A meta-synthesis exploring nurses' experiences of assisted dying and participation decision-making.

AIMS AND OBJECTIVES: To explore nurses' experiences of assisted dying and understand how their perspectives inform their participation decision-making. BACKGROUND: Assisted dying is a complex and contentious issue with the potential to create moral unrest for nurses. The nursing role in assisted dying varies between jurisdictions. DESIGN: Systematic review. A meta-synthesis using thematic analysis. METHODS: Three electronic databases were searched for primary qualitative studies published in English, from New Zealand, Australia or Canada, up to October 2022. Seven articles were included; themes were analysed and key themes were established. Reporting adhered to PRISMA. RESULTS: The findings highlight the complexity of nurses' decision-making about participation or non-participation in assisted dying and the moral, philosophical and social influences that impact on their decision-making. This is presented as a spectrum of influence which persuades or dissuades nurses to participate in assisted dying. The 12 themes have been categorised into four key themes: personal persuaders, personal dissuaders, professional persuaders and professional dissuaders. CONCLUSIONS: The findings suggest that nurses should be involved in policy and procedure guideline development and be offered education and training programmes to ensure safe, confident and informed practice. The need for mentorship programmes was also prevalent in the research. RELEVANCE TO CLINICAL PRACTICE: It is crucial that nurses be offered education and training in assisted dying. Clear policy and procedure guidelines are essential, and nurses should be involved in the development of these.

Meeting the needs of four generations of nurses.

Every year increasing numbers of nurses and midwives leave the NHS. In the current climate of staff shortages it is crucial to understand why this is happening and try to resolve the problem; in Birmingham we have taken steps to do this. This article explores the different workforce generations, along with strategies that could enhance nursing and midwifery careers, ensuring they meet the needs of all generations, thereby encouraging practitioners to stay in their profession for longer.

Exploratory factor analysis of the Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T).

BACKGROUND AND PURPOSE: The Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) scale measures student nurses' perceptions of clinical learning environments. This study evaluates the construct validity and internal reliability of the CLES+T in hospital settings in New Zealand. Comparisons are made between New Zealand and Finnish data. METHODS: The CLES+T scale was completed by 416 Bachelor of Nursing students following hospital clinical placements between October 2008 and December 2009. Construct validity and internal reliability were assessed using exploratory factor analysis and Cronbach's alpha. RESULTS: Exploratory factor analysis supports 4 factors. Cronbach's alpha ranged from .82 to .93. All items except 1 loaded on the same factors found in unpublished Finnish data. The first factor combined 2 previous components from the published Finnish component analysis and was renamed: connecting with, and learning in, communities of clinical practice. The remaining 3 factors (Nurse teacher, Supervisory relationship, and Leadership style of the manager) corresponded to previous components and their conceptualizations. CONCLUSION: The CLES+T has good internal reliability and a consistent factor structure across samples. The consistency across international samples supports faculties and hospitals using the CLES+T to benchmark the quality of clinical learning environments provided to students.

The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review.

Introduction The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middle-income countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems.

Graduate entry to nursing: An exploration of the demographic characteristics of New Zealand students.

This paper describes the characteristics of student enrolled in New Zealand's first Graduate Entry to Practice (GEN) programme. Data were collected from students enrolled in the first five cohorts of the programme from 2014 to 2018 (n = 93). In total 69 students responded to an on-line, self-report survey, resulting in a 74% return rate. The majority of respondents were female (87%, n = 60), aged 21-30 (68%, n = 47) and New Zealand European (77%, n = 53). The educational background of respondents ranged from theology, to marine biology and more commonly science based degrees. Their motivation for entering nursing was to work in a diverse and caring profession with many wanting to eventually move to advanced practice roles. A key finding was that the students considered that the primary role of the nurse was the provision of holistic care to both the patient and their family. The majority wish to start their nursing careers in the acute hospital based areas of care provision.

Leaving from and returning to nursing practice: contributing factors.

Many nurses leave nursing and never return. Others return after a period of time. Given the global shortage of nurses a better understanding of these movements is needed. The present study focused on nurses who had been out of nursing for more than five years, and explored factors that influenced their leaving and return to practice. All the nurses who had undertaken a Competency Assessment Programme at a given New Zealand tertiary institution during 2005 were invited to participate. Of the 70 questionnaires mailed out 32 (44.5%) were completed and returned. Quantitative data were analysed using Microsoft Excel, and the qualitative data were coded and analysed by means of content analysis. For each, leaving and returning, three key issues emerged. Nurses left for personal reasons, to seek a career change, or because of poor working conditions. They returned when they had the personal freedom to do so, for fiscal reasons, or because they were motivated by some sense of unfinished business. These findings indicate that it is important for educators involved with Competency Assessment Programmes to collaborate with employers in ensuring that there are opportunities for re-entry to positive work environments, with a degree of flexibility that suits the demographic characteristics of those nurses returning to practice.

Readiness for practice: The views of New Zealand senior nursing students.

The concept of 'readiness to practice' of nursing students is not well understood even though being 'ready for practice' is the focus of undergraduate programs. The aim of this study was to critically explore senior student's views about their readiness to practice as a registered nurse. This study was undertaken in a school of nursing in the South Island of New Zealand. The participants included all senior nursing students assigned to their final clinical practicum from five cohorts across two and half years. The response rate for the survey across five cohorts was 46% (n = 245). The majority of students were New Zealand European females aged 30 years or younger. Students felt they were confident with their professional responsibilities and considered that they had prepared well for the profession. They agreed that they were confident with their communication skills. Areas of concern were; caring for a dying patient and caring for more than four patients at one time. This study suggests that senior nursing students feel they are work ready.

Attracting men to nursing: Is graduate entry an answer?

There is evidence which suggests that second degree graduate entry nursing programs may be a potential strategy to increase the number of men in nursing. This qualitative study used thematic analysis to describe the reasons underpinning men's enrolment in the first three intakes of the first such program in New Zealand. Interrogation of the data revealed two primary themes. First, in search of a satisfying career with the associated subthemes: was at a loss; fulfilment through working with and helping people; and a career with options. The second theme the time was right was underpinned by two subthemes: The right time of life; and, the right course. In contrast, to previous studies of men in nursing it was found that vertical career progression into management was not attractive, and that career satisfaction was seen as being able to help others. The findings may provide insight for developing strategies which encourage men's entry into nursing.

Generation Y New Zealand Registered Nurses' views about nursing work: a survey of motivation and maintenance factors.

AIM: The aim of this article was to report on the analysis of qualitative, open text data, received from a national on-line survey of what factors Generation Y New Zealand Registered Nurses wish to change about nursing and consideration of the potential policy and practice impacts of these requests on their retention. BACKGROUND: Prior to the economic recession of 2007-2010, the growing shortage of nurses in New Zealand presented a serious concern for the healthcare workforce. Given the ageing New Zealand nursing workforce, an ageing population and the increasing demands for health care, it is imperative that issues of retention of Generation Y nurses are resolved prior to the imminent retirement of more experienced nurses. DESIGN: A descriptive exploratory approach using a national wide, on-line survey, eliciting both quantitative and qualitative data was used. METHOD: The survey, conducted from August 2009-January 2010, collected data from Generation Y New Zealand Registered Nurses (n = 358) about their views about nursing, work and career. Herzberg's Motivation-Hygiene theory was used as the framework for the analysis of the open text data. RESULTS: The factors that nurses wanted changed were skewed towards Herzberg's hygiene-maintenance factors rather than motivating factors. This is of concern because hygiene-maintenance factors are considered to be dissatisfiers that are likely to push workers to another employment option.