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Hildebrand F, Gray M, McCullough K. Models of clinical supervision of relevance to remote area nursing & primary health care: A scoping review. Aust J Rural Health 2023; 31:826-838. [PMID: 37694928 DOI: 10.1111/ajr.13038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
INTRODUCTION Nurses in remote primary health care settings work in difficult conditions, in isolated and disadvantaged communities, and often must work beyond their scope to provide advanced assessments and treatments to support the community. Therefore, remote area nurses require support to develop their skills and knowledge to work safely within their full scope of practice. Clinical supervision is widely used in health professions for this purpose; however, models of supervision for nursing have not been implemented or evaluated within remote primary health care settings. OBJECTIVE The purpose of this study was to search the literature to source suitable clinical supervision models that could pertain to the remote area nursing context. DESIGN An initial search of the literature found no clinical supervision models developed for remote or isolated practice nurses so a scoping review was conducted searching for publications related to advanced practice generalist health practitioners in primary health care, including practice nurses, nurse practitioners and general practitioners. This was seen as a suitable substitute because the phenomena of interest were the model of supervision rather than the specific skills or knowledge being developed. FINDINGS The scoping review search yielded 251 articles from 5 journal databases of which 11 articles met the inclusion criteria. Each clinical supervision model was described and synthesised using qualitative description. The 11 models of clinical supervision had differing formats including; individual and group clinical supervision, in-person, telephone, medical records review and video case study. DISCUSSION Whilst several models were described in the literature, none were directly transferrable to the remote area context. The absence of supervision for cultural safety was significant. There was a variety of modes including face-to-face, virtual, individual and group proposed. Cultural considerations were lacking in all of the models. CONCLUSION Our study recommends a hybrid clinical supervision model suitable for consultation and validation through pilot testing with remote area nurses. There is potential for this model to be used globally in isolated contexts due to the option of virtual participation.
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Affiliation(s)
- Fiona Hildebrand
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
- Majarlin Kimberley Centre for Remote Health, University of Notre Dame Australia, Broome, Western Australia, Australia
| | - Michelle Gray
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kylie McCullough
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
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Beks H, Clayden S, Versace VL. Translating aspects of The National Rural and Remote Nursing Generalist Framework 2023-2027 into practice: opportunities and considerations. AUST HEALTH REV 2023; 47:626-628. [PMID: 37574253 DOI: 10.1071/ah23098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
Reforms that grow the capabilities of the health workforce are critical to improving outcomes for populations residing in rural and remote areas of Australia. Nurses are central to improving the accessibility of health care for populations in these areas. The Australian Government's recent release of The National Rural and Remote Nursing Generalist Framework 2023-2027 is timely for identifying opportunities to strengthen the rural and remote nursing workforce. Further consideration of how the nursing workforce can be supported to translate aspects of the framework into practice is required. To achieve this, it is necessary to identify strategies to support registered nurses to develop capabilities stipulated within the framework. A logical vehicle for this translation is through the continued support of the Australian Government's Rural Health Multidisciplinary Training program, which includes an established network of 19 University Departments of Rural Health. Leveraging from this national network that is geographically expansive and has a long-term strategic impetus for growing the rural and remote nursing workforce, provides an opportunity for translating aspects of the framework at a national scale.
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Affiliation(s)
- H Beks
- Deakin Rural Health, School of Medicine, Warrnambool, Vic., Australia
| | - S Clayden
- Deakin Rural Health, School of Medicine, Warrnambool, Vic., Australia; and Specialist Physicians Clinic, South West Healthcare, Warrnambool, Vic., Australia
| | - V L Versace
- Deakin Rural Health, School of Medicine, Warrnambool, Vic., Australia
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Crossley C, Collett M, Thompson SC. Tracks to Postgraduate Rural Practice: Longitudinal Qualitative Follow-Up of Nursing Students Who Undertook a Rural Placement in Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5113. [PMID: 36982020 PMCID: PMC10049296 DOI: 10.3390/ijerph20065113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
The nursing workforce is the backbone of healthcare provision in rural and remote Australia. Introducing student nurses to rural clinical placements is one strategy used to address the shortfall of healthcare workers outside of major cities, with the goal of improving the training, recruitment and retention of nurses in rural areas. The aim of this qualitative, longitudinal study was to better understand personal and professional decision-making around rural nursing practice intentions and subsequent rural employment and retention. The study methodology consisted of repeated semi-structured interviews with student nurses who had completed at least one rural placement and following them on their journey to becoming graduate nurses over a 6-year period. Thematic longitudinal analysis was undertaken, with three main themes developing, each with further subthemes: (1) participants' satisfaction with rural placements; (2) their challenges with gaining employment; and (3) considerations regarding 'going rural' for work. The participants engaged in both prospective and retrospective reflection around several professional, personal, and wider systemic barriers and enablers to rural practice, which are discussed in detail in this paper. The insights from this longitudinal study have the potential to assist the development of a sustainable rural nursing workforce through informing rural workforce programs, strategies and policies.
