`All things to all people`: indigenous teachers in the Australian teaching profession

This paper reports on the findings of a four-year study that seeks to understand the experiences and career pathways of Indigenous teachers in Australia. We present data obtained from in-depth interviews with current and former teachers in order to provide a qualitative account of what lies behind demographic trends in Indigenous teacher recruitment and retention in Australia. The paper highlights the expectations of school and wider communities that Indigenous teachers will be 'all things to all people' and will fill a number of complex and sometimes conflicting roles within and beyond classrooms. We speculate that these expectations contribute to their decisions to resign from the school system to work elsewhere. We also introduce and problematise the notion of the Indigenous teacher as a category in the consciousness of teachers, administrators and other participants in the discourses of Australian schooling.
We conclude by arguing the need for non-Indigenous student-teachers to be better prepared to work alongside Indigenous colleagues and to take more active roles in the implementation of policy and initiatives around Indigenous education. The paper also raises implications for the recruitment and retention of Indigenous teachers.

Scope of practice in forensic nursing

1. There is significant role variation, across the Western world, in relation to how forensic nurses practice. 2. The authors conducted a pilot survey of forensic nurses in Australia, New Zealand, the United States, and the United Kingdom to examine forensic nursing practice, role definition, and role boundaries. 3. Issues arising from the data include the visibility of forensic nurses, the client group, forensic-specific education, and role development.

Can written nursing practice standards improve documentation of initial assessment of ED patients?

Introduction: There is wide variation in emergency nursing practice in terms of initial patient assessment and the interventions implemented in response to these patient assessment findings. It is hypothesised that written ED nursing practice standards will reduce variability in documentation standards related to initial patient assessment.

Aim: This study aimed to examine the effect of written ED nursing practice standards augmented by an in-service education programme on the documentation of the initial nursing assessment.

Method: A pre-test/post-test design was used. Initial patient assessment was assessed using the Emergency Department Observation Chart. All adult patients (>18 years) who presented with chest pain and who were triaged to the general adult cubicles were eligible for inclusion in the study. Random sampling was used to select the patients for the pre-test (n = 78) and post-test groups (n = 74).

Results: There was significant improvement in documentation of all aspects of symptom assessment except quality and historical variables: pre-hospital care, cardiac risk factors, and past medical history. Improvements in documentation of elements of primary survey assessment were variable. There were significant increases in documentation of respiratory effort, chest auscultation findings, capillary refill and conscious state. There was a significant 18.3% decrease in the frequency of documentation of respiratory rate and no significant changes in documentation of oxygen saturation, heart rate or blood pressure.

Conclusion: Written ED nursing practice standards were effective in improving the documentation of some elements of initial nursing assessment for patients with chest pain. Active implementation strategies are important to ensure effective uptake of written practice standards and the relationship between nursing documentation and actual clinical practice warrants further consideration using a naturalistic approach in real practice settings.

Making decisions: nursing practices in critical care

This article reports the types and complexity level of decisions made in everyday clinical practice by critical care nurses. It also reports factors that influence the complexity of those decisions. A combination of methods were chosen for the two phase study. In the first phase, 12 qualified critical care nurses documented decisions (over a 2 hour period) on a clinical decision recording form designed by the researcher. In the second phase, participants attended a semi-structured focus group.

From the analysis, five types of decisions were identified; assessment, intervention, organisation, communication and education. In addition to these documented decisions, three factors that influenced decision complexity were identified from a thematic analysis of the transcribed interviews; communication, patient related and properties of the decision. Nurses reported that communication decisions were the most difficult to make. However, the concept of nurses knowing the patient reduced the level of decision complexity. It is suggested that this has important implications for decision making practices of nurses working in the area of critical care and potentially for patient outcomes.

Career development year in emergency nursing: using specific educational preparation and clinical support to facilitate the transition to specialist practice

This article outlines the development, implementation and evaluation of the Career Development Year (CDY) in the Emergency Department (ED) at Dandenong Hospital in Victoria, Australia. As a consequence of a shortage of emergency nurses, hospitals have recruited inadequately prepared nurses to staff their EDs. The resultant increase in stress of qualified and experienced emergency nurses has had a major impact on the retention of emergency nurses. The CDY aims to provide nurses with little or no experience in emergency nursing with supported entry into this area of specialist practice. The CDY is based on three factors identified as important in the transition to emergency nursing; knowledge, clinical support and professional development. By providing beginning emergency nurses with supported entry to a new and challenging clinical environment, the CDY has been an effective recruitment and retention strategy. In addition it has demonstrated that a committed ED team has the capability to teach and nurture the emergency nurses of the future.

