more studies in which consumers of nursing care were the point of inquiry. Both qualitative and quantitative methods were utilised. Given the importance of rationalising nursing practice and adding new knowledge to evidence based care, it is imperative for the nursing profession to disseminate research findings. Failure to do this may result in poor return in investment outcomes for the future of nursing in Australia and internationally.
Abstract: This discussion paper argues for the critical importance of successful leadership for effective mental health nursing, observing that nursing leadership has long been regarded problematically by the profession. Using empirical and theoretical evidence we debate what leadership styles and strategies are most likely to result in effective, recovery-orientated mental health nursing. Models of transformational and distributed leadership are found to be highly congruent with mental health nursing values, yet the literature suggests it is a type of leadership more often desired than experienced. We note how the scholarly literature tends to ignore the "elephant in the room" that is organizational power, and we question whether transformational leadership pursued within a specific clinical context can influence beyond those confines. Nevertheless it is within these contexts that consumers experience nursing, effective or otherwise, thus we should advocate what is known about effective leadership wherever it is required.
Abstract: Mid-career students who undertake doctoral studies have often achieved standing and success in their careers and may already hold quite senior leadership positions in the profession. In view of this, mid-career students may struggle with the transition to student, particularly if they have not studied for a number of years and have multiple pressures on their time. Supervisors on the other hand, operate within cultures of performance based indicators, and are under pressure to facilitate timely student completions. While students must take ultimate responsibility for their doctoral work, it is possible for supervisors to identify problems early, and offer practical solutions to assist mid-career students overcome their problems, and facilitate optimal engagement. In this paper we highlight some of the challenges this vulnerable student group can present, and identify some practical strategies supervisors can suggest to assist in the timely and successful completion of doctorate degrees.
Abstract: Attrition from undergraduate nursing programs continues to warrant investigation particularly in the climate of nursing shortages and fiscal reflection on academic institutional programs. This three-year study used a prospective longitudinal survey design to determine entry characteristics of students, attrition, progression and completion in an undergraduate program. Students were surveyed in the first three weeks of commencing their program and gave permission for academic grades to be collected during their six session, three year Bachelor of Nursing program. Of the 740 students enrolled 48% (357 students) were surveyed and 352 students (99%) gave consent for their grades to be collected. One-third of the student cohort graduated in the expected three-year timeframe, one-third had dropped out and one-third was still completing their studies. A higher Grade Point Average and being a native English speaker were most predictive of students completing their course in the minimum expected timeframe.
Abstract: Academic writing skills are essential to the successful completion of preregistration nursing programs, yet the development of such skills is a challenge for many nursing students, particularly those who speak English as a second language (ESL). It is vital to develop and evaluate strategies that can support academic writing skills for ESL nursing students. This qualitative study evaluated a four-day academic writing intervention strategy designed to support ESL first-year nursing students. Data from the program showed two major areas of difficulty for participants relating to academic writing: problems understanding course content in English, and problems expressing their understanding of that content in English. The participants noted a key benefit of this program was the provision of individual feedback. Programs such as this intervention successfully meet the demands of ESL nursing students, although ongoing support is also needed.
Abstract: Commonly, the expression 'PhD' evokes a level of trepidation amongst potential candidates from both the clinical and academic spheres. In contemporary settings, a Doctor of Philosophy is highly regarded and increasingly necessary for a successful academic nursing career. The aim of this paper is to explore the options for doctoral education for nurses, and consider the role of the doctorate in career planning for nursing, and in the attainment of career goals. Here we discuss some key issues and practicalities including career planning, selecting a doctoral program, choosing a university, supervision, committees and panels, achieving a work-life balance and dealing with conflict. The PhD process should be an enriching and satisfying experience which may lead to enhanced professional and personal growth; however, there are potential pitfalls that nurses should be aware of before embarking on doctoral training. Future studies are needed to assess the impact of the different doctorates offered to see if, in fact, they are advancing nursing practice and research endeavours.
