Competency Standards and Educational Requirements for Specialist Breast Nurses in Australia

There is substantial evidence that Specialist Breast Nurses (SBNs) make an important contribution to improved outcomes for women with breast cancer, by providing information and support and promoting continuity of care. However, a recent study has identified significant variation in how the role functions across individual nurses and settings, which is likely to contribute to varied outcomes for women with breast cancer. The project reported in this paper illustrates how a set of competency standards for SBNs were developed by the National Breast Cancer Centre. The competency standards were developed through a review of published literature and consultation with key stakeholders. The resulting SBN Competency Standards reflect the core domains and elements of SBN practice seen as integral to achieving optimal outcomes for women with breast cancer. This project identifies the SBN as a registered nurse who applies advanced knowledge of the health needs, preferences and circumstances of women with breast cancer to optimise the individual's health and well-being at various phases across the continuum of care, including diagnosis, treatment, rehabilitation, follow-up and palliative care. The five core domains of practice identified are: Supportive care; Collaborative care; Coordinated care; Information provision and education; and Clinical leadership. A variety of education programs are currently available for nurses who wish to learn about breast cancer nursing. The majority of stakeholders consulted in this project agreed that a Graduate Diploma level of education is required at minimum in order for an SBN to develop the minimum level of competence required to perform the role. The evidence supports the view that as an advanced role, nurses practising as SBNs require high-quality programs of sufficient depth and scope to achieve the required level of competence

Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.

Colin Marsh (2008) Becoming a Teacher: Knowledge, Skills and Issues. 4th edition, Frenchs Forrest: Pearson Education Australia, 460 pages

Becoming a Teacher is structured in five very readable sections. The introductory section addresses the nature of teaching and the importance of developing a sense of purpose for teaching in a 21st century classroom. It also introduces some key concepts that are explored throughout the volume according to the particular chapter focus of each part. For example, the chapters in Part 2 explore aspects of student learning and the learning environment and focus on how students develop and learn, learner motivation, developing self esteem and learning environments. The concepts developed in this section, such as human development, stages of learning, motivation, and self-concept are contextualised in terms of theories of cognitive development and theories of social, emotional and moral development. The author, Colin Marsh, draws on his extensive experience as an educator to structure the narrative of chapters in this part via checklists for observation, summary tables, sample strategies for teaching at specific stages of student development, and questions under the heading ‘your turn’. Case studies such as ‘How I use Piaget in my teaching’ make that essential link between theory and practice, something which pre-service teachers struggle with in the early phases of their university course. I was pleased to see that Marsh also explores the contentious and debated aspects of these theoretical frameworks to demonstrate that pre-service teachers must engage with and critique the ways in which theories about teaching and learning are applied. Marsh weaves in key quotations and important references into each chapter’s narrative and concludes every chapter with summary comments, reflection activities, lists of important references and useful web sources. As one would expect of a book published in 2008, Becoming a Teacher is informed by the most recent reports of classroom practice, current policy initiatives and research.

Colin Marsh (2010) Becoming a Teacher : Knowledge, Skills and Issues. 5th edition, Frenchs Forrest : Pearson Education Australia, 459 pages. [Book Review]

In the preface to the fifth edition of Becoming a Teacher, Colin Marsh reminds us that teachers need to have passion, energy and a commitment to enhance students’ learning. This most recent edition certainly provides examples of the author’s wide ranging knowledge and depth of insights that reflect his own commitment to inspirational and dedicated teaching practice. The fifth edition shares those characteristics which made previous editions so worthwhile. Most notable is the subtle but significant dual theme of Marsh’s narrative. That is, first, teaching is a vehicle for increasing the life opportunities of students, and second, teaching is profession that requires continual commitment and critical reflection. These are very important messages for any course that develops teaching methodology. Becoming a Teacher continues to be structured in five readable sections, however the 2010 edition has some exciting new features that warrant the attention of teacher educators and their pre-service students.

Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia

Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.

Training the natives as nurses in Australia: So what went wrong?

The story of the Aboriginal women who participated in Australias nursing history remains largely untold. In the first six decades of the twentieth century, Aboriginal people were confronted with harsh exclusionary practices that forced them to live in settlements, reserves and missions.¹ While many Aboriginal women worked in domestic roles (in white peoples homes and on rural properties), small numbers were trained at public hospitals and some Aboriginal women received training to be native nurses who worked in hospitals on settlements

In this chapter, an indigenous historical lens is applied to the status of Indigenous nurses and midwives in Australia.