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Smith JM, Smith J, Cho S(C, Olson R, dela Cruz A. A commentary on suicide prevention training: The process of implementing an ASIST pilot in postsecondary nursing education. TEACHING AND LEARNING IN NURSING 2023. [DOI: 10.1016/j.teln.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Hawkins N, Jeong SYS, Smith T, Sim J. A conflicted tribe under pressure: A qualitative study of negative workplace behaviour in nursing. J Adv Nurs 2023; 79:711-726. [PMID: 36394212 PMCID: PMC10100446 DOI: 10.1111/jan.15491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/28/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022]
Abstract
AIM This study explored workplace interactions of Australian nurses in regional acute care hospitals through an examination of nurses' experiences and perceptions of workplace behaviour. DESIGN This research is informed by Social Worlds Theory and is the qualitative component of an overarching mixed methods sequential explanatory study. METHODS Between January and March 2019, data were collected from 13 nursing informants from different occupational levels and roles, who engaged in semi-structured, in-depth, face-to-face interviews. Data analysis was guided by Straussian grounded theory to identify the core category and subcategories. RESULTS Theoretical saturation occurred after 13 interviews. The core category identified is A conflicted tribe under pressure, which is comprised of five interrelated subcategories: Belonging to the tribe; 'It's a living hell'; Zero tolerance-'it's a joke'; Conflicted priorities; Shifting the cultural norm. CONCLUSION This study provides valuable insight into the nursing social world and the organizational constraints in which nurses work. Although the inclination for an individual to exhibit negative behaviours cannot be dismissed, this behaviour can either be facilitated or impeded by organizational influences. IMPACT By considering the nurses' experiences of negative workplace behaviour and identifying the symptoms of a struggling system, nurse leaders can work to find and implement strategies to mitigate negative behaviour and create respectful workplace behaviours. PATIENT OR PUBLIC CONTRIBUTION This study involved registered nurse participants and there was no patient or public contribution. CLINICAL TRIAL REGISTRATION Study registration Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).
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Affiliation(s)
- Natasha Hawkins
- The School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sarah Yeun-Sim Jeong
- Faculty of Medicine and Health, School of Nursing, University of Sydney, Sydney, New South Wales, Australia
| | - Tony Smith
- Department of Rural Health, The University of Newcastle, New South Wales, Taree, Australia
| | - Jenny Sim
- The School of Nursing and Midwifery, The University of Newcastle, Gosford, New South Wales, Australia.,School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.,Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
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Graf AC, Nattabi B, Jacob E, Twigg D. Experiences of Western Australian rural nursing graduates: A mixed method analysis. J Clin Nurs 2021; 30:3466-3480. [PMID: 33993567 DOI: 10.1111/jocn.15849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/05/2021] [Accepted: 04/26/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To determine whether the current rural graduate programmes in Western Australia adequately support new graduate nurses transitioning into practice. BACKGROUND Graduate nurse's transition to employment is a time of significant change and challenge, often resulting in periods of transition shock. These challenges are magnified in rural areas where graduates have to relocate to commence their career with limited rural nursing experience. Graduate programmes were developed to smooth the transition for university trained bachelor's degree registered nurses into the workforce. Supportive graduate nursing programmes are essential for enabling transition to practice and reduce attrition rates. DESIGN Longitudinal convergent mixed method parallel design was informed by Duchscher's transition stage model. METHOD Thematic analysis was applied to all interviews. COREQ checklist was completed. Descriptive statistics and content analysis were used to analyse the survey responses. RESULTS New graduates cycled through both transition shock and honeymoon periods on commencement of employment, reporting high levels of satisfaction in simultaneity with signs of transition shock. Satisfaction dropped within 7 months indicating a transition crisis before an adjustment period occurred at the end of their graduate year. Limited resources were highlighted as obstacles to providing adequate support to rural graduate nurses. CONCLUSION The honeymoon stage of transition co-existed with transition shock at the commencement of graduate programmes, which may obscure the need for continuing adequate support. Inadequate and/or a lack of preceptorship was evident throughout the Western Australian rural graduate programmes. Graduate programmes need to be structured but flexible to allow for individual differences in graduates' and clinical contexts. RELEVANCE TO CLINICAL PRACTICE Structured but flexible graduate programmes allow for individual differences in graduates and clinical situations. New graduate nurses would benefit from a break midway through their graduate year to assist and overcome the transition crisis stage. Education of nurses undertaking the preceptor role is required to deliver adequate support to graduate nurses and decrease transition shock.
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Affiliation(s)
- Amanda C Graf
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | | | - Elisabeth Jacob
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Vic, Australia
| | - Diane Twigg
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
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Abelsen B, Strasser R, Heaney D, Berggren P, Sigurðsson S, Brandstorp H, Wakegijig J, Forsling N, Moody-Corbett P, Akearok GH, Mason A, Savage C, Nicoll P. Plan, recruit, retain: a framework for local healthcare organizations to achieve a stable remote rural workforce. HUMAN RESOURCES FOR HEALTH 2020; 18:63. [PMID: 32883287 PMCID: PMC7469323 DOI: 10.1186/s12960-020-00502-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/14/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Recruiting and retaining a skilled health workforce is a common challenge for remote and rural communities worldwide, negatively impacting access to services, and in turn peoples' health. The research literature highlights different factors facilitating or hindering recruitment and retention of healthcare workers to remote and rural areas; however, there are few practical tools to guide local healthcare organizations in their recruitment and retention struggles. The purpose of this paper is to describe the development process, the contents, and the suggested use of The Framework for Remote Rural Workforce Stability. The Framework is a strategy designed for rural and remote healthcare organizations to ensure the recruitment and retention of vital healthcare personnel. METHOD The Framework is the result of a 7-year, five-country (Sweden, Norway, Canada, Iceland, and Scotland) international collaboration combining literature reviews, practical experience, and national case studies in two different projects. RESULT The Framework consists of nine key strategic elements, grouped into three main tasks (plan, recruit, retain). Plan: activities to ensure that the population's needs are periodically assessed, that the right service model is in place, and that the right recruits are targeted. Recruit: activities to ensure that the right recruits and their families have the information and support needed to relocate and integrate in the local community. Retain: activities to support team cohesion, train current and future professionals for rural and remote health careers, and assure the attractiveness of these careers. Five conditions for success are recognition of unique issues; targeted investment; a regular cycle of activities involving key agencies; monitoring, evaluating, and adjusting; and active community participation. CONCLUSION The Framework can be implemented in any local context as a holistic, integrated set of interventions. It is also possible to implement selected components among the nine strategic elements in order to gain recruitment and/or retention improvements.
