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1
Hutchinson, Marie L. "Bullying in the workplace a study of Australian nurses /." View thesis, 2007. http://handle.uws.edu.au:8081/1959.7/33181.
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Thesis (Ph.D.)--University of Western Sydney, 2007.A thesis presented to the University of Western Sydney, College of Business, in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliographies.
2
Nitschke, Monika. "Glutaraldehyde exposures and health effects among South Australian hospital nurses /." Title page, table of contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmn732.pdf.
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3
Suiter, S. R. "Factors influencing Western Australian clinical registered nurses in discharge planning." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1995. https://ro.ecu.edu.au/theses/1166.
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A descriptive quantitative study was conducted to determine what factors nurses considered when discharge planning, and how these factors compared with factors identified in the literature as being effective in planning for discharge. This study was undertaken because with the intended Prospective Payment System (PPS) of funding to hospitals, it is essential that Western Australian Clinical Registered Nurses are able to prepare patients for discharge effectively to prevent the financial burden of cost outliers and re-admissions. Anderson and Steinberg ( 1984) in their studies of factors that influence the cost of hospital care for the elderly, found that the results of inappropriate and premature discharges resulted in a 22% readmission rate within 60 days of discharge for all Medicare hospitalisation. Their (1988) study of readmission rates of Medicare beneficiaries between 1974 and 1977 showed that the added costs associated readmissions cost the U.S. government more than US$2.5 billion per annum. It would seem probable that such a system introduced into the Australian health:care system will have the potential to produce similar effects for Western Australian patients, nurses and nursing.
4
Seaton-Sykes, Philippa, and n/a. "Teaching and Learning in Internet Environments in Australian Nursing Education." Griffith University. School of Nursing, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040218.122119.
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Since the introduction of the Internet, there has been an increase in the adoption of this technology for educational purposes. This development and widespread availability of Internet technologies, alterations in the needs of clinical practice and the characteristics of students, have all inspired changes in nursing education (Mallow & Gilje, 1999). In response, nursing education has embraced the opportunity this communication medium offers to the diverse groups of students in nursing. These students may be studying at a distance, or due to other constraints such as time or professional commitments, studying in flexible ways where students may or may not be in the classroom. In other instances, Internet technologies are being used with the aim of enriching learning in nursing. However, despite widespread development and implementation of these innovations, the effects on nursing education have not been extensively researched (Cheek, Gilham & Mills, 1998; Gillham, 2002; Mallow & Gilje, 1999) and little is known about how the Internet contributes to teaching and learning, what learning outcomes are, or what support is required by teachers and students (Billings, 2000). At this time of rapid development of Internet-based and Internet-supported courses in the Australian nursing education system, there is a need to ensure such courses are educationally effective, clinically relevant, and that resources are appropriately assigned. This exploratory study aimed to contribute to effective discipline-specific use of internet learning environments through increased understanding of students and academics experiences of teaching practices and learning processes. There were two phases to this mixed-method study, a survey of course coordinators, and secondly, interviews with eleven students and sixteen academics. The survey of diverse schools of nursing across Australia provided foundational information about the ways the Internet was integrated into nursing education, and the preparation and supports that were offered to students for Internet-based or Internet-supported learning. Guided by a constructivist theoretical framework, and analysed thematically, the key findings of this study were drawn from the academics and students experiences in a variety of nursing courses in universities located across Australia. The Internet was employed in these courses in a variety of ways. At the time of data collection for both the survey and the interviews, more courses were Internet-supported than Internet-based. A variety of Internet information and communication features were used in courses. The survey findings provided both a context for the interview findings, and a degree of confirmation of these findings. The context reported was diverse, consistent with an emergent educational environment that has few precedents to guide its implementation. The academics experiences revealed that teaching in online environments was vastly different to face-to-face teaching and required different practices of teaching and learning that took into consideration the separation of teachers from learners, and learners from each other. While often enthusiastic about the new environment, many teachers needed specific preparation, support, and adequate resources to teach in this new environment. Similarly, students experienced a dislocation from the learning environments to which they were accustomed. Significant shifts were apparent in the students constructions of both individual and collaborative learning that were contingent upon the separation of teachers and learners, and the necessity of communicating in a written medium. Both teachers and learners revealed how, consequent upon their dislocation, they were relocating to a new interpretation of time, place and relationships in Internet learning environments, and were reconstructing teaching and learning. The reconstructions of learning included ways of relating that built learning communities predicated on a shift in focus from teaching to learning. These included both a shift in individual students learning, and a constructed understanding that arose variously from shaping a fundamental comprehension or challenging thinking, to expand comprehension in the group. Through new understandings and practices, the participants were beginning to construct a place for students and teachers to realise the possibilities for enriched learning that online communities can provide. The findings of this study are discussed in terms of the possibilities for teaching and learning in nursing education, and recommendations are made.
5
Chan, Cheuk Bun. "Nurses’ attitudes toward family witnessed resuscitation in Western Australian emergency departments." Thesis, Curtin University, 2009. http://hdl.handle.net/20.500.11937/1162.
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Since 1982, healthcare institutions and professionals have been questioning whether family members should be allowed to enter resuscitation rooms during such critical period of treatment. A self-administered questionnaire is used in this research to investigate Western Australian emergency nurses’ attitudes towards family witnessed resuscitation and to explore possible factors influencing their attitudes.The findings of this work suggest that nurses, assuming a betwixt-between position, evaluate the costs and benefits of allowing family presence in the resuscitation room from patients, families and healthcare professionals’ perspectives. Nurses have an overwhelming agreement on the beneficial aspects of the practice, while also share concerns commonly reported in previous studies with an emphasis on a family member’s capability to cope with and comprehend the resuscitation procedures and a healthcare professional’s ability to handling pressure.Overall, the research suggests nurses are ambivalent in their attitude. Despite the nurses’ awareness of some family members’ desire to witness resuscitation and their reported benefits, in doing so, they are reluctant to initiate or formally incorporate this practice as a standard procedure. There is also a lack of consensus on the management of families’ presence, however, nurses agree on the need for preresuscitation assessment, support staff during resuscitation and post-resuscitation debriefing. Institutional factor is identified as a significant influence on nurses’ attitudes. This work will provide useful input in the future development of guidelines and will help stimulate discussion on this topic in Western Australia.
6
Fulford, Sarah Margaret. "Training, ethos, camaraderie and endurance of World War: Two Australian POW nurses." Thesis, Curtin University, 2016. http://hdl.handle.net/20.500.11937/48486.
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This thesis examines the ethos, camaraderie and resourcefulness of a group of Australian nurses who became prisoners of war to the Japanese during World War Two after their ship, the Vyner Brooke, was sunk on 14 February 1942 as it evacuated from Singapore. It investigates how their living-in-training and patient first mentality contributed to their survival during internment and after, with reference to characteristics attributed to Australian soldiers.
7
Blue, Ian A. "The professional working relationship of rural nurses and doctors : four South Australian case studies." Title page, table of contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phb6582.pdf.
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8
Kitchener, Betty Ann, and n/a. "Nurses' attitudes towards active voluntary euthanasia : a survey in the Australian Capital Territory." University of Canberra. Nursing, 1998. http://erl.canberra.edu.au./public/adt-AUC20060814.145314.
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In a country such as Australia which claims adherence to democratic values, it would
appear important that policies and laws on such a controversial and value laden issue
as active voluntary euthanasia (AVE), need to have at least some basis in public
opinion and in that of relevant professional groups. It has been argued that public
opinion may be of limited value due to the public's lack of experience and exposure to
this issue. The opinions of people with more exposure to and reflection on the ethical
issues surrounding euthanasia need to be ascertained. Nurses are one group who
have prolonged involvement with the care of dying or suffering people and their
families. Nurses in the Australian Capital Territory (ACT) could be a particularly well
informed group because of the ongoing open debate resulting from four proposed
laws on AVE in this Territory since 1993. The overall purpose of this thesis was to
identify the attitudes of nurses in the ACT towards AVE.
This thesis was supported by a study which provided information on four aspects of
nurses' attitudes towards AVE. Firstly, the attitudes of registered nurses in the ACT
were compared to those of other nurses, medical practitioners and members of the
general public in Australia. Secondly, the associations between characteristics of the
nurses and their attitudes were investigated. Thirdly, the legal conditions which
nurses believe should be in a law allowing active voluntary euthanasia were identified.
Finally, the arguments nurses put forward to support their attitudes towards AVE
were analysed This thesis does not attempt to evaluate the ethical arguments
proposed, merely to reflect the views put forward.
A postal survey was carried out in late 1996 of 2000 randomly selected registered
nurses from the Australian Capital Territory. Responses were received from 1218
nurses (61%).
Attitudes of Nurses:
A majority of nurses who responded, supported AVE as "sometimes right", be it
homicide by request (72%) or physician assisted suicide (71%). A slightly smaller
majority of nurses believed the law should be changed to allow homicide by request
(69%) and physician assisted suicide (67%) under certain conditions. If AVE were
legal, 66% of the nurses indicated they were willing to be involved in the procedure.
Only 30% were willing to assist patients to give themselves the lethal dose, while 14%
were willing to administer the lethal dose to the patient. Comparing these results with
previous surveys, it appears that nurses are less in favour of AVE than the general
public but more in favour than medical practitioners.
Associations between Characteristics of Nurses and Attitudes:
Those nurses who were more likely to agree that the law should allow AVE, were
under the age of 40 years, agnostic, atheist or of the Anglican religion, to have less
contact with terminally ill patients, to work in the area of critical care or mental health,
and to take less interest in the issue of AVE. Palliative care nurses were the only
subgroup without a majority in favour (33%). There is other evidence in the
euthanasia literature indicating that nurses and doctors are less in favour of AVE than
the general public. Taken together with the present findings, it may be concluded that
attitudes towards AVE are more favourable in people who have less contact with the
terminally ill.
Legal Conditions in an AVE Law:
The conditions most strongly supported in any future AVE law were "second
doctor's opinion" (85%), "cooling off period" (81%), "patient must have unbearable
protracted suffering" (80%), "doctor must inform patient about illness and treatment"
(78%) and "patient must be terminally ill" (63%). There was only minority support
for "patient not suffering from treatable depression" (42%), "patient administers or
assists to administer, the fatal dose themselves" (32%) and "patient over a certain
age" (7%). Support for a change in the law to allow AVE was 38% for a young man
with AIDS, 39% for an elderly man with early stage Alzheimer's disease, 44% for a
young woman who had become quadriplegic and 71 % for a middle aged woman with
metastases from breast cancer.