Abstract: In contemporary Western society, infertility has the capacity to impact greatly on couples, emotionally and socially. In the face of such infertility, couples are able to seek assisted reproductive technologies to assist in the pursuit of biological parenthood. These technologies are not infallible though, and the likelihood of success remains small. Therefore it is inevitable that some couples will remain childless, and this has been associated with grief and adversity. Findings present the narratives of participant couples' through and beyond the many adversities encountered due to remaining childless despite infertility treatment. Regardless of theories that seek to pathologise couples experiencing this type of adversity, participant couples demonstrated resilience in redirecting their energies into areas of their lives where they could achieve positive outcomes. This research highlights the importance of caring for couples rather than individuals undergoing infertility treatment. It provides support for approaches that foster couples' relationships with the aim of promoting individuals' resilience.
Abstract: Many women privilege the mothering role over other areas of their lives, and for ill women, it can be difficult to relinquish maternal responsibility. Not being able to mother in their usual way can have consequences for women's wellbeing and view of themselves as 'good' mothers.
Abstract: This paper explores the challenges of interviewing people about sensitive topics. It uses existing literature and the first author's experience of interviewing women traumatised by having an emergency hysterectomy following a severe postpartum haemorrhage. It also highlights the strategies that can assist interviews.
Abstract: Sessional teachers are taking an increasing role in classroom teaching in Schools of Nursing. However, there is a paucity of literature reporting the experiences of, and impact on, career academics working with or alongside the burgeoning numbers of sessional teachers. Therefore, the purpose of this paper is to explore the experiences of continuing academics working with sessional teachers. This qualitative study used purposive sampling to recruit nurse academics and collect narrative data related to their experiences of working with sessional teachers. Four major themes emerged from the data, namely: They have got real credibility - perceptions of clinical currency, We've got people who are very good clinically, but don't know how to teach - lacking skills and confidence, No allegiance to the school or the students - perceived lack of commitment and accountability, and A terrible burden - workload implications for continuing academics. The development and implementation of standards for the recruitment and employment of sessional teachers would benefit both continuing academics and sessional teachers, and assist in the delivery of quality teaching and learning to nursing students.
Abstract: This article describes the development and tests the reliability and validity of a new survey instrument, the Child-to-Mother Violence Scale (CMVS). This instrument was devised specifically to measure data regarding the incidence, perpetrators, targets, experiences and influences on child-to-mother violence as the first phase of a larger study that investigated child-to-mother violence in the western suburbs of Sydney, Australia.
Abstract: This paper provides an overview of some challenges facing mental health practice nurses transitioning to academic life, and suggests possible strategies to prevent foreseeable difficulties.
Abstract: Students who transition from high school to college are often excited by the new phase of their lives. However, they are exposed to circumstances and expectations which place them at risk for psychiatric disorders or that may exacerbate pre-existing problems. In this paper, we discuss risk factors and other issues associated with students transitioning to college or university life, identify challenges for health professionals, and suggest possible strategies to improve the mental health of young adults on college campuses. Academic staff and health care providers need to be aware of how best to engage and assist students during an important phase of their life. Processes and care pathways also need to be easily understood, user friendly, and appropriately resourced. It is anticipated that staff, students, and industry health care providers will benefit from a greater awareness of some of the mental health issues that may occur in higher education.
Abstract: In this qualitative study, the experiences of a small cohort of registered nurses (RN) during the first 2 years of mental health employment were documented. A total of 13 semistructured interviews were completed from within a specialist mental health setting. Eleven issues were identified: (i) teamwork; (ii) experiential learning; (iii) self-development; (iv) confidence; (v) listening; (vi) rapport; (vii) keen observation; (viii) patience; (ix) empathy; (x) learning from colleagues; and (xi) maintaining a positive approach towards patients. The nurses focused on the here-and-now circumstances, rather than on future plans, or past preparation, and were able to elucidate the qualities and skills that they brought to their clinical work. Participants were most proud of achievements that bridged the personal and professional, such as self-development, working closely with patients to develop rapport, experiential learning, and teamwork. Findings highlight the importance of teamwork to newly-graduated RN entering the mental health environment. It is known that teamwork can convey a sense of belonging and help create an environment in which applied experiential clinical learning can occur. Therefore, it is important that efforts are made to facilitate team building and opportunities for teamwork when new graduates are transitioning into the mental health clinical practice environment.
