Equal pay for equal work

Truck from Jackson Pty Ltd with banner for equal pay for equal work during the 1965 May Day march, in Roma Street, Brisbane, Australia. Truck also has Queensland Trades and Labour Council of Queensland and affiliated unions banner. Facade of buildings including Vetoy and Foley Bros can be seen in the background.

Mental health nursing standards and practice indicators for Australia: a review of current literature

There are many changes and challenges facing the mental health care professional working in Australia in the 21st Century. Given the significance of their number and the considerable extent to which care is delivered by them, mental health nurses in particular must be at the forefront of the movement to enhance and improve mental health care. Mental health nurses in Australia must not only keep up with the changes, we should be setting the pace for others across the profession worldwide. The increasingly complex field of mental health nursing demands nurses who are not only equipped to face the challenges but are confident in doing so. Definitive guidelines for practice, clear expectations regarding outcomes and specific means by which to evaluate both practice and outcomes are vital. Strengthening the role and vision of mental health nursing so that there is clarity about both and highlighting core values by which to perform will enable us to become focused on our future and what we can expect to both give to and receive from our chosen profession and how we can, and do, contribute to mental health care. The role of the mental health nurse is undergoing expansion and there are new hurdles to overcome along with the new benefits this brings. To support this, nationally adopted, formalised standards of practice and means by which to measure these, i.e., practice indicators formerly known as clinical indicators, are required. It is important to have national standards and practice indicators because of the variances in the provision of mental health across Australia – different legislation regarding mental health policies and processes, different nursing registration bodies and Nursing Councils, for example – which create additional barriers to cohesion and uniformity. Improvements in the practice of mental health nursing lead to benefits for consumer outcomes as well as the overall quality of mental health care available in Australia. The emphasis on rights-based care, particularly consumer and carer rights, demands evidence-based, up-to-date mental health care delivered by competent, capable professionals. Documented expectations for performance by nurses will provide all involved with yardsticks by which to evaluate outcomes. Flowing on from these benefits are advances in mental health care generally and enhancements to Australia’s reputation and position within the health care arena throughout the world. Currently, the ‘Standards for Practice’ published by the Australian New Zealand College of Mental Health Nurses (ANZCMHN) in 1995 and the practice indicators developed by Skews et al. (2000) provide a less formal guide for mental health nurses working in Australia. While these earlier standards and practice indicators have played some role in supporting mental health nurses they have not been nationally or enthusiastically adopted and there are a multitude of reasons for this. This report reviews the current literature available on practice indicators and standards for practice and describes an evidence-based rationale as to why a review and renewal of these is required and why it is important, not just for mental health nurses but to the field of mental health in general. The term ‘practice indicator’ is used, except where a quotation utilises ‘clinical indicator’, to more accurately reflect the broad spectrum of nursing roles, i.e. not all mental health nursing work involves a clinical role.

Challenge or opportunity: can regional training hospitals capitalise on the impending influx of interns?