Arguments Supporting AVE Attitudes:
The most common argument in support of AVE was that people should have the right
to control their own lives and thus be able to decide for themselves when and how
they wanted to die. The most common argument against AVE was that of the slippery
slope in which it is feared that the boundaries which society puts on killing will be
extended.
Conclusions:
This inquiry pinpoints the discordance between attitudes towards AVE and the legal
status of AVE. Parliamentary representatives need to consider the current attitudes of
their constituents, and especially those of relevant health care professionals towards
AVE. It is important that a nursing perspective is represented in any law legalising
AVE and that the role of the nurse is clearly described in relevant legal acts. Future
research would also be beneficial to investigate further the association between the
experience of nurses working in a palliative care setting and AVE attitudes. There
needs to be further debate about the legal conditions required in any future AVE bills.
given the lack of support from nurses for some conditions which have been included
in proposed AVE laws. Furthermore, it would be valuable to carry out surveys of the
opinions of other health practitioners in order to inform legislators. These results
form a baseline to examine the changes in attitudes towards AVE over time and
change in the legal status of AVE.
9
Rae, Ruth Lillian. "Jessie Tomlins: An Australian Army Nurse World War One." University of Sydney. Clinical Nursing, 2001. http://hdl.handle.net/2123/840.
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There is an abundance of historical and anecdotal material relating to the experiences of the Australian soldier during World War 1. These soldiers were conscious both during and after the war that their contribution was important and that it was recognised as such by Australian society at large. Conversely there is an almost total absence of historical or anecdotal material about the role of the Australian nurse who served during this same conflict. Whether these nurses had the same degree of consciousness, either during or after the war, that their contributions were valued or seen as important by Australian society remains, largely, unknown. This thesis attempts to redress, in part, this absence by telling the story of a nurse, Jessie Tomlins, who served in the Australian Army Nursing Service during this period. At the same time specific aspects of the historical events surrounding World War One will be explored. Jessie Tomlins served, first as a Staff Nurse and later as a Sister, in the 14th Australian General Hospital in Egypt during 1916. At the same time her brother, Fred Tomlins, was already serving in the 1st Australian Light Horse Regiment and spent the entire four years of World War 1 in Palestine and Egypt. At the end of 1916 their younger brother, Will Tomlins, also joined the Army and became a member of the Anzac Mounted Division. The letters, postcards and photographs that Jessie, Fred and Will sent home to their mother and family, as well as Fred's fourteen diaries, form the foundation of this thesis. This thesis provides a meaningful snapshot of one woman from rural Australia who completed her nurse training during the war and then served her country during one of the most brutal periods of humankind. Her own words clearly tell the story of her war time experiences whilst, at the same time, conveying her expectations, prior to, during and after, this event. The development of the Australian Army Nursing Service, as it affected Jessie, over this period is also considered. It will be demonstrated that whilst ordinary men, soldiers, were at the military front line so too were ordinary women, nurses. The thesis will provide support for the contention that the contribution of Australian nurses in World War One, especially that of the ordinary nurse caring for the ordinary soldier, has been poorly recorded and as a result remains under-valued.
10
While, Eileen, and n/a. "Female registered nurses and stress : a quantitative analysis." University of Canberra. Professional & Community Education, 1996. http://erl.canberra.edu.au./public/adt-AUC20061110.130058.
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This study examines the perceived causes of occupational stress amongst female
Registered Nurses working in the clinical setting at both Calvary Public and Calvary
Private Hospitals ACT Incorporated.
A modified Gray-Toft, Anderson Nursing Stress Scale (1981) was used as the instrument
for the research. The questionnaire was modified by the addition of six questions.
The questionnaire was distributed to seventy female Registered Nurses. Twenty
questionnaires were distributed to staff working within the Private Hospital and fifty to
staff in the Public Hospital.
Relevant data dating back to 1956 was examined regarding stress and burnout amongst
nurses and allied health professionals.
The results of this study, not surprisingly, supported the finding of Gray-Toft, Anderson.
That is that nursing remains an inherently stressful occupation. Respondents working in
both public and private hospitals indicated that Lack of Funding and Death and Dying
were considered to be major sources of perceived stress.
Registered Nurses working in the Public Hospital perceive higher levels of stress than do
those Registered Nurses working within the Private Hospital with respect to relative
staffing levels, workload and funding.
Comparisons by age group indicated a generally higher reported level for the youngest age
group. Comparison of full time versus part time staff indicated a significantly higher level
of perceived stress from full time staff. Analysis of reported stress by ward type indicated
that staff working in the "medical" groupings experienced higher perceived levels of stress
than those working in the "surgical" groupings.
11
Lee, Irene University of Ballarat. "An Investigation into the experiences of occupational stress of graduate nurses in Hong Kong." University of Ballarat, 2006. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12749.
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"The major criticism by hospital trained clinical nurses is that university graduates are perceived as not being competent practioners as a result of limited time spent in clinical areas. This lack of clinical experience is thought to contribute to new graduates' sense of occupational stress."--leaf xii.Doctor of Philosophy
12
Lee, Irene. "An Investigation into the experiences of occupational stress of graduate nurses in Hong Kong." University of Ballarat, 2006. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/14588.
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"The major criticism by hospital trained clinical nurses is that university graduates are perceived as not being competent practioners as a result of limited time spent in clinical areas. This lack of clinical experience is thought to contribute to new graduates' sense of occupational stress."--leaf xii.Doctor of Philosophy
13
Leka, Nikola. "Building, Reality, Caring: What Nurses in Three Australian Psychogeriatric Assessment Units Say about the Built Environment." University of Sydney, 2007. http://hdl.handle.net/2123/2806.
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Doctor of Philosophy(PhD)Many people believe that ‘purpose-built’ facilities will diminish some of the challenging behaviours exhibited by older people with dementia or psychiatric conditions. This study aimed to explore and understand what hands-on nurses in psychogeriatric assessment units experience and think of the built environment as a part of their day to day work. Twenty-one unstructured interviews were conducted with nurses at three psychogeriatric assessment units. The units ranged in style from an ancient adapted building to a contemporary 'purpose-built' facility. A critical hermeneutics derived from Gadamer was used to explore the interviews. It found that nurses think of the built environment in relation to the care needs of their patients, and feel bureaucratic restrictions in using the built environment more keenly than the shortcomings of the built environment itself. Nurses saw themselves and their patients as 'outcasts' or victims of those with money and power. The study concludes with suggestions for challenging the status quo, but also considers that being regarded as 'outcasts' allows opportunities to avoid being overly impressed by technological marvels.
14
Ku, Tan Kan. "Culture and stigma towards mental illness : a comparison of general and psychiatric nurses of Chinese and Anglo-Australian backgrounds /." Connect to thesis, 2007. http://repository.unimelb.edu.au/10187/8400.
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A sample of 208 nurses (a response rate of 63%) participated in a study by responding to a questionnaire comprising of 170 items which examined nurses’ attitudes towards mental illness, and the association between contact, cultural values, general and practice stigma. General stigma refers to attitudes towards the mentally ill while practice stigma is informed from differential clinical practice approaches towards the care of two case vignettes describing a patient with mental illness and one with diabetes. Subjects were recruited using the snowballing technique and comprised of nurses (83 Anglo Psychiatric, 41 Anglo General, 49 Chinese Psychiatric and 35 Chinese General) currently practising in Victoria. Age ranged from 21 to 65 years. Principal components analyses were conducted on items to develop subscales related to individualism and collectivism, contact types, general and practice stigma. Analyses of variance and covariance were conducted to examine differences between nurse type and ethnicity and respectively, to account for possible differences in background, contact and in the case of practice stigma, general stigma.The key findings revealed differences according to nurse type and ethnicity in several of the subscales. Psychiatric nurses endorsed a higher level of contact than general nurses with mentally ill people on the variables ‘Contact Through Work Situation’, ‘Patient Help Nurses’ and ‘External Socialisation with Patient’, but not on the variable ‘Relative With Mental Illness’. By virtue of more contact, psychiatric nurses also endorsed less general stigma than general nurses, assessed by results from analysing social distancing, but not by negative stereotyping of people with mental illness. With respect to practice stigma, while care and satisfaction did not differ according to patient type and nurse type, psychiatric nurses expressed less authoritarianism and negativity than general nurses towards the mental illness case than general nurses while lesser differences between nurse types were evident for the diabetes case. Chinese nurses when compared with Anglo-Australian nurses, endorsed more highly collectivist values measured by the variables ‘Ingroup Interdependence’ and ‘Ingroup Role Concern’ but there was no difference in individualist values. This may reflect acculturation towards Western values but also retention of Chinese values, interpreted in the light of other results on cultural affiliation, as a bicultural position. Chinese nurses endorsed more highly general stigma towards the mentally ill than Anglo nurses when statistically controlling for differences in background demographics and contact factors.
Nursing satisfaction did not differ in ethnicity and patient type. Chinese nurses endorsed more highly care and authoritarianism in their clinical practice approaches than Anglo-Australian nurses, although there was no significant interaction effect between ethnicity and patient type on care and authoritarianism. Chinese nurses endorsed more highly negativity than Anglo-Australian nurses for the mental illness case than the diabetes case, an effect later shown to be mediated by differences in general stigma between the two ethnic groups. Within the Chinese sample, higher contact was associated with lower differential negativity for the mental illness than the diabetes case. Several path analyses suggested Chinese values influenced differential negativity, mediated by general stigma and prior diversified contact with people having a mental illness.
It may be concluded from these results that practice stigma is related to cultural values but the relationship is mediated by general stigma and contact. What aspect of the Chinese values specifically correlates with general stigma remains a question for further research, but several possibilities are discussed.
15
Osborne, Sonya Ranee, and n/a. "Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia." University of Canberra. Nursing, 2002. http://erl.canberra.edu.au./public/adt-AUC20060823.161225.
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Occupational exposures of healthcare workers tend to occur because of
inconsistent compliance with standard precautions. Also, incidence of occupational
exposure is underreported among operating room personnel. The purpose of this
project was to develop national estimates for compliance with standard precautions
and occupational exposure reporting practices among operating room nurses in
Australia. Data was obtained utilizing a 96-item self-report survey. The Standard
Precautions and Occupational Exposure Reporting survey was distributed
anonymously to 500 members of the Australian College of Operating Room Nurses.
