A snapshot of Australian nurse practitioners’ extended practice activities

Introduction The Australian Nurse Practitioner Project (AUSPRAC) was initiated to examine the introduction of nurse practitioners into the Australian health service environment. The nurse practitioner concept was introduced to Australia over two decades ago and has been evolving since. Today, however, the scope of practice, role and educational preparation of nurse practitioners is well defined (Gardner et al, 2006). Amendments to specific pre-existing legislation at a State level have permitted nurse practitioners to perform additional activities including some once in the domain of the medical profession. In the Australian Capital Territory, for example 13 diverse Acts and Regulations required amendments and three new Acts were established (ACT Health, 2006). Nurse practitioners are now legally authorized to diagnose, treat, refer and prescribe medications in all Australian states and territories. These extended practices differentiate nurse practitioners from other advanced practice roles in nursing (Gardner, Chang & Duffield, 2007). There are, however, obstacles for nurse practitioners wishing to use these extended practices. Restrictive access to Medicare funding via the Medicare Benefit Scheme (MBS) and the Pharmaceutical Benefit Scheme (PBS) limit the scope of nurse practitioner service in the private health sector and community settings. A recent survey of Australian nurse practitioners (n=202) found that two-thirds of respondents (66%) stated that lack of legislative support limited their practice. Specifically, 78% stated that lack of a Medicare provider number was ‘extremely limiting’ to their practice and 71% stated that no access to the PBS was ‘extremely limiting’ to their practice (Gardner et al, in press). Changes to Commonwealth legislation is needed to enable nurse practitioners to prescribe medication so that patients have access to PBS subsidies where they exist; currently patients with scripts which originated from nurse practitioners must pay in full for these prescriptions filled outside public hospitals. This report presents findings from a sub-study of Phase Two of AUSPRAC. Phase Two was designed to enable investigation of the process and activities of nurse practitioner service. Process measurements of nurse practitioner services are valuable to healthcare organisations and service providers (Middleton, 2007). Processes of practice can be evaluated through clinical audit, however as Middleton cautions, no direct relationship between these processes and patient outcomes can be assumed.

Australian construction industry KPIs

The Australian Construction Industry Forum (which is a peak industry association) and the Australian Procurement and Construction Council (which is a peak government organisation) have jointly agreed on a set of KPIs for the Australian Construction Industry. The goal of such a process is to work collaboratively in order to lift industry performance overall, and thereby bring about economic and social benefits to the industry and broader community. This paper seeks to underpin the process of KPI measurement by providing: an overview of international approaches to KPI measurement, summary of difficulties identified in performance measurement together with possible responses to these problems, and finally a discussion on the various methods for reporting KPIs. A number of findings throughout the paper, based on the review, made in order to advance the goal of performance measurement in the construction industry in Australia. Such findings would be relevant to other countries considering a KPI measurement process as well.

Skills for creative industries graduate success

Purpose: Although there is increasing evidence that the creative industries are essential to national economic growth as well as social and cultural well-being, creative graduates often find it difficult to become established professionally. This study investigates the value of career management competence and intrinsic career motivations (as elements of ‘protean career orientation’) in predicting positive graduate outcomes. ----- ----- Design/methodology: Self-report surveys were administered to 208 creative industries graduates from two Australian universities at two points in time: at course completion, and one year later. ----- ----- Findings: Individual career management competence and intrinsic work motivations, measured at course completion, were significant predictors of early career success, using both subjective and objective measures, measured one year later. ----- ----- Practical implications: This study suggests that an emphasis on student development beyond the traditional ‘key’ employability skills may well be worthwhile. The article also suggests a broad learning and teaching approach by which universities can encourage the development of student career identity, and thus engender student intrinsic career motivations and career self management skills and behaviours. ----- ----- Originality/value: This is one of the first studies to demonstrate empirically a link between a particular set of skills and graduate outcomes. In addition, it provides insights into the role of student career motivations in positive transitions to the world of work in the creative industries.

Gender equality in national politics : the views of Australian male politicians

Studies of gender and politics have typically been studies of women and politics. In contrast, this paper places men at the centre of its inquiry by drawing on interviews with 15 current federal male politicians. Of concern is exploring the ways in which men conceptualise the question of gender equity in the Australian parliament. Three frameworks are identified in the men's narratives. These are that the parliament is a masculinised space but that this is unavoidable; that the parliament is now feminised and women are advantaged; and that the parliament is gender neutral and gender is irrelevant. It is argued that collectively these framing devices operate to mask the many constraints which exist to marginalise women from political participation and undermine attempts to address women's political disadvantage as political participants. The paper concludes by highlighting the significance of the paper beyond the Australian context and calling for further research which names and critiques political men and their discourses on gender and parliamentary practices and processes.