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Affiliation(s)
- Birgit Abelsen
- The National Centre for Rural Medicine, The Department of Community Medicine, UiT, Tromsø, Norway.
| | - Roger Strasser
- Northern Ontario School of Medicine, Lakehead and Laurentian Universities, Thunder Bay and Sudbury, Canada
| | | | | | | | - Helen Brandstorp
- The National Centre for Rural Medicine, The Department of Community Medicine, UiT, Tromsø, Norway
| | - Jennifer Wakegijig
- Northern Ontario School of Medicine, Lakehead and Laurentian Universities, Thunder Bay and Sudbury, Canada
| | | | - Penny Moody-Corbett
- Northern Ontario School of Medicine, Lakehead and Laurentian Universities, Thunder Bay and Sudbury, Canada
| | - Gwen Healey Akearok
- Northern Ontario School of Medicine, Lakehead and Laurentian Universities, Thunder Bay and Sudbury, Canada
- Qaujigiartiit Health Research Centre, Iqaluit, Canada
| | | | | | - Pam Nicoll
- NHS Education for Scotland, Centre for Health Science, Inverness, Scotland
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Smith S, Lapkin S, Sim J, Halcomb E. Nursing care left undone, practice environment and perceived quality of care in small rural hospitals. J Nurs Manag 2020; 28:2166-2173. [DOI: 10.1111/jonm.12975] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/02/2020] [Accepted: 02/05/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Sarah Smith
- School of Nursing University of Wollongong Wollongong NSW Australia
| | - Sam Lapkin
- School of Nursing University of Wollongong Wollongong NSW Australia
| | - Jenny Sim
- School of Nursing University of Wollongong Wollongong NSW Australia
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McCullough K, Whitehead L, Bayes S, Williams A, Cope V. The delivery of Primary Health Care in remote communities: A Grounded Theory study of the perspective of nurses. Int J Nurs Stud 2019; 102:103474. [PMID: 31835121 DOI: 10.1016/j.ijnurstu.2019.103474] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/03/2019] [Accepted: 11/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Australia has vast areas of desert, wilderness and offshore islands where nurses provide the majority of health care services. The residents of Australia's remote communities generally have poorer health status than their metropolitan counterparts. Despite recognition of Primary Health Care as a comprehensive model of acute and preventative care well suited to areas of high health and social need, there is little known about how nurses employ the Primary Health Care model in practice. OBJECTIVES This study described and explained from the perspective of nurses, the actions and interactions involved in the delivery of Primary Health Care in remote communities. DESIGN This study was conducted from a Constructivist Grounded Theory perspective. SETTINGS The setting was community health centres or Aboriginal Medical Services located in 'remote' or 'very remote' areas. Communities with inpatient health services were excluded. PARTICIPANTS Twenty four Nurse Practitioners, Registered Nurses and nursing academics participated. Participants had worked or were working, in a variety of remote communities across Australia. Length of service ranged from three months to over 15 years nursing in remote areas. METHODS Data were collected through 23 telephone interviews and an expert reference group. Theoretical sampling and constant comparative analysis were used to reach theoretical saturation. RESULTS The core issue participants faced was the inability to provide Primary Health Care. Four conditions impacted on the core issue: understanding the social world of the remote community, availability of resources, clinical knowledge and skill and, shared understanding and support. The process of doing the best you can with what you have, emerged as the way participants dealt with the inability to provide Primary Health Care. The process involved four primary activities: facilitating access to health care, continually learning, seeking understanding, and home-making in a work environment. The outcome of this process was considered to be making compromises to provide Primary Health Care. CONCLUSIONS This study describes the substantive theory: making compromises to provide Primary Health care services in the remote Australian setting. Understanding the process of making compromises could direct employers and educators in their efforts to improve the provision of Primary Health Care in a variety of settings. Increased attention to the education, resources and support of nurses is likely to increase access to safe, quality care for remote communities.
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Affiliation(s)
- Kylie McCullough
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; Centre for Postgraduate Nursing Studies, University of Otago, New Zealand.
| | - Sara Bayes
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.
| | - Anne Williams
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia; Centre for Nursing Research, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA 6009, Australia.
| | - Vicki Cope
- Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia.
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Smith S, Sim J, Halcomb E. Nurses' experiences of working in rural hospitals: An integrative review. J Nurs Manag 2018; 27:482-490. [PMID: 30204275 DOI: 10.1111/jonm.12716] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/16/2018] [Accepted: 09/06/2018] [Indexed: 11/29/2022]
Abstract
AIM To critically analyse the international literature describing the experiences of nurses working in rural hospitals. BACKGROUND Nursing shortages in rural areas is an ongoing issue. Given the significant role nurses play in the delivery of rural health care, a sufficient workforce is essential. However, maintaining this workforce is challenging. Understanding the experiences of nurses working in rural hospitals is essential to inform strategies around job satisfaction and staff retention. EVALUATION An integrative review was conducted. Six primary sources were included related to the experiences of nurses working in rural hospitals. RESULTS Four themes emerged, namely: (a) Professional Development; (b) Workplace stressors; (c) Teamwork; and (d) Community. CONCLUSION There is a need for further research exploring the experiences of nurses working in rural hospitals and its impact on job satisfaction, turnover intention and patient safety. IMPLICATIONS FOR NURSING MANAGEMENT This review highlights some key issues impacting nurses' working in rural hospitals. This understanding can be used by nurse managers to inform strategies for recruitment and retention of nurses in these areas.