The Health Belief Model was the theoretical framework used to guide the analysis of
data. Data was analysed to examine relationships between specific constructs of the
Health Belief Model to identify factors that might influence the operating room nurse
to undertake particular health behaviours to comply with standard precautions and
occupational exposure reporting. Results of the study revealed compliance rates of
55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with
using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0%
with adequate eye protection. Although 31.6% of respondents indicated receiving an
occupational exposure in the past 12 months, only 82.6% of them reported their
exposures. The results of this study provide national estimates of compliance with
standard precautions and occupational exposure reporting among operating room
nurses in Australia. These estimates can now be used as support for the development
and implementation of measures to improve practices in order to reduce occupational
exposures and, ultimately, disease transmission rates among this high-risk group.
16
McCullough, Kylie. "The delivery of Primary Health Care in remote Australian communities: A Grounded Theory study of the perspective of nurses." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2153.
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Around 85% of Australia’s landmass is remote and sparsely populated. Across these vast areas of desert, wilderness and tropical islands, nurses provide the majority of health care services. The residents of Australia’s remote communities have poorer health status than their metropolitan counterparts. The proportion of Indigenous people is high and health and social disadvantage is widespread. The characteristics of each remote community are unique and often reflect challenges associated with distance to tertiary health services and limited health resources. As a result, nursing practice within this context is very different to other nursing contexts. Despite recognition of Primary Health Care (PHC) as a comprehensive model of acute and preventative care well suited to areas of high health and social need, there is little known about how nurses use the PHC model in practice and research pertaining to this nursing context is limited.
This study was conducted from a Constructivist Grounded Theory perspective to generate a substantive theory. Data were collected through 23 telephone interviews and an expert reference group.
This study adds previously unknown information to the body of work about remote area nursing. The context of providing PHC in a remote setting was described as social with a focus on illness prevention and equality of care. Participants described personal satisfaction as a feeling of making a difference to the health and wellbeing of the community. However, the core issue participants faced was the inability to provide PHC. Four conditions that impacted on the core issue, were described as: understanding of the social world of the remote community, availability of resources, clinical knowledge and skill and, shared understanding and support. The process labelled doing the best you can with what you have emerged as the way participants dealt with the inability to provide PHC. The process involved four primary activities: facilitating access to health care, continually learning, seeking understanding, and home‐making in a work environment. The outcome of this process was considered to be making compromises to provide PHC.
This study proposes a substantive theory to understand and explain Australian remote nursing practice. Recommendations include further exploration, testing and refinement of the substantive theory. The implications for practice include development of education and support programs and the findings promote the case for providing additional resources to health services in remote areas in order to support nurses in providing PHC.
17
Coe, Christine, and n/a. "Identifying the health needs of refugees from the former Yugoslavia living in the Australian Capital Territory." University of Canberra. Nursing, 1998. http://erl.canberra.edu.au./public/adt-AUC20060629.093233.
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Most health professionals are aware of the amazing diversity of the Australian
population, which is made up of people from over 140 different countries. Of these,
an increasing number have arrived as refugees under Australia's humanitarian
resettlement program.
Research indicates that at least 30% of the 12,000 or so people arriving in Australia
under the humanitarian assistance programmes each year have been exposed to
physical and emotional torture and trauma. They also have well documented health
deficits relating to the health standards in their countries of origin, the level of
deprivation experienced prior to arrival in Australia, and the time they have spent in
transit before arriving in Australia.
The purpose of this study was to review the health status of refugees from the
former Yugoslavia, and to identify the perceived needs of this group, which
represents one of Canberra's largest communities of recently arrived refugees.
Utilising both qualitative and quantitative methodologies, findings showed that the
cohort had significantly lower levels of both physical and mental health than the
wider ACT and Australian population. The difficulties of socialisation of the refugees
into the Australian lifestyle are highlighted. In particular, findings from the study
have demonstrated the lack of appropriate information given to some refugees on
arrival, and the struggles experienced by most of the group with learning a new
language, and coping with unemployment and inadequate housing. The problem of
covert political harassment in Canberra was also described during the interview
process.
Recommendations for improving the situation for these refugees were that
information for refugees prior to, and following arrival in Australia needs to be
consistent and readily available, and there needs to be provision of a formalised
support system from the time of arrival, including a review of language facilities. The
study also recommended that culturally sensitive health promotion and treatment
programs should be incorporated into current health service provision. Nurses are
identified as the appropriate health providers to take a leading role in developing
such programs for refugees, although findings from this study indicate that current
nurse education programs need to place more emphasis on a transcultural
framework for the provision of care.
18
Lea, Dorothy University of Ballarat. "Spiritual awareness of professional nurses in the western region of Victoria: Investigation of a significant component of holistic heath care." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12789.
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A desire to more fully understand the impact of altered states of spiritual health on the general health of patients has been a focus of recent research activity. Studies have explored the meaning of spirituality held by patients and nurses, the spiritual needs of patients, and methods of providing spiritual care in nursing. However, few studies have investigated nurses’ own spiritual health and the significance this may have on the provision of holistic nursing care. The aim of this study, therefore, was to inform nursing regarding the spiritual health of nurses and the influence that nurses’ own spiritual health has on their ability to provide holistic nursing care to their patients. The study was conducted in two phases using both quantitative and qualitative methodologies. Phase one consisted of a survey of Division 1 nurses currently employed in the Grampians region of Victoria to describe key dimensions of their spiritual health. This survey provided biographical data and, through the use of the “Shalom Measure of Spiritual Health”, discovered the ideal of spiritual health held by nurses as well as the nurses’ perception of patient needs pertaining to the achievement of spiritual health. Phase two utilised Naturalistic Inquiry to further explore the meaning of spirituality and spiritual health held by nurses, and the methods of achieving these for nurses and patients. The findings revealed that although nurses perceive the spiritual dimension of patient care to be important, they feel ill-equipped to provide this aspect of care. In addition, the major support for nurses, who themselves experience spiritual distress whilst at work, comes from colleagues. Further, prevailing health care systems in place do not always lend themselves to holistic approaches to care. This study identifies the need for nurse education to redress the clearly inadequate preparation nurses are given for this aspect of their role. Health care policy-makers and administrators also have a responsibility to consider all dimensions of care when designing and implementing health care guidelines and systems.Master of Nursing
19
Lea, Dorothy. "Spiritual awareness of professional nurses in the western region of Victoria: Investigation of a significant component of holistic heath care." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/14624.
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A desire to more fully understand the impact of altered states of spiritual health on the general health of patients has been a focus of recent research activity. Studies have explored the meaning of spirituality held by patients and nurses, the spiritual needs of patients, and methods of providing spiritual care in nursing. However, few studies have investigated nurses’ own spiritual health and the significance this may have on the provision of holistic nursing care. The aim of this study, therefore, was to inform nursing regarding the spiritual health of nurses and the influence that nurses’ own spiritual health has on their ability to provide holistic nursing care to their patients. The study was conducted in two phases using both quantitative and qualitative methodologies. Phase one consisted of a survey of Division 1 nurses currently employed in the Grampians region of Victoria to describe key dimensions of their spiritual health. This survey provided biographical data and, through the use of the “Shalom Measure of Spiritual Health”, discovered the ideal of spiritual health held by nurses as well as the nurses’ perception of patient needs pertaining to the achievement of spiritual health. Phase two utilised Naturalistic Inquiry to further explore the meaning of spirituality and spiritual health held by nurses, and the methods of achieving these for nurses and patients. The findings revealed that although nurses perceive the spiritual dimension of patient care to be important, they feel ill-equipped to provide this aspect of care. In addition, the major support for nurses, who themselves experience spiritual distress whilst at work, comes from colleagues. Further, prevailing health care systems in place do not always lend themselves to holistic approaches to care. This study identifies the need for nurse education to redress the clearly inadequate preparation nurses are given for this aspect of their role. Health care policy-makers and administrators also have a responsibility to consider all dimensions of care when designing and implementing health care guidelines and systems.Master of Nursing
20
Dahl, Maxine Claire. "Air evacuation in war : the role of RAAF nurses undertaking air evacuation of casualties between 1943-1953." Thesis, Queensland University of Technology, 2009. https://eprints.qut.edu.au/31883/1/Maxine_Dahl_Thesis.pdf.
Full textAbstract:
Air transportation of Australian casualties in World War II was initially carried out in air ambulances with an accompanying male medical orderly. By late 1943 with the war effort concentrated in the Pacific, Allied military authorities realised that air transport was needed to move the increasing numbers of casualties over longer distances. The Royal Australian Air Force (RAAF) became responsible for air evacuation of Australian casualties and established a formal medical air evacuation system with trained flight teams early in 1944.
Specialised Medical Air Evacuation Transport Units (MAETUs) were established whose sole responsibility was undertaking air evacuations of Australian casualties from the forward operational areas back to definitive medical care. Flight teams consisting of a RAAF nursing sister (registered nurse) and a medical orderly carried out the escort duties. These personnel had been specially trained in Australia for their role.
Post-WWII, the RAAF Nursing Service was demobilised with a limited number of nurses being retained for the Interim Air Force. Subsequently, those nurses were offered commissions in the Permanent Air Force. Some of the nurses who remained were air evacuation trained and carried out air evacuations both in Australia and as part of the British Commonwealth Occupation Force in Japan.
With the outbreak of the Korean War in June 1950, Australia became responsible for the air evacuation of British Commonwealth casualties from Korea to Japan. With a re-organisation of the Australian forces as part of the British Commonwealth forces, RAAF nurses were posted to undertake air evacuation from Korea and back to Australia from Iwakuni, Japan. By 1952, a specialised casualty staging section was established in Seoul and staffed by RAAF nurses from Iwakuni on a rotation basis.
The development of the Australian air evacuation system and the role of the flight nurses are not well documented for the period 1943-1953. The aims of this research are three fold and include documenting the origins and development of the air evacuation system from 1943-1953; analysing and documenting the RAAF nurse’s role and exploring whether any influences or lessons remain valid today. A traditional historical methodology of narrative and then analysis was used to inform the flight nurse’s role within the totality of the social system. Evidence was based on primary data sources mainly held in Defence files, the Australian War Memorial or the National Archives of Australia. Interviews with 12 ex-RAAF nurses from both WWII and the Korean War were conducted to provide information where there were gaps in the primary data and to enable exploration of the flight nurses’ role and their contributions in war of the air evacuation of casualties.
Finally, this thesis highlights two lessons that remain valid today. The first is that interoperability of air evacuation systems with other nations is a force multiplier when resources are scarce or limited. Second, the pre-flight assessment of patients was essential and ensured that there were no deaths in-flight.
21
Forrester, Kim, and n/a. "The Impact of Structural (Legislation and Policy), Professional and Process Factors on the Outcomes of Disciplinary Tribunals and Committees in Cases of Sexual Misconduct and Incompetent or Unsafe Practice." Griffith University. School of Nursing, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040615.144659.
