Nursing educations and graduates : profiles for 2001 and projections for 2002

The present study was commissioned for the National Review of Nursing Education. This is the second of two national studies commissioned to map in detail nursing education programs and to profile and make future projections regarding graduates from undergraduate and postgraduate nursing education courses in Australia.

The first study was undertaken in 2001 by Deakin University School of Nursing under the auspices of the 2001 Evaluation Investigations Project titled "Nursing Education and Graduates: Profiles for 1999, and 2000 with projections for 2001". This project sought data on nursing education within Australia in order to improve the accuracy of nursing education databases and to strengthen the ability of DETYA to provide advice on workforce planning. Issues that arose from that project included differences in data sets for undergraduate nursing courses in Australia and the complex process of attempting to tease out and accurately quantify postgraduate specialty courses when a trend towards postgraduate generic courses was evident. Approximately 26% of postgraduate domestic student enrolment data were reported utilising a generic nursing course category.

The purpose of this study was, therefore, twofold. Firstly, this study validated and extended the existing database developed in the previous study mapping in detail the full range of undergraduate programs offered by tertiary education providers across Australia that lead to an initial qualification and entry into nursing practice.

New data about the following was sought:

* Undergraduate nursing degrees (both three-year and four-year courses);
* Double/combined nursing degrees;
* Courses offered by private universities;
* Four-year bachelor degrees that concurrently provide both initial nurse registration and preparation for specialty nursing practice;
* Courses that facilitate ‘fast-tracking’ of students for initial nurse registration with previous tertiary or nursing studies,
* Hours and configuration of clinical experience in undergraduate nursing courses.

Clinical education : a challenging component of undergraduate nursing education

Clinical education is an essential part of every undergraduate nursing curriculum. The main benefits are that it allows students to put theory into practice and experience the realities of the practice- based nursing profession. Limitations include the unstable nature of the clinical area as a learning environment and the challenges this produces with students' assessments. This article reviews the literature and concludes there is room for significant improvement in the area of clinical education and numerous strategies can be implemented to do so.

Should nurse academics engage in clinical practice?

The education of nurses has traditionally been conducted in the hospital based setting. This changed over the last few decades, with nursing education now being a tertiary based course in many countries. There were numerous reasons for this move, the main goal being to improve the educational experience of students and thus the competence of graduates. Nurse academics whose role is to educate students are faced with the challenge of ensuring their teaching reflects the contemporary nursing environment. One way of doing this is by actively engaging in clinical practice. However there are arguments for and against (as well as barriers to) them doing so and little empirical evidence to support either argument. Individually, nurse academics must make a decision about whether engaging in clinical practice is beneficial to their career and the students they teach.

Clinical risk managment and the ethics of open disclosure : part 2 : implications for the nursing profession

Patient safety experts and other authorities have strongly postulated the open disclosure of errors and adverse events to patients and their nominated support persons as an essential component of effective clinical risk management in health care. Commentators also contend that ‘when things go wrong’, openly disclosing such events to the patient is simply ‘the right thing to do’. Important questions about the ethics of open disclosure remain, however. Is openly disclosing errors and adverse events to patients necessarily ‘the right thing to do’? Do hospital authorities and health care professionals always have an overriding duty to openly communicate with patients and their families when thing go wrong? If patients do not suffer any material harm when a mistake is made, should they or their nominated support persons still be told? Are there overriding moral considerations that might justify non-disclosure in certain circumstances? Despite the obvious importance of these issues and their possible implications for the nursing profession, they have not been comprehensively explored in the nursing literature. An important aim of this article (the second of a two-part discussion) is to contribute to the positive project of redressing this oversight.

Generation of statements for the development of clinical indicators for mental heath nursing in New Zealand : achieving a bicultural focus

Aim : In this paper, the first of 4 stages of a large study aiming to develop culturally and clinically valid clinical indicators to flag the achievement of mental health nursing standards of practice in New Zealand are described.

Methods : A bicultural design was employed throughout the research project to ensure that nurses' views of practice and the cultural differences between New Zealand's indigenous Maori and non-Maori peoples could be identified. Accordingly, separate focus groups of Maori- and non-Maori-experienced mental health nurses were asked to develop lists of statementd reflective of the Australian and New Zealand College of Mental Health Nurses' Standards of Practice in New Zealand.

Results : The focus group participants produces 473 statements, which were synthesized into 190 clinical indicator statements. In keeping with the bicultural research design, Maori and non-Maori data were analysed separately until the data were merged to provide a single set of indicator statements. Although both Maori and non-Maori groups wrote statements relevant to clinical practice, there was a difference in the way the 2 groups addressed cultural issues. The Maori focus group wrote statements about cultural issues for 4 of the 6 Standards of Practice, whereas the non-Maori focus group participants wrote statements about cultural issues for only the Standard focusing on cultural safety.

Conclusion : The research design of this project in mental health nursing was unique in that it sought the perspectives of both indigenous and non-indigenous nurses about quality mental health nursing practice related to the professional standards of practice. The involvement of Maori and non-Maori mental health nurses enhanced the cultural and clinical validity of the study and the obtained from it. The bicultural approach adopted for the study highlights the need for more mental health nursing research involving indigenous partners.

New Zealand development and trial of mental health nursing clinical indicators - a bicultural study

This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand. ANZCMHN, Greenacres). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. During the national field study, consumer files (n=327) from 11 District Health Boards, and registered nurses (n=422) completed an attitude questionnaire regarding the regularity of specific nursing and service activities. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5–89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.

Collaboration : integrating education and clinical practice : The Case of La Trobe University/The Alfred Clinical School of Nursing

A Clinical School of Nursing combines resources, opportunities and benefits for hospital and university staff as well as students. Collaboration is essential in the partnership between the two institutions and aspects will be explored in this paper, including antecedent conditions of organisational commitment, cooperation and trust, identification of costs, and a formal agreement. Collaboration itself is built on cooperative endeavour, willing participation, shared planning and decision making, a team approach, and shared responsibility and power. These attributes are readily identifiable in this exciting initiative.

The learning experience of nursing students in a clinical setting

Analysed the experiences of nine baccalaureate degree nursing students in their final year of a School of Nursing in a small provincial acute hospital setting in New Zealand. The findings draw attention to the factors influencing the nursing student's learning experience, and create an awareness for favourable change.

Clinical teachers' conceptions of nursing

Lack of knowledge exists about clinical teachers’ understanding of nursing. A likely relationship between teachers’ conceptions of nursing and what they focus on when teaching nursing students in the clinical setting means that the identification of different conceptions of nursing is important. This study investigated clinical teachers’ experiences of nursing and clinical teaching of undergraduate nursing students. This article reports on clinical teachers’ conceptions of nursing. Semistructured interviews of 20 nurses employed as clinical teachers in Australian universities were conducted. Data were analyzed using a phenomenographic approach. The findings suggest that nursing is conceived as performing tasks; providing appropriate care; providing individualized patient care aimed at achieving patient outcomes; or collaborating with health care team members to provide appropriate, individualized patient care aimed at achieving patient outcomes. Insights will assist with future preparation and support of clinical teachers, the education of nursing students, and improved curriculum design.