Judy Mannix

Abstract: Since the transfer in Australia of preparatory nurse education from the hospital to the university sector, debate and discussion have continued regarding the perceived benefits and failings of the current system. In this paper we consider issues related to student clinical practicum from the perspectives of the student learner, the educational provider, the health service sector, the health consumer and the profession as a whole. The aim of this paper is to generate further discussion about clinical learning, a critical component of undergraduate nursing education. We argue that all stakeholders have a role to play in contributing to optimising all the clinical learning experiences for students in Bachelor of Nursing programs -- the professional nurses of the future.

Abstract: AIM: 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. BACKGROUND: Nursing is a rapidly ageing, and female-dominated workforce. However, despite the ageing of the nursing workforce, little is known about the needs and health concerns of older nurses. METHOD: A feminist perspective was used and 12 female Registered Nurses aged 40-60 years, employed in various acute hospital and community health settings in Australia took part in qualitative interviews in late 2004. Narratives were audio taped, transcribed and analysed thematically. FINDINGS: Two major themes were identified. The first theme -Aches and pains of ageing- had four subthemes: Neglecting self: 'You don't think of yourself first'; Physical changes: 'The body is wearing out'; Living with pain: 'You just work around it'; and Tiredness: 'I'm just tired all the time'. The second theme -Evolving lifestyles: works in progress - had three subthemes: The power of exercise: 'I feel great...and I'm enjoying life'; Healthy eating: 'Low fat, lots of fruit and veg, little processed food'; and Adapting to ageing: 'I think it's quite a good time of life'. CONCLUSION: Further research is needed to explore the need for protective work practices and promoting healthy lifestyle practices for ageing nurses. Managers need to recognize the changing health needs of older clinical nurses and offer, for example, flexible rostering and tailored exercise programmes to promote their health.

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: There is vigorous research and debate into family violence. However, there is a paucity of enquiry into violence directed from child-to-mother. This paper presents preliminary results from the pilot of a larger study that examines child-to-mother violence in the western suburbs of Sydney Australia. The data are from questionnaires distributed to women who are or have been mothers of children aged 10 to 24 years. Descriptive analysis revealed that an overwhelming majority of the 129 women surveyed experienced some form of threatening behaviour or acts of violence from their child/ren. The main perpetrators were sons and targets mothers. More than half the women had not spoken to anyone about the behaviour previously and a number of women stated their child had witnessed violence in the home. Findings suggest the complexity for women is increased as women are often encouraged to separate from violent partners but their role as mothers prevents them from dividing from a violent child. The incidence appears high, however further evidence from larger samples is required to reveal the full extent of this important social issue.

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: AIM: This paper reports a study exploring the strategies a group of mothers of overweight and obese children were using and planned to use in the future to assist their children to achieve a healthy weight. BACKGROUND: Over the past two decades, the prevalence of childhood obesity has grown exponentially to become a major public health concern. Extant literature suggests that childhood obesity is associated with a range of physical, social and psychological effects, including poor self-esteem, depression, social isolation, and cardio-vascular and other morbidity. Parents are known to be important in determining early eating and exercise habits, and their involvement is crucial to achieving positive child health outcomes. METHODS: An exploratory-descriptive design informed by feminist research principles shaped the study, which was carried out in 2003-2004. Eleven mothers meeting the inclusion criteria took part in in-depth interviews. These were transcribed, and qualitatively analysed. FINDINGS: Participants revealed sound understandings of the concept and ramifications of obesity. They had initiated a range of strategies including role modelling, developing opportunities for increased physical activity, reducing the use of junk food, and heightened awareness of how they used food. Participants viewed the problem as a family rather than an individual problem, and aimed many of the interventions at the entire family to avoid targeting the focus child. CONCLUSIONS: Further research into how childhood obesity is managed within the context of family life is needed. Specifically, additional perspectives on how mothers from various socio-cultural groups address childhood obesity within family life, and longitudinal studies to explore the efficacy and sustainability of family-based lifestyle changes that are made in response to concerns about child weight issues. Additional research to explore the type and nature of family support that can best assist families to achieve sustainable lifestyle improvements is needed.

