Round the bend : a history of psychiatric nursing in Victoria

This feature length documentary explores the development of psychiatric nursing from the early colonial beginnings in 1848 through to the post-institutional present. The film commences with a montage of photos, film and narrative that documents the period until 1930s.

The period from the 1930s to the present is described chronologically in oral histories provided by personal interviews with psychiatric nurses. The interviews include a number of key psychiatric nurse leaders who were instrumental in bringing about significant changes to nursing practice and education, and were also at the forefront of leading major reforms to service delivery in Victoria such as the community mental health movement.

The oral histories provide an account of the history of this unique area specialty of nursing. At times confronting and challenging, the film also highlights the significant contribution of psychiatric nursing to the development of humanistic, person-centered philosophies of care in mental health. The narratives are woven together with photographs and film footage of historical artifacts and institutions.

Evaluating objective structured clinical assessment (OSCA) in undergraduate nursing

The aims of this mixed methods study were to gain insight into how individual assessors determine an Objective Structured Clinical Assessment (OSCA) result for undergraduate nursing students and identify whether individual assessor perceptions and professional characteristics have an impact on students' results. Results from 25 participants showed that although less than half (44%) of the participants were teaching in the course that they were assessing, the participants were highly experienced clinicians and nearly three-quarters (72%) had completed formal teaching qualifications. There were wide variations in pass rates (16.7–90%) between assessors. The widest disparity was observed between assessors with and those without critical care experience (66% versus 39%), as well as assessors who were teaching the course and those who were not (68% versus 49%). Qualitative analysis revealed three dominant themes within participants' transcripts. The themes focused on determining student safety, and the use of personal perceptions and clinical experience to determine competency. Findings indicate that assessors' individual perceptions and clinical experience have the potential to influence and determine undergraduate nursing students OSCA results. Development of criteria standards and objective assessment may be enhanced by greater involvement of assessors and thorough education and training within the context of student assessments.

Nursing the patient with severe communication impairment

Background. Effective communication with patients is critical to effective nursing practice. Surprisingly, there is little information on nurses' experiences in caring for patients who are unable to speak. Purpose and method. This study provides descriptive information from interviews with 20 nurses who cared for patients with severe communication impairment. The interview protocol explored positive and negative experiences of nursing patients with severe communication impairment. Frequency counts and descriptive analyses were conducted to identify the major themes emerging from the interviews. Results. The results suggest that nurse-patient communication is difficult when the patient has severe communication impairment, although some nurses discovered effective strategies to facilitate communication with such patients. Many of the difficulties could be viewed as a breakdown in understanding arising from the lack of a readily interpretable communication system that could be used by nurse and patient. Conclusions. The results suggest a need for training nurses in the use of alternative modes of communication. Nurses also need access to a variety of simple augmentative communication devices for use with patients who are unable to speak. Finally, nurses should collaborate with speech pathologists on the development of preadmission information and bedside training for people who are admitted to hospital with severe communication impairment.

Initial emergency nursing management of patients with severe traumatic brain injury : development of an evidence-based care bundle for the Thai emergency department context.

Thai emergency nurses play a vital role in caring for patients with severe TBI, and are an important part of the healthcare team throughout the resuscitation phase. They are also responsible for continuous physiological monitoring, and detecting deterioration associated with increased intracranial pressure and preventing secondary brain injury. However, there is known variation in Thai nurses' knowledge and care practices for patients with severe TBI. In addition, there are no specific evidence-based practice guidelines available for emergency nursing management of patients with severe TBI.

What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients.

To examine the feedback given by nurse educators and clinicians on the quality of communication skills of nurses in interactions with simulated patients.

Leadership and teamwork in medical emergencies: performance of nursing students and registered nurses in simulated patient scenarios

Aims and objectives: To examine nursing students' and registered nurses' teamwork skills whilst managing simulated deteriorating patients. Background: Studies continue to show the lack of timely recognition of patient deterioration. Management of deteriorating patients can be influenced by education and experience. Design: Mixed methods study conducted in two universities and a rural hospital in Victoria, and one university in Queensland, Australia. Methods: Three simulation scenarios (chest pain, hypovolaemic shock and respiratory distress) were completed in teams of three by 97 nursing students and 44 registered nurses, equating to a total of 32 student and 15 registered nurse teams. Data were obtained from (1) Objective Structured Clinical Examination rating to assess performance; (2) Team Emergency Assessment Measure scores to assess teamwork; (3) simulation video footage; (4) reflective interview during participants' review of video footage. Qualitative thematic analysis of video and interview data was undertaken. Results: Objective structured clinical examination performance was similar across registered nurses and students (mean 54% and 49%); however, Team Emergency Assessment Measure scores differed significantly between the two groups (57% vs 38%, t = 6·841, p < 0·01). In both groups, there was a correlation between technical (Objective Structured Clinical Examination) and nontechnical (Team Emergency Assessment Measure) scores for the respiratory distress scenario (student teams: r = 0·530, p = 0·004, registered nurse teams r = 0·903, p < 0·01) and hypovolaemia scenario (student teams: r = 0·534, p = 0·02, registered nurse teams: r = 0·535, p = 0·049). Themes generated from the analysis of the combined quantitative and qualitative data were as follows: (1) leadership and followership behaviours; (2) help-seeking behaviours; (3) reliance on previous experience; (4) fixation on a single detail; and (5) team support. Conclusions: There is scope to improve leadership, team work and task management skills for registered nurses and nursing students. Simulation appears to be beneficial in enabling less experienced staff to assess their teamwork skills. Relevance to clinical practice: There is a need to encourage less experienced staff to become leaders and for all staff to develop improved teamwork skills for medical emergencies. © 2014 John Wiley & Sons Ltd.

Situation awareness in undergraduate nursing students managing simulated patient deterioration

Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice.

Evaluation of postgraduate critical care nursing students' attitudes to, and engagement with, Team-Based Learning: a descriptive study

The aim of this study was to evaluate postgraduate critical care nursing students' attitudes to, and engagement with, Team-Based Learning (TBL).