Specialist palliative care nurses' management of the needs of patients with depression.

BACKGROUND: Depression is an important condition to consider if we are to optimise the care outcomes for patients with palliative care needs. Depression has a high incidence in palliative patients, with up to 15% diagnosed with major depression and 37% expressing some form of depressive symptoms ( O'Connor et al, 2010 ). The challenge is to ensure that palliative care patients with depression are identified in a timely manner and that their depression is effectively managed. AIM: To examine how Australian specialist inpatient palliative care nurses perceive, assess and respond to depression in a patient case study. METHOD: This descriptive pilot study is a replication of a United States study by Little et al (2005) , exploring contemporary Australian specialist palliative care nurses' screening, assessment and management of depression in people with a progressive life-limiting illness. A survey titled 'Specialist palliative care nurses managing patients with complex care needs' questioned the nursing assessment, knowledge and clinical care priorities related to a case vignette of a patient demonstrating signs of depression. RESULTS: A total of 33 nurses completed this survey. Less than half (39.4%) of the participants identified depression as a major issue arising from the case vignette. Depression screening tools were not widely known. Functionality assessments measuring activities of daily living were the most recognised and widely used tools by participants. CONCLUSION: This small sample pilot study demonstrated that specialist palliative care nurses are still not confident in their screening and responding to a patient with depression. The available evidenced based depression screening tools were unfamiliar to these nurses and not widely used which can result in depression remaining undetected and undermanaged. The connections between physical health and mental health need stronger recognition and response within nursing care of palliative patients.

The "Strengthening Nursing Culture Project" - an exploratory evaluation study of nursing students' placements within Aboriginal Medical Services.

BACKGROUND: Cultural awareness and cultural competence have been the focus of the transcultural nursing literature that has explored the roles and responsibilities of nurses in their care of Aboriginal and Torres Strait Islander Peoples. Cultural immersion programs, upholding cultural safety and cultural humility, offer valuable guidance to the education of nursing students regarding Aboriginal and Torres Strait Islander health and cultures. OBJECTIVES: This study seeks to explore nursing students' experiences of a cultural immersion program within Aboriginal Medical Services (AMSs) in New South Wales, Australia. DESIGN: Eight nursing students participated in a mixed methods design exploratory study of their clinical placement within AMSs. METHODS: A survey gathered data regarding levels of preparation and confidence, learning barriers, placement stressors and personal reflections. FINDINGS: Nursing students reported positive and transformative experiences of intercultural learning. CONCLUSIONS: Cultural immersion programs provide a valuable framework for the design and evaluation of clinical placement programs for nursing students within intercultural learning spaces.

Looking up to the sky! An exploration of new graduate nurses' perceptions of remote area nursing.

Remote area nursing is characterised by two known realities: health inequalities and nursing challenges. The health inequalities are complex consequences of social determinants and health care access. Remote area nurses must negotiate these realities that powerfully interact. Yet we, as new graduate nurses, contemplate a remote area nursing career pathway with additional points of view, including a strong attraction to the long-lasting image of the 'Flying Nurse' within aero medical remote health services. This image holds for us the possibilities of excitement, drama, vital service, and intensive care. This paper explores the realities of this career attraction, and consequently explores the aspirations of contemplative new graduate nurses, as they assimilate their knowledge of remote area nursing with their plans for their future transitions into nursing practice.

Giving Voice to Values: an undergraduate nursing curriculum project.

Among the competency standards stipulated by the Australian Nursing and Midwifery Council for graduating students are competencies in moral and ethical decision making and ethics education within professions such as nursing has traditionally focussed on these competencies, on raising ethical awareness and developing skills of analysis and reasoning. However, ethics education in tertiary settings places less emphasis on developing students' capacities to act on their values. This paper explains and explores the adoption of Dr. Mary Gentile's curriculum (the Giving Voice to Values curriculum).which specifically focuses on developing students' capacities to act on their values. The curriculum (Gentile, 2010) assists students and professionals to explore, script and rehearse responses which build upon their capacity to respond in accordance with their own values in complex workplace settings in which they face conflicts of value and belief. The paper firstly examines the theoretical underpinnings of the Giving Voice to Values (GVV) curriculum. It then presents the integration and evaluation phase of a Project inspired by the GVV methodology, using a case study approach within two areas of an undergraduate nursing curriculum. As a pilot project, this initiative has provided signposts to further curriculum development and to research pathways within the UNDA School of Nursing, by highlighting students' uncertainties regarding their own professional values, and their intense struggles to voice their values within health care contexts.

Fly-in/Fly-out nursing: is it for us? New graduate nurses' perspectives.

Fly-in/Fly-out models of health care for rural-remote communities are currently the focus of evaluation and debate, as the health inequalities of rural and remote communities continue to challenge both health service providers and healthcare consumers. At first glance, these models of health care may attract new graduate nurses transitioning to practice, because they appear to resolve some of the tensions in career planning and aspirations. However, FIFO models may also present significant tensions between healthcare services and the communities they serve. This article presents the thoughts and perceptions of new graduate nurses as they explore future career pathways in rural-remote nursing. It draws on the rural and remote health literature, in recognition of the enduring inequalities of rural and remote health in Australia.

"Bridging two worlds?": Towards cultural safety within Schools of Nursing in Australian Universities.

BACKGROUND: Cultural safety has a stronghold within nursing practice and nursing education in Australia and is seen as a philosophy and practice that challenges and refutes previous concepts and frameworks of cultural awareness and cultural competence (Petric, 2019). Cultural safety practices are required for all members of the nursing profession, with a gaze now focused upon Australian Schools of Nursing to demonstrate their commitment and readiness towards cultural safety. AIM: This research study measures the commitment and readiness towards cultural safety within Schools of Nursing in Australian universities. METHODS: This research study utilises a quantitative descriptive survey design, inviting the Deans of Schools of Nursing in Australia to respond to a modified Occupational Commitment and Health Professional Program Readiness Assessment Compass (DOH, 2014), that measures the current levels of commitment and readiness towards cultural safety. FINDINGS: This research study provides evidence of cultural safety strategies within Australian Schools of Nursing with leadership and commitment being the highest scoring factor (M = 34.81; SD 6.34). However, structures towards and support for the implementation of cultural safety strategies and practices were demonstrated as weaknesses (M = 21.18; SD 4.71). DISCUSSION: There is a valuable opportunity for leadership and knowledge sharing between Schools of Nursing in Australia. The research outcomes highlight the importance for Schools of Nursing to review, reflect upon, and fully implement the Nursing and Midwifery Curriculum Framework (CATSINaM, 2017) and to audit and report levels of cultural safety. CONCLUSIONS: There are cultural safety champions and their leadership is important to the continuing development of curricula, organisations and the profession. These individuals' actions must also be reflected within and supported by organisational cultures, as they fundamentally encourage or obstruct the development of cultural safety in nursing students and academics; material, cultural and human resources are fundamental to the transformations towards cultural safety and to the decolonising practices of the nursing profession (Petric, 2019).