To the Editor: The increase in medical graduates expected over the next decade presents a huge challenge to the many stakeholders involved in providing their prevocational and vocational medical training. 1 Increased numbers will add significantly to the teaching and supervision workload for registrars and consultants, while specialist training and access to advanced training positions may be compromised. However, this predicament may also provide opportunities for innovation in the way internships are delivered. Although facing these same challenges, regional and rural hospitals could use this situation to enhance their workforce by creating opportunities for interns and junior doctors to acquire valuable experience in non-metropolitan settings. We surveyed a representative sample (n = 147; 52% of total cohort) of Year 3 Bachelor of Medicine and Bachelor of Surgery students at the University of Queensland about their perceptions and expectations of their impending internship and the importance of its location (ie, urban/metropolitan versus regional/rural teaching hospitals) to their future training and career plans. Most students (n = 127; 86%) reported a high degree of contemplation about their internship choice. Issues relating to career progression and support ranked highest in their expectations. Most perceived internships in urban/metropolitan hospitals as more beneficial to their future career prospects compared with regional/rural hospitals, but, interestingly, felt that they would have more patient responsibility and greater contact with and supervision by senior staff in a regional setting (Box). Regional and rural hospitals should try to harness these positive perceptions and act to address any real or perceived shortcomings in order to enhance their future workforce.2 They could look to establish partnerships with rural clinical schools3 to enhance recruitment of interns as early as Year 3. To maximise competitiveness with their urban counterparts, regional and rural hospitals need to offer innovative training and career progression pathways to junior doctors, to combat the perception that internships in urban hospitals are more beneficial to future career prospects. Partnerships between hospitals, medical schools and vocational colleges, with input from postgraduate medical councils, should provide vertical integration4 in the important period between student and doctor. Work is underway to more closely evaluate and compare the intern experience across regional/rural and urban/metropolitan hospitals, and track student experiences and career choices longitudinally. This information may benefit teaching hospitals and help identify the optimal combination of resources necessary to provide quality teaching and a clear career pathway for the expected influx of new interns.

An experimental study of the effects of work stress, work control, and task information on adjustment

The present study was designed to examine the main and interactive effects of task demands, work control, and task information on levels of adjustment. Task demands, work control, and task information were manipulated in an experimental setting where participants completed a letter-sorting activity (N = 128). Indicators of adjustment included measures of positive mood, participants' perceptions of task performance, and task satisfaction. Results of the present study provided some support for the main effects of objective task demands, work control, and task information on levels of adjustment. At the subjective level of analysis, there was some evidence to suggest that work control and task information interacted in their effects on levels of adjustment. There was minimal support for the proposal that work control and task information would buffer the negative effects of task demands on adjustment. There was, however, some evidence to suggest that the stress-buffering role of subjective work control was more marked at high, rather than low, levels of subjective task information.

The effects of work control and job demands on employee adjustment and work performance

The present study examined the effects of work control and job demands on employee adjustment and work performance using a multidimensional measure of work control (assessing levels of task control, decision control and work scheduling control). It was proposed that the negative effects of job demands and employee adjustment would be moderated by high levels of task control. It was also proposed that there would be evidence of main effects of both job demands and work control (particularly task-related levels of control) on employee adjustment. To test these predictions, a study of 135 university employees holding administrative positions was undertaken. Methodological improvements over previous research included the use of both self-reported adjustment measures and supervisor ratings of work performance as outcome variables, and the assessment of the predictor and outcome measures at different points in time (self-reported adjustment was assessed at both Times 1 and 2). The results revealed some support for the proposal that the effects of job demands would be buffered by high levels of task control, but not more peripheral aspects of work control. There were also significant main effects of task control on job satisfaction.

Effects of coping strategies, social support and work-nonwork conflict on shift worker's health

Objectives This study examines the direct and mediated effects of shift workers' coping strategies and social support on structural work-nonwork conflict and subjective health. Methods The participants were 172 registered female nurses, aged 21 to 40 years. They all worked full-time, on rapidly rotating, 8-hour shifts in metropolitan general hospitals. All the respondents completed a self-administered questionnaire requesting demographic information and data on sources of social support, work-nonwork conflict, and coping strategies. Results A path model with good fit (chi(2)=28.88, df=23, P>.23, CFI=0.97) demonstrated complex effects of social support and coping on structural work-nonwork conflict and health. Conclusions Structural work-nonwork conflict mediated the effects of social support from supervisors and emotionally expressive coping on psychological symptoms. Control of shifts mediated the effect of social support from supervisors on structural work-nonwork conflict. Disengagement coping had direct and mediated effects on psychological and physical health. However, it also had mediated effects, with the effect on psychological health being mediated by support from co-workers and the effect on physical symptoms being mediated by family support. Go-worker support mediated the effect of social support from supervisors on psychological symptoms. Overall, these findings support previous research and clarify the process by which coping strategies and social support affect structural work-nonwork conflict and health in shift work.