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Lindsay DJ, Ahern TA, Pardon MK, McAuliffe MT, Rannard SG. Student Employment Models for Undergraduate Nurses and Midwives in Australia: A Scoping Review. SAGE Open Nurs 2023; 9:23779608231186026. [PMID: 37425286 PMCID: PMC10328162 DOI: 10.1177/23779608231186026] [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: 04/13/2023] [Revised: 05/10/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Evidence has shown that throughout their undergraduate years, many nursing and midwifery students obtain paid employment in a wide variety of clinical and non-clinical positions. Across Australia, inconsistencies exist in the models of clinical employment available to these student groups. Previous Australian studies have described the employment of undergraduate nursing and midwifery students in regulated and unregulated clinical roles. No studies have reported on the various regulated roles available to both student nurses and midwives in Australia. The purpose of this scoping review is to identify and synthesize evidence related to nursing and/or midwifery students employed in regulated and unregulated clinical roles in Australia. Methods This scoping review utilized published recommendations for data screening, abstraction, and synthesis. One of the authors, a librarian, undertook systematic searches in CINAHL Complete (1937-present), Emcare on Ovid (1995-present), Scopus (1969-present), and Ovid MEDLINE(R) (including Epub Ahead of Print, In-Process, and In-Data-Review & Other Non-Indexed Citations, 1946-present). The initial searches were completed in April 2019 and repeated in March 2021 and May 2022 to identify any new literature. Manual searching of reference lists in the included papers was also undertaken, together with selected organizational websites. The extracted data included the lead author, date, title, study design, study sample and location, and key findings. Results From the 53 items retrieved, 23 peer-reviewed studies met the inclusion criteria and were included in the review. All items were published between 2011 and 2022. Only four of the studies focused upon student midwives. Undergraduate nursing and midwifery students in Australia obtain paid employment in a variety of regulated and unregulated clinical roles. Conclusion The literature reported here demonstrates that there are differing models, nomenclature, educational requirements, and pay scales in place for student employment in clinical roles across Australian states and territories.
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Affiliation(s)
- David J. Lindsay
- College of Healthcare Sciences, Nursing and
Midwifery, James Cook University, Townsville, Australia
| | - Tracey A. Ahern
- College of Healthcare Sciences, Nursing and
Midwifery, James Cook University, Townsville, Australia
| | - Madelyn K. Pardon
- College of Healthcare Sciences, Department of
Psychology, James Cook University, Townsville, Australia
| | - Marie T. McAuliffe
- College of Healthcare Sciences, Nursing and
Midwifery, James Cook University, Townsville, Australia
| | - Sam G. Rannard
- Library and Information Services, James Cook University, Townsville, Australia
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Roche MA, Glover S, Luo X, Joyce M, Rossiter C. Extending the role of nursing assistants in mental health inpatient settings: A multi-method study. Int J Ment Health Nurs 2021; 30:1070-1079. [PMID: 33742529 DOI: 10.1111/inm.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
With continued growth in the demand for nursing care, many organizations have incorporated nursing assistants into the acute care workforce. However, role descriptions are often generic and do not provide clarity in specialist areas such as mental health inpatient settings. Issues have been noted regarding the role of assistants, delegation, and their integration with the nursing team. This study extended an existing set of care activities and explored the perceptions of nursing assistants and registered nurses regarding these activities. A modified Delphi approach added 14 new care activities for nursing assistants. A follow-up survey found significant differences between nursing assistants and registered nurses regarding utilization of the activities, delegation, teamwork, and role clarity. Future research must incorporate the perspectives of those with lived experience of mental health issues, and develop an understanding of the interactions between nursing assistant care activities and other factors such as local supports, skillmix, and the practice environment, as these may impact how an organization can introduce nursing assistants to specialty areas while maintaining consumer and staff safety.
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Affiliation(s)
- Michael A Roche
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia.,School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Suzanne Glover
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Xiaoou Luo
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Mark Joyce
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Chris Rossiter
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
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Blay N, Roche MA. A systematic review of activities undertaken by the unregulated Nursing Assistant. J Adv Nurs 2020; 76:1538-1551. [PMID: 32190928 DOI: 10.1111/jan.14354] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/05/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Abstract
AIM To identify activities performed by Nursing Assistants in acute and primary healthcare. DESIGN Systematic review. DATA SOURCES The databases MedLine/PubMed, ProQuest and Google Scholar were searched for empirical studies published in the English language between 2008 and 2018 that addressed the work of Nursing Assistants. REVIEW METHODS From an initial yield of 2,944 publications, 71 publications were retained for full text review and 20 publications included in this review. Activities undertaken by Nursing Assistants from eight countries were extracted and categorized into one of six categories. RESULTS Over 200 activities were identified as being delegated to Nurse Assistants globally. Many of these activities are beyond the training of the Nurse Assistant and are being performed with limited Registered Nurse supervision. CONCLUSION Patient safety is at risk. Nurse Assistants' roles vary widely, with some seeing their role as similar to that of a regulated nurse, while recognizing their need for additional training. IMPACT Over 31% of activities delegated to Nurse Assistants require skill and comprehension beyond their level of training. Patients and regulated nurses need to have confidence that Nursing Assistants responsible for care provision are appropriately trained and practicing within regulatory standards.
