Graduate entry nurses' initial perspectives on nursing: Content analysis of open-ended survey questions.

BACKGROUND: Graduate entry nursing courses offer individuals with prior degrees the opportunity to gain nursing qualifications and facilitate career change. While it is known that accelerated graduate entry courses are increasingly popular, the perceptions of nursing held by such individuals and the influence this has on those seeking to enter the profession are less clearly understood. OBJECTIVE: To explore graduate entry nursing students' perceptions of nursing on entering their pre-registration course. DESIGN: A descriptive design utilising cross-section survey with two open-ended questions: What do you believe the role of the nurse is? What things have influenced that view? were asked. Demographic data were analysed using descriptive frequencies, while the two open-ended questions were analysed using summative content analysis. SETTING: One university-based postgraduate graduate entry nursing course in Australia PARTICIPANTS: Eight cohorts (n=286) commencing students with prior degrees other than nursing. RESULTS: The course attracts students from diverse backgrounds. Exposure to nursing and nurses, either as a consumer of health care or other health care role, plays a primary role in influencing career change. However, similar to those found with school leavers, there remains much misinformation about nurses' roles for students in these courses. Most identify the role of caring in nursing. For some, media representations are the only information sources. DISCUSSION: Graduate entry courses offer opportunities to attract new nurses and contribute to addressing workforce shortages. However, there is still a lack of knowledge of nursing roles among students on entry. More work is required by the profession to ensure nursing is accurately and positively represented to the community.

Is graduate entry education a solution to increasing numbers of men in nursing?

Males have traditionally constituted a very small proportion of the nursing workforce in many countries, including Australia. Together with a need to address the gender imbalance, nursing workforce shortages require strategies for recruiting new nurses, including males. This study examined characteristics of males entering one accelerated graduate entry masters pre-registration nursing program in Victoria, Australia. A quantitative survey gathered a variety of demographic data and factors relating to participants' decisions to undertake nursing. Data were analysed using descriptive statistics including frequencies and distributions. Forty-three male nursing students from four cohorts of the Master of Nursing Practice (MNP) course from 2009 to 2011 completed the survey. The proportion of males (30%) was considerably greater than traditional nursing courses and the profession generally. Participants demonstrated wide distributions in age ranges, professional backgrounds and previous years in the workforce. Graduate entry appears attractive to males of varying ages, personal and professional backgrounds. More research is needed to examine this phenomenon on a larger scale.

Toward interventions to address moral distress: navigating structure and agency.

BACKGROUND: The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. DISCUSSION: Some researchers suggest that a closer examination of how socio-political structures influence healthcare delivery will move moral distress from being seen as located in the individual to an experience that is also located in broader healthcare structures. Informed by new thinking in relational ethics, we draw on research findings from neuroscience and attachment literature to examine the reciprocal relationship between structures and agents and frame the experience of moral distress. CONCLUSION: We posit moral distress as a form of relational trauma and subsequently point to the need to better understand how nurses as moral agents are influenced by-and influence-the complex socio-political structures they inhabit. In so doing, we identify this reciprocity as a framework for interventions.

Hearing, listening, action: Enhancing nursing practice through aural awareness education.

Abstract Noise overload within the clinical environment has been found to interfere with the healing process for patients, as well as nurses' ability to assess patients effectively. Awareness and responsibility for noise production begins during initial nursing training and consequently a program to enhance aural awareness skills was designed for graduate entry nursing students in an Australian university. The program utilized an innovative combination of music education activities to develop the students' ability to distinguishing individual sounds (hearing), appreciate patients' experience of sounds (listening) and improve their auscultation skills and reduce the negative effects of noise on patients (action). Using a mixed methods approach, students reported heightened auscultation skills and greater recognition of both patients' and clinicians' aural overload. Results of this pilot suggest that music education activities can assist nursing students to develop their aural awareness and to action changes within the clinical environment to improve the patient's experience of noise.

Hearing, Listening, Action: Enhancing nursing practice through aural awareness education.