Applying a quality use of medicines framework to using essential oils in nursing practice

Nurses are increasingly incorporating complementary therapies into their practices. Aromatherapy is one of the most popular therapies. The basis of aromatherapy is essential oils, which are chemically active substances with a long history of safe traditional use and a growing evidence base to support their use in nursing care. In Australia, essential oils are classified and regulated under the same policies as conventional medicines such as the National Medicines Policy and the Quality Use of Medicines (QUM) framework applies. QUM is a framework for selecting and using medicines safely and effectively if medicines are indicated. The key elements of QUM are a systems-based approach to using medicines based on relevant evidence, partnerships, and informed client consent. Clients are placed at the centre of a QUM medication management process, which is consistent with holistic care. Applying a QUM approach to essential oil use, Quality Use of Essential Oils (QUEO), involves developing effective systems for managing essential oils from an holistic perspective that includes structured assessment and diagnostic processes to enable effective essential oil prescribing and outcome monitoring. In a QUEO approach, essential oils are integrated into the client's overall medication regimen and care plan rather than being used as ‘add-ons’. Adopting QUEO is consistent with the current national focus on the quality use of therapeutic substances, increases the profile of aromatherapy in nursing care and provides important information to guide future aromatherapy practices.

A Euro-American-Australian study of the mechanical engineering profession as a foundation for the study of mechanical engineering attributes

The increasing attribute focus in the formation (engineering education, training, work-based learning and experience) of engineers now being adopted by engineering education accrediting bodies is based on meeting the perceived needs of professional practice. Related to this is an increasing expectation of new graduates being work-ready rather than relying on work-based learning and experience to develop many of the essential professional practice attributes.

The scope of the mechanical engineering profession is broad and practitioners contributing to debate on attribute requirements have their own individual views of the nature of the profession, largely influenced by their own professional formation. As a foundation for detailed study on attribute requirements for effective Australian professional mechanical engineers, in this paper we provide a concise study of the development of the established scope of practice and knowledge base of the profession over the last two centuries. Formation practices in Europe and the United States played significant roles in the 19th century.

We conclude with a discussion on the impact of the considerable changes currently affecting mechanical engineering practice in the UK, US and Australia, including organisational, technical and societal expectations, industry profile, and educational factors.

Who is the 'lovable larikan'? : an historical inquiry using biography and autobiography

Every profession has its myth that defines its self-identity and work culture. For nursing, it's Florence Nightingale; for theatre, Homer and Shakespeare; for medicine, Hippocrates. Australian journalism too, has its myth - that of the hard-working, hard-drinking, aggressive and defiant 'Lovable Larrikin'. But unlike other professions, Australian journalism's 'myth' cannot be pinned down to one historical figure. It is therefore difficult to investigate the 'real' story behind the myth. Using an open-coding analysis of biographical and autobiographical material, this paper aims to detect larrikin-like characteristics among early Australian journalists (Colonial era to, and including, the interwar period), to identify significant people and events that developed larrikinism as a specific Australian journalism identity.

The accounting profession: a religious and community platform for change

Following the failure of large corporations in both Australia and the United States, considerable dialogue has been generated on the integrity and role of accountants. This focus of this study was to examine the role of the professional accounting community, which shapes, and is shaped by the value, religion and culture of accounting members. In view of the impetus towards internationalization of accounting standards it is suggested the accounting profession re-examine its position as part of the international human community
and re-examine its core values.

The re-emergence of the public accountancy profession in China: a contextual analysis

Little has been published on the professionalisation projects in non-English speaking countries. In particular, where these countries operate under a non-capitalist environment, the role of accountants and their professionalisation process have been relatively under-explored. This paper seeks to contribute to addressing this apparent gap by choosing the public accountancy profession in China as the subject matter of the research. This paper draws on Gramsci's concept of hegemony to examine the circumstances leading to the re-emergence of the public accountancy profossion in China. In particular, the paper attempts to understand the political ana' ideological influence upon the professionalisation process of the Chinese accountants. To this aim, the paper examines the social and cultural environment of China highlighting the importance attached to propagating the political ideology by the hegemonic ruling class in the history of China. The paper concludes that while the re-emergence of the CPA profession is a by-product of the government's push for economic reconstruction, the real contextual factor that led to the revival of the public accountancy profession is the political ideologies, which were propagated by the ruling political force in an attempt to establish hegemony.