Out of touch? On the lack of emotional support over the mobile phone

Findings from an Australian case study of adult women expose general, light and basic use of mobile phones. Participants used their mobile phone mainly for coordination and to a lesser extent for practicing intrinsic interactions motivated by emotional support purposes. This paper focuses on social and emotional support over the mobile phone. Though crucial to individuals, emotional support seems to be a neglected area of research among mobile communication studies, all the more so when focusing on adult women. This study addresses this literature gap. The empirical findings are based on a case study of 26 women over 35 years of age residing in one coastal Australian town. The research design included a combination of quantitative and qualitative methods. This paper examines the communication methods adult women use for social and emotional support, and analyses reasons and social implications of this limited intrinsic communication use pattern over the mobile phone.

The Simple Laws of Proportion

The Simple Laws of Proportion was shortlisted in the 2010 John Marsden Writing Prize for Young Australian Writers. It was subsequently published online by Express Media in December, 2010.

‘You can interview me, but I don’t have a story’: Local Accounts of Wandering Women, Rewondering Queensland Landscapes.

This paper investigates how contemporary works of women’s travel writing are reworking canonical formations of environmental literature by presenting imaginative accounts of travel writing that are both literal and metaphorical. In this context, the paper considers how women who travel/write may intersect the spatial hybridities of travel writing and nature writing, and in doing so, create a new genre of environmental literature that is not only ecologically sensitive but gendered. As the role of female travel writers in generating this knowledge is immense but largely unexamined, this paper will investigate how a feminist geography can be applied, both critically and creatively, to local accounts of travel. It will draw on my own travels around Queensland in an attempt to explore how many female storytellers situate themselves, in and against, various discourses of mobility and morality.

A green drought : the challenge of mentoring for Australian accounting academics

Purpose: The purpose of this paper is to expose the impact of the shortage of senior academics,particularly professors, in Australian accounting schools, to relate the way one school addressed this shortage through a mentoring scheme, and to challenge existing institutional arrangements.----------- Design/methodology/approach: This is a contextualised qualitative case study of a mentoring scheme conducted in an Australian accounting school. Data collected from semi-structured interviews, personal reflections and from Australian university web sites are interpreted theoretically using the metaphor of a “green drought”.---------- Findings: The mentoring scheme achieved some notable successes, but raised many issues and challenges. Mentoring is a multifaceted investment in vocational endeavour and intellectual infrastructure, which will not occur unless creative means are developed over the long term to overcome current and future shortages of academic mentors.---------- Research limitations/implications: This is a qualitative case study, which, therefore, limits its generalisability. However, its contextualisation enables insights to be applied to the wider academic environment. ----------Practical implications: In the Australian and global academic environment, as accounting professors retire in greater numbers, new and creative ways of mentoring will need to be devised. The challenge will be to address longer term issues of academic sustainability, and not just to focus on short-term academic outcomes.---------- Originality/value: A mentoring scheme based on a collegial networking model of mentoring is presented as a means of enhancing academic endeavour through a creative short-term solution to a shortage of accounting professors. The paper exemplifies the theorising power of metaphor in a qualitative study.

Australian landscape architecture in China

Urbanisation of the Chinese landscape continues at a great pace. Landscape architecture is only a newly recognized profession here, in contemporary practice terms at least, but our expertise is in great demand. However only some Australian companies and a few Australian expats have managed to overcome the complexities of working in the Chinese context. It is worthwhile knowing how some of these individuals reflect on working in China and what they consider to be our strongest areas of expertise here.

12 fingers or one, it’s how you play? Genetic discrimination in the Australian workforce

For quite some time, debate has raged about what the human race can and should do with its knowledge of genetics. We are now nearly 60 years removed from the work of Watson and Crick who determined the structure of deoxyribonucleic acid (DNA), yet our opinions as how best to employ scientific knowledge of the human genome, remain as diverse and polarised as ever. Human judgment is often shaped and coloured by popular media and culture, so it should come as no surprise that box office movies such as Gattaca (1997) continue to play a role in informing public opinion on genetics. In order to perform well at the box office, movies such as Gattaca take great liberty in sensationalising (and even distorting) the implications that may result from genetic screening and testing. If the public’s opinion on human genetics is strongly derived from the box office and popular media, then it is no wonder that the discourse on human genetics is couched in the polar parlances of future utopias or future dystopias. When legislating in an area like genetic discrimination in the workforce, we must be mindful of not overplaying the causal link between genetic predisposition towards a disability and an employee’s ability to perform the inherent requirements of their job. Genetic information is ultimately about people, it is not about genes. Genetic discrimination is ultimately about actions, it is not about the intrinsic value of genetic information.

