Authentic practice environments to support undergraduate nursing students' readiness for hospital placements. A new model of practice in an on campus simulated hospital and health service.

This paper reports on a unique practice based learning model to prepare undergraduate nursing students for clinical placement. The learning and teaching model described in this paper outlines the establishment of an entire on-campus simulated hospital and health service (SHHS) at the University of South Australia, School of Nursing and Midwifery. The model is pedagogically structured to immerse students in an authentic clinical environment to achieve deep learning in preparation for safe practice. A quality improvement cycle was used to evaluate the outcomes of the model in two phases: Phase 1: Purposive sampling of first and second year Bachelor of Nursing students from 2012 to 2015 who were surveyed about their satisfaction with the model of learning. Bachelor of Nursing students were invited to complete a survey about their experience with the teaching and learning model employed in the SHHS in response to the question, 'What aspects of the SHHS are the most important to your success?' Phase 2: External clinical stakeholders working with nursing students in clinical placements were asked to respond to questions about the preparedness of students educated in this model to transition to employment. The evaluation showed that the SHHS model positively influenced students' satisfaction and confidence and increased the perception of clinicians of the work readiness of students.

Sleep, stress and compensatory behaviors in Australian nurses and midwives / Sono, estresse e comportamentos compensatórios por enfermeiras e parteiras australianas / Sueño, estrés y comportamientos compensatorios por enfermeras y parteras australianas

OBJECTIVE: To describe sleep, stress and compensatory behaviors in nurses and midwives. METHODS: The study included 41 midwives and 21 nurses working in Australian hospitals between 2005 and 2009. Participation was voluntary. All participants recorded on a daily basis their work and sleep hours, levels of stress and exhaustion, caffeine intake and use of sleep aids for a month (1,736 days, 1,002 work shifts). RESULTS: Participants reported moderate to high levels of stress and exhaustion on 20-40 percent of work days; experienced sleep disruption on more than 50 percent of work days; struggled to remain awake on 27 percent of work days; and suffered extreme drowsiness or experienced a near accident while travelling home on 9 percent of workdays. Age, perceived sleep duration and work hours were significant predictors of caffeine intake. About 60 percent of participants reported using sleep aids (about 20 percent reported taking prescription medications and 44 percent of nurses and 9 percent of midwives reported alcohol use as a sleep aid at least once during the study). Stress and workdays were significant predictors of sedative use. Overall, 22 percent reported being indifferent or mildly dissatisfied with their job. CONCLUSIONS: Sleep problems, high levels of stress and exhaustion and low job satisfaction are prevalent among nurses and midwives. The use of alcohol and sleeping pills as sleep aids, and the use of caffeine to help maintain alertness is also common. Nurses and midwives may use caffeine to compensate for reduced sleep, especially on workdays, and sleeping pills to cope with their daily work-related stress.

OBJETIVO: Descrever sono, estresse e comportamentos compensatórios em enfermeiras e parteiras. MÉTODOS: O estudo incluiu 41 enfermeiras 21 parteiras em hospitais australianos de 2005 a 2009. A participação foi voluntária. Os participantes registraram diariamente as horas de trabalho, sono, stress e níveis de exaustão, cafeína e uso de ajuda para dormir durante um mês (1.736 dias, 1.002 turnos). RESULTADOS: Os participantes relataram de moderados a elevados níveis de stress e de exaustão em 20 por cento-40 por cento dos dias de trabalho; experimentaram distúrbios do sono em mais de 50 por cento dos dias de trabalho; relataram esforço para permanecer acordado em 27 por cento dos dias de trabalho; e sofreram sonolência extrema ou acidente perto de casa em 9 por cento dos dias de trabalho. Idade, duração do sono percebida e jornadas foram preditores significativos da ingestão de cafeína. Aproximadamente 60 por cento dos participantes relataram utilizar a ajuda para dormir: cerca de 20 por cento relataram uso de medicação prescrita e 44 por cento das enfermeiras e 9 por cento das parteiras consumiam álcool como auxílio para dormir pelo menos uma vez durante o estudo. Estresse e dias de trabalho foram preditores significativos do uso de sedativos. Em geral, 22 por cento relataram ser indiferente, ou ligeiramente insatisfeito com seu trabalho. CONCLUSÕES: Problemas no sono, estresse e exaustão elevados e diminuição na satisfação no trabalho são prevalentes. São comuns o uso de álcool e de medicamentos para dormir, e consumo de cafeína para se manter alerta. Enfermeiras e parteiras parecem usar a cafeína para compensar a redução do sono, especialmente em dias de trabalho, e usar soníferos para compensar o estresse diário.