Full textAbstract:
This study was conducted in the context of the regulation of professional nursing and midwifery practice in the Australian health care system. In this environment, professional regulatory authorities established by State and Territory legislation in all jurisdictions, regulate and control the work of health professionals. In Queensland, registered nurses, enrolled nurses and midwives are regulated by the Queensland Nursing Council, the statutory body created by the Nursing Act 1992 (Qld). Part of the regulatory role of this and other authorities is to discipline professionals whose conduct or behaviour falls short of appropriate and acceptable standards of practice. All regulated health professionals, including nurses and midwives, are potentially subject to professional disciplinary action if a complaint is lodged in relation to their conduct. This being an important issue in the management and delivery of health care, and an increased trend among health care consumers, the dearth of existing research into the disciplinary process is a major concern. This exploratory study examined the disciplinary role of the Queensland Nursing Council in adhering to its legislative mandate to ensure safe and competent nursing practice. The study focused on the extent to which structural (legislation and policy), professional, and process factors impacted on the outcomes of disciplinary Tribunals and Committees in cases of incompetent or unsafe practice and sexual misconduct. The study was situated within the interpretive paradigm using a case study approach. Specifically, it investigated cases of sexual misconduct by nurses and unsafe or incompetent practice by midwives. The study was guided by Donabedian's conceptual framework of structure-process-outcome. This framework was seen to be most suited to the aims of the study and provided a template for in-depth analysis of the data emerging from the two cases. The findings of this study provided insight into the factors underpinning the decisions of the disciplinary bodies in making determinations and formulating outcomes. There was found to be a lack of consistency and predictability in both the legislative frameworks and the interpretation of terms and concepts used to identify conduct warranting a disciplinary response from regulatory authorities. Although the processes of disciplinary proceedings are prescribed by both legislation and policy, their practical application was characterised by considerable challenges, which resulted in varying outcomes. The thesis reports this information so that it can be used as an initial basis to build a body of knowledge from practical experience with disciplinary proceedings that will inform future processes. Subsequent case studies in other contexts and systems will increase the level of knowledge available to nurses, other health care providers, health care institutions and regulatory authorities. The initial base of evidence suggests implications for practice, education and further research which are outlined in the final chapter of the thesis.
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Nicholas, Jennifer. "The roles and responsibilities of WA general practice nurses in diabetes care and management." Thesis, Curtin University, 2009. http://hdl.handle.net/20.500.11937/1313.
Full textAbstract:
The rising incidence of chronic diseases such as diabetes, associated comorbidities, an ageing population and rising health expenditure are all creating a greater burden on the Australian health care system.Purpose of the Study. The role of the practice nurse (PN) working within the general practice setting is expanding in response to health care demands and government policies, yet there is a lack of Australian research into how this role may impact upon the management of diabetes. This study explores current practice of PNs, their diabetes specific education, and driving and restraining forces that influence their involvement in diabetes management.Methodology. A cross sectional design with a postal survey, whereby 758 surveys were distributed to PNs via each of the 13 Western Australian Divisions of General practice, between October 2006 and May 2007. The final response rate was 16% (n = 118) with 118 surveys completed and returned. The Statistical Package for Social Sciences 15.0 was used for data entry and analysis.General Practice Setting. In the current study 85% (n = 94) of practices had a diabetes register, with 75% (n = 83) of PNs involved in operating this system. The PN has a defined role in contributing towards the development of chronic disease care plans and annual diabetes complication screening processes, services that are reimbursed through Medicare. However, current models of primary care delivery and funding appear to support the PN in this role as an adjunct to the general practitioner (GP), which may not permit full utilisation and recognition of the PNs’ professional scope of practice.The Role of the Practice Nurse. A statistically significant association was found between those PNs having completed diabetes related continuing education and the greater likelihood of providing education in insulin initiation, blood glucose monitoring, dietary advice, exercise and sick day education (p < .05). Whilst PNs in the current study displayed a high level of involvement in various areas of diabetes care, not all will be educationally prepared, yet may be undertaking what could be considered a more advanced practice role in diabetes self management education.Diabetes Knowledge Test. There was significantly higher scoring in the Diabetes Knowledge Test (DKT) where questions related to insulin therapy, amongst those PN’s with a role in providing education in self monitoring of diabetes (p = .036). Likewise, where the provision of dietary advice was part of the PN role, scoring was significantly higher in the DKT overall (p = .029). For those spending greater than two hours per week in diabetes related care, scores were significantly higher where questions examined principles surrounding management of blood glucose levels (p = .031). Practice nurses having undertaken a clinical audit related to diabetes care, scored significantly higher in the DKT overall (p = .037), particularly where those questions related to the complications associated with diabetes (p = .009).Barriers and Facilitators to PN Role in Diabetes Self Management Education. Practice nurses in the current study placed a significantly high level of importance on their role in patient teaching. However, time was found to be a significant barrier to this role (p < .05). The current study displays a high level of involvement by PNs in various areas of diabetes self management education and related clinical assessment, with a low level of involvement in diabetes specific continuing formal education. Whilst this facet of their role has more recently been acknowledged within general practice guidelines for diabetes management, the question remains as to the level of educational preparedness of the PN, to meet this expanding role.
23
James, Jennifer Ann, and n/a. "The extent to which registered nurses in the ACT state that they use physical assessment skills as a basis for nursing practice." University of Canberra. Education, 1988. http://erl.canberra.edu.au./public/adt-AUC20060406.121506.
Full textAbstract:
The purpose of this research was to discover the extent
to which practising registered nurses in the ACT
undertake physical assessment. It was also organized to
discover the perceived reasons why, in appropriate
instances, it was not undertaken and the extent to which
certain variables may have influenced its practice or
non-practice. It was directed also at discovering the
extent to which the practising registered nurse would be
prepared to undertake workshops on the subject, so that,
if appropriate, a core of registered nurses could be
provided to act as the role-models and to create the
necessary learning environment in the ACT hospitals and
agencies where most of the Canberra College's graduates
would find employment.
Since the first undergraduate course in nursing was
introduced in the tertiary sector, nurse academics have
placed significant emphasis on the teaching of the
nursing process. It is within the first phase of this
process, the assessment phase, that the physical
assessment of the patient/client is conducted.
Discussions with practising registered nurses and
observations, led to some uncertainty as to the extent
to which physical assessment was actually being used. A
review of the literature showed that no investigation of
the matter had been reported in the Australian
literature. It was, therefore, proposed to make good
this deficiency and to resolve any uncertainty about the
extent of use of physical assessment in the ACT.
This study was restricted to registered nurses in the
ACT where all beginning nurses are educated at the CCAE
with a curriculum which includes a comprehensive study
of physical assessment. Even so, it is recognized that
such studies will only reach a beginning level of
competency. In order to ensure that the graduates of
these courses extend their competency in physical
assessment they need to be able to use these skills in
every day nursing practice.
This research, therefore, was conducted using a
questionnaire which incorporated questions about the use
of 36 physical assessment skills. The survey, on a onetime
participation basis, was conducted for all
registered nurses rostered on a fortnightly period in
April 1987. A 66.7% response rate was achieved.
The responses were analyzed and the findings, results
and recommendations are included in the appropriate
sections of this thesis.
24
Reid, Carol. "Examination of relationships and mediating effects of self-efficacy, locus of control, coping and the practice environment on caring efficacy and job satisfaction in Australian registered nurses." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/53139/1/Carol_Reid_Thesis.pdf.
Full textAbstract:
Background to the Problem: Improving nurses' self-efficacy and job satisfaction may improve the quality of nursing care to patients. Moreover, to work effectively and consistently with professional nursing standards, nurses have to believe they are able to make decisions about their practice. In order to identify what strategies and professional development programmes should be developed and implemented for registered nurses in the Australian context, a comprehensive profile of registered nurses and factors that affect nursing care in Australia needs to be available. However, at present, there is limited information available on a) the perceived caring efficacy and job satisfaction of registered nurses in Australia, and b) the relationships between the demographic variables general self-efficacy, work locus of control, coping styles, the professional nursing practice environment and caring efficacy and job satisfaction of registered nurses in Australia.
This is the first study to 1) investigate relationships between caring efficacy and job satisfaction with factors such as general self-efficacy, locus of control and coping, 2) the nursing practice environment in the Australian context and 3) conceptualise a model of caring efficacy and job satisfaction in the Australian context.
Research Design and Methods: This study used a two-phase cross-sectional survey design. A pilot study was conducted in order to determine the validity and reliability of the survey instruments and to assess the effectiveness of the participant recruitment process. The second study of the research involved investigating the relationships between the socio-demographic, dependent and independent variables. Socio-demographic variables included age, gender, level of education, years of experience, years in current job, employment status, geographical location, specialty area, health sector, state and marital status. Other independent variables in this study included general self-efficacy, work locus of control, coping styles and the professional nursing practice environment. The dependent variables were job satisfaction and caring efficacy.
Results: A confirmatory factor analysis of the Brisbane Practice Environment Measure (B-PEM) was conducted. A five-factor structure of the B-PEM was confirmed. Relationships between socio-demographic variables, caring efficacy and job satisfaction, were identified at the bivariate and multivariable levels. Further, examination using structural equation modelling revealed general self-efficacy, work locus of control, coping style and the professional nursing practice environment contributed to caring efficacy and job satisfaction of registered nurses in Australia.
Conclusion: This research contributes to the literature on how socio-demographic, personal and environmental variables (work locus of control, general self-efficacy and the nursing practice environment) influence caring efficacy and job satisfaction in registered nurses in Australia. Caring efficacy and job satisfaction may be improved if general self-efficacy is high in those that have an internal work locus of control. The study has also shown that practice environments that provide the necessary resources improve job satisfaction in nurses. The results have identified that the development and implementation of strategies for professional development and orientation programmes that enhance self-efficacy and work locus of control may contribute to better quality nursing practice and job satisfaction. This may further assist registered nurses towards focusing on improving their practice abilities. These strategies along with practice environments that provide the necessary resources for nurses to practice effectively may lead to better job satisfaction. This information is important for nursing leaders, healthcare organisations and policymakers, as the development and implementation of these strategies may lead to better recruitment and retention of nurses. The study results will contribute to the national and international literature on self-efficacy, job satisfaction and nursing practice.
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Tahghighi, Mozhdeh. "Resilience in Nurses Working Shift Work in Australia." Thesis, Curtin University, 2018. http://hdl.handle.net/20.500.11937/69326.