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Affiliation(s)
- Sarah Smith
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Christiansen A, Jacob E, Twigg D. Is it time to consider a four year Nursing Bachelor Degree in Australia? A discussion paper. Collegian 2018. [DOI: 10.1016/j.colegn.2018.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fowler AC, Twigg D, Jacob E, Nattabi B. An integrative review of rural and remote nursing graduate programmes and experiences of nursing graduates. J Clin Nurs 2018; 27:e753-e766. [DOI: 10.1111/jocn.14211] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Amanda C Fowler
- School of Nursing and Midwifery; Edith Cowan University; Joondalup WA Australia
| | - Diane Twigg
- School of Nursing and Midwifery; Edith Cowan University; Joondalup WA Australia
| | - Elisabeth Jacob
- School of Nursing and Midwifery; Edith Cowan University; Joondalup WA Australia
| | - Barbara Nattabi
- Rural and Remote Health; Western Australia Centre for Rural Health; The University of Western Australia; Geraldton WA Australia
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Ferguson MS, Reis JA, Rabbetts L, Ashby HJ, Bayes M, McCracken T, Ross C, Procter NG. The Effectiveness of Suicide Prevention Education Programs for Nurses. CRISIS 2017; 39:96-109. [PMID: 28990823 DOI: 10.1027/0227-5910/a000479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Education to improve health professionals' responses to suicide is considered an important suicide prevention strategy. However, the effectiveness of this approach for nurses is unclear. AIM To systematically review the peer-reviewed literature regarding the effectiveness of suicide prevention education programs for nurses. METHOD Nine academic databases (CINAHL, Cochrane Reviews & Trials, Embase, Informit Health Collection, Joanna Briggs Institute, Medline, PsycINFO, Scopus, and Web of Science) were searched in November 2016, utilizing search terms related to suicide, education, and nurses, with no limits placed on publication date or study design. RESULTS The search yielded 5,456 identified articles, 11 of which met the inclusion criteria. Studies were primarily quantitative (RCTs n = 3; quasi-experimental n = 6; qualitative n = 2), and involved nurses (range = 16-561) working in a diversity of settings, particularly hospitals (n = 9). Studies revealed positive changes in nurses' competence, knowledge, and attitudes associated with training over the short term. LIMITATIONS The heterogeneity of education programs and methodological weaknesses of included studies limit the conclusions drawn. CONCLUSION There is a moderate body of evidence to support the effectiveness of suicide prevention education programs for nurses. Future research should examine longer-term changes in clinical practice and strategies for continuing education, with more rigorous study designs.
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Affiliation(s)
- Monika S Ferguson
- 1 School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
| | - Julie A Reis
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Lyn Rabbetts
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Heather-Jean Ashby
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Miriam Bayes
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Tara McCracken
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Christine Ross
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Nicholas G Procter
- 1 School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
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Knight K, Kenny A, Endacott R. From expert generalists to ambiguity masters: using ambiguity tolerance theory to redefine the practice of rural nurses. J Clin Nurs 2017; 25:1757-65. [PMID: 27139173 DOI: 10.1111/jocn.13196] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2015] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To redefine the practice of rural nurses and describe a model that conceptualises the capabilities and characteristics required in the rural environment. BACKGROUND The way in which the practice of rural nurses has been conceptualised is problematic. Definitions of rural nursing have been identified primarily through the functional context of rural health service delivery. The expert generalist term has provided a foundation theory for rural nurses with understandings informed by the scope of practice needed to meet service delivery requirements. However, authors exploring intrinsic characteristics of rural nurses have challenged this definition, as it does not adequately address the deeper, intangible complexities of practice required in the rural context. Despite this discourse, an alternative way to articulate the distinctive nature of rural nursing practice has eluded authors in Australia and internationally. DESIGN A theoretical paper based on primary research. METHODS The development of the model was informed by the findings of a study that explored the nursing practice of managing telephone presentations in rural health services in Victoria, Australia. The study involved policy review from State and Federal governments, nursing and medical professional bodies, and five rural health services; semi-structured interviews with eight Directors of Nursing, seven registered nurses and focus group interviews with eight registered nurses. RESULTS An ambiguity tolerance model drawn from corporate global entrepreneurship theory was adapted to explain the findings of the study. The adapted model presents capabilities and characteristics used by nurses to successfully manage the ambiguity of providing care in the rural context. CONCLUSIONS Redefining the practice of rural nurses, through an adapted theory of ambiguity tolerance, highlights nursing characteristics and capabilities required in the rural context. This perspective offers new ways of thinking about the work of rural nurses, rural nurse policy, education, recruitment, retention and clinical governance. RELEVANCE TO CLINICAL PRACTICE A greater understanding of rural nurse practice will assist in achieving positive care outcomes in an environment with competing stakeholder needs, and limited resources and options for care.