Abstract: There is a considerable body of literature scrutinising and theorising negative and hostile behaviour such as violence and interpersonal conflict in the nursing workplace. However, relatively little empirical work has examined the experiences of undergraduate nursing students in the context of negative workplace cultures, and even fewer studies have explored how students develop and enact strategies to counter hostile behaviours in the clinical workplace. Based on qualitative analysis of open-ended survey questions, this study explored undergraduate students' experiences of negative behaviours in the clinical environment to identify strategies used to manage and resist such behaviours. While dominant individuals in the clinical environment sought to enforce and uphold their version of legitimacy--one where students were relegated to complete subordination--the tenacity and resourcefulness of students was evident in their attempts to counter this oppression with acts of resistance. Our findings provide new and valuable insights into organisational aggression and acts of resistance in the nursing workplace. The resistance offered by these students draws attention to the struggles for legitimacy within institutions. In drawing attention to organisational aggression as a mechanism by which students are 'othered' through pejorative behaviour, homogenisation, and de-authentication, and the dynamics of resistance offered by these student nurses, we provide an alternative explanation of nursing socialisation.
Abstract: This paper reports a study which evaluated a brief, embedded academic support workshop as a strategy for improving academic writing skills in first-year nursing students with low-to-medium English language proficiency.
Abstract: The aim of this study was to generate insight into younger women's experiences of recovery from breast cancer-related breast surgery and to contribute to the knowledge base for clinicians practising in this field.
Abstract: This paper reports the benefits and challenges of a mentoring programme through which retired and senior nurses continued to support and nurture nurses and midwives currently working in the health system.
Abstract: This paper is a report of a study conducted to explore the reasons behind the decision to blow the whistle and provide insights into nurses' experiences of being whistleblowers.
Abstract: Violence against nurses is an on-going issue in healthcare settings, and is regularly documented in the literature. Assessing the potential for violence against nurses in the emergency department is essential to maintain their safety. The aim of this study was to develop a violence assessment tool by refining a list of predictive cues identified from both a previous study and existing literature. Using the Delphi technique, a panel of 11 expert nurse academics and clinicians developed a 37-item questionnaire and used three rounds of Delphi to refine the violence assessment questionnaire. The resulting tool comprises 17 cues of potential violence that can be easily observed and requires no prior knowledge of the perpetrators' medical history.
Abstract: Heavy, pressured workloads are a feature of health workplaces internationally, presenting challenges to communication and contributing to tension and negative emotions. This paper explores supportive and unsupportive workplace conversations between nurses and midwives and their colleagues. The findings focus on qualitative interviews of ten nurses and midwives that were audio-taped and analysed for perceptions about the role of workplace conversations. Conversations between colleagues were significant for building and maintaining collaborative capital, but unsupportive conversations also threatened it. Findings suggest the need for considering the impact of co-worker conversations on workplace culture. Nurse managers and management may play a pivotal role in establishing and maintaining supportive conversations. Recognising the role and potential of workplace conversations for building capacities for support, conflict resolution, job satisfaction and the personal resilience of nurses and midwives can raise the collaborative capital of the workplace.
Abstract: This paper is a report of a literature review of qualitative empirical research investigating women's experiences of mothering disrupted by illness.
Abstract: To evaluate nurses' knowledge of adolescent sleep and sleep disturbance and the strategies they employ to facilitate sleep in adolescent patients.
Abstract: Stories convey values and emotions, and can reveal the differences and similarities between people's experiences. Elucidating personal stories involves sharing which can help form bonds and supportive networks. With reflection, these can help to develop resilience. While the literature recognises the potential cathartic and therapeutic benefits associated with storytelling in research, links between the development of personal resilience and storytelling for research purposes have not been drawn. This paper argues that storytelling aids the development of personal resilience and provides opportunities to celebrate the hardiness of research participants who contribute to knowledge by recounting their stories of difficulty and adversity.
Abstract: Internationally, nursing faculty shortages have been reported and there is a potential for them to worsen into the next decade as existing faculty age. To, in part, address this issue, across disciplines there is clearly an international trend towards the increasing casualisation of the higher education workforce. Despite the potential impact of this two-tiered workforce structure, there has been limited examination of the discipline specific issues related to the employment of a growing number of sessional nursing staff. This paper provides a critical review of the literature related to the employment of sessional teachers in higher education. The paper advances the discourse around the role and implications of employing sessional teachers in undergraduate nursing schools. Recommendations for supporting sessional staff and further research are presented.