Full textAbstract:
The aim of this study was to investigate the impact of shift work on resilience and associated mental health and professional quality of life of nurses. Overall, this study found nurse shift workers had significantly lower levels of compassion satisfaction compared to non-shift workers, and they are coping with unique stressors that are in addition to the general stress all nurses are facing.
26
Vafeas, Caroline J. "Migration matters : the experience of United Kingdom registered nurses migrating to Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2013. https://ro.ecu.edu.au/theses/703.
Full textAbstract:
This qualitative study uses heuristic inquiry to investigate the unique journey of 21 registered nurses (RN) who migrated from the United Kingdom (UK) to Perth in Western Australia (WA) between 2003 and 2008. The study explores the reasons for migration as well as the professional, social and psychological impact on each participant and their accompanying family during the first two years of settling in a new country.
In the contemporary climate of international nurse mobility, many employers are attempting to attract new employees, often with tantalising offers of an immediate visa and the enticement of a better climate and standard of living. Migration is costly financially and socially, with many nurses finding that the dream does not live up to the reality.
The purpose of this study is to search for the essence of the phenomenon of migration for RNs from the UK moving to WA, including the psychological and sociocultural adaptation experienced by the participants. With the focus being to capture the experience of UK migrant nurses in WA, heuristic inquiry was chosen as the research methodology, offering the researcher an opportunity to be included in the study due to personal experience as an RN migrating to WA in 2003.
The professional and personal challenges faced by the participants are examined in detail and offer an insight into the complicated and often frustrating process faced by UK nurses when migrating to WA. Three main themes were uncovered during the heuristic process: (a) making the move: finding a way; (b) new life: fitting in; and (c) here to stay. Heuristic inquiry encouraged the development of a creative synthesis to represent the whole experience and resulted in my distinctive representation, Nurse migration: A model for success. This model is underpinned by the theoretical framework used to support the research, the work of Kingma who identified the main push and pull factors affecting the decision of nurses to migrate.
Three main coping strategies identified in this study were: (a) developing resilience; (b) finding a new professional identity; and (c) having the ability to adapt to a new life. Feelings of belonging were found to be necessary to make the move a success, with the need for new friends and a replacement family being a high priority for all participants. This study also highlighted many issues that need to be considered by future UK migrant nurses before embarking on such a massive upheaval to their professional and personal life. Policy makers and Australian employers must consider the total impact of migration upon the nurses they employ and investigate how they can improve conditions that may allow them to “live the dream” both professionally and personally.
27
Zhou, Yunxian. "The experience of China-educated nurses working in Australia : a symbolic interactionist perspective." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/31866/1/Yunxian_Zhou_Thesis.pdf.
Full textAbstract:
Transnational nurse migration is a growing phenomenon. However, relatively little is known about the experiences of immigrant nurses and particularly about non-English speaking background nurses who work in more economically developed countries. Informed by a symbolic interactionist framework, this research explored the experience of China-educated nurses working in the Australian health care system. Using a modified constructivist grounded theory method, the main source of data were 46 face to face in-depth interviews with 28 China-educated nurses in two major cities in Australia. The key findings of this research are fourfold. First, the core category developed in this study is reconciling different realities, which inserts a theoretical understanding beyond the concepts of acculturation, assimilation, and integration. Second, in contrast to the dominant discourse which reduces the experience of immigrant nurses to language and culture, this research concludes that it was not just about language and nor was it simply about culture. Third, rather than focus on the negative aspects of difference as in the immigration literature and in the practice of nursing, this research points to the importance of recognising the social value of difference. Finally, the prevailing view that the experience of immigrant nurses is largely negative belies its complexities. This research concludes that it is naïve to define the experience as either good or bad. Rather, ambivalence was the essential feature of the experience and a more appropriate theoretical concept. This research produced a theoretical understanding of the experience of China-educated nurses working in Australia. The findings may not only inform Chinese nurses who wish to immigrate but also contribute to the implementation of more effective support services for immigrant nurses in Australian health care organisations.
28
Cope, Vicki. "Portraits of nursing resilience: Listening for a story." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2012. https://ro.ecu.edu.au/theses/553.
Full textAbstract:
The nursing workforce in Australia is a workforce under pressure. Within in-patient settings, rapidly increasing turnover of more acutely ill or co-morbid patients, and staff retention issues, place those staff that remain under extra pressure to maintain a quality service. In nurse education settings the increasing imperative to recruit more students into the profession combined with financial cutbacks leading to staff retention issues creates a similar tension. Yet many Registered Nurses (RNs) do remain in their chosen work setting displaying tenacity and resilience despite well documented trials and tribulations.
A qualitative approach, Portraiture, was used to construct a collection of portraits which enabled an exploration of the ‘why’ that relates to the individual nurse’s remaining in a workplace often described as awful.
A narrative analysis of the portrait data allowed a meaningful interpretation based in current literature and contemporary experience in uncovering the individual’s resilience and motivation to continue. The portraits give an overarching insight of the nurse participant’s world view and why each continues in her work. The traits and attitudes uncovered have implications for educators and employers of nurses as well as for consumers of nursing care.
Several recommendations arose from the findings in relation to further research, education and policy making. These recommendations could contribute to enhance a satisfying professional milieu for the practising nurse; and to the education and ongoing professional development of nurses which acknowledges the changing socio-political and fiscal environment in which nursing service takes place.
29
Smedley, Alison. "Developing the nurse professional and nurse education for the 21st century." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/333.
Full textAbstract:
The purpose of this portfolio was to establish what educational strategies would enhance the professional education for the nurse of the future. Through an examination of various contemporary educational theorists' work. a conceptual framework was developed using the concepts of Hargreaves (2003) as an overarching model to establish the current positioning of nursing and nursing education in the knowledge society. The preparation ofa nurse who can function effectively and efficiently within a rapidly changing health workplace relies heavily on educational preparation that includes the development of knowledge, skills and attitudes appropriate for the role. This portfolio has examined critical aspects of nursing and nurse education in relation to the development of these necessary areas for future nurse professionals.
30
Rae, Ruth. "Jessie Tomlins an Australian army nurse - World War One /." Connect to full text, 2001. http://hdl.handle.net/2123/840.
Full textAbstract:
Thesis (Ph. D.)--University of Sydney, 2001."... The letters, postcards and photographs that Jessie, Fred and Will sent home to their mother and family, as well as Fred's fourteen diaries, form the foundation of this thesis..." -- p. 2. Title from title screen (viewed Apr. 23, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Clinical Nursing, Faculty of Nursing. Includes bibliography. Also available in print form.
31
Bakker, Susette. "Covert violence in nursing." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1296.
Full textAbstract:
There is no official avenue in nursing for the reporting of incidences of covert violence to staff and so they remain unrecorded and often stressful. This study sought to collect data from currently employed nurses concerning covert violence in their workplace, and to collate the information to obtain a valid assessment of this hidden problem. A qualitative methodology was used to report on the experiences of nurses in relation to covert violence directed at them by their peers, other health professionals, patients and patients' families. The participants were all registered nurses employed by a suburban health service. Each was given an open-ended questionnaire to: 1. establish the participant's position and professional experience within the Health Service, 2. request for incidences regarding the various forms of covert violence encountered by them in the workplace, 3. describe how they dealt with such episodes It is anticipated that this study will lead to an acknowledgement of, and interventions to prevent, such forms of violence. It is also anticipated that minimising the occurrence of covert violence will improve nursing productivity, provide greater job satisfaction for nurses, and promote savings in terms of less staff absenteeism, Workers' Compensation insurance claims and staff turnover.
32
Carville, Keryln. "The evolution and experience of stomal therapy nurses in Australia 1959-2000." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1488.
Full textAbstract:
In Australia, stomal therapy nurses are registered nurses who have undertaken an educational programme in the care, counselling and rehabilitation of persons-who have, or who could potentially have, a wound, an ostomy (that is an artificial opening into a body cavity) or incontinence of bodily waste. The genesis of stomal therapy nurses in Australia as a specialty group within the broader nursing profession was in 1971, when 11 founding members established an association for registered nurses with an interest in the care of patients with stomas. However, the serendipitous event that pre-empted the formation of this special interest group, can be traced to an individual nurse's first clinical experience of caring for a patient with a stoma in 1959. The purpose of this study was to uncover the historical events that led to the development and evolution of stomal therapy nurses in Australia, and to describe the lived experiences of stomal therapy nurses within that historical context. The study employed two different qualitative methodological approaches. Separate historical and phenomenological studies were conducted and the uniqueness and philosophical foundations of both methodologies were preserved. The two independent studies stand alone in their sample population, data collection, data analysis and findings. The historical study findings opened a window to the past and revealed the persons, events and forces, that were instrumental in the development and evolution of stomal therapy nurses and nursing in Australia. The phenomenological study findings revealed the essence of what it is to be a stomal therapy nurse in Australia and a member of the Australian association of Stomal Therapy Nurses. Comparative and contextual analysis of the historical and phenomenological findings was then conducted in order to enhance the understanding of the phenomena. This comparative and contextual analysis of historical and phenomenological findings has been termed histro-phenomenology and this approach has revealed the key findings of this study. These key findings revealed an exciting insight into the professional characteristics that define a Good nurse and-the behaviours and attitudes that reflect the essence of Good nursing.
33
Ardern, Rachel. "The function of competencies in the Australian nursing sector: A critical exploration." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/235389/1/Rachel%2BArdern%2BThesis%282%29.pdf.
Full textAbstract:
By the end of the 20th century, hospital-based nurse training was replaced by nursing university programs with a greater focus on theoretically informed practice. This move coincided with the appearance of the competency movement across industries. Nursing competencies were primarily associated with political interests of increasing the flexibility through the demonstration of generic skills that could effectively increased scopes of practice. This flexibility created a blurring between RNs/ENs that contributed to an environment where neither role had clearly defined disciplinary boundaries. Competencies provided financial rewards for the organisation while increasing the workload of ENs and limiting the functions of RNs.
34
Kay, Kate. "(Mis)powered practice: A critical investigation of nurses' manual handling experiences in Australia." Thesis, Australian Catholic University, 2015. https://acuresearchbank.acu.edu.au/download/aff5b143120e868cfdd79daf383dab498e97e6fac3ebbd7dd71abf81dea54ac3/3386211/201502_Kate_Kay.pdf.
