Tourism, guest workers, and resident immiserization

This paper analyses the impact of a boom in tourism on the welfare of the residents in the presence of guest workers. Guest workers are employed in the tourism industry and they consume non-traded goods and services. This consumption by guest workers converts non-traded goods into
exportables and creates guest worker generated monopoly power in trade in the home country. It is established that under certain plausible conditions a tourist boom (in the presence of guest workers) results in the immiserization of the resident population. This result arises due to an adverse movement in the terms-of-trade, specifically those associated with the guest workers consumption of non-traded goods. These results are based on a static model of trade and may not be necessarily
valid in a growth model with guest workers, tourism and labor shortages. It is not the object of the paper to be either anti-tourism or anti-guest worker, but only to show a possible source of resident immiserization that is associated with guest workers. This possibility may require correction via a suitable policy both in static and dynamic models.

Complementary therapies or 'luxury' therapies? A nurse's experience in the use of complementary therapies in nursing practice

Complementary therapies have an increasing popularity. This case study explores the experience of a nurse who practises complementary therapies within the health care system where there is a still a widespread of skepticism within the medical profession. It is considered by the nurse that it is a 'luxury' to include these therapies in nursing practice.

Nurse academics meeting the challenges of scholarship and research

This research study explored nurse academics' perceptions and experiences of scholarship and research. Interviews were carried out with 20 nurse academics in four Australian states. A grounded theory approach was used to explore issues they faced. The paper discusses how academics engaged in research and scholarship integrate it into their work practices. The participants spoke of problems encountered, such as the difficulty of gaining higher degrees whilst undertaking additional research. They indicated they felt under significant pressure to publish. The organisational structures that a small number of institutions put in place to facilitate the development of a scholarly research culture are illustrated.

A trial of nurse practitioner scope of practice

Aims. The aim of this paper is to report a trial to investigate the feasibility of the nurse practitioner role in local health service delivery and to provide information about the educational and legislative requirements for nurse practitioner practice.

Background. Nurse practitioners have been shown to offer a beneficial service and fill a gap in health care provision. However, the lack of publications describing, critiquing, or defending the way that existing nurse practitioner roles have been developed may lead to a lack of clarity in comparing the nurse practitioner scope of practice internationally. In Australia, credible exploratory research is needed to realize the potential of nurse practitioners to bridge the divide of inequitable distribution of health services. A trial of nurse practitioner services in the Australian Capital Territory provided an excellent opportunity to investigate these scope and continuity issues.

Methods. This was an observational analytic study using multiple data sources. Four models of nurse practitioner service were chosen from a competitive field of applications that were evaluated according to efficacy, feasibility, and sustainability across specified selection criteria. Each model in the trial included a clinical support team, with the nurse practitioner candidate 'working-into-the-role' and collecting demographic, clinical practice, patient outcome, and health service and consumer survey data over a 10 month period.

Findings. The trial identified the broad potential of the nurse practitioner role, its breadth and limitations, and its impact on selected health services in the Australian Capital Territory. Data from individual models were compared highlighting generic elements, and formed the basis for the development of the scope of practice for the Australian Capital Territory nurse practitioner models.

Conclusions. This study has validated a research-based, iterative process for initial development of nurse practitioner scope of practice for any Australian specialization. Importantly, the study concluded with the scope of practice as a finding, rather than commencing with it a priori. Although general areas of health care need and under-servicing were identified at the outset, the process tested both the expansion and parameters of the roles.

Attitudes and perceptions of workers to sexual harrassment

The authors investigated how individual factors (age, gender, gender role, past experiences of sexual harassment) and organizational factors (gender ratio, sexual harassment policies, the role of employers) related to workers' attitudes toward and perceptions of sexual harassment. In Study 1, participants were 176 workers from a large, white-collar organization. In Study 2, participants were 75 workers from a smaller, blue-collar organization. Individuals from Study 2 experienced more sexual harassment, were more tolerant of sexual harassment, and perceived less behavior as sexual harassment than did individuals from Study 1. For both samples, organizational and individual factors predicted workers' attitudes toward and experiences of sexual harassment. Individual factors—such as age, gender, gender role, past experiences of sexual harassment, and perceptions of management's tolerance of sexual harassment—predicted attitudes toward sexual harassment. Workers' attitudes, the behavioral context, and the gender of the victim and perpetrator predicted perceptions of sexual harassment. The authors discussed the broader implications of these findings and suggested recommendations for future research.

A historical review of the nurse practitioner role in Australia

Internationally, the nurse practitioner role has been shown to be cost-effective, safe, and instrumental in improving patient outcomes. The nurse practitioner role in Australia is in its infancy. Major stakeholders such as the nurses' boards and state departments of health throughout Australia were contacted to identify major policies and discussion papers. Database searches were conducted in CINAHL and EBSCOhost. Disparity between states exists in all facets of the nurse practitioner role, especially in definition of the role, scope of practice, educational qualifications, and specialized functions. Access to Medicare funding is unobtainable, resulting in inequity of access to health services for disadvantaged communities. The State Nurse Practitioner Taskforce Reports highlight the disparity between the role of nurse practitioner in each State of Australia and has led to fragmentation of the role at a national level. There is a need for consistency, which could be achieved if it were coordinated by a national nursing body with a voice in national health policy development and implementation

Winners or losers? Work/life balance and temporary agency workers

This article focuses upon temporary' agency workers' capacity to balance work/life needs. Two extremes are identified within the Victorian temporary agency labour market. On the one hand, there are skilled temporary agency workers employed in areas of high demand accompanied by labour shortages. Nurses are one such group. At the other extreme, there are skilled and semi-skilled temporary agency workers who face a shortfall in demand for permanent, direct hire employees. Drawing upon a survey and focus groups of temporary agency workers, their potential for achieving a satisfactory work/life balance is assessed in relation to control over working time, income and employment security, and a narrow band of employment conditions. The findings differ substantially between the two groups of agency workers, contributing to significantly different perceptions of the personal benefits of working through a temporary employment agency.

