Value and vulnerability: reflections on joint appointments

Optimization of home care nurses in Canada: A scoping review

Nurses are among the largest providers of home care services thus optimisation of this workforce can positively influence client outcomes. This scoping review maps existing Canadian literature on factors influencing the optimisation of home care nurses (HCNs). Arskey and O'Malley's five stages for scoping literature reviews were followed. Populations of interest included Registered Nurses, Registered/Licensed Practical Nurses, Registered Nursing Assistants, Advanced Practice Nurses, Nurse Practitioners and Clinical Nurse Specialists. Interventions included any nurse(s), organisational and system interventions focused on optimising home care nursing. Papers were included if published between January 1, 2002 up to May 15, 2015. The review included 127 papers, including 94 studies, 16 descriptive papers, 6 position papers, 4 discussion papers, 3 policy papers, 2 literature reviews and 2 other. Optimisation factors were categorised under seven domains: Continuity of Care/Care; Staffing Mix and Staffing Levels; Professional Development; Quality Practice Environments; Intra-professional and Inter-professional and Inter-sectoral Collaboration; Enhancing Scope of Practice: and, Appropriate Use of Technology. Fragmentation and underfunding of the home care sector and resultant service cuts negatively impact optimisation. Given the fiscal climate, optimising the existing workforce is essential to support effective and efficient care delivery models. Many factors are inter-related and have synergistic impacts (e.g., recruitment and retention, compensation and benefits, professional development supports, staffing mix and levels, workload management and the use of technology). Quality practice environments facilitate optimal practice by maximixing human resources and supporting workforce stability. Role clarity and leadership supports foster more effective interprofessional team functioning that leverages expertise and enhances patient outcomes. Results inform employers, policy makers and relevant associations regarding barriers and enablers that influence the optimisation of home care nursing in nursing, intra- and inter-professional and inter-organisational contexts.

Revitalizing academic-service partnerships to resolve nursing faculty shortages

Vacancy rates of nursing faculty are on the increase as fewer educators are being prepared and nurses at the bedside are in short supply. Advanced practice nurses--uniquely suited to provide clinical education for undergraduate and graduate students--are underutilized. However, without release time, preparation as educators, ongoing support from education and administration, and remuneration for providing both evidence-based education and evidence-based patient care, they can hardly be expected to assume additional responsibilities. This article reviews academic-service partnerships, noting a general lack of published efficacy and cost-effectiveness data, and highlights 21st-century innovations for academia and service to share resources for the benefit of all stakeholders--especially patients and students.

Appreciative Leadership

Partnerships are relationships and are only as effective as the communication between participants. Partnerships imply building something new by bringing together varying elements to achieve mutual goals. Appreciative inquiry initiates change through questions derived from valuing. Leaders who use inquiry to initiate business planning to create academic and practice partnerships move away from traditional industrial models in healthcare to focus on the symbiotic, interdependent, and complex need for partnerships between education and practice as evidenced in exemplars.

Nursing research programs gather strength in Australia

To shed light on programmatic research through direct experience is highly beneficial to nursing scholarship. Following a recent description of a successful Australian program of research centered around people's chronic illness experience we are inspired to continue the commentary (Koch et al 2005). Koch et al's (2005) case study reported on several 'core elements' they believe have contributed to the growth and effectiveness of their program. In this paper we consider some of these in light of current literature and our own challenging experiences within several Australian universities. Koch et al (2005) also makes a not too subtle distinction between dedicated research units independent of universities and research programs emanating from academia, suggesting the former are more productive. While one of the authors in the above paper, a UK scholar and nursing academic, makes interesting observations about this assertion, we contend that his UK perspective fails to capture the urgency of establishing nursing research programs in Australian universities. Consequently, we have chosen to extend the discussion about nursing research programs from the perspective of Australian academe, including comment on building productive relationships, strengthening a track record, research and practice as symbiotic processes, competitive funding strategies, and the integral role of research students. The entire commentary is located in a celebratory context of 20 years of Australian nursing education in the university sector, a context not without controversy. We give consideration to the best way ahead for the future of nursing research programs and hope our ideas spark further sharing of experiences.