Abstract: This paper reports a study aiming to present and describe the effects of whistleblowing episodes on nurses' workplace relationships. Eighteen participants with direct experience of whistleblowing were recruited into the study, which was informed by a qualitative narrative inquiry design. Findings were clustered into four main themes, namely: Leaving and returning to work-The staff don't like you; Spoiled collegial relationships-Barriers between me and my colleagues; Bullying and excluding-They've just closed ranks; and, Damaged inter-professional relationships-I did lose trust in doctors after that. Findings suggest a need to facilitate a climate in which it is safe for nurses (and others) to raise concerns about patient care or organisational wrongdoing, and to eliminate the existing belief that whistleblowing is a negative act fuelled by revenge or sedition.
Abstract: Casualisation of the academic workforce has resulted in an increase in the employment of sessional teachers in Bachelor of Nursing (BN) programs. Many of these teachers are drawn from specialty clinical areas and continue to work clinically while teaching part-time. The aim of this study was to explore the perceptions of sessional teachers about their perceived contribution to an undergraduate Bachelor of Nursing program in a single Australian university. Twelve sessional teachers participated in semi-structured interviews as part of a larger mixed method study exploring the issues related to sessional teaching in the Bachelor of Nursing program. Three themes emerged from the data; (1) "Bringing 'reality' to the classroom", (2) "Privileging experiential knowledge", and (3) "Establishing boundaries with students". Underpinning the narratives was a strong subtext related to the theory-practice gap. Proactive strategies to facilitate the potential of sessional staff are articulated in the paper.
Abstract: In this article, we identify key aspects for enhancing real-world research in mental health care clinical settings and broadly discuss some practicalities and issues that must be considered beforehand.
Abstract: The purpose of the study was to explore the issues surrounding chronic hepatitis C, combination therapy and its impact on personal relationships to enhance understanding of the experiences of patients living with hepatitis C. This paper focuses on the experiences of the patients and their partners' experiences will be published separately.
Abstract: The aim of this review was to explore the literature to determine what is known about adolescent sleep, the causes and consequences of disturbed sleep in adolescence and the implications this has for nursing practice.
Abstract: Violence towards nurses in Emergency Department's is a world wide problem that some contend is increasing in severity and frequency, despite the many strategies implemented to prevent violent events. This paper presents the findings of an instrumental case study in a busy rural Emergency Department. Twenty Registered Nurses participated in the study and data from 16 unstructured interviews, 13 semi-structured field interviews, and 290 h of participant observation were thematically analysed. In addition, 16 violent events were observed, recorded via a structured observation tool and analysed using frequency counts. Thematically there were five attributes rural emergency nurses were observed to use to avert, reduce and prevent violence. The five attributes were being safe, being available, being respectful, being supportive and being responsive. We argue that these attributes were embodied in the emergency nurses routine practice and their conceptualization of caring.
Abstract: This paper is a report of a study to explore the perceptions and experiences of mothers parenting a child with attention deficit hyperactivity disorder.
Abstract: Up to 40 percent of adolescents experience some form of sleep difficulty, with adolescent girls often reporting higher levels of sleep disturbance and daytime fatigue than boys. This article explores the literature surrounding female adolescent sleep disturbance. The findings reveal that sleep problems in young women can be linked to girls being at an increased risk for puberty-related fatigue, sexual abuse, a higher prevalence of mental illness and sensitivity to familial disruption, and increased domestic and grooming expectations. Implications for nursing practice include initiating conversations about sleep, sleep disturbance and sleeping arrangements when working with adolescent girls. Nurses should gather accurate sleep histories, provide adolescent girls and their caregivers with information and recommend interventions to improve sleep if necessary. Nurses should remain sensitive to the confounding effects of pubertal status, menarche and the cyclic release of hormones when designing and conducting future research into female adolescent sleep disturbance.
Abstract: This study aimed to build understandings of women's recovery experiences in the presence of continued pelvic problems extending beyond the puerperium to provide nurses and other health care professionals with information to enhance current practice.