Full textAbstract:
Inherent in the nursing role are manual handling activities required for the provision of patient care. The physical demands upon nurses have resulted in high rates of musculoskeletal disorders (MSDs) within the profession. Despite the development of programs intended to reduce MSDs, sustainable solutions have remained elusive. Nurses continue to be disproportionately represented in the statistics for injuries arising from manual handling. Over 95% of nurses are likely to incur at least one MSD during their professional lifetime. The scholarly literature provides little evidence of the inclusion of nurses in the manual handling dialogue, despite their intimate knowledge of the healthcare environment. This thesis reports on a study of nurses speaking about their perspectives on current manual handling practices and their experiences of participation in injury prevention programs. The research explored nurses' experiences of manual handling within acute and aged care health facilities in two Australian states, with the intent to make explicit the assumptions underlying contemporary approaches to manual handling issues. The overall aim of this research was to explore nurses' manual handling experiences in the specific context of healthcare organisations. An improved understanding of manual handling from the perspectives of nurses has the potential to explicate aspects of manual handling not previously considered in the development of programs to reduce injuries. The overarching intention of this study was to give nurses the opportunity to verbalise and examine their manual handling experiences and perceptions, with an aim to explore any possible transformative practices.
35
Suppiah, Dall Veronica-Ann. "Factors influencing nurses’ attitudes towards information technology in nursing practice in Western Australia." Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/1589.
Full textAbstract:
To understand factors that influence Western Australian nurses’ attitudes towards using information technology in nursing practice, a mixed-methods approach involving quantitative and qualitative approaches was used. A questionnaire was responded to by 134 registered nurses and this was followed by interviews with selected participants. Various barriers that hampered nurses’ embracing computers and information technology were identified.
36
Sands, Jaynie E. "A reflective analysis of burn wound care: The Australian burns nurse' perspective." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/940.
Full textAbstract:
The purpose of this historiographical nursing study was to explore Australian Burn Wound Care from a nursing perspective, at two periods of time. It was the intention of the author to explore practices at the inception of specialised burns units, from the 1950's, presenting an historical perspective, and at the present time, May 1995. Eleven burns units across Australia participated in the study. There were 22 participants in the research sample. Each burns unit identified the first Charge Nurse (n =11) and the current Clinical Nurse Specialist (n =11), to be involved in the data collection process. The conceptual framework for this study incorporates the Reflective Cycle (Gibbs, 1988) succinctly incorporating the 'who', 'where', 'why', 'when' and 'what' aspects of the historical method of inquiry. An interview guide, used in conjunction with three photographs depicting burn wounds, provided interview structure for the data collection. A variety of historical data were gathered and analysed. These included scientific medical and nursing texts, foundation minutes, reports and conference papers of Australian and New Zealand Bums Association, to gain perspective of Australian Bum Wound Care. However, the data collated from 1950 to 1996 uncovered no written material on bum wound care. The information available was obtained exclusively from the indepth interviews. The data collated for the current perspective included hospital/ burns unit protocols and indepth interviews with key nursing personnel. A field trip facilitated the data collection, enabling semi-structured, audiotaped interviews in person and the opportunity to visit hospital libraries. The findings of the study have been organised to show bum wound care practices endorsed by Australian burns units, at the inception of specialised facilities, and at the present time.
37
Osborne, Sonya. "Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia." Thesis, University of Canberra, 2002. https://eprints.qut.edu.au/66689/1/Osborne_2002_SP_and_OER_UC_Masters_Thesis.pdf.
Full textAbstract:
Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.
38
Hense, Sibasis. "Intention to migrate to Australia: a mixed-method study of Indian physicians and nurses." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/96241/4/Sibasis_Hense_Thesis.pdf.
Full textAbstract:
International migration of physicians and nurses is a growing concern in India as it is linked to skill and staff shortages in the Indian health system. This research investigated the migration intention of Indian physicians and nurses internationally with a special focus on Australia. The research employed a mixed methods approach, involving surveys and interviews with physicians, nurses and key informants. The conceptual framework driving the analysis employed a push-pull framework of migration. The study has both policy and practical implications for retention of physicians and nurses in India and in relation to the regulatory environment of skilled migration in Australia.
39
Piercey, Carol Ann. "Nurse education in Western Australia from 1962-1975: A historical perspective of influences and changes." Thesis, Curtin University, 2002. http://hdl.handle.net/20.500.11937/1886.
Full textAbstract:
National trends in nurse education have changed from the Nightingale system of on-the-job training to a professional preparation in institutions of higher learning. Western Australia was one of the first States in Australia to commence a professional preparation of nurses at an institution of higher education in 1975. Graduates of the program were presented with their Bachelor of Applied Science from the Western Australian Institute of Technology (now Curtin University of Technology), in March 1979. This thesis seeks to answer the question concerning the genesis of such an event. The focus of the study is primarily to follow the progress of general nurse education in Western Australia and to highlight the accompanying influences that shaped its development. The purpose of this study was to explore, analyse, interpret and describe the history of nurse education in Western Australia from 1962-1975. The study used a pluralistic approach employing a variety of historical methods. The research commenced with broad questions and ideas developed from documents and people. The process of data collection, historical criticism and analysis took place simultaneously. The synthesis was written as a chronological narrative. The material of the study thus 'spoke' for itself by providing answers to questions raised during the investigation. The history of nurse education from 1962 to 1975 revealed visible milestones that represented nurse education reform. Beginning from the antecedents of the study these were the sanctioning of a review of nurse training in 1960 together with the commencement of the Western Australian Nursing Survey and the appointment of the Nurses Registration Board Education Officer. In 1962 the survey was completed.It exposed the deficits of nurse training which led to the development of a new Hospital Based Diploma curriculum and an Associate Diploma in Nursing in 1966. The establishment of the College of Nursing Australia Western Australian Branch in 1966 paved the way to solve the shortage of tutors to implement the Hospital Based Diploma. The Nurses Act in 1970 enhanced the plans for implementing the Hospital Based Diploma and conferred autonomy to the Nurses Registration Board. In 1973 the first independent school of nursing came into being. The Western Australian School of Nursing carried the hopes of a continuation of hospital nurse training. In 1974, however, the entry of students to the Western Australian Institute of Technology School of Nursing saw a turn of events that led to a degree for nurses in 1975 and a decision for the transfer of all nurse education in Western Australia to the Western Australian Institute of Technology. These milestones did not emerge as an accident of history. There were forces that facilitated and impeded the perceptibility of the reform landmarks. These were crucial in the shaping the history of nurse education in Western Australia from 1962-1975.
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McConigley, Ruth. "Providing education and support for rural palliative care nurses in Western Australia: An intervention study." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2004. https://ro.ecu.edu.au/theses/1655.
Full textAbstract:
Rural palliative care nurses (RPCNs) in Western Australia (WA) are a small population, who have embraced the specialist palliative care role since the first palliative care service in rural WA began in 1990. However, there are some challenges involved with being a specialist nurse in a generalist health care setting. fu particular, there is a suggestion in the literature that RPCNs may be professionally isolated, may be prone to burnout, and may therefore experience decreased job satisfaction and may consider leaving the palliative care field.
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Sayers, Jan Maree. "The role of the nurse educator in acute care hospitals Australia." Thesis, Curtin University, 2013. http://hdl.handle.net/20.500.11937/622.
Full textAbstract:
The health workforce is one of the critical issues facing contemporary Australian health care systems. Therefore carefully defining roles in the health care system is of great importance. The Role of the Nurse Educator in Australian Acute Care Hospitals study used a mixed-method research design to develop a performance self-assessment scale for nurse educators and describe instances of role ambiguity and conflict. These findings will facilitate comprehensive understanding and integration of nurse educator roles throughout healthcare and education.
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Henderson, Anthony R. "The politics of nurse education in education in Australia 1961-1984." Thesis, Henderson, Anthony R. (1988) The politics of nurse education in education in Australia 1961-1984. Masters by Coursework thesis, Murdoch University, 1988. https://researchrepository.murdoch.edu.au/id/eprint/46067/.
Full textAbstract:
This paper examines the political activities of nurses in Australia, within the context of interest group theory and, in particular, the work of Gamson (1968) and Zeigler and Peak (1972). It spans 1961 to 1984 and takes into consideration the dynamics of both the nursing profession and the political systems during that time. The specific issue dealt with is the transfer of nurse education, from traditional hospital based schools of nursing to tertiary institutions. This transition involved the co-ordination of a national campaign by nurses in an attempt to influence policy makers at both state and federal level.
The dissertation is an historical and political analysis which required this writer to study the documents of professional nursing organisations, parliamentary debates and the print media. Interviews were also conducted with some of the key people involved in the transfer. In order to validate the information, and ensure its reliability, multiple methods of triangulation were used.
From 1961 to 1984, nursing organisations progressed through a number of stages before finally emerging in 1977 as a fully-fledged pressure group. Until 1983, they were viewed by those in authority as 'alienated' and consequently were unable to achieve any of their goals satisfactorily. However, nurses correctly perceived the political system generally, as being ambivalent to their demands. Gamson terms such ambivalence "neutrality", and hypothesises that when a pressure group identifies neutrality in a political system, it is highly likely to take action. This proved to be the case with nurses. Although their campaign lasted seven long years, it proved ultimately to be fairly successful. However, as will be demonstrated, an 'authority' will only concede to the demands of a particular pressure group to the extent that a counter group is not disadvantaged.
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Helms, Christopher. "Consensus on a Specialist Clinical Learning and Teaching Framework for Australian Nurse Practitioners." Thesis, Australian Catholic University, 2017. https://acuresearchbank.acu.edu.au/download/076a30ffd066dd97be47f344a5e7e97fccc7dfc2f30d6d180e730e48a5209ea7/81980443/HELMS_2017_THESIS.pdf.
Full textAbstract:
Background
The Australian nurse practitioner (NP) role is represented by over 1,400 endorsed NPs practising in over 50 different specialty areas. Generic standards have broadly supported the role’s behavioural, professional and expanded practice expectations since 2006, and have been used for the accreditation of NP Masters programmes nationally.
The need for consistent and flexible specialty clinical education for NP students has been described in the Australian literature. The clinical learning and teaching of Australian NP specialty roles has traditionally occurred in the student’s workplace, within a specified area of practice. Jurisdictional differences at state/territory and local levels have influenced how NP students develop and enact their roles once endorsed. Factors such as the student’s clinical supervisor, local legislation and policy, role ambiguity, restrictive local clinical guidelines and protocols influence what NP students learn in their clinical learning environments. These factors contribute to a highly differentiated NP workforce, with differing clinical skills, knowledge and abilities noted within the same specialty area. Similar difficulties have led to the development of broad specialty areas in the United States of America. To better complement the generic learning and teaching students receive through their academic programmes, this research aims to validate a specialist clinical learning and teaching framework for Australian nurse practitioners. This framework will not only enhance consistency in their specialty clinical learning and teaching, but create greater workforce flexibility.
