Development and implementation of the Bachelor of Nursing (Conversion) course in Vanuatu.

CONTEXT: Vanuatu, a Pacific Island nation in the Western Pacific region, has to date educated its nurses by diploma program. Research evidence in developed countries has consistently shown that nurses educated by bachelor degree improve patient health outcomes and reduce hospital length of stay. In seeking to improve health outcomes, the Vanuatu Ministry of Health decided to introduce a new Bachelor of Nursing degree to provide a skilled, safe nursing workforce for the provision of health care to its peoples{1-3}. The curriculum for this degree was to be developed by Ni-Vanuatu nurse educators with the collaboration of educators from the WHO Collaborating Centre, University of Technology Sydney. However, it was first necessary to upgrade (from diploma to bachelor level) the qualifications of teachers and senior nursing practitioners who would lead the new degree course by introducing a Bachelor of Nursing (Conversion) course. ISSUES: In order to design and implement a Bachelor of Nursing (Conversion) course that would be relevant for the educational and healthcare context in Vanuatu and that would meet qualification requirements of the local regulatory bodies, it was essential to build collaborative relationships with key stakeholders in Vanuatu. A second key concern was to design a program that would cater for participants who were working full time, who were not all living in the same physical location, and who had limited access to internet technology and resources. The course also needed to take into account that participants were multilingual, and that English was not their first language. LESSONS LEARNED: Lessons learned included the importance of coming to understand the sociocultural nexus within which this course was developed and implemented, as well as appreciating the constraints that affect nursing education within the Pacific.

Barriers to developing midwifery as a primary health-care strategy: a Jordanian study.

AIM: To identify the current barriers to developing midwifery as a primary health-care strategy in Jordan and to explore the strategies to overcome these barriers. DESIGN: An exploratory design using an action research approach was undertaken. Workshop discussion groups and reflection were used to collect the data. A thematic approach was taken for the analysis. PARTICIPANTS: Data were collected from a convenience sample of 64 midwives and educators who attended workshops. FINDINGS: The professional identity and image for midwifery has been confused within a medically dominated health system and has not been seen as a primary health strategy. Midwives are not able to practice to the full role and scope of the midwife. IMPLICATIONS FOR PRACTICE: Key issues identified need to be addressed before midwifery can be part of a primary health-care strategy in Jordan.

Factors that contribute to midwives staying in midwifery: a study in one area health service in New South Wales, Australia.

OBJECTIVE: The Australian health workforce is experiencing workforce shortages like many other countries. Managing retention is one important element of workforce planning. Determining the drivers of retention in midwifery can assist workforce planning. The objective of this study was to determine the factors that contribute to the retention of midwives, that is, why do midwives stay? DESIGN: A descriptive design was undertaken in two phases. Phase one used focus groups to adapt a questionnaire used in the 'Why Midwives Stay' study in England for the Australian context. Phase two used the questionnaire to collect qualitative and quantitative data. SETTING: One area health service in New South Wales, Australia. PARTICIPANTS: 392 midwives employed in the area health service either full-time, part-time or on a casual basis were invited to participate and 209 (53%) responded. FINDINGS: The majority of respondents were women aged 23-69 years (mean age 42 years). Just over half had received their midwifery qualification through the hospital-based system which was usual prior to 1994 reflecting the age of the cohort. The top three reasons for staying in midwifery were 'I enjoy my job', 'I am proud to be a midwife' and 'I get job satisfaction'. Job satisfaction was received when midwives felt that they made a difference to women, had positive interactions with women in their care and saw women happy. The motivation to keep going was achieved through having a positive outlook; having job satisfaction, and, having work colleagues with a sense of belonging. IMPLICATIONS FOR PRACTICE: The findings have implications for the organisation of care, models of care, and management systems. Health services and departments of health need to consider these issues especially in an environment of workforce shortages. Addressing the way care is arranged and how staff are supported may lead to higher retention rates, thus reducing costs.