Abstract: BACKGROUND: Childhood obesity is a growing health concern and the literature implicates parents, particularly mothers. AIM: To develop understandings into the views of a group of mothers with an overweight or obese child, about their child's overweight or obesity. METHOD: A qualitative design informed by feminist insights. Eleven English speaking mothers of at least one overweight or obese child were drawn from a large urban community in metropolitan Australia to participate in this study. RESULTS: Participants attributed their child's obesity to factors such as slow metabolism, sedentary lifestyle, familial or cultural factors, genetics, eating habits such as not drinking enough water, or not chewing food adequately. Participants were very concerned about their child's weight problems and their immediate concerns focussed on social problems associated with obesity/overweight. CONCLUSION: Understanding parental views about their children's overweight and obesity is a key step in forming effective liaisons between health professionals and parents.

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: Child-to-mother violence is a common aspect of family violence, and presents nurses and health workers with continuing challenges. Though noted in the literature as early as the 1950's, this phenomenon remains poorly understood. A number of reasons for the lack of research scrutiny are proposed, the most compelling being that child-to-mother violence has been framed within the discourse of juvenile delinquency rather than family violence. Thus, unlike other forms of family violence, it has escaped close examination by health and welfare workers. A literature review was conducted to examine current knowledge of child-to-mother violence. Study of the literature reveals only partial understandings of this neglected aspect of family pathology. Directions for research to address these gaps in knowledge are drawn from the findings of this literature review.

Abstract: Rapid social changes and the pressures of contemporary living have put families under increasing stress. Nurses have the potential to offer support for families experiencing stress. Therefore, it behoves nurses to develop a greater understanding of the stressors affecting families in contemporary Australia. This paper reports an exploratory descriptive study of urban women's experiences of dealing with difficult and demanding situations in their lives as mothers and family carers in contemporary Australian society, and explores women's experiences of seeking support for family issues. Participants' insights about the nature and availability of support for themselves and their families when in these stressful situations are revealed. Participants sought support from various personal networks, community and self help groups, and professional helpers. However, adequate support was not always available. Nurses have the potential to further develop their role in relation to providing support to women raising families.

Abstract: Adolescent drug use provides challenges for parents, health professionals and the wider community. Of those adolescents who use drugs, cannabis is often the drug of choice. A number of adolescents will develop problems associated with cannabis use, and the burden of managing these problems will fall on the family, particularly the mother. This paper explores adolescent cannabis use from the perspective of mothers of affected young people. Twelve women took part in conversational style audio-taped interviews. Stories were extracted from the resulting narratives and were analysed guided by the work of Anderson and Jack (1991). Detailed findings are grouped under the themes: First awareness: 'I couldn't deny it was happening'; Constant vigilance: 'I watched his every move'; Cannabis and family life: 'I'd start to shake when he walked into the house'; Disrupted lives: 'I was terrified he'd go to prison'; Shifting aspirations: 'just staying alive'; and, Maintaining a loving relationship: 'always told him I loved him'. Implications for nursing practice are drawn from the findings.

Abstract: In a climate of a declining nursing workforce where violence and hostility is a part of the day-to-day lives of most nurses, it is timely to name violence as a major factor in the recruitment and retention of registered nurses in the health system. Workplace violence takes many forms such as aggression, harassment, bullying, intimidation and assault. Violent acts are perpetrated against nurses from various quarters including patients, relatives, other nurses and other professional groups. Research suggests that nurse managers are implicated in workplace violence and bullying. Furthermore, there may be a direct link between episodes of violence and aggression towards nurses and sick leave, burnout and poor recruitment and retention rates. This paper explores what is known about workplace violence as it affects nurses, and calls for managerial support and policy to act to improve work environments for all nurses.

Abstract: Nursing is facing a crisis nationally and internationall, with Australia, the United States, New Zealand, Canada, the United Kingdom and Western Europe experiencing critical shortages of nurses. Problems with recruitment, retention and an ageing workforce means that attempts to ensure a viable nursing workforce must be placed at the top of the professional agenda. Strategies currently used to manage the crisis, such as overseas recruitment, are not sustainable and are ethically dubious. The demographic timebomb is ticking and up to half the current nursing workforce will reach retirement age by 2020. It is vital that there are adequate numbers of skilled and qualified nurses to take their places. Nursing and nurses are facing unprecedented challenges and pressures in the workplace. Job satisfaction is threatened as nurses are pressured to do more with less, Nursing productivity has increased phenomenally over the past ten years in response to increased demands and decreasing numbers of staff. The nursing workplace has disturbingly high levels of occupational violence, and many nurses operate within a culture of blame and scapegoating. There is evidence that organizational change is imposed upon nurses with little or no consultation and the literature reveals that this has a direct and negative effect on job satisfaction and on retention of nurses. This paper explores some of the critical issues that nursing must confront to be successful in establishing and maintaining a vigorous, dynamic and viable workforce.