Advertising education in Australia: Looking back to the future

In Australia, advertising is a $13 billion industry which needs a supply of suitably skilled employees. Over the years, advertising education has developed from vocational based courses to degree courses across the country. This paper uses diffusion theory and various secondary sources and interviews to observe the development of advertising education in Australia from its early past, to its current day tertiary offerings, to discussing the issues that are arising in the near future. Six critical issues are identified, along with observations about the challenges and opportunities within Australia advertising education. By looking back to the future, it is hoped that this historical review provides lessons for other countries of similar educational structure or background, or even other marketing communication disciplines on a similar evolutionary path.

Australia : LIS education

The topic of library and information science (LIS) education has been under the spotlight in the professional literature in Australia and New Zealand for a number of years. Critical issues of discussion encompass the apparent lack of a core curriculum for the discipline, the perceived gulf between LIS education and LIS practice, and the pressing need for career-long learning and development. One of the central points of debate that emerges repeatedly is the long-standing question about the positioning of the profession: Is LIS a graduate profession of highly skilled individuals valued for their expertise and professionalism or is it a profession of anyone who works in a library, regardless of their qualifications (LIANZA, 2005)? While Australia and New Zealand do not stand alone in this debate – similar issues are echoed in many other countries – there are inevitably some local characteristics which warrant exploration. The discussion presented here highlights the historical background to professional training, the specific professional policies and standards that guide LIS education and some of the challenges facing professional and paraprofessional education, given the changing environment of education in Australia as a whole, with some comparisons made with the New Zealand situation. While all too often library practitioners point the finger at the library educators to ‘right the wrongs’, the authors wish to reinforce the idea that the future of effective and relevant LIS education is a matter for all stakeholders in the profession: practitioners and educators, students and staff, employers and employees, with cohesion potentially offered by the professional body.

The experience of China-educated nurses working in Australia : a symbolic interactionist perspective

Transnational nurse migration is a growing phenomenon. However, relatively little is known about the experiences of immigrant nurses and particularly about non-English speaking background nurses who work in more economically developed countries. Informed by a symbolic interactionist framework, this research explored the experience of China-educated nurses working in the Australian health care system. Using a modified constructivist grounded theory method, the main source of data were 46 face to face in-depth interviews with 28 China-educated nurses in two major cities in Australia. The key findings of this research are fourfold. First, the core category developed in this study is reconciling different realities, which inserts a theoretical understanding beyond the concepts of acculturation, assimilation, and integration. Second, in contrast to the dominant discourse which reduces the experience of immigrant nurses to language and culture, this research concludes that it was not just about language and nor was it simply about culture. Third, rather than focus on the negative aspects of difference as in the immigration literature and in the practice of nursing, this research points to the importance of recognising the social value of difference. Finally, the prevailing view that the experience of immigrant nurses is largely negative belies its complexities. This research concludes that it is naïve to define the experience as either good or bad. Rather, ambivalence was the essential feature of the experience and a more appropriate theoretical concept. This research produced a theoretical understanding of the experience of China-educated nurses working in Australia. The findings may not only inform Chinese nurses who wish to immigrate but also contribute to the implementation of more effective support services for immigrant nurses in Australian health care organisations.

Teachers’ conceptions of essential knowledge for integrated social education : a middle years of schooling perspective from Australia

Integrated social education in Australia is a divisive educational issue. The last decade has been marked by a controversial integrated social studies curriculum called Studies of Society and Environment (SOSE) where history, geography and environmental studies were integrated with civics and citizenship. The introduction of a compulsory K-10 Australian Curriculum from 2011, however, marks the return to history and geography and the abandonment of SOSE. Curriculum reform aside, what do teachers think is essential knowledge for middle years social education? The paper reports on a phenomenographical exploration of thirty-one middle school teachers’ conceptions of essential knowledge for SOSE. Framed by Shulman’s (1986, 1987) theoretical framework of the knowledge base for teaching, the research identified seven qualitatively different ways of understanding essential knowledge for integrated social education. The study indicates a practice-based theorization of integrated social education that justifies attention to disciplinary process and teacher identity in middle school social education.

Examination of relationships and mediating effects of self-efficacy, locus of control, coping and the practice environment on caring efficacy and job satisfaction in Australian registered nurses