OBJETIVO: Describir sueño, estrés y comportamientos compensatorios en enfermeras y parteras. MÉTODOS: El estudio incluyó 41 enfermeras 21 parteras en hospitales australianos de 2005 a 2009. La participación fue voluntaria. Los participantes registraron diariamente las horas de trabajo, sueño, estrés y niveles de agotamiento, cafeína y uso de ayuda para dormir durante un mes (1.736 días, 1.002 turnos). RESULTADOS: Los participantes relataron de moderados a elevados niveles de estrés y de agotamiento en 20 por ciento-40 por ciento de los días de trabajo; experimentaron disturbios del sueño en más de 50 por ciento de los días de trabajo; relataron esfuerzo para permanecer despierto en 27 por ciento de los días de trabajo; y sofrieron somnolencia extrema o accidente cerca de casa en 9 por ciento de los días de trabajo. Edad, duración del sueño percibido y jornadas fueron predictores significativos de la ingestión de cafeína. Aproximadamente 60 por ciento de los participantes relataron utilizar la ayuda para dormir: cerca de 20 por ciento usaron de medicación prescripta y 44 por ciento de las enfermeras y 9 por ciento de las parteras consumirán alcohol como auxilio para dormir al menos una vez durante el estudio. Estrés y días de trabajo fueron predictores significativos del uso de sedativos. En general, 22 por ciento relataron ser indiferente, o ligeramente insatisfecho con su trabajo. CONCLUSIONES: Problemas en el sueño, estrés y agotamiento elevados y disminución en la satisfacción en el trabajo son prevalecientes. Uso de alcohol y de medicamentos para dormir, y consumo de cafeína para mantenerse alerta también es común. Enfermeras y parteras pueden usar la cafeína para compensar la reducción del sueño, especialmente en días de trabajo, y usar somníferos para compensar el estrés diario.

Sleep, stress and compensatory behaviors in Australian nurses and midwives.

OBJECTIVE: To describe sleep, stress and compensatory behaviors in nurses and midwives. METHODS: The study included 41 midwives and 21 nurses working in Australian hospitals between 2005 and 2009. Participation was voluntary. All participants recorded on a daily basis their work and sleep hours, levels of stress and exhaustion, caffeine intake and use of sleep aids for a month (1,736 days, 1,002 work shifts). RESULTS: Participants reported moderate to high levels of stress and exhaustion on 20-40% of work days; experienced sleep disruption on more than 50% of work days; struggled to remain awake on 27% of work days; and suffered extreme drowsiness or experienced a near accident while travelling home on 9% of workdays. Age, perceived sleep duration and work hours were significant predictors of caffeine intake. About 60% of participants reported using sleep aids (about 20% reported taking prescription medications and 44% of nurses and 9% of midwives reported alcohol use as a sleep aid at least once during the study). Stress and workdays were significant predictors of sedative use. Overall, 22% reported being indifferent or mildly dissatisfied with their job. CONCLUSIONS: Sleep problems, high levels of stress and exhaustion and low job satisfaction are prevalent among nurses and midwives. The use of alcohol and sleeping pills as sleep aids, and the use of caffeine to help maintain alertness is also common. Nurses and midwives may use caffeine to compensate for reduced sleep, especially on workdays, and sleeping pills to cope with their daily work-related stress.

Mood change and perception of workload in Australian midwives.

Investigations of mood and workload in health care settings have focussed primarily on nurses and junior doctors. Given the critical shortfall in the Australian midwifery workforce, and the specialised nature of midwifery as an occupation, it is important to understand how mood and workload are experienced by midwives. Twenty midwives (18F, 2M) in an Australian metropolitan hospital completed logbooks assessing daily fluctuations in subjective mood and workload. Participants also provided information about history of psychopathology and sleep quality. Results revealed that midwives were relatively stable in terms of mood but did experience increased fear and decreased happiness when at work. Further, workload factors significantly predicted mood at work. Specifically, when participants felt that their work was more demanding and frustrating and required more effort, or when they felt that they could not accomplish all that was expected, mood was negatively influenced. This supports the connection between workload and negative mood change in healthcare. Given the potential for mood to influence a multitude of functions relevant to safety, performance and psychosocial wellbeing it is important to understand the factors which influence mood, particularly in light of the current shortfall in the Australian healthcare workforce.