The Australian Palliative Care Outcomes Collaboration (PCOC) : measuring the quality and outcomes of palliative care on a routine basis

Australia is leading the way in establishing a national system (the Palliative Care Outcomes Collaboration – PCOC) to measure the outcomes and quality of specialist palliative care services and to benchmark services across the country. This article reports on analysis of data collected routinely at point-of-care on 5939 patients treated by the first fifty one services that voluntarily joined PCOC. By March 2009, 111 services have agreed to join PCOC, representing more than 70% of services and more than 80% of specialist palliative care patients nationally. All states and territories are involved in this unique process that has involved extensive consultation and infrastructure and close collaboration between health services and researchers. The challenges of dealing with wide variation in outcomes and practice and the progress achieved to date are described. PCOC is aiming to improve understanding of the reasons for variations in clinical outcomes between specialist palliative care patients and differences in service outcomes as a critical step in an ongoing process to improve both service quality and patient outcomes. What is known about the topic? Governments internationally are grappling with how best to provide care for people with life limiting illnesses and how best to measure the outcomes and quality of that care. There is little international evidence on how to measure the quality and outcomes of palliative care on a routine basis. What does this paper add? The Palliative Care Outcomes Collaboration (PCOC) is the first effort internationally to measure the outcomes and quality of specialist palliative care services and to benchmark services on a national basis through an independent third party. What are the implications for practitioners? If outcomes and quality are to be measured on a consistent national basis, standard clinical assessment tools that are used as part of everyday clinical practice are necessary.

The Australian Parliament: a gendered organisation

This study, drawing on interviews with 13 male and 15 female members of the Australian parliament, has two aims. The first is to contribute to knowledge about the nature of the Australian parliament, an institution which has seldom been subjected to gender analysis. This is particularly pertinent given the significant increase in women's representative status over the past decade. The second of the paper's aims is to demonstrate the efficacy of contemporary gender and organisational theory, particularly work on men and masculinities, for investigating questions related to women's involvement in politics. The paper draws on Joan Acker's (‘Hierarchies, Jobs, Bodies: A Theory of Gendered Organizations’, Gender and Society, 4, 1990, 139–58; ‘From Sex Roles to Gendered Institutions’, Contemporary Sociology, 21, 1992, 565–9.) notion of ‘gendered organisations’ to interrogate the data.

Colonising Shakespeare? : agency and authority in Gregory Rogers's Shakespearean picture books

“You need to be able to tell stories. Illustration is a literature, not a pure fine art. It’s the fine art of writing with pictures.” – Gregory Rogers. This paper reads two recent wordless picture books by Australian illustrator Gregory Rogers in order to consider how “Shakespeare” is produced as a complex object of consumption for the implied child reader: The Boy, The Bear, The Baron, The Bard (2004) and Midsummer Knight (2006). In these books other worlds are constructed via time-travel and travel to a fantasy world, and clearly presume reader competence in narrative temporality and structure, and cultural literacy (particularly in reference to Elizabethan London and William Shakespeare), even as they challenge normative concepts via use of the fantastic. Exploring both narrative sequences and individual images reveals a tension in the books between past and present, and real and imagined. Where children’s texts tend to privilege Shakespeare, the man and his works, as inherently valuable, Rogers’s work complicates any sense of cultural value. Even as these picture books depend on a lexicon of Shakespearean images for meaning and coherence, they represent William Shakespeare as both an enemy to children (The Boy), and a national traitor (Midsummer). The protagonists, a boy in the first book and the bear he rescues in the second, effect political change by defeating Shakespeare. However, where these texts might seem to be activating a postcolonial cultural critique, this is complicated both by presumed readerly competence in authorized cultural discourses and by repeated affirmation of monarchies as ideal political systems. Power, then, in these picture books is at once rewarded and withheld, in a dialectic of (possibly postcolonial) agency, and (arguably colonial) subjection, even as they challenge dominant valuations of “Shakespeare” they do not challenge understandings of the “Child”.

Who has rights to what? Inclusion in Australian early childhood programs

In early childhood settings prior to school and in the early years of primary school, debate continues over the meaning of inclusion and its scope in terms of the groups under consideration. The genealogies of early childhood education and care, early primary school, special education and cultural education were examined to identify recurring and emerging approaches to inclusion within Australian programs for children aged birth to eight years. Approaches to inclusion encompassing multiple forms of diversity co-exist in the Australian educational literature with targeted approaches focused on disabilities or risk. These differing approaches reflect underlying ideological divisions and varying assumptions about diversity. Multiple approaches, including the expansion of early childhood services, reflect tensions over children’s rights, conceptualisations of inclusion, expectations of teachers, system coordination, economic constraints and political pressure to cater for a complex range of young children in varied settings. The paper incorporates discussion on underlying philosophical tensions within the early childhood field.

The role of the internet on international market growth of Australian firms : an exploratory study

The Internet has been shown to positively influence the internationalisation activities of firms through enhanced information, knowledge and network development. Although there has been evidence of a positive impact of the Internet on internationalisation process components, it is vague as to whether the Internet has an impact on firm international market growth. This paper examines the role of the Internet in the outward internationalisation of a cross-national sample of 224 firms from Australia. The results show evidence that a there is a link between Internet usage, Internet intensity and the international market growth of the firm. The findings indicate that firms are using Internet technologies beyond simple e-mail and websites in their international marketing. For example, Internet directories and Internet market spaces are assisting international market expansion of the firm. Firms are integrating the Internet into international marketing processes such as advertising, marketing, market research and international market management as well as in data transference between company and supplier and company and customer. Further, there is evidence in this study of the statistical relationships between the use of website, e-mail and online sales with the international market growth of the firm.