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Affiliation(s)
- Kaye Knight
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, Vic., Australia
| | - Amanda Kenny
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, Vic., Australia
| | - Ruth Endacott
- Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK.,Critical Care Nursing, Monash University, Berwick, Vic., Australia
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Abstract
AIM To re-examine and expand understanding of the concept 'lack of anonymity' as a component of rural nursing theory. BACKGROUND Early healthcare literature reports lack of anonymity as part of social and working environments, particularly rural nursing. Rural nursing theory included the first published concept analysis on lack of anonymity but lacked empirical referents. Workforce, societal and rural healthcare changes support an updated analysis. To further understand lack of anonymity, its present day use and applicability to diverse environments, research from multiple disciplines was reviewed. DESIGN Concept analysis. DATA SOURCES A literature search using eight terms in eleven databases was conducted of literature published between 2008-2013. METHOD Walker and Avant's concept analysis methodology guided the analysis. RESULTS The previous concept analysis is supported in part by current literature. The defining attributes, 'identifiable', 'establishing boundaries for public and private self and interconnectedness' in a community were updated. Updated antecedents include: (i) environmental context; (ii) opportunities to become visible; (iii) developing relationships and (iv) unconscious or limited awareness of public or personal privacy. Consequences are: (i) familiarity; (ii) visibility; (iii) awareness of privacy and (iv) manage or balance of lack of anonymity. Cases were constructed and empirical referents identified. CONCLUSION The concept of lack of anonymity was updated; portions of the original definition remain unchanged. Empirical referents reveal the defining attributes in daily life and may guide future research on the effect of lack of anonymity on nursing practice. This analysis advances the conceptual understanding of rural nursing theory.
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Affiliation(s)
- Marilyn A Swan
- School of Nursing, Minnesota State University, Mankato, MN, USA
| | - Barbara B Hobbs
- College of Nursing, South Dakota State University, Rapid City, SD, USA
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Whittall D, Lee S, O'Connor M. Factors affecting rural volunteering in palliative care - an integrated review. Aust J Rural Health 2016; 24:350-356. [PMID: 27385270 DOI: 10.1111/ajr.12313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2016] [Indexed: 11/30/2022] Open
Abstract
To review factors shaping volunteering in palliative care in Australian rural communities using Australian and International literature. Identify gaps in the palliative care literature and make recommendations for future research. A comprehensive literature search was conducted using Proquest, Scopus, Sage Premier, Wiley online, Ovid, Cochran, Google Scholar, CINAHL and Informit Health Collection. The literature was synthesised and presented in an integrated thematic narrative. Australian Rural communities. While Australia, Canada, the United States (US) and the United Kingdom (UK) are leaders in palliative care volunteer research, limited research specifically focuses on volunteers in rural communities with the least occurring in Australia. Several interrelated factors influence rural palliative care provision, in particular an increasingly ageing population which includes an ageing volunteer and health professional workforce. Also current and models of palliative care practice fail to recognise the innumerable variables between and within rural communities such as distance, isolation, lack of privacy, limited health care services and infrastructure, and workforce shortages. These issues impact palliative care provision and are significant for health professionals, volunteers, patients and caregivers. The three key themes of this integrated review include: (i) Geography, ageing rural populations in palliative care practice, (ii) Psychosocial impact of end-end-of life care in rural communities and (iii) Palliative care models of practice and volunteering in rural communities. The invisibility of volunteers in rural palliative care research is a concern in understanding the issues affecting the sustainability of quality palliative care provision in rural communities. Recommendations for future Australian research includes examination of the suitability of current models of palliative care practice in addressing the needs of rural communities; the recruitment, training, ongoing education and support of volunteers in rural palliative care provision to ensure equitable care for all communities in Australia regardless of location.
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Affiliation(s)
- Dawn Whittall
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Susan Lee
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Margaret O'Connor
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.,Nursing, Swinburne University of Technology, Hawthorne, Victoria, Australia
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Fuller J, Mills J, Skinner I. Nursing and midwifery: Pillars of rural and remote health innovation and development. Aust J Rural Health 2015; 23:311-2. [PMID: 26683711 DOI: 10.1111/ajr.12265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Hegney D, Eley R, Osseiran-Moisson R, Francis K. Work and personal well-being of nurses in Queensland: Does rurality make a difference? Aust J Rural Health 2015; 23:359-65. [DOI: 10.1111/ajr.12206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Desley Hegney
- School of Nursing and Midwifery; Faculty of Health Sciences; Curtin University; Perth Western Australia Australia
| | - Robert Eley
- School of Medicine and Princess Alexandra Hospital Emergency Department; The University of Queensland; Brisbane Queensland Australia
| | - Rebecca Osseiran-Moisson
- School of Nursing and Midwifery; Faculty of Health Sciences; Curtin University; Perth Western Australia Australia
| | - Karen Francis
- School of Nursing, Midwifery and Indigenous Health; Charles Sturt University; Bathurst New South Wales Australia
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Enhancing computer literacy and information retrieval skills: A rural and remote nursing and midwifery workforce study. Collegian 2015; 22:283-9. [DOI: 10.1016/j.colegn.2014.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Knight KM, Kenny A, Endacott R. Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned. BMC Health Serv Res 2015; 15:145. [PMID: 25884686 PMCID: PMC4396727 DOI: 10.1186/s12913-015-0827-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 03/30/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Due to large geographical distances, the telephone is central to enabling rural Australian communities to access care from their local health service. While there is a history of rural nurses providing care via the telephone, it has been a highly controversial practice that is not routinely documented and little is known about how the practice is governed. The lack of knowledge regarding governance extends to the role of Directors of Nursing as clinical leaders charged with the responsibility of ensuring practice safety, quality, regulation and risk management. The purpose of this study was to identify clinical governance processes related to managing telephone presentations, and to explore Directors of Nursing perceptions of processes and clinical practices related to the management of telephone presentations to health services in rural Victoria, Australia. METHODS Qualitative documentary analysis and semi structured interviews were used in the study to examine the content of health service policies and explore the perceptions of Directors of Nursing in eight rural health services regarding policy content and enactment when people telephone rural health services for care. Participants were purposively selected for their knowledge and leadership role in governance processes and clinical practice. Data from the interviews were analysed using framework analysis. The process of analysis resulted in the identification of five themes. RESULTS The majority of policies reviewed provided little guidance for managing telephone presentations. The Directors of Nursing perceived policy content and enactment to be largely inadequate. When organisational structures failed to provide appropriate governance for the context, the Directors of Nursing engaged in protective mechanisms to support rural nurses who manage telephone presentations. CONCLUSIONS Rural Directors of Nursing employed intuitive behaviours to protect rural nurses practicing within a clinical governance context that is inadequate for the complexities of the environment. Protective mechanisms provided indicators of clinical leadership and governance effectiveness, which may assist rural nurse leaders to strengthen quality and safe care by unlocking the potential of intuitive behaviours. Kanter's theory of structural power provides a way of conceptualising these protective mechanisms, illustrating how rural nurse leaders enact power.