A consensus-based research methodology was needed to validate the specialty clinical learning and teaching framework. Delphi Technique is a consensus-based research methodology commonly employed in nursing research to explore solutions to questions that have unclear or indeterminate answers. It aims to achieve a pre-determined level of consensus on a research question, using content experts through an anonymous and iterative process. Critical to the method’s validity is the participation of a heterogeneous group of experts with advanced knowledge of the content area, and whose feedback to other panelists is controlled to minimise social influence. Individual participant characteristics, such as experience level and confidence in decision-making, and the influence of these upon consensus are poorly described in the Delphi literature. There was little previous empirical research to inform how to best describe heterogeneity of opinion informing the specialty clinical learning and teaching framework using nurse practitioners. Aims - To validate a specialty clinical learning and teaching framework for Australian NP students.
Specific objectives that addressed this aim were: - To validate a previously developed Australian NP metaspecialty taxonomy.
- To validate supporting clinical practice standards used for the metaspecialty taxonomy.
- To contribute knowledge of how consensus is achieved when using Reactive Delphi methodology.
Specific questions that addressed this aim were: - Does Reactive Delphi methodology potentiate the negative influence of the bandwagon effect in Delphi panelists?
- What effect does panelist confidence have on decision-making in Delphi panelists?
- How can experience level be objectively demonstrated in individual Delphi panelists?
- What effect does experience level have on decision-making in Delphi panelists?
- Does confidence relate to opinion change in individual Delphi panelists?
- What effect does panel composition have on consensus outcomes?
- To demonstrate the application of web-based methods in Delphi research.
Specific objectives that addressed this aim were: - Describe the advantages of using a web-based Delphi method.
- Describe the risks of using a web-based Delphi method.
- Describe how panelist feedback was managed during six concurrent Delphi studies.
Methodology and Methods
This mixed-methods research used Delphi Technique to achieve consensus on, and therefore validate, a NP specialty clinical learning and teaching framework. Two sequential 3-round Reactive Delphi surveys were used to achieve the research aims. The first Delphi survey was designed to validate a proposed broad Australian NP specialty taxonomy previously established by the 2014 CLLEVER (CLinical LEarning goVERnance) study. The second Delphi survey was designed to validate clinical practice standards, which would support and provide definition to the specialty taxonomy. Together, the taxonomy and standards informed the proposed specialty clinical learning and teaching framework. Consensus Development Conference methodology was used to refine the proposed specialty clinical learning and teaching framework. Data collected during the conduct of the first Delphi survey achieved the second research aim. The third research aim was achieved by using metadata, paradata and embedded data in an advanced web-based survey design for both Delphi surveys. Purposive sampling and snowballing techniques were used to recruit from an eligible population of NPs, endorsed by the Nursing and Midwifery Board of Australia, with at least 12 months’ post-endorsement experience (N=966). Web-based survey technology was used to collect data. Data were analysed using content analysis, descriptive and inferential statistics. The Content Validity Index and non-parametric testing using McNemar’s Test for Change were used to determine consensus that informed the proposed framework. Results
Approximately 20% of the eligible Australian NP population contributed to both Delphi surveys. Six broad specialty areas, termed metaspecialties, were validated for the proposed specialty taxonomy. A Consensus Development Conference refined the names of two metaspecialties. The metaspecialties served as a foundation for validated clinical practice standards, which provided substance and definition to the final specialty clinical learning and framework. Heterogeneity of expert NP opinion informing the framework was demonstrated using professional activities representative of advanced practice nursing. There was no indication of negative social influence determining the manner by which panelists achieved consensus on the proposed framework. A novel method of using metadata, paradata and embedded data in web-based surveys was applied, which supported high survey response rates and identified non-response bias. A novel application of web-based surveys allowed the researcher to concurrently conduct six Delphi surveys nested within a larger research project. Conclusion
This research demonstrates a rigorous approach in validating a proposed specialty clinical learning and teaching framework for Australian NP students. It contributes new knowledge on the internal and external validity of Reactive Delphi methodology.
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Langridge, Miriam E. "A deconstruction and reconstruction of advanced nurse specialisation and education." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2002. https://ro.ecu.edu.au/theses/709.
Full textAbstract:
The purpose of this study was to present issues and the paradoxes surrounding advanced nurse specialisation (ANS) and education, This study was conducted in two parts. Part A examined the prospective experiences of 13 registered nurses (RNs) who were advancing in an area of special is III ion: they were working in a specialist area of practice and studying in II course specific 10 their specialisation. Two rounds of interviews were completed over six-month intervals. Part B examined the data gathered from a focus group interview and follow-up feedback from 10 nurse executives as stakeholders. The intersubjective data from this group of nurses expanded on the political, economic, and social complexities surrounding the same phenomenon of interest.
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Bradshaw, Beverley. "An evaluation of a workshop on pain assessment and management for nurses." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1993. https://ro.ecu.edu.au/theses/1149.
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The purpose of this study was to assess nurses’ knowledge of pain assessment and management, examine what change occurred immediately following a pain assessment and management workshop and examine whether any changes were retained one month later. Chin and Benne’s theory of change provided the theoretical framework for this study. Their approach to planned change involves assessing the existing structure, formulating and implementing a plan to change that structure, then evaluating the change. The following hypothesis was formulated for investigation: That nurses’ knowledge of pain assessment and management would increase after a workshop on the subject and be retained over one month. Based on the assumption that nurses’ demographic characteristics can influence their styles of learning and ability to disseminate knowledge, this study also examined whether changes in nurses’ knowledge were related to their demographic characteristics. To analyse this, the following were examined in relation to nurses’ knowledge of pain assessment and management: age, years of nursing, area of employment, level of practice, level of education and previous education in pain management. The design for this study was a one-group pretest-posttest-follow-up design. The subjects were 67 Registered and State Enrolled Nurses from country hospitals in Western Australia, involved in direct patient care, who voluntarily attended a pain assessment and management workshop. A questionnaire was adapted by the researcher and an expert nurse to measure nurses' knowledge. The results of the study support the main hypothesis that the workshop significantly increased nurses' pain assessment and management knowledge (ᵽ < .001), and that this knowledge was retained one month later. The remaining hypotheses related to demographic characteristics were not supported by this study (p > .05) with the following exceptions: Level Two Clinical Nurses (CNs) had more knowledge on the pretest, gained and retained more knowledge on the posttest and follow-up test than State Enrolled Nurses (ENs). Level One Registered Nurses (RNs) retained more knowledge on the follow-up test than ENs. In this study, each item on the questionnaire was analysed for each test. The value of this analysis was that it served to highlight where there was acceptance of or resistance to change in nurses' knowledge of pain assessment and management. Although generalisation of these results is inappropriate due to the convenience sample used, they support the opinion that a one day educational workshop can improve nurses' knowledge of pain assessment and management, and embrace the need for continued education related to this subject. An implication for nursing practice is that when nurses are prepared to learn new knowledge and change outdated concepts with the aim of improving patient care, this knowledge can be gained in relatively short courses of study.
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Walker, Annette Clare, of Western Sydney Nepean University, and Faculty of Nursing and Health Studies. "Nurse and patient work: comfort and the medical-surgical patient." THESIS_FNHS_XXX_Walker_ A.xml, 1996. http://handle.uws.edu.au:8081/1959.7/286.
Full textAbstract:
This grounded theory study investigates the experiences and perceptions of comfort and discomfort of hospital patients admitted for medical-surgical conditions, with a focus on the post-accute stage of hospitalisation. In-depth post-discharge interviews were conducted with seventeen English speaking adults who had been admitted to nine Australian hospitals. A substantive theory of finding comfort and of managing discomfort was generated. Processes of self-talk (anticipating, interpreting, accepting, making allowances and maintaining perspective) and self-care (self-help and seeking help, which involved accommodating to the level and type of help available through deferring, avoiding, persisting or desisting) were used to find comfort and to manage discomfort. The study has implications for nursign practice, management, research and education. Existing practice in the areas of assessment, communication, individualised care planning and the management of discomfort need to be strengthened if nursing care is to make a difference for this category of patient. The study revealed that integrated caring by nurses perceived by informants as 'experts', contributed most to the experience of finding comfort and managing discomfort in this group of informantsDoctor of Philosophy (PhD)
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Scott, Beverley Margaret. "Situational Positioning: A Grounded Theory of Registered Nurse Decision-making in Western Australian Nursing Homes." Thesis, Curtin University, 2003. http://hdl.handle.net/20.500.11937/1940.
Full textAbstract:
This grounded theory study investigated how registered nurses (RNs) managed problem-solving and decision-making in residential aged care facilities (nursing homes) in Western Australia. The outcome of the study was the substantive theory of situational positioning, the process used by the RN participants when they were trying to get things right .In-depth interviews were conducted with 25 purposefully selected registered nurses and nursing home management staff. The interviews were transcribed verbatim, and analysed using the constant comparative method. Other sources of data. guided by theoretical sampling. were selected documents such as government reports regarding aged care, and some field observations. Situational positioning was a process that involved physical. cognitive, emotional, and moral dimensions, and reflected how the RN participants acted and responded when dealing with situations at work. Situational positioning was conceptualised as occurring along two intersecting continua of behaviours, and these behaviours emerged from the data as four interrelated categories. Yielding and confronting represented the poles on a continuum of action-oriented behaviour, with being flexible and being rigid on a continuum that reflected more affective or attitudinal responses. The four categories that made up the positioning continua had both positive and negative meanings in relation to the actions and responses of the participants, depending on the particular situation. Yielding was a conceptual category that reflected participants' comments about stopping a particular action and trying something else or giving up completely and even leaving the situation. f he term confronting was used to describe participants' actions that were based on assertiveness that was seen as a constructive behaviour, or anger that tended to be non-productive.Being flexible meant that the participants were responsive to changing situational variables, and this was usually seen as a desirable attribute of effective nursing practice in aged care. However, it could also mean being pliant and ready to compromise in order to get through situations when the participants realised that they would be unable to get things right. At the other end of the response axis, the term being rigid was defined as the opposite of being flexible, that is, having firmly fixed or set ways of responding. or a tendency to respond to situations in the same way in all circumstances. The basic psychosocial problem, being unable to get things right, had two properties. One property was temporal, in that the problem occurred when the participants were getting behind or running late because of having insufficient time. usually due to interruptions. The second property of the problem was more qualitative in that contextual and intervening conditions led the participants to feel that they were not doing things properly because of adverse conditions. Conditions that varied .situational positioning were those that led to the participants being unable to get things right, such as having insufficient time. working with unqualified carers. and trying to meet the differing expectations of various stakeholders. Situations that were easy for the participants to manage involved known routines and few, if any. interruptions. In those circumstances, si uational positioning was intuitive and the phases of recognising, prioritizing, and moving on were negotiated quickly. In more complex situations, or when significant interruptions occurred, the participants followed an alternative pathway, which involved recognising that something in the situation changed. then compromising. that is. choosing a new course of action.Compromising required tolerance, as the participants adjusted their expectations of what could be achieved in the circumstances. Repositioning then occurred belore they moved on to the next task or to the end of their shifts. Moving on. the third phase in the process, involved persevering as they continued trying to get things right. The adverse conditions that prevailed in nursing homes during the time of this study impeded nursing practice and the delivery of consistently good standards of care for all residents. Situational positioning enabled the participants to persevere in their efforts to try to get things right, but their capacity to maintain the effort was eroded by the apparently unrelenting nature of the adverse conditions that existed in nursing homes. The main conclusion of this study was that the RN role in nursing homes in Western Australia was ill-defined, and inefficient in terms of best utilisation of nursing time. Recommendations included a review of the RN role in aged care and implementation of strategies that would enable aged care RNs to focus on their clinical roles.