Abstract: Increasing numbers of nurses seek to undertake doctoral education as nursing continues to develop as a discrete area of clinical and theoretical scholarship. Effective supervision is a crucial aspect of doctoral education and has been identified as essential to successful completion of doctoral training. Relatively little, however, is written about the relationship aspects of doctoral supervision in nursing. This paper presents some reflections on doctoral education in nursing from the perspective of four people who have established intergenerational supervisory relationships.
Abstract: Mentoring relationships occur across a range of nursing contexts and are shown to have multiple, favourable personal and professional outcomes. Specifically, mentoring has been associated with the development of nurse leaders. This study describes features that are integral to initiating mentoring relationships that focus on nursing leader development. These significant features are addressed in relation to the nursing literature. Thirteen nurse leaders from eastern states of Australia were interviewed during 2005 and 2006 about their understanding and experiences of mentoring for leadership. Their narratives were analysed using a hermeneutic phenomenological methodology. Mentoring relationships for nurse leadership were revealed as developing from esteemed connections between two people. Mentors were shown to unconditionally champion their mentee's careers, and mentees were shown to possess a leadership vision for nursing. The findings of this study have implications for establishing mentoring relationships for nurse leader development. Consideration should be given to the specific focus and context of these relationships to ensure that the full potential of the mentoring process is realised. It is also important to better understand the key aspects that contribute to the phases of mentoring relationships for nurse leader development because they are shown to influence the dynamic and function of these relationships over time.
Abstract: There is an increasing expectation that academic and clinical nurses will contribute to disciplinary and professional discourses through scholarly writing. However, the difficulties and challenges associated with writing for publication mean that many papers will never be written. This current paper describes an innovative approach developed to support skill development and outcomes in writing for publication. Intensive residential writing retreats informed by the principles of servant leadership and incorporating strategies such as mentoring and peer learning were conducted in 2005 and 2007. Positive outcomes and benefits included publications submitted to peer-reviewed journals, as well as positive effects on collegial relationships, and team building. Novice writers benefited from intensive and sustained support and coaching by experienced writers. Organisational benefits included increased participation by staff and research higher degree students in publication activities, enhanced collegial relationships and opportunities for senior established writers to work with inexperienced writers.
Abstract: The aim of this paper is to explore maternal views and experiences of stimulant pharmacotherapy in children with attention deficit hyperactivity disorder (ADHD).
Abstract: The Australian nursing workforce is ageing and there is a well-documented shortage of nurses. This global phenomenon means that retaining nurses in the workforce is gaining in importance as older nurses retire and leave nursing. The existing literature reveals deficiencies in knowledge about older nurses as they adapt to ageing often within stressful work environments. The aim of this narrative-based study, informed by feminist principles, was to explore the views and experiences of female registered nurses aged 40-60 years, in acute hospital and community health care settings. In-depth semi-structured interviews of approximately 1 h duration were gathered during late 2004. The transcribed narratives were subjected to thematic analysis. Two major themes were identified. The first theme: "Feeling uncared for" contained three sub-themes--Unsupportive work relationships: "We should be helping each other"; Workplace bullying: "It hurts me and I feel really bad"; and, Stress and burnout: "It's just like being in a pressure cooker all the time". The second major theme identified was "Adapting to ageing: my nursing career". Findings of this research suggest some unmet support needs for older nurses in the workforce which could discourage them from remaining in nursing. The findings highlight a need for further research into the support needs of older nurses.
Abstract: Providing a safe work environment where nurses can practice without fear or threat of aggression is acknowledged as a critical global issue for healthcare organizations. Although there has been growing recognition that workplace bullying is one of the most concerning forms of aggression experienced by nurses, to date, there has been little progress in developing explanatory models. In this article, we outline our recently validated model of bullying, which specifies organizational characteristics as critical antecedents. The model has important implications for the management of bullying, identifying that to be effective, interventions need to address features of workplace climate.
