Enablers of the interpersonal relationship between registered nurses and students on clinical placement: A phenomenological study.

AIM/OBJECTIVE: The aim of this qualitative study was to explore the lived experiences (nature and extent) of the interpersonal relationship between RNs and students during clinical placement. BACKGROUND: In Australia, as elsewhere, nursing students' clinical placements are facilitated and supervised by registered nurses (RNs). There is evidence of positive teaching and learning interactions between RNs and students influencing student placement outcomes. Comparatively, little is known about the value of interpersonal relationships between RNs and students in the contribution to positive placement experiences. DESIGN: A descriptive phenomenological approach was used to investigate the interpersonal relationship between RNs and students from the perspective of the lived experience of the RN. METHOD: In depth, semi-structured interviews were conducted with ten RNs and analysed using Colaizzi's seven-step analytical approach. RESULTS: Study findings revealed that RNs are committed to building positive interpersonal relationships with students to enhance learning and achieve successful clinical learning outcomes. Positive relationships are enabled through factors encompassing three overarching themes; Getting to know the student is essential; Effective communication is a reciprocal process, and Mutuality of engagement and commitment is critical. Vital to the relationship was the capacity to know the student, communicate with them openly and effectively, and have a mutually engaging, committed relationship with them. CONCLUSIONS: The establishment of positive interpersonal relationships is important to the RNs who facilitate and supervise the clinical learning of nursing students for meaningful learning and successful student outcomes. Key findings included that getting to know the student is essential, effective communication is a reciprocal process, and mutuality of engagement and commitment is critical to building a positive relationship. Findings can be utilised to advise professional development for RNs who work with students on clinical placement with regard to the importance of developing positive interpersonal relationships with students and the characteristics that enable that to occur. The primacy of the relationship, brought about through RNs requirement to facilitate student clinical learning needs acknowledgement. Also, the importance of the interpersonal relationship for RNs and students needs recognition by both, to help them achieve success in clinical placements through effective interpersonal and professional relationships which promote good learning opportunities.

Emotional labour in mental health nursing: An integrative systematic review.

Emotional labour is the effort consumed by suppressing one's own emotions to care for others effectively while also caring for oneself. Mental health nurses are required to engage in effective therapeutic interactions in emotionally-intense situations. The aim of the present integrative systematic review was to investigate the emotional labour of mental health work and how this manifested, the impacts, and the ways to mitigate these impacts. In June 2016, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, a systematic search of the bibliographic databases was undertaken to identify relevant literature. Screening, data extraction, and synthesis were performed by three reviewers. The inclusion criteria included any original research that investigated the emotional work of mental health nurses. We identified a total of 20 papers to be included in this review. Thematic synthesis of the findings revealed three emergent themes: emotional labour and caring, emotional exhaustion, and self-protection (expressed as emotional intelligence). Emotional labour, emotional exhaustion, and emotional intelligence were considered to be intrinsically linked, where they were both the influencing factor for burnout and a contributor to attrition. The results highlighted that emotional labour could inspire the development and personal growth of emotional intelligence in mental health nurses. In light of these findings, recommendations for clinical practice were considered; they included supportive work environments, involving nurses in shared decision-making, and the provision of ongoing professional development opportunities that facilitate the development of emotional intelligence and resilience.

Motivations of nursing students regarding their educational preparation for mental health nursing in Australia and the United Kingdom: a survey evaluation.

BACKGROUND: There has been much debate by both academics and clinical agencies about the motivations and abilities of nurse graduates to work in mental health nursing. The aim of this study was to recruit student nurses from a dedicated mental health nursing program in the United Kingdom (UK) and a comprehensive nursing program in Australia and illuminate their motivations towards considering mental health nursing as a career choice. METHODS: This study comprised of two UK and four Australian Schools of Nursing within Universities. A 12 item survey was developed for the purpose of this study and was checked for face validity by experienced mental health nurses. Convenience sampling was used and 395 responses were received. RESULTS: The comprehensive program represented by the Australian sample, revealed a third of respondents indicated that mental health nursing was definitely not a career option, while only 8 % of the UK specialised program reported mental health nursing was not seven for them. In both groups a higher level of motivation to work in mental health emanated from personal experience and/or work experience/exposure to mental health care. CONCLUSIONS: A greater focus on clinical exposure in comprehensive programs could enhance professional experience needed to increase student motivations for mental health nursing.

Developing graduate student competency in providing culturally sensitive end of life care in critical care environments - a pilot study of a teaching innovation.

BACKGROUND: Australia's immigration policy has generated a rich diverse cultural community of staff and patients in critical care environments. Many different cultural perspectives inform individual actions in the context of critical care, including the highly sensitive area of end of life care, with nurses feeling poorly prepared to provide culturally sensitive end of life care. PURPOSE: This article describes and evaluates the effectiveness of an educational innovation designed to develop graduate-level critical care nurses' capacity for effective interpersonal communication, as members of a multi-disciplinary team in providing culturally sensitive end-of-life care. METHODS: A mixed method pilot study was conducted using a curriculum innovation intervention informed by The Excellence in Cultural Experiential Learning and Leadership Program (EXCELL),(1) which is a higher education intervention which was applied to develop the nurses' intercultural communication skills. 12 graduate nursing students studying critical care nursing participated in the study. 42% (n=5) of the participants were from an international background. Information about students' cultural learning was recorded before and after the intervention, using a cultural learning development scale. Student discussions of end of life care were recorded at Week 2 and 14 of the curriculum. The quantitative data was analysed using descriptive statistical analysis and qualitative data was thematically analysed. RESULTS: Students demonstrated an increase in cultural learning in a range of areas in the pre-post surveys including understandings of cultural diversity, interpersonal skills, cross cultural interactions and participating in multicultural groups. Thematic analysis of the end of life discussions revealed an increase in the levels of nurse confidence in approaching end of life care in critical care environments. CONCLUSION: The EXCELL program provides an effective and supportive educational framework to increase graduate nurses' cultural learning development and competence to manage culturally complex clinical issues such as end of life care, and is recommended as a framework for health care students to learn the skills required to provide culturally competent care in a range of culturally complex health care settings.

Perceptions from the front line: professional identity in mental health nursing.

In the context of a growing population of people experiencing mental illness worldwide, mental health nurses are a crucial workforce. Their recruitment and retention, however, is in decline. Drawing on qualitative data obtained from interviews with mental health nurses (MHN) in Victoria, Australia, the paper employs a range of concepts from role theory to explore professional identity within mental health nursing. The data highlight three key issues in relation to the future recruitment and retention of MHN: (i) the ambiguity of the MHN role; (ii) the weak definition and lack of understanding of the scope of the MHN role by nursing students; and (iii) a lack of communication about MHN as a profession to a wider audience. These findings indicate three avenues through which recruitment and retention in mental health nursing could be improved: (i) public communication; (ii) training and educating of the next generation of MHN; and (iii) more accurately defining the role of the MHN.

Burnout in the caring nurse: learning resilient behaviours.

This paper reviews current literature to offer a discussion related to burnout, an issue that affects the entire healthcare sector, including nurses and patients. Literature suggests a correlation between moral distress and burnout in nurses. These issues are considered to be current and affect recruitment and retention of nurses. The authors propose supporting nurses by using knowledge of resilient behaviours as a means of transcending burnout and workplace stress. The authors believe that this process can be achieved through existing hospital professional development processes, for example supervision, reflective practice, in-service education and other forms of professional development.