Nurses serving on clinical ethics committees: a qualitative exploration of a competency profile.

The competency profile underlying higher nursing education in the Netherlands states that bachelor-prepared nurses are expected to be able to participate in ethics committees. What knowledge, skills and attitudes are involved in this participation is unclear. In five consecutive years, groups of two to three fourth-year (bachelor) nursing students conducted 8 to 11 semi-structured interviews each with nurses in ethics committees. The question was what competencies these nurses themselves say they need to participate in such committees. This article reports the aggregate of the 52 interviews in these five studies. Regarding knowledge, the article reports on health law, ethics and professional knowledge. Regarding skills, communication is mentioned, as are professional skills and skills for 'doing ethics'. An open and respectful attitude towards patients and fellow committee members is required, as well as commitment to patient care, committee work and professional ethics. The right attitude for a nurse in an ethics committee is said to include a reflective and perceptive attitude, along with an awareness of one's own limitations and convictions. A detailed competency profile for nurses' participation in ethics committees as outlined in the recommendations may serve nursing education, institutional committees and nurses themselves to meet the demands of nurses' preparation for clinical ethics consultations.

Predicting NCLEX-RN Success: the Seventh Validity Study HESI Exit exam.

The findings of six previously conducted studies indicated that the HESI (E) was highly accurate in predicting NCLEX-RN success. The purpose of this study-the seventh study to investigate the validity of the E-was to examine the accuracy of three parallel versions of the Ein predicting licensure success and to describe program practices regarding E benchmark scores, remediation programs, and retesting policies. The findings of this study again indicated that the E was highly accurate in predicting NCLEX-RN success. Additionally, all three versions of the E were found to have a predictive accuracy above 90%. The most common E benchmark score designated by faculty at the participating schools was 850, and most schools required students to retest with different versions of the E until the faculty-designated E benchmark score was achieved. Remediation seemed to be effective in raising students' E scores, and it was recommended that future research investigate the effectiveness of specific remediation strategies.

Health, sustainability and student travel.

A survey of 246 pre-registration nursing students in a University in the South West of England was carried out to explore the impact of course related travel on the student experience. Results from the survey indicated that students' main mode of transport to practice placements was by car which reflects the rural nature of the South West and the relative paucity of public transport. Long distances that many students travel to their study centre and to placements, and the concurrent financial strain that this creates, impacted negatively on the student experience. Students recognised the need to travel to a place of study and clinical placements and suggestions of minimising the negative impact of travel were offered. These included the increased use of electronic delivery of lectures, attendance at local university premises, the provision of shared transport to placements and placements closer to the student's home. Few students, however, considered the environmental impact of travel. Higher Education Institutions need to address issues of sustainability through promoting student wellbeing and taking steps to reduce greenhouse gas emissions. It is therefore important that student awareness of sustainability related issues is increased as well as focusing on reducing the environmental impact through organisational change.

Pre-registration nursing degree students in rural Victoria: characteristics and career aspirations.

This paper describes the preliminary phase of a longitudinal research project involving students enrolling in three different pre-registration nursing programs in two locations in rural Victoria, Australia. This initial report discusses the demographic characteristics, entry pathway, course choice and career aspirations of students enrolled in these programs at both the main rural campus and an outreach satellite school of a major Australian university. Demographic findings from this study demonstrate that most of participants were female, aged between 18 and 50 years. The majority of participants resided in non-metropolitan areas and were enrolled in the flagship Bachelor of Nursing Program, with a large number having entered their chosen course of study via a non-traditional pathway. Career projections reported by participants demonstrate the intention of those from non-metropolitan areas to remain in this location on completion of their studies. Participants indicated their preferred areas of future practice to be in midwifery, emergency and paediatrics. Overall the findings of this part of the study summarise the characteristics of students entering nursing courses via various mechanisms. Exploration and comparison of these characteristics raise a number of issues for discussion, particularly in relation to conversion of level 2 (enrolled) nurses to level 1 (registered) status, and intended career specialisation and location of practice for students of nursing in rural areas.

[Stay in, dropout of and re-entry into the nursing profession of nurses under the aspect of specific types of nursing professionals in Austria]. / Berufsverbleib, -wiedereinstieg und -ausstieg diplomierter Pflegender in Osterreich unter Berücksichtigung spezifischer Berufsgruppen.

BACKGROUND: In Austria, a short to very short employment period of registered nurses has been recognised. On closer inspection, however, one can see that there is hardly any scientific data available on this topic. AIM: The aim of the study was to gather data on the duration of the employment period andto investigate the reasons for the stay in, dropout of, and re-entry into the profession by registered nurses in Austria. Another objective was to find out whether there are correlations between specific individual types of registered nurses and their professional careers. METHOD: Registered nurses, who obtained their nursing degree in Austria between 1965 and 2003, were surveyed through a questionnaire that had been elaborated within the framework of a focus group. RESULTS: The analysis revealed a considerably longer stay than reported in German-speaking literature. Furthermore, we were able to identify five different types of individuals with regard to the stay in, dropout of and re-entry into the nursing profession.

The relationship of education level to the job tenure of nursing home administrators and directors of nursing.

BACKGROUND: Research indicates that the length of time a nursing home administrator (NHA) or director of nursing (DON) has worked in a nursing home may have a positive relationship to quality of care. Few studies, however, have focused on factors associated with the job tenure of NHAs and DONs. One important factor may be education level. PURPOSE: This study used a nationally representative sample of nursing homes to examine the influence of education level on the current job tenure of NHAs and DONs. METHODOLOGY/APPROACH: The data sources were the 2004 National Nursing Home Survey and the Area Resource File. Control variables for facility characteristics (e.g., ownership type), market characteristics (e.g., unemployment rate), and career experience were included. Data on NHAs, DONs, and nursing facility characteristics came from the National Nursing Home Survey. Market characteristics came from the Area Resource File. The analysis on NHA tenure included 1,082 cