Promoting sustainability in nursing and midwifery clinical laboratories: Strategies for resource reduction, reuse, and recycling.

BACKGROUND: The impacts of climate change on planetary health are multifaceted and threaten public health gains made since World War II. Healthcare is the fifth largest global emitter of greenhouse gas emissions, demanding significant efforts to transition to an environmentally sustainable future. Addressing these issues will require collective societal action. In this regard, universities have a dual responsibility - (1) to tackle complex social, economic, and environmental challenges by championing sustainability initiatives designed to positively impact planetary health; and (2) to ensure that graduates are equipped with the knowledge, attitudes and skills needed to steward planetary health towards a more sustainable future. The future nursing and midwifery workforce must be educated to mitigate the health sector's impact on the environment, advocate for action on climate change, prepare for ongoing health impacts of unpredictable climate and environmental changes, and help communities and healthcare systems become more climate resilient. WHAT THIS PAPER CONTRIBUTES: To help increase nursing and midwifery educators' and students' capacity to support planetary-health related interventions, the overarching purpose of this paper is to provide a series of exemplars that illustrate sustainability initiatives used in four university-based clinical skills laboratories. These initiatives each demonstrate a commitment to the United Nation's Sustainable Development Goals and can be used to help embed the importance of planetary health in student learning.

'She would wash the patients as if she was scrubbing a dirty plate in the sink': Exploring nursing students experiences of care delivery.

BACKGROUND: While much is known about nursing students' clinical placement experiences in general, less has been reported about their specific encounters with poor care delivery. A few small-scale qualitative studies have been undertaken, which suggest that nursing students do witness poor care but often decide not to act on what they see. This study sought to explore a wider international perspective on this issue. AIMS: To explore nursing students' experiences of the care delivery practices witnessed during clinical placements and to provide descriptions of poor care. SETTING AND PARTICIPANTS: Nursing students from undergraduate pre-registration nursing programmes across three universities, two in the United Kingdom (UK) and one in Australia. DESIGN AND ANALYSIS: A qualitative/quantitative survey design was utilised, and data were descriptively analysed. RESULTS: Two hundred and sixty-five students participated in the study. Overall the results were positive. Nevertheless, the participants did provide multiple and recurring examples of poor nursing care which related to a lack of compassion, poor communication, unkind and indifferent provision of personal care, and patient safety. Reporting of poor care was viewed as difficult and many participants highlighted potential repercussions should they take this course of action. CONCLUSION: This research provides contemporary international insights into care delivery practices from the perspective of a large number of nursing students. The results, although mainly positive, outline multiple examples of poor and ineffective practice. While the precise prevalence of these remains unknown, educators, practitioners and students should consider how best to address them when they occur.

'Planning ahead' among community-dwelling older people from culturally and linguistically diverse background: a cross-sectional survey.

AIMS AND OBJECTIVES: To explore preparedness of end-of-life care planning among community-dwelling older persons of culturally and linguistically diverse background. BACKGROUND: To improve end-of-life care through advance care planning, the key concept 'Planning ahead' has been promoted in Australia. However, since the introduction of the model in 2008, it is not known whether 'Planning Ahead' practice by older people from culturally and linguistically diverse backgrounds has improved. DESIGN: A cross-sectional survey. METHODS: A total of 453 community older adults (65+) who attended 17 day care centres in a region were invited to participate in the study. A total of 229 people completed the survey with a response rate of 50·5%. The questions relevant to this study include: (1) awareness of enduring guardian, advance care directive and advance care planning, (2) the preference for substitute decision-makers and (3) the challenges experienced with advance care planning. RESULTS: Awareness of advance care planning was low, and completion of advance care directive was very low. 37·5% of Anglo Celtic group had an enduring guardian, compared with 15·5, 24·1 and 13·3% from Mediterranean, Eastern European and Asia/Pacific group, respectively. Children were the most preferred substitute decision-makers more for Asia/Pacific group than Anglo Celtic, Mediterranean and Eastern Europeans. The various difficulties experienced included being time-consuming, difficult to understand terms and forms, and do not know how to do it. CONCLUSION: Regardless of cultural and ethnic backgrounds, a low level of 'Planning ahead' practices was apparent because of a lack of understanding of the concept, the forms and the processes involved. The gap identified between the existing legal/ethical frameworks and the preferences of older people as substitute decision-makers adds new knowledge for further discussion. RELEVANCE TO CLINICAL PRACTICE: Nursing professionals are provided with an opportunity to improve their practice to meet the needs of older persons and their families in planning ahead for future treatment options.