Abstract: This paper aims to report lifestyle factors of Asian Indians in Australia in relation to coronary heart disease. This issue has not been previously explored in the Australian context. This study also seeks to identify factors that could inform health education and rehabilitation programs for migrant Asian Indians in Australia. The qualitative descriptive approach of constructivism was used for this study. Semi-structured, in-depth conversations were conducted with eight patients and five family members. Participants were at risk for coronary heart disease either due to unhealthy diet and/or lack of physical exercise and irregular health checks. Although lifestyle modifications were implemented by participants after the cardiac event; these changes were implemented inconsistently and without continuity. Knowledge of the beneficial effects of a healthy diet did not deter the participants from continuing to follow unhealthy dietary habits. The introduction of any exercise or physical activity by participants in this study lacked consistency. A positive aspect revealed from this study was the influence of culture and religious faith, which helped patients and family members to cope with the illness trajectory. The results of this study suggest that health education and rehabilitation programs need to be designed specifically for this high-risk group would be beneficial when initiated early in life and need to be targeted to the individual.
Abstract: The purpose of the study was to explore the meaning(s) that emergency department nurses ascribe to acts of violence from patients, their family and friends and what impact these meaning(s) have upon how they respond to such acts.
Abstract: This paper is a report of a study of the health and ageing concerns and self-care strategies of older female Registered Nurses currently working in direct care-giving roles in acute public hospitals and community facilities.
Abstract: Marie Hutchinson, Lesley Wilkes, Margaret Vickers and Debra Jackson describe an Australian study of bullying that provides a putative model for further testing in nursing and other contexts.
Abstract: This paper is a report of a study to describe residential aged care nurses' and care assistants' perceptions of a multi-faceted palliative care intervention to identify potential areas to be addressed during subsequent action research phases.
Abstract: In the current professional climate, research activities are highly valued with nurses in all sectors actively encouraged to participate. However, working environments for many nurses are such that it can be difficult to privilege research activities in any sustained way. A number of organisational challenges coalesce to impede participation in research activities, including limited resources, lack of skills, knowledge and opportunities, and a culture of individualism. Strong, effective research leadership is essential to help mediate some of these negative aspects of organisational life, and promote creative environments to facilitate the development of research capacity. Servant leadership is a service-oriented approach that focuses on valuing and developing people, and offers a participatory and collaborative framework within which to build creative and productive research communities. Such communities can encourage connectedness between people, deepen the capacity for supportive collegiality, and foster a holistic social learning milieu to support researchers of all levels, including early career researchers and research higher degree candidates.
Abstract: The recent wave of immigrants to Australia includes people from countries where female genital mutilation (FGM) is predominant. FGM is the terminology used by the World Health Organisation to describe all procedures involving partial or total removal of female external genitalia. A review of the literature has found that FGM still exists and the influx of immigrants to Western countries such as Australia has seen more women in these countries with the physical and psychological after-effects of the procedure. Findings of this literature review highlight the need for heightened awareness of issues around FGM so as to better provide adequate physical and psychological support to women affected by FGM.
Abstract: Father absence is associated with negative child and adolescent outcomes, including early sexual activity, teenage pregnancy, behavioural difficulties and life adversity. However there is a lack of literature that explores the lived experiences of daughters who grew up in father absent environments. This study aimed to generate insights into the lived experience of being a girl-child growing up in a father absent environment through the perspectives of daughters who experienced father absence during their childhood and/or adolescent years.
Abstract: This paper is a report of a literature review to explore the concept of personal resilience as a strategy for responding to workplace adversity and to identify strategies to enhance personal resilience in nurses.
Abstract: New reproductive technologies have the capacity to impact on both personal and healthcare relationships. This article utilizes a case study approach to unpack experiences of one couple who encountered immense and unforeseen difficulties as a result of treatment with assisted reproductive technology. Findings of this case reveal both difficulties and breaches in obtaining informed consent and the consequences these breaches have on relationships. Comprehensive information contributes to positive relationships between patients and healthcare providers. Maintaining supportive relationships between all parties concerned with assisted reproductive technology services is essential, as rifts in these relationships can be devastating and long-lasting.
Abstract: This paper reports the findings of a qualitative study that used a hermeneutic phenomenological methodology to develop insights into the experience of parents of young people who engage in self-harming behaviour. Six mothers (and one father who accompanied his wife) participated in the study. Findings reveal that mothers experienced guilt and shame, and that these feelings shaped their reactions and responses. These mothers described experiencing emotional dilemmas, such as the degree to which they could be responsible, uncertainty about how to understand self harm, and the best course of action to take with their child. They also encountered difficulties in combating the negative emotional effects for themselves and other family members. Findings provide insights that can help nurses and family health workers to understand and assist parents with greater effectiveness; by maintaining a non-judgemental stance, acknowledging the difficulties of their experiences, encouraging confidence in their parenting abilities, and promoting effective stress management strategies.