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Affiliation(s)
- Kaye M Knight
- La Trobe Rural Health School, Bendigo, VIC, Australia.
| | - Amanda Kenny
- La Trobe Rural Health School, Bendigo, VIC, Australia.
| | - Ruth Endacott
- Centre for Health and Social Care Innovation, Faculty of Health and Human Sciences, University of Plymouth, Drake Circus, Plymouth UK & Monash University, Melbourne, Australia.
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Roden J, Jarvis L, Campbell-Crofts S, Whitehead D. Australian rural, remote and urban community nurses' health promotion role and function. Health Promot Int 2015; 31:704-14. [PMID: 25838551 DOI: 10.1093/heapro/dav018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors.
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Affiliation(s)
- Janet Roden
- New South Wales Nurses and Midwives' Association & Australian Nursing and Midwifery Federation-NSW Branch, 50 O'Dea Avenue, Waterloo, NSW 2017, Australia
| | - Lynda Jarvis
- School of Nursing and Midwifery, University of Western Sydney, PO Box 1797, Penrith South, DC 2751, Australia
| | - Sandra Campbell-Crofts
- School of Nursing and Midwifery, University of Tasmania, PO Box 184, Rozelle, NSW 2039, Australia
| | - Dean Whitehead
- Faculty of Medicine, Nursing and Health Sciences, School of Nursing & Midwifery, Flinders University, SA 5042, Australia
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Knight K, Kenny A, Endacott R. Assessing clinical urgency via telephone in rural Australia. Nurs Health Sci 2014; 17:201-7. [DOI: 10.1111/nhs.12161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 06/22/2014] [Accepted: 06/27/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Kaye Knight
- La Trobe Rural Health School; Bendigo Victoria Australia
| | - Amanda Kenny
- La Trobe Rural Health School; Bendigo Victoria Australia
| | - Ruth Endacott
- School of Nursing & Midwifery; Monash University; Melbourne Victoria Australia
- School of Nursing & Midwifery; Plymouth University; Plymouth UK
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Reed FM, Fitzgerald L, Bish MR. District nurse advocacy for choice to live and die at home in rural Australia: a scoping study. Nurs Ethics 2014; 22:479-92. [PMID: 24981253 DOI: 10.1177/0969733014538889] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Choice to live and die at home is supported by palliative care policy; however, health resources and access disparity impact on this choice in rural Australia. Rural end-of-life home care is provided by district nurses, but little is known about their role in advocacy for choice in care. OBJECTIVES The study was conducted to review the scope of the empirical literature available to answer the research question: What circumstances influence district nurse advocacy for rural client choice to live and die at home?, and identify gaps in the knowledge. METHOD Interpretive scoping methodology was used to search online databases, identify suitable studies and select, chart, analyse and describe the findings. RESULTS 34 international studies revealed themes of 'the nursing relationship', 'environment', 'communication', 'support' and 'the holistic client centred district nursing role. DISCUSSION Under-resourcing, medicalisation and emotional relational burden could affect advocacy in rural areas. CONCLUSION It is not known how district nurses overcome these circumstances to advocate for choice in end-of-life care. Research designed to increase understanding of how rural district nurses advocate successfully for client goals will enable improvements to be made in the quality of end-of-life care offered.
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Henderson J, Koehne K, Verrall C, Gebbie K, Fuller J. How is Primary Health Care conceptualised in nursing in Australia? A review of the literature. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:337-351. [PMID: 23952616 DOI: 10.1111/hsc.12064] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2013] [Indexed: 06/02/2023]
Abstract
Australia, in common with many other countries, is expanding the role of Primary Health Care (PHC) to manage the growing burden of chronic disease and prevent hospitalisation. Australia's First National Primary Health Care Strategy released in 2010 places general practice at the centre of care delivery, reflecting a constitutional division of labour in which the Commonwealth government's primary means of affecting care delivery in this sector is through rebates for services delivered from the universal healthcare system Medicare. A review of Australian nursing literature was undertaken for 2006-2011. This review explores three issues in relation to these changes: How PHC is conceptualised within Australian nursing literature; who is viewed as providing PHC; and barriers and enablers to the provision of comprehensive PHC. A review of the literature suggests that the terms 'PHC' and 'primary care' are used interchangeably and that PHC is now commonly associated with services provided by practice nurses. Four structural factors are identified for a shift away from comprehensive PHC, namely fiscal barriers, educational preparation for primary care practice, poor role definition and interprofessional relationships. The paper concludes that while moves towards increasing capacity in general practice have enhanced nursing roles, current policy and the nature of private business funding alongside some medical opposition limit opportunities for Australian nurses working in general practice.