Loyalty to the profession? A study of Australian financial planners

The purpose of this paper is to examine the demographic variables of age and gender in conjunction with three independent variables: Internal versus external locus of control personality dimension, individualist versus collectivist personality dimension, and perceived environmental uncertainty and to relate same to the professional commitment (PC) of financial planners in Australia. A questionnaire was used to survey a sample of 312 financial planners nationally, with a 36% response rate and statistically significant results. At the 90% confidence level (p=0.10) respondents over the age of 35 demonstrated no difference between their levels of professional commitment than did those under the age of 35, while at the same level of confidence, females demonstrated a statistically significant higher level of PC than did their male counterparts. Respondents with an external locus of control displayed lower levels of PC (p=0.10) that those with an internal locus of control. These findings contribute to our understanding of the professional commitment of financial planners, and are important from a public policy perspective in an era of increasing attention to, and likely increased regulation of, the financial planning industry.

The diversity of critical care nursing education in Australian universities

A range of critical care nursing educational courses exist throughout Australia. These courses vary in level of award, integration of clinical and academic competence and desired educational outcomes; this variability potentially leads to confuson by stakeholders regarding educational and clinical outcomes. The study objective was to describe the range of critical care nursing courses in Australia. Following institutional ethics approval, all relevant higher education providers (n=18) were invited to complete a questionnaire about course structure, content and nomenclature. Information about desired professional and general graduate characteristics and clinical competency was also sought.

A total of 89% of providers (n=16) responded to the questionnaire. There was little consistency in course structure in regard to the proportion of each programme devoted to core, speciality or generic subjects. In general, graduate certificate courses concentrated on core aspects of critical care, graduate diploma courses provided similar amounts of critical care core and speciality content, while master's level courses concentrated on generic nursing issues. The majority of courses had employment requirements, although only a small proportion specified the minimum level of critical care unit required for clinical experience. The competency standards developed by the Australian College of Critical Care Nurses (ACCCN) were used by 83% of providers, albeit in an adapted form, to assess competency. However, only 60% of programmes used personnel with a combined clinical and educational role to assess such competence.

In conclusion, stakeholders should not assume consistency in educational and clinical outcomes from critical care nursing education programmes, despite similar nomenclature or level of programme. However, consistency in the framework for speciality nurse education has the potential to prove beneficial for all stakeholders.

A longitudinal evaluation of nursing home care quality in Taiwan

Aging populations worldwide have important implications for elderly care composition and quality, particularly with regard to care provided by nursing homes. Our study investigated quality of nursing home care in Taiwan using resident satisfaction and clinical outcomes as indicators.
We randomly recruited 306 residents in 13 nursing homes and assessed them at initial, 3, 6, and 12-months follow-up. The outcomes of the nursing home care in the 12-month follow-up period showed significant decreases in pressure sores and moderate satisfaction of nursing home care, but increases in physical restraints and psychological loneliness. Study results suggest that longterm nursing home care may improve residents' quality of life. However, to achieve this, nursing homes must provide improved psychological support for residents and decrease the use ofphysical
restraints.

Is rehabilitation associated with change in functional status among nursing home residents?

Assessing functional status of residents in nursing homes is one way to evaluate the quality of care provided. The purpose of this study was to investigate whether rehabilitation interventions could lead to improved functional independence. A prospective study was carried out to examine the change in activities of daily living (ADL) of 310 residents aged 65 or above over a period of 6 months. About 41.3% (n = 128) received rehabilitation therapy. Functional improvement was observed in 30.6% of the participants. The corresponding figures for stabilization and functional decline were 45.2% and 24.2%, respectively. Using a multinomial logistic regression, we found that factors significantly associated with change in functional status included baseline ADL score, family visit, number of beds in the institution, and transfer to acute hospitals. After adjusting for these confounding variables, change in functional status of those who received rehabilitation and those who did not was not significantly different.