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Scott, Beverley Margaret. "Situational Positioning: A Grounded Theory of Registered Nurse Decision-making in Western Australian Nursing Homes." Curtin University of Technology, School of Nursing and Midwifery, 2003. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=13781.
Full textAbstract:
This grounded theory study investigated how registered nurses (RNs) managed problem-solving and decision-making in residential aged care facilities (nursing homes) in Western Australia. The outcome of the study was the substantive theory of situational positioning, the process used by the RN participants when they were trying to get things right .In-depth interviews were conducted with 25 purposefully selected registered nurses and nursing home management staff. The interviews were transcribed verbatim, and analysed using the constant comparative method. Other sources of data. guided by theoretical sampling. were selected documents such as government reports regarding aged care, and some field observations. Situational positioning was a process that involved physical. cognitive, emotional, and moral dimensions, and reflected how the RN participants acted and responded when dealing with situations at work. Situational positioning was conceptualised as occurring along two intersecting continua of behaviours, and these behaviours emerged from the data as four interrelated categories. Yielding and confronting represented the poles on a continuum of action-oriented behaviour, with being flexible and being rigid on a continuum that reflected more affective or attitudinal responses. The four categories that made up the positioning continua had both positive and negative meanings in relation to the actions and responses of the participants, depending on the particular situation. Yielding was a conceptual category that reflected participants' comments about stopping a particular action and trying something else or giving up completely and even leaving the situation. f he term confronting was used to describe participants' actions that were based on assertiveness that was seen as a constructive behaviour, or anger that tended to be non-productive.Being flexible meant that the participants were responsive to changing situational variables, and this was usually seen as a desirable attribute of effective nursing practice in aged care. However, it could also mean being pliant and ready to compromise in order to get through situations when the participants realised that they would be unable to get things right. At the other end of the response axis, the term being rigid was defined as the opposite of being flexible, that is, having firmly fixed or set ways of responding. or a tendency to respond to situations in the same way in all circumstances. The basic psychosocial problem, being unable to get things right, had two properties. One property was temporal, in that the problem occurred when the participants were getting behind or running late because of having insufficient time. usually due to interruptions. The second property of the problem was more qualitative in that contextual and intervening conditions led the participants to feel that they were not doing things properly because of adverse conditions. Conditions that varied .situational positioning were those that led to the participants being unable to get things right, such as having insufficient time. working with unqualified carers. and trying to meet the differing expectations of various stakeholders. Situations that were easy for the participants to manage involved known routines and few, if any. interruptions. In those circumstances, si uational positioning was intuitive and the phases of recognising, prioritizing, and moving on were negotiated quickly. In more complex situations, or when significant interruptions occurred, the participants followed an alternative pathway, which involved recognising that something in the situation changed. then compromising. that is. choosing a new course of action.
Compromising required tolerance, as the participants adjusted their expectations of what could be achieved in the circumstances. Repositioning then occurred belore they moved on to the next task or to the end of their shifts. Moving on. the third phase in the process, involved persevering as they continued trying to get things right. The adverse conditions that prevailed in nursing homes during the time of this study impeded nursing practice and the delivery of consistently good standards of care for all residents. Situational positioning enabled the participants to persevere in their efforts to try to get things right, but their capacity to maintain the effort was eroded by the apparently unrelenting nature of the adverse conditions that existed in nursing homes. The main conclusion of this study was that the RN role in nursing homes in Western Australia was ill-defined, and inefficient in terms of best utilisation of nursing time. Recommendations included a review of the RN role in aged care and implementation of strategies that would enable aged care RNs to focus on their clinical roles.
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Mousa, Ahmad. "Nurse staffing, patient falls and medication errors in Western Australian hospitals: Is there a relationship?" Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2017. https://ro.ecu.edu.au/theses/1998.
Full textAbstract:
Background: According to the Australian Bureau of Statistics (2013) falls and medication errors in hospitals are among the first twenty leading causes of death. Research on the relationship between nurse staffing, patient falls, and medication errors are limited. Even scarcer are studies that examine this relationship on a nursing shift by shift and ward by ward basis, and no research exists on shift overlap periods and adverse patient outcomes.
Objective: This study examined whether there was a relationship between hospital inpatient falls and medication errors and nurse staffing on a shift by shift and ward by ward basis, including an analysis of patient characteristics and the severity of incidents.
Research Design: Multinomial logistic regression models were used. Data were collected using a secondary analysis of two existing databases: Advanced Incident Management System (AIMS) database and the nursing staff roster database (RoSTAR) over two years (January 2011 to December 2012). The Kane framework of nurse staffing was used to guide the current study.
Setting: The study was conducted in three adult tertiary teaching hospitals in Perth, Western Australia.
Participants: Reports of 7,558 incidents that occurred during the study period from 76 nursing wards and wards (4,677 medical, 2,209 surgical, and 672 critical care wards incidents), and 320,009 nursing shift records in three hospitals, were examined.
Measures: The occurrence and severity of shift-level inpatient falls and medication errors were measured as dependent variables. Independent variables included nursing staff skill-mix, staff experience, and actual nursing hours. Control variables were shift, ward type, and hospital.
Results: This study supports the importance of RN staffing levels in improving patient outcomes. However, it also shows that the relationship between nurse staffing and patient outcomes can be affected by different factors such as patient characteristics, nurse characteristics, and ward type. The number of total clinical incident reports decreased by 7.4% from 2011 to 2012. Falls declined by 4.6% and medication errors declined by 10.8%. The average age of patients who fell or had medication errors was 56.3 years (range of 15 to 100 years) but was more common in patients over 65 years old (57.3%). The number of incidents was highest during the morning shift, less during the evening and lowest during the night shift (28.4%, 27.2%, and 21.8% respectively). Notably, 22.6% of total incidents were reported during the overlap period (13:00 pm to 15:29 pm) which is only two and a half hours. Medical wards had the highest incident records followed by surgical wards; fewer incidents occurred in critical care wards (61.9%, 29.2%, and 8.9% respectively). More registered nurses and more experienced staff on the shift were both associated with fewer falls and medication error incidents, as well as less severe injuries. An increase in the actual nursing hours was associated with fewer medication errors but not fewer fall incidents. However, an increase in in the actual nursing hours was associated with less severe falls but not less severe medication errors.
Conclusion: Overall, the fall and medication error incidents in three Perth hospitals decreased over the study period. However, the large variation in the incidents at both the shift and the ward level indicated room for improvement related to fall and medication error prevention. A relationship was identified between both more RNs and more experienced nurses in attendance and fewer incidents and less severe injuries. Further studies are necessary to identify prevention strategies for hospital falls and medication errors in the overlap period. Immediate consideration of the number of incidents that occurred during the overlap period is required. It is necessary to improve communication and teamwork among staff. Actions should be taken to review, implement and evaluate policies and procedures.
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Ohr, Se Ok. "An examination of how overseas qualified nurses and Australian nurses work together in the Australian context." Thesis, 2016. http://hdl.handle.net/1959.13/1332738.
Full textAbstract:
Research Doctorate - Doctor of Philosophy (PhD)Increasingly, cultural diversity is a feature of the Australian nursing workforce due to globalisation and global movement of the workforce. Whilst much of this diversity has resulted from general migration over generations, a significant proportion results from nurses who migrate after qualifying as a nurse in another country. The participation of these nurses in the nursing workforce has the potential to enrich workforce culture and practice. However, cultural diversity in the workplace has also been reported as challenging for both incoming and receiving nurses; this calls for more research into the context, culture and experiences in multicultural workplaces. This study examined how overseas qualified nurses (OQNs) and Australian nurses (ANs) work together in the Australian context. Specifically, it explored the experiences of OQNs and ANs working together in a Local Health District (LHD). Unlike previous studies, this study aimed to examine and give voice to both OQNs and ANs using Critical Social Theory as the theoretical framework and Interpretive Description as the methodological framework. The study enabled articulation of the nurses’ perspectives of factors contributing to their experiences, explored the practices and underlying mindsets that both groups of nurses employed while working together, and identified strategies or resources that helped to overcome some of the difficulties they experience in their working environment. The experiences of these nurses were compared with the expectations for and intentions of RNs in Australia formally outlined by professional, organisational policies and regulations. Findings suggest that the experiences of the participants were personally, professionally, organisationally and socio-culturally constructed. All nurses were committed to providing safe and quality nursing care to their patients and to a collaborative working relationship with each other. However, the extent to which they perceived they were ‘working together’ in a novel situation was questionable in that they were not equipped to work with ‘differences’ and ‘the unknown’. They reported having difficulty in building optimal working relationships due to experiences where exclusion, bullying, distrust, disrespect, racism and lack of organisational and supportive leadership were evident in their practice environment. Therefore, there was professional and cognitive dissonance, and power differentials in their working relationships. The study identified that facilitative influences for them to work together well included how well the nurses themselves managed any dissonance, power differential and differences through attempts at collegial engagement and high levels of civility as well as through strategic organisational support. The study assists to build on knowledge of the topic and to guide the development of strategies to enhance cross-cultural experiences of both OQNs and ANs and provide suggestions for reciprocal benefits. Further, in addressing this area of ongoing concern in health care settings, the findings also inform workforce policy and future research and educational strategies related to OQNs and ANs in the workplace and for the Australian nursing profession.