Abstract Noise overload within the clinical environment has been found to interfere with the healing process for patients, as well as nurses ability to effectively assess patients. Awareness and responsibility for noise production begins during initial nursing training and consequently a program to enhance aural awareness skills was designed for graduate entry nursing students in an Australian university. The program utilised an innovative combination of music education activities to develop the students' ability to distinguishing individual sounds (hearing), appreciate patient's experience of sounds (listening) and improve their auscultation skills and reduce the negative effects of noise on patients (action). Using a mixed methods approach, students' reported heightened auscultation skills and greater recognition of both patients' and clinicians' aural overload. Results of this pilot suggest that music education activities can assist nursing students to develop their aural awareness and to action changes within the clinical environment to improve the patient's experience of noise.

Understanding moral habitability: a framework to enhance the quality of the clinical environment as a workplace.

There is compelling evidence in the nursing literature that the workplace is experienced as morally uninhabitable for many nurses and yet the concept of moral habitability remains underdeveloped. An integrative review on moral habitability in nursing was undertaken. The findings reveal that the primary concepts by which nurses write and research aspects of moral habitability are moral climate, moral agency, moral sensitivity and moral distress. It is revealed that nurses in their clinical work experience adversity and moral distress through relational challenges and contextual difficulties that can challenge habitability and inhibit nurses' capacity to provide morally sensitive patient care. The primary concepts identified provide a framework for further development of the concept of moral habitability within nursing practice. The related data within the integrative review also highlights the need for further research into enhancing and sustaining morally habitable workplaces for nurses.

Maximised learning through integrated assessment: Evidenced through nursing practice.

It is well accepted that assessment approaches impact student learning and yet there are a number of constraints that inhibit the ability to develop and implement more effective assessment practices. Higher workload challenges faced by academics coupled with the needs of a changing student demographic were the impetus for a multidisciplinary project aimed at developing an integrated assessment approach. The project aimed to redevelop some of the current assessment practices across a number of faculties within an Australian university with the primary goal of demonstrating a more strategic, integrated and meaningful learning experience, and a more efficient assessment workload for students. The approach particularly targeted assessments that focused on the students' professional development by capitalising on individual unit criteria in integrated, contextual assignments. The integrated assessment approach was trialled in three distinctly different disciplinary areas. Each discipline developed assessment items that were consistent with their particular course aims; however, the implementation of each assessment was evaluated using the same method. This paper discusses the rationale for the overall project as it pertains to implementing integrated assessment, and describes the nursing case study which produced the most successful outcomes compared to the other disciplines. The strengths, challenges and limitations associated with using an integrated assessment approach are highlighted as evidence to support wider implementation.

An action research protocol to strengthen system-wide inter-professional learning and practice [LP0775514].

BACKGROUND: Inter-professional learning (IPL) and inter-professional practice (IPP) are thought to be critical determinants of effective care, improved quality and safety and enhanced provider morale, yet few empirical studies have demonstrated this. Whole-of-system research is even less prevalent. We aim to provide a four year, multi-method, multi-collaborator action research program of IPL and IPP in defined, bounded health and education systems located in the Australian Capital Territory (ACT). The project is funded by the Australian Research Council under its industry Linkage Program. METHODS/DESIGN: The program of research will examine in four inter-related, prospective studies, progress with IPL and IPP across tertiary education providers, professional education, regulatory and registration bodies, the ACT health system's streams of care activities and teams, units and wards of the provider facilities of the ACT health system. One key focus will be on push-pull mechanisms, ie, how the education sector creates student-enabled IPP and the health sector demands IPL-oriented practitioners. The studies will examine four research aims and meet 20 research project objectives in a comprehensive evaluation of ongoing progress with IPL and IPP. DISCUSSION: IPP and IPL are said to be cornerstones of health system reforms. We will measure progress across an entire health system and the clinical and professional education systems that feed into it. The value of multi-methods, partnership research and a bi-directional push-pull model of IPL and IPP will be tested. Widespread dissemination of results to practitioners, policymakers, managers and researchers will be a key project goal.