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Affiliation(s)
- Julie Henderson
- School of Nursing & Midwifery, Flinders University, Adelaide, SA, Australia
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25
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Trede F, McEwen C, Kenny A, O'Meara P. Supervisors' experiences of workplace supervision of nursing and paramedic students in rural settings: a scoping review. NURSE EDUCATION TODAY 2014; 34:783-8. [PMID: 24698307 DOI: 10.1016/j.nedt.2013.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 10/07/2013] [Indexed: 05/23/2023]
Abstract
OBJECTIVES We present our findings from a scoping review that sought to identify what is known about nursing and paramedic clinical supervisors' experiences of their supervision practices in rural settings. Our interest in these two groups is based on the central role that nurses and paramedics play in rural health care. DESIGN Scoping reviews support identification of a broad range of literature, including all types of study designs. We adopted Arksey and O'Malley's five-stage approach: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting results. DATA SOURCES Databases searched included Academic Search Complete, Springer, Factiva, ProQuest, Ebsco, Informit, VOCEDplus and Scopus. REVIEW METHOD Based on our research question and inclusion and exclusion criteria we selected relevant literature and summarised and reported it using Arksey and O'Malley's framework. RESULTS The review yielded five articles from four countries: Sweden, Belgium, Malaysia and Australia. CONCLUSION From this scoping review, we identified key themes related to supervisors' experiences, including clarification of expectations, support from managers and colleagues, the need for shared understanding between university, students and supervisors and required skills and competence in supervising students.
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Affiliation(s)
- Franziska Trede
- The Education For Practice Institute, Charles Sturt University, Locked Bag 450, Silverwater, NSW 2128, Australia.
| | - Celina McEwen
- The Education For Practice Institute, Charles Sturt University, Locked Bag 450, Silverwater, NSW 2128, Australia.
| | - Amanda Kenny
- La Trobe Rural Health School, Faculty of Health Sciences, La Trobe University Health Sciences, Bendigo, VIC 3550, Australia.
| | - Peter O'Meara
- La Trobe Rural Health School, Faculty of Health Sciences, La Trobe University Health Sciences, Bendigo, VIC 3550, Australia.
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Abstract
New graduate registered nurses (NGRN's) have an expectation of clinical support as they make the transition from novice to advanced beginner. In this 2008-2009 study of three rural transition to practice programs we found that clinical support did not eventuate. Consequently, NGRN's reported feeling underprepared for practice, overwhelmed by responsibility and often abandoned. Against this background, many were concerned that their inexperience had implications for safe patient care. Graduate nurse transition programs need to have the physical and human resources necessary to deliver the clinical support as promised in their prospectus, to ensure patient safety. This grounded theory study identified three essential core elements - leadership support, clinical supervision, and effective interprofessional relationships. Recommendation is made to address these deficits by mandating their inclusion in all transition to professional practice programs.
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Affiliation(s)
- Peter Mellor
- School of Nursing & Midwifery, Flinders University, Renmark Campus, SA, Australia
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27
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Mellor P, Greenhill J. A patient safety focused registered nurse transition to practice program. Contemp Nurse 2013:3614-3632. [PMID: 24359268 DOI: 10.5172/conu.2013.3614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract As undergraduate rural nursing students approach completion of their degree and become eligible for registration as a nurse they anticipate becoming part of a transition to practice program. Promises of clinical support, guidance and being welcomed into the profession are provided. Unfortunately the reality for new graduate registered nurses is often quite different. Promised clinical support does not eventuate and patient safety is often compromised. Graduate nurse transition programs need to have the physical and human resources to deliver the clinical support that was promised in their prospectus. This paper describes the nature of professional support experienced by participants of transition to practice programs. Three core elements are recommended to ensure patient safety.
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Affiliation(s)
- Peter Mellor
- School of Nursing & Midwifery, Flinders University, Renmark Campus, SA, Australia
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Patelarou AE, Patelarou E, Brokalaki H, Dafermos V, Thiel L, Melas CD, Koukia E. Current Evidence on the Attitudes, Knowledge and Perceptions of Nurses Regarding Evidence-Based Practice Implementation in European Community Settings: A Systematic Review. J Community Health Nurs 2013; 30:230-44. [DOI: 10.1080/07370016.2013.838501] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bish M, Kenny A, Nay R. Factors that influence the approach to leadership: directors of nursing working in rural health services. J Nurs Manag 2013; 23:380-9. [DOI: 10.1111/jonm.12146] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Melanie Bish
- La Trobe Rural Health School; Bendigo Campus; La Trobe University; Bendigo Victoria Australia
| | - Amanda Kenny
- La Trobe Rural Health School; Bendigo Campus; La Trobe University; Bendigo Victoria Australia
| | - Rhonda Nay
- Australian Institute for Primary Care and Ageing; La Trobe University; Bundoora Victoria Australia
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Kenny A, Allenby A. Implementing clinical supervision for Australian rural nurses. Nurse Educ Pract 2013; 13:165-169. [DOI: 10.1016/j.nepr.2012.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 08/07/2012] [Accepted: 08/21/2012] [Indexed: 11/28/2022]
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31
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Guzys D, Kenny A, Bish M. Sustaining secondary school nursing practice in Australia: a qualitative study. Nurs Health Sci 2013; 15:353-9. [PMID: 23480208 DOI: 10.1111/nhs.12039] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 12/10/2012] [Accepted: 12/30/2012] [Indexed: 11/30/2022]
Abstract
This interpretive descriptive, qualitative study explored secondary school nurses' perceptions of factors that impact on their role and their views on how their role can be best supported. Nine secondary school nurses from four Department of Human Services regions in Victoria, Australia, participated in semistructured, in-depth interviews. Purposive sampling was used, with participants required to have a minimum of 2 years' experience as secondary school nurses. Data were thematically analyzed, revealing a complex and challenging role. The findings identified key factors necessary to support quality practice. All stakeholders need a shared understanding of the purpose and principles underpinning the secondary school nurse role and the nurse's professional obligations. Knowledge and experience are required that recognize the breadth and depth necessary for secondary school nurses to work effectively within their scope of practice. The adoption of a model of critical companionship is recommended to provide facilitated reflection on practice as a support mechanism for the role.
