Can New Zealand achieve self-sufficiency in its nursing workforce?

Managing an ageing healthcare workforce: a systematic literature review

PURPOSE

The aim of this paper is to review research conducted on managing the ageing healthcare workforce and identify gaps for further research.

DESIGN/METHODOLOGY/APPROACH

A systematic literature search of studies in the English language was carried out in Scopus and Web of Science databases.

FINDINGS

The study consists of an analysis of 75 published articles. The majority of the papers were published in recent years, indicating a growing interest in the field. The authors specified the following inclusion criteria: all years, articles/reviews, English language and full text in the Web of Science and Scopus databases. The authors of the paper illustrated seven major categories with different topics that were suggested for future research. It included: challenges of labor market in the healthcare field, age-related changes and their influence on work ability, training opportunities and lifelong learning among ageing health workforce, motives of early retirement, ageing and its relationship to Occupational Health and Safety. Longitudinal studies and case study strategy with mixed-methods approaches were suggested for future research by the authors.

ORIGINALITY/VALUE

The paper summarizes knowledge related to the management of ageing health workforce, describes topics researched and as a result, presents findings on and conclusions about the most important future implications of the ageing workforce for management in the healthcare field providing lines for further research. To the authors' knowledge, no holistic systematic literature reviews have been published in academic journals targeted specifically to ageing healthcare workers.

Career interests of undergraduate nursing students: A ten-year longitudinal study

An understanding of students' career interests at entry and exit from undergraduate nursing programmes could inform decisions regarding curricula and clinical placements. Since 2006, the University of Auckland has surveyed healthcare students at entry to and exit from their respective programmes, collecting information on a range of demographic, and career-related factors. This article describes career interests of over 500 undergraduate nursing students in New Zealand over a ten-year period. All Bachelor of Nursing cohorts commencing between 2006 and 2016 were invited to complete a questionnaire which included questions about their career interests. In total 1875 questionnaires were completed (89% response rate). Among the overall cohort at entry, there was strongest interest for emergency care and child health, and least interest in older person's health. At exit, child health and surgery (general) were of strongest interest to the cohort, while older person's health remained of least interest. The analysis of the paired data (n = 564) identified decreases in interest for mental health and child health over the course of the programme, while there was an increased interest in primary health care. Changes in career interests indicate that education and clinical exposure to specialty areas during the programme may influence career interests.

Determining rural learning outcomes for medical student placements using a consensus process with rural clinical teachers

Short, longer and programmatic rural attachments have developed in a number of medical programmes around the world. However, there is limited literature on the development of the underpinning learning outcomes to guide these attachments. Rural populations are commonly under-served and the specific needs and challenges of rural health care need to be emphasised, as well as encouraging future practice in these areas. Our aim was to produce common rural-specific learning outcomes, aligned with a rationalisation of existing guiding principles and objectives, for our medical student regional-rural programmes. This was achieved through a Delphi technique involving the relevant clinical teachers and supervisors. Forty-nine consenting participants collectively provided 72 learning outcomes which were synthesised down to 16. A consensus process was used to anonymously rate and then rank to reach consensus for the top four learning outcomes. The learning outcomes were placed within the theoretical framework of a 'pedagogy of place' based on rurality and triangulated with rural learning outcomes from an Australian study. The four final outcomes were resolved around two areas of 'place': geographical and developmental. The co-design approach enabled those involved in providing the rural exposure education to generate appropriate learning outcomes.

Experiences of overseas nurse educators teaching in New Zealand

BACKGROUND

Globalisation and a shortage of registered nurses in New Zealand have caused an increase in the number of overseas qualified registered nurses and nurse educators migrating to New Zealand. This reflects the overall international context. If overseas qualified nurse educators are to work optimally, providing the maximum benefit for students, their experiences need to be examined in order to identify potential issues and provide support.

OBJECTIVES

To investigate the experiences of overseas qualified nurse educators teaching in New Zealand nursing schools and relate this to the international context.