Mature workers, training and using TLM frameworks

Mature workers have been at the centre of policies aimed at encouraging higher workforce participation, longer working life and enhanced savings for retirement. Low mature age workforce participation rates reflect labour market withdrawal in the face of multiple barriers to participation for many. Their apparent voluntary joblessness conceals the fact that mature workers endure longer periods of unemployment, discrimination, redundancy and other barriers to employment (hence the drift to 'early retirement'). The policy dilemma is not just about addressing discrimination barriers, access to appropriate retraining or skills enhancement for mature workers, but what this tells us about lifelong learning as a means of managing and mitigating risk. The mismatch between work opportunities/skills shortages and the low education and skills base of many mature workers, means it is simplistic to think that working longer might be a short term way to address skills shortages; without an enormous investment in the current ageing cohort. Drawing on Transitional Labour Market (TLM) theory and European reform agendas, this article argues that the link between investment in lifelong education/ skills training and stronger labour market participation needs attention; not just for current cohorts of excluded or underemployed mature workers but to position strategically for future generations.

Emergency nurse practitioner care and emergency department patient flow: case-control study

Objective: The present study aimed to compare ED waiting times (for medical assessment and treatment), treatment times and length of stay (LOS) for patients managed by an emergency nurse practitioner candidate (ENPC) with patients managed via traditional ED care. Methods: A case–control design was used. Patients were selected using the three most common ED discharge diagnoses for ENPC managed patients: hand/wrist wounds, hand/wrist fractures and removal of plaster of Paris. The ENPC group (n = 102) consisted of patients managed by the ENPC who had ED discharge diagnoses as mentioned above. The control group (n = 623) consisted of patients with the same ED discharge diagnoses who were managed via traditional ED care. Results: There were no significant differences in median waiting times, treatment times and ED LOS between ENPC managed patients and patients managed via traditional ED processes. There appeared to be some variability between diagnostic subgroups in terms of treatment times and ED LOS. Conclusion: Patient flow outcomes for ENPC managed patients are comparable with those of patients managed via usual ED processes.

Development, reliability and validity of an instrument measuring the attitudes and knowledge of emergency department staff regarding the emergency nurse practitioner role

Introduction: The Emergency Department (ED) at The Northern Hospital is currently participating in the Victorian Department of Human Services funded Emergency Nurse Practitioner Project. This project aims to develop, implement and evaluate the Emergency Nurse Practitioner role in Victorian EDs. This led to a need to develop a specific data collection tool called The Northern Emergency Nurse Practitioner Staff Survey to examine the knowledge and attitudes of ED medical and nursing staff. This paper describes the development of The Northern Emergency Nurse Practitioner Staff Survey and presents the results of reliability and validity studies. Method: Twenty-five items were developed and piloted on a sample of 58 ED medical and nursing staff. Content and face validity were established by expert panel review. Reliability was established by tests of unidimensionality, exploratory factor analysis and internal consistency. Results: Four items were discarded because of low item to total correlation. Exploratory factor analysis of the remaining items revealed five factors with eigenvalues >1 and acceptable correlation coefficients that explained 76.7% of the variance. Cronbach’s coefficent α for these items was 0.926 indicating a high degree of internal consistency. The factors were titled to reflect the content domain of the items in each factor and the factors arranged in a logical sequence to form the final version of The Northern Emergency Nurse Practitioner Survey.

Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department

This study examined the emergency nurse practitioner candidate (ENPC) scope of practice in a Victorian emergency department (ED). The emergency nurse practitioner (ENP) role is relatively new in Victoria and the scope of the ENP(C) practice is yet to be defined. International research literature regarding the ENP role has focused on outcomes such as patient satisfaction, waiting times and/or ED length of stay, accuracy and adequacy of documentation, use of radiography, and patient education, health promotion and communication issues. A prospective exploratory design was used to conduct this cohort study. There were 476 ENPC-managed patients between 14 July 2004 and 31 March 2005 with an average age of 29 years. The majority (77.2%) of ENPC-managed patients were discharged from the ED. The majority of the ENPC time was devoted to clinical practice (55%) and development of clinical practice guidelines (25%). Of patients managed by the ENPC, 49.6% required medications, 51% required diagnostic imaging and 8.6% required pathology testing during their ED stay. The most common discharge referrals were made to local medical officers (73.5%) and the most common referrals made for patients requiring admission were made to the plastic surgery (37.3%) and orthopaedic (35.5%) units. Extensions to the current scope of emergency nursing practice are pivotal to effective management of specific patient groups by ENP. The ENP model of care is an important strategy for the management of increased service demands in Victoria; however, little is known about the scope of the ENPC practice and many outcomes of the ENP care are yet to be defined. Further research to better understand the relationships between ENP outcomes is required if the contribution that ENPs make to emergency care is to be accurately quantified.