Abstract: This paper reports the findings of a study which sought to gain insights about the role of clinical nursing staff in the planned clinical experience of undergraduate nursing students. This study differs from others in that the perspectives of students of nursing in their first year of the undergraduate programme are sought, and the role of clinical nurses rather than clinical teachers is of particular interest. Using a story-telling approach, an exploration of students' perspectives on the role of clinical nursing staff in their clinical learning was undertaken. Analysis allowed findings to be grouped into helpful and unhelpful behaviours, Helpful behaviours included understanding and being friendly, showing interest and explaining. Behaviours that students found unhelpful to their learning were often passive rather than active, but they made students feel acutely aware of being unwelcome in the clinical area. Several students described feeling intrusive, uncomfortable and even unwelcome in clinical areas because o the attitudes and behaviour of clinicians. Findings of this study highlight the importance of clinicians and academic nurses working together to ensure that students of nursing, who represent the future of the profession, are provided with the best possible opportunities for clinical learning.

Abstract: A diagnosis of ovarian cancer is a crisis for any woman. Ovarian cancer has the highest mortality of all the gynaecological cancers. In addition to the very real threat of death, such a diagnosis raises critical issues concerning femininity, motherhood and sexuality. The high mortality associated with this disease is due (in part) to problems associated with early diagnosis. Women frequently experience non-specific symptoms, which may be attributed to other, less alarming causes. The lack of specific symptoms experienced by women, as well as the lack of effective mass screening strategies, make early detection difficult. This makes it crucial that nurses involved in the care of women be alert to the insidious and non-specific onset of this serious condition.

Abstract: Information and messages concerning health-related issues are not confined to material provided by official figures or sources. Much information exists in the community and comes from a variety of sources. One such source is the media. This paper reports the findings of a study conducted over a 12-month period of advertisements for menstrual products in a selection of four monthly Australian magazines (n = 48) directed towards young women. The study examined the way in which menstruation and the menstrual experience were depicted in terms of page space, textual content and visual images. Findings revealed that advertisements for menstrual products provided confusing, conflicting and paradoxical messages. These included stressing the normality of menstruation while also emphasising the importance of keeping it hidden and secret. Menstruation was depicted as being a state of tainted (idealised) femininity because of the potential for the menstrual silence to be shattered by people finding out. Protection failure was depicted as being the ultimate in tainted femininity and a result of a woman's incorrect choice of product. Choosing menstrual-care products was depicted as simple but, paradoxically, complex and confusing. Women were depicted as liberated and sophisticated but images and language related to infancy were used. Freedom and liberation were conferred by the use of the advertised product. Overall, in common with previous studies, menstruation was depicted as a crisis of hygiene that is a risk to femininity. Advertisements for pantyliners suggest that femininity itself poses a threat to (idealised) femininity. This study demonstrates the crucial role of the media as a source of health information for young women.

Abstract: Holism is claimed to be the signifying feature that sets women's health apart from traditional approaches to health care. As such, articles published in the nursing literature about women's health would, one might expect, reflect the centrality of holism to women's health care nursing. The findings of a study which examined the content and the focus of articles published about women's health in journals indexed by CINAHL in the period 1993-1995 challenge this assumption. It was found that women's health is a taken-for-granted notion and is used interchangeably and synonymously to refer to reproductive health, maternal health, neonatal health, family health and (hetero) sexual health. Confounding the view that holism is foundational to a women's health perspective, the papers forming the study's sample largely depict issues to do with women's health from a narrow and stereotypical perspective and with a bio-medical focus. Women were referred to as fragmented bodies, body parts and diseases, and were depicted as being passive and silent. By contrast, the voice (and the activity) of nurses and nursing's imperative to intervene was clearly discernible.

Abstract: Over the past three years, Australian nurses have witnessed a proliferation of locally published refereed nursing journals. This paper considers the refereed content published in four selected Australian nursing journals over a recent twelve month period. Material appearing in the Australian Journal of Advanced Nursing (AJAN), Contemporary Nurse, Nursing Inquiry and Collegian was categorized according to subject matter and authorship by gender and discipline. Findings indicate that articles pertaining to clinical practice, the practice of research, and professional nursing issues are well represented in the literature. These findings mark a change from earlier analyses of Australian nursing journals, which suggested that the epistemologies of other disciplines were over-represented in Australian nursing journals, and thus exerted a powerful influence over the development of nursing theory and scholarship. The increase in the number of refereed Australian nursing journals is indicative of the dynamic state of Australian nursing, in terms of confidence, scholarship and clinical practice development.