DESIGN

A qualitative study using van Manen's hermeneutic approach to phenomenology.

METHODS

The lived experiences of 17 overseas qualified nurse educators were explored through in-depth, semi -structured individual interviews.

RESULTS

The study revealed that overseas qualified nurse educators initially experienced a sense of non-belonging in New Zealand, while their separation from their homeland and migration to a new country resulted in a sense of disorientation. Integration was the preferred method of adaptation to New Zealand among the study participants. However, they wanted to choose which aspects of the new culture they would adopt and to what extent they would adapt.

CONCLUSION

The initial phase of adaptation was a difficult process for the majority of participants, however, it was found that the adaptation process was easier for the participants who were actively engaging in New Zealand society. Understanding and improving the experiences of overseas qualified nurse educators will enable nursing students to receive maximum educational benefits wherever they train in the world.

New graduate separations from New Zealand's nursing workforce in the first 5 years after registration: a retrospective cohort analysis of a national administrative data set 2005-2010

AIM

To describe workforce separation rates and its relationship with demographic and work characteristics in the 2005 new graduate cohort's first 5 years as practising RNs in NZ.

BACKGROUND

Retaining new graduate RNs is critical to nursing workforce sustainability; one study showed that if an RN is still employed in a hospital setting 5 years after graduation, he/she tends to remain active in the health industry.

DESIGN

Retrospective analysis using the Nursing Council of New Zealand's registration data set for years 2005-2010.

METHODS

All newly registered NZ graduates practising in NZ in 2005 (n = 1236) were tracked for 5 years.

RESULTS

Within 5 years of graduation, 26% of the cohort had separated from the NZ nursing workforce, 18% in the first year. The under-25s (n = 517), 42% of the cohort, had the highest loss, 32%, in 5 years. Separations were significantly lower for graduates in their 30s vs. their 20s and for those who gained postgraduate tertiary qualifications post-registration (10%) vs. those who did not (29%). Hospitals were the most frequent employment setting over 5 years, the largest increase being community settings. Five-year retention rates in the four largest practice areas were surgical 26%, medical 16%, mental health 60% and continuing care 10%. After 5 years, 24% of those still practising (n = 920) worked in a different health board region.

CONCLUSIONS

New graduate RN losses were higher than in previous research, with younger RNs at most risk, threatening future sustainability of the nursing workforce and highlighting the need for evidence-based targeted strategies to retain them.

New graduate nurses as knowledge brokers in general practice in New Zealand: a constructivist grounded theory

Practice nursing in New Zealand is not well described in the literature. One survey illustrated that most of the New Zealand practice nurses sampled did not know of the country's two premier evidence-based health websites. A recent review compared general practice in the UK, New Zealand and Australia and found that whereas there had been significant developments in empowering the practice nurse workforce to run nurse-led clinics in the UK, New Zealand and Australia lagged behind. The aim of this reported constructivist grounded theory study was to investigate practice nurses' use of information. Conducted in Auckland, New Zealand, data were collected through ethnographic techniques in one general practice between September 2009 and January 2010 to enhance theoretical sensitivity to the area of information use. Subsequently, six experienced practice nurses (one twice after moving jobs) and five new graduate nurses from five different general practices were interviewed, using open-ended questions, between January 2010 and August 2011. Concurrent data collection and analysis occurred throughout the study period. The use of memos, the constant comparative method, data categorisation and finally, data abstraction resulted in the final theory of reciprocal role modelling. Experienced practice nurses role modelled clinical skills to new graduate nurses. Unexpectedly, new graduate nurses were unconscious experts at sourcing information and role modelled this skill to experienced practice nurses. Once this attribute was acknowledged by the experienced practice nurse, mutual learning occurred that enabled both groups of nurses to become better practitioners. Graduate nurses of the millennial generation were identified as a resource for experienced practice nurses who belong to the baby boomer generation and generation X.