Background to the Problem: Improving nurses' self-efficacy and job satisfaction may improve the quality of nursing care to patients. Moreover, to work effectively and consistently with professional nursing standards, nurses have to believe they are able to make decisions about their practice. In order to identify what strategies and professional development programmes should be developed and implemented for registered nurses in the Australian context, a comprehensive profile of registered nurses and factors that affect nursing care in Australia needs to be available. However, at present, there is limited information available on a) the perceived caring efficacy and job satisfaction of registered nurses in Australia, and b) the relationships between the demographic variables general self-efficacy, work locus of control, coping styles, the professional nursing practice environment and caring efficacy and job satisfaction of registered nurses in Australia. This is the first study to 1) investigate relationships between caring efficacy and job satisfaction with factors such as general self-efficacy, locus of control and coping, 2) the nursing practice environment in the Australian context and 3) conceptualise a model of caring efficacy and job satisfaction in the Australian context. Research Design and Methods: This study used a two-phase cross-sectional survey design. A pilot study was conducted in order to determine the validity and reliability of the survey instruments and to assess the effectiveness of the participant recruitment process. The second study of the research involved investigating the relationships between the socio-demographic, dependent and independent variables. Socio-demographic variables included age, gender, level of education, years of experience, years in current job, employment status, geographical location, specialty area, health sector, state and marital status. Other independent variables in this study included general self-efficacy, work locus of control, coping styles and the professional nursing practice environment. The dependent variables were job satisfaction and caring efficacy. Results: A confirmatory factor analysis of the Brisbane Practice Environment Measure (B-PEM) was conducted. A five-factor structure of the B-PEM was confirmed. Relationships between socio-demographic variables, caring efficacy and job satisfaction, were identified at the bivariate and multivariable levels. Further, examination using structural equation modelling revealed general self-efficacy, work locus of control, coping style and the professional nursing practice environment contributed to caring efficacy and job satisfaction of registered nurses in Australia. Conclusion: This research contributes to the literature on how socio-demographic, personal and environmental variables (work locus of control, general self-efficacy and the nursing practice environment) influence caring efficacy and job satisfaction in registered nurses in Australia. Caring efficacy and job satisfaction may be improved if general self-efficacy is high in those that have an internal work locus of control. The study has also shown that practice environments that provide the necessary resources improve job satisfaction in nurses. The results have identified that the development and implementation of strategies for professional development and orientation programmes that enhance self-efficacy and work locus of control may contribute to better quality nursing practice and job satisfaction. This may further assist registered nurses towards focusing on improving their practice abilities. These strategies along with practice environments that provide the necessary resources for nurses to practice effectively may lead to better job satisfaction. This information is important for nursing leaders, healthcare organisations and policymakers, as the development and implementation of these strategies may lead to better recruitment and retention of nurses. The study results will contribute to the national and international literature on self-efficacy, job satisfaction and nursing practice.

Trends in nurse-administered procedural sedation and analgesia across cardiac catheterisation laboratories in Australia and New Zealand : results of an electronic survey

Background Knowledge of current trends in nurse-administered procedural sedation and analgesia (PSA) in the cardiac catheterisation laboratory (CCL) may provide important insights into how to improve safety and effectiveness of this practice. Objective To characterise current practice as well as education and competency standards regarding nurse-administered PSA in Australian and New Zealand CCLs. Design A quantitative, cross-sectional, descriptive survey design was used. Methods Data were collected using a web-based questionnaire on practice, educational standards and protocols related to nurse-administered PSA. Descriptive statistics were used to analyse data. Results A sample of 62 nurses, each from a different CCL, completed a questionnaire that focused on PSA practice. Over half of the estimated total number of CCLs in Australia and New Zealand was represented. Nurse-administered PSA was used in 94% (n = 58) of respondents CCLs. All respondents indicated that benzodiazepines, opioids or a combination of both is used for PSA (n = 58). One respondent indicated that propofol was also used. 20% (n = 12) indicated that deep sedation is purposefully induced for defibrillation threshold testing and cardioversion without a second medical practitioner present. Sedation monitoring practices vary considerably between institutions. 31% (n = 18) indicated that comprehensive education about PSA is provided. 45% (n = 26) indicated that nurses who administer PSA should undergo competency assessment. Conclusion By characterising nurse-administered PSA in Australian and New Zealand CCLs, a baseline for future studies has been established. Areas of particular importance to improve include protocols for patient monitoring and comprehensive PSA education for CCL nurses in Australia and New Zealand.

Influences on compliance with standard precautions among operating room nurses

Background Occupational exposures of health care workers occur because of inconsistent compliance with standard precautions. The purpose of this study was to develop national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses (specifically, scrub nurses) in Australia and to assess variables that influence compliance. Methods A descriptive correlation design was used to investigate relationships between variables and compliance, using a theoretical framework, the Health Belief Model, to give meaning to the variables. Data collection was done through mail-out surveys to members of the Australian College of Operating Room Nurses. Results This article reports the results of compliance with the following 2 specific self-protective behaviors: double-gloving and wearing adequate eye protection. Mean compliance rates were 55.6% with always double-gloving during surgical procedures and 92% with always wearing adequate eye protection. In addition, the variable that had the most influence on compliance was the perception of barriers to compliance, specifically, that adhering to standard precautions interfered with duties. Conclusion These results have implications for the development of multifaceted perioperative infection control programs, including strategies for prevention, education, and policy development, to improve practices aimed at reducing occupational exposures among this high-risk group.