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Affiliation(s)
- Nicole Blay
- Western Sydney University School of Nursing and Midwifery, Penrith South DC, NSW, Australia.,Ingham Medical Institute, Liverpool, NSW, Australia.,South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Michael Anthony Roche
- University of Technology Sydney, Ultimo, NSW, Australia.,Mental Health Drug and Alcohol Directorate, Northern Sydney Local Health District, North Ryde, NSW, Australia
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Crevacore CA, Duffield CM, Twigg DE. Undergraduate registered nursing students working as assistants in nursing within the acute care environment: Program development and discussion. Collegian 2019. [DOI: 10.1016/j.colegn.2018.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gerace A, Muir-Cochrane E, O'Kane D, Couzner L, Palmer C, Thornton K. Assistants in nursing working with mental health consumers in the emergency department. Int J Ment Health Nurs 2018; 27:1729-1741. [PMID: 29762891 DOI: 10.1111/inm.12477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2018] [Indexed: 12/19/2022]
Abstract
Nursing students, regardless of setting, require skills in working with people with mental health issues. One way to provide students with learning opportunities within the context of limited undergraduate mental health content and lack of mental health placements is through employment as assistants in nursing (AIN). The purpose of the study was to investigate the use of AINs employed in an emergency department in South Australia to supervise (continuous observation) mental health consumers on inpatient treatment orders. Twenty-four participants took part in the study, with AINs (n = 8, all studying in an undergraduate nursing programme), nurse managers (n = 5), and nurses (n = 11) participating in semi-structured interviews. Data were analysed using thematic analysis. Themes focused on (i) the AIN role, their practice, boundaries or restrictions of their role, and the image consumers have of AINs; (ii) learning through experience, where the AIN role was a practical opportunity to learn and apply knowledge obtained through university studies; and (iii) support, which focused on how AINs worked with nursing staff as part of the healthcare team. Overall, participants believed that AINs played an important role in the ED in supervising consumers on involuntary mental health treatment orders, where their unique role was seen to facilitate more positive consumer experiences. The AIN role is one way for nursing students to develop skills in working with people with mental health issues.
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Affiliation(s)
- Adam Gerace
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,School of Health, Medical and Applied Sciences, Central Queensland University, Norman Gardens, Queensland, Australia
| | - Eimear Muir-Cochrane
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Deb O'Kane
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Leah Couzner
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Christine Palmer
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Karleen Thornton
- Nursing and Midwifery Education, Research and Practice Development Department, Northern Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
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Boardman G, Lawrence K, Polacsek M. Preceptors' perspectives of an integrated clinical learning model in a mental health environment. Int J Ment Health Nurs 2018; 27:1420-1429. [PMID: 29441663 DOI: 10.1111/inm.12441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 11/29/2022]
Abstract
Supervised clinical practice is an essential component of undergraduate nursing students' learning and development. In the mental health setting, nursing students traditionally undertake four-week block placements. An integrated clinical learning model, where preceptors mentor students on an individual basis, has been used successfully in the clinical learning environment. This flexible model provides the opportunity for students to work across morning, afternoon, night and weekend shifts. There is a need to improve the evidence base for a flexible model for students undertaking a mental health placement. The aim of this study was to understand preceptors' experience of, and satisfaction with, a mental health integrated clinical learning model. Focus groups were used to elicit the views of preceptors from a mental health service. Findings highlight the advantages and disadvantages of an integrated clinical learning model in the mental health setting. Participants suggested that students may benefit from flexible work arrangements, a variety of experiences and a more realistic experience of working in a mental health service. However, they found it challenging to mentor and evaluate students under this model. Most also agreed that the model impeded students' ability to engage with consumers and develop rapport with staff. The findings indicate the need to develop a placement model that meets the unique needs of the mental health setting.
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Affiliation(s)
- Gayelene Boardman
- College of Health and Biomedicine (Nursing & Midwifery), Victoria University, Melbourne, Victoria, Australia
| | - Karen Lawrence
- College of Health and Biomedicine (Nursing & Midwifery), Victoria University, Melbourne, Victoria, Australia
| | - Meg Polacsek
- College of Health and Biomedicine (Nursing & Midwifery), Victoria University, Melbourne, Victoria, Australia
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Cowan D, Frame N, Brunero S, Lamont S, Joyce M. Assistants' in nursing perceptions of their social place within mental health-care settings. Int J Ment Health Nurs 2015; 24:439-47. [PMID: 26032120 DOI: 10.1111/inm.12137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
An international nurse shortage, tightening fiscal constraints, and increased service demands have seen health systems increasingly turn to employing assistants in nursing (AIN) as a cost-effective means to meet demand. This paper describes social positioning from the perspective of 11 AIN who were employed to work in specialist mental health settings in a metropolitan health service in Sydney. Data was collected by means of semistructured interviews. Interview questions encouraged AIN to explore their experience with reference to positioning within the service, role perception, role development, staff relationship, and role satisfaction. Thematic analysis was utilized to generate themes and explore meaning within the data. The following themes emerged: role definition and clarity; socialization and adaptation; and enhancing education. Analysis suggests that whilst AIN were integrated into mainstream service, the scope of activities or role remains geographically variable and inconsistent. Encouragingly, as AIN became familiar with their work environments and teams, they considered themselves to be of value and were able to play a meaningful role. A desire for learning and a need for continuing education also emerged as a primary theme. Findings from the data suggest that AIN in the mental health setting remain a novel and, to some extent, poorly utilized resource.
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Affiliation(s)
- Darrin Cowan
- Mental Health Drug and Alcohol Macquarie Hospital, Sydney, New South Wales, Australia
| | - Nicholas Frame
- Mental Health Drug and Alcohol Macquarie Hospital, Sydney, New South Wales, Australia
| | - Scott Brunero
- Mental Health Liaison, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Scott Lamont
- Mental Health Liaison, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Mark Joyce
- Mental Health Drug and Alcohol Macquarie Hospital, Sydney, New South Wales, Australia
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Direct care activities for assistants in nursing in inpatient mental health settings in Australia : A modified Delphi study. Collegian 2015; 22:53-60. [DOI: 10.1016/j.colegn.2013.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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