Abstract: Overweight and obesity in children is a major and ongoing public health concern and the negative physical, social, and psychological sequelae of childhood obesity are well documented. Parents, particularly mothers, are implicated in discourses around childhood obesity; however, little is known about women's experiences of mothering an overweight or obese child. This article reports findings from a narrative-based study that sought to develop understandings into women's experiences of mothering an overweight or obese child. The findings provide insights into the experiences of mothering an overweight or obese child, and reveals how the climate of blame associated with mothering an overweight or obese child complicated the mothering experience for the women in this study. These insights can assist health, welfare and child care workers to understand the importance of establishing supportive and no-blame relationships with mothers of obese and overweight children, in order to develop supportive therapeutic alliances better.
Abstract: Drug or substance abuse by adolescents continues to have a major impact on the health and well-being of young people and poses a serious management problem for health workers. While the majority of the problems surrounding adolescent substance abuse rest on the parents, little is actually known about their experiences. This study aimed to describe and construct an interpretation of the lived experiences of parenting an adolescent who abuses illicit substances. A qualitative approach, underpinned by the tenets of phenomenology, was used to conduct in-depth interviews with 18 parents. Thematic analysis revealed eight themes: confronting the lies, deceit, and suspicion; struggling to set limits; dealing with the consequences; living with the blame and the shame; trying to keep the child safe; grieving the child that was; living with the guilt; and choosing self-preservation. The results indicate that parents struggle to manage the problem, are left to deal with the consequences of the behaviour with little support, and are constantly looking for answers to the questions raised by the problem.
Abstract: This paper is a report of a longitudinal study to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership by exploring the experiences of the nurse leaders of nine Australian units as they attempted to develop their existing wards or units into recognized centres of nursing excellence.
Abstract: Mental health nursing in remote Australian Aboriginal communities provides opportunities and challenges unique from other experiences of nursing. The purpose of this article was to explore how mental health nurses experience working in remote communities and how they developed relevant knowledge and skills. Six remote area mental health nurses participated in audiotaped conversational style interviews. Narratives were transcribed and analyzed thematically. Themes identified were being focused on relationships, adapting to the culture, struggling with two contexts, being enraptured by place, and being transformed. The participants adapted and developed ways of working at the interface of another culture and also derived personal and professional benefit from the experience.
Abstract: This paper is the report of a study to explicate the components of observable behaviour that indicate a potential for violence in patients, their family and friends when presenting at an emergency department.
Abstract: Rapid social change has seen increasing numbers of woman-headed single-parent families, meaning that more and more children are growing up without a father resident in the home. Father absence is a term that is not well defined and much of the literature does not discriminate between father absence due to death, parental relationship discord or other causes. This article presents a critical review of the extant literature on father absence, particularly as it relates to adolescent well-being and development. Findings from the literature point to the importance of father presence in children's lives and suggest that father absence has ramifications for children and adolescents. The conclusions drawn from this literature review suggest that father absence and its effects on children and families is an area for further research, with the view of developing strategies to ameliorate the impact of father absence on children and adolescents.
Abstract: Drug use in young people has serious ramifications for health and well-being of young people and their families and continues to be an area of major concern for health workers. Though the task of dealing with drug-related problems falls on families, particularly parents, very little literature has explored parental experiences of managing drug use within the context of family life. Eighteen parents of drug-abusing young people were recruited into this qualitative study that aimed to develop understandings into the effects of adolescent drug use on family life. Findings revealed that the experience of having a drug-abusing adolescent family member had a profound effect on other members of the immediate family. Family relationships were fractured and split as a result of the on-going destructive and damaging behaviour of the drug-abusing young person. Five themes were identified that captured the concept of fractured families. These are: betrayal and loss of trust: 'You had to have the doors locked'; abuse, threats and violence: 'there were holes in the wall'; sibling anger and resentment: 'Better off now with him gone'; isolated, disgraced and humiliated: 'You are on your own with it'; and, feeling blamed: 'You are not a good parent'. Implications for practice and further research are drawn from the findings of this paper.