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Affiliation(s)
- Diana Guzys
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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32
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Hickey N, Harrison L, Sumsion J. Transition to work and the career destinations of double degree nurses. Contemp Nurse 2013. [DOI: 10.5172/conu.2013.3384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yates K, Kelly J, Lindsay D, Usher K. The experience of rural midwives in dual roles as nurse and midwife: “I’d prefer midwifery but I chose to live here”. Women Birth 2013; 26:60-4. [DOI: 10.1016/j.wombi.2012.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 01/31/2012] [Accepted: 03/19/2012] [Indexed: 10/28/2022]
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Bish M, Kenny A, Nay R. Perceptions of structural empowerment: nurse leaders in rural health services. J Nurs Manag 2012; 22:29-37. [PMID: 27531198 DOI: 10.1111/jonm.12029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2012] [Indexed: 11/28/2022]
Abstract
AIM To provide insight into the perceptions of structural empowerment of nurse leaders working in rural and regional Victoria, Australia. BACKGROUND Fostering nurse leadership in rural health services may be informed by gaining insight into rural nurse leaders' perceptions of structural empowerment. METHOD A sample of nurse executives (n = 45) from hospitals throughout rural Victoria, Australia completed the Conditions of Work Effectiveness Questionnaire II (CWEQ-II) aimed to measure structural empowerment. RESULTS Rural nurse leaders' perceive themselves to be moderately empowered. CONCLUSION The concept of structural empowerment may be useful to inform rural leadership practices. IMPLICATIONS FOR NURSING MANAGEMENT Acknowledgement of structural empowerment by nurse leaders may assist in the process of formulating strategies to facilitate an open, honest and responsive culture of patient safety, removing silos, departmental turf issues, and professional territoriality in healthcare services.
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Affiliation(s)
- Melanie Bish
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Amanda Kenny
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Rhonda Nay
- Australian Institute for Primary Care and Ageing, La Trobe University, Bundoora, Victoria, Australia
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Bish M, Kenny A, Nay R. A Scoping Review Identifying Contemporary Issues in Rural Nursing Leadership. J Nurs Scholarsh 2012; 44:411-7. [DOI: 10.1111/j.1547-5069.2012.01471.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sanderson H, Lea J. Implementation of the Clinical Facilitation Model within an Australian rural setting: the role of the Clinical Facilitator. Nurse Educ Pract 2012; 12:333-9. [PMID: 22578780 DOI: 10.1016/j.nepr.2012.04.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 03/21/2012] [Accepted: 04/08/2012] [Indexed: 11/19/2022]
Abstract
Education providers globally use various models for undergraduate nurse clinical education. This paper presents the major findings of a research project conducted by a rural university in Australia that aimed to explore the Clinical Facilitation Model of undergraduate nursing education from a rural perspective. In particular how the Clinical Facilitators enacted their role within the rural environment and to identify any barriers to the provision of effective clinical learning during facilitated clinical experience within this context. This qualitative study used a phenomenological approach to explore the experiences of Clinical Facilitators. Individual in-depth interviews were conducted with eight Clinical Facilitators. Data was analysed using thematic analysis and several themes emerged from the study. This paper will report two of the major findings which are based on how Clinical Facilitators enacted their role within the rural environment. Whilst this study has a rural focus the findings will add to the limited body of knowledge internationally regarding the Clinical Facilitation model used as a result of balancing educational needs of the student with the care needs of the patients in the current health policy climate. The findings will be useful for informing undergraduate curricula, and will assist faculty and health services in planning and implementation of models of clinical education that meet the needs of the student and that are specific to the rural environment. In addition, the findings will provide insight into strategies that the rural Clinical Facilitator can utilise to assist in fulfilling their teaching role.
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Affiliation(s)
- Helena Sanderson
- School of Health, University of New England, Armidale, Australia.
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Yates K, Usher K, Kelly J. The dual roles of rural midwives: The potential for role conflict and impact on retention. Collegian 2011; 18:107-13. [DOI: 10.1016/j.colegn.2011.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sustaining and growing the rural nursing and midwifery workforce: understanding the issues and isolating directions for the future. Collegian 2011; 18:55-60. [PMID: 21706992 DOI: 10.1016/j.colegn.2010.08.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Nurses and midwives represent the largest group of health professionals in the Australian health care system. In rural environments nurses and midwives make up a greater proportion of the health workforce than in urban settings, which makes their role in service provision even more significant. The role and scope of these nurses and midwives' practice is by necessity more generalist than specialist, which results in disciplinary strengths and weaknesses. As generalist health professionals they work in diverse settings such as public hospitals, multi-purpose services, community health, aged care and in non-government and private for profit and no-profit organisations including general practices. Their scope of practice covers prevention, intervention and rehabilitation and is lifespan inclusive. Rural nurses and midwives are older than their metropolitan based counterparts, work part-time and traditionally have limited access to professional development often due to ineffective locum relief programs. Workplace inflexibility, access to acceptable housing and partner employment are factors cited as inhibitors to growing this workforces. The future of the rural nursing and midwifery workforce will only be secured if Government invests to a greater degree in both education and training and the development of a nationally agreed remuneration scale that allows for part-time work.
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Keane S, Smith T, Lincoln M, Fisher K. Survey of the rural allied health workforce in New South Wales to inform recruitment and retention. Aust J Rural Health 2011; 19:38-44. [DOI: 10.1111/j.1440-1584.2010.01175.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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