Abstract: Changes in family structures have resulted in many children growing up in non-traditional families, where their father is not resident in the family home. Father absence that occurs as a result of the breakdown of the parental relationship is associated with life adversity and less than optimal outcomes for children and adolescents. However, little research exists that explores this phenomenon from the perspective of the father absent young person. This phenomenological study was conducted in 2005 and aimed to explore women's perceptions about relationships with their fathers within the context of a father absent childhood. Nine women participated in this study. Findings revealed that growing up without their father present in the family home disrupted the relationship these daughters held with their fathers. Due to the perceived lack of interest these daughters felt from their fathers, they expressed feelings of hurt and diminished respect for their fathers. Furthermore, participants felt that their fathers were unable to provide them with the father-daughter relationship that they sought. The findings of this paper provide insights that can help nurses and other healthcare professionals to recognise the emotional impact that father absence can have on young women. Findings suggest a need for further research to gain greater insights into the experiences of family members who undergo disruption of relationships due to family breakdown.
Abstract: There are a variety of structured and unstructured supportive relationships available to nurses. Internationally, nurses commonly use preceptorship, clinical supervision, and mentorship to meet distinct needs and provide differing levels of commitment, intensity, and enabling functions. Of particular interest to the nursing profession is the use of mentoring relationships to support nurses in achieving leadership positions. In Australia, preceptorship and clinical supervision are freely used and understood by nurses however, mentoring relationships are less readily applied, and agreed meanings and understanding are lacking. This paper will explore the range of supportive relationships available to nurses. The terms used to define and describe these relationships, and how these relationships are contextualised, will be explored in order to better understand the position of mentorship for nurses in Australia. The potential value of mentorship in developing nursing leadership in Australia will also be identified.
Abstract: This paper grew from a series of conversations about the challenges associated with clinical education for undergraduate nurses. In it we consider clinical education for undergraduate nurses within the current context of increasing resource and industry constraints. Beginning level clinical competence is the major aim of undergraduate nurse education, and therefore clinical education is central to nursing curricula. However, almost 20 years after the transfer of nurse education to the tertiary sector in New South Wales, Australia, concerns about the clinical learning opportunities in undergraduate nursing curricula continue to be raised. Many educational providers have adopted various permeations of the sessional clinical facilitator model. However, this model has inherent problems that threaten its sustainability and usefulness for undergraduate nurse education. We call upon the discipline to explore alternative pathways for undergraduate clinical education, and present sustainable options for future development in this area.
Abstract: The success of biotechnology has created moral and ethical dilemmas concerning end-of-life care in the Intensive Care Unit (ICU). Whilst the competent individual has the right to refuse or embrace treatment, ICU patients are rarely able to exercise this right. Thus, decision-making is left to medical professionals and family/significant others.
Abstract: Mother blaming has been identified as a pervasive and serious problem and it is known that the professional literature has strong and entrenched mother-blaming messages. Using a feminist approach, this paper explores mother blaming as it has been experienced by a group of mothers themselves. Analysis of narrative exposes mother blaming as a burden that complicates the already-complex responsibilities that comprise mothering. Health providers are among those identified by women as being particularly likely to attribute problems with (even grown) children to maternal fault. Implications for practice and research are drawn from the findings of this paper.
Abstract: A literature review utilising literary databases, World Wide Web and hand checking of written articles was conducted to determine the magnitude of the problem of coronary heart disease (CHD) in Indians with a particular emphasis on those in Australia. Health care professionals need to be aware that Indians have a higher than average risk of CHD at an earlier age and poorer survival and this is impacted on by genetic, social and cultural factors. The experiences of Indians with CHD needs to be researched so that prevention and rehabilitation programs can be individualised for this well developed community group in Australia.
Abstract: Coronary heart disease (CHD) is one of the main causes of death and disability in the Aboriginal population, and is the major cause of the twenty-year gap in life expectancy of Aboriginal and non-Aboriginal Australians. This paper explores Aboriginal health in relation to CHD, and suggests self-management as a culturally acceptable therapeutic and sustainable ideology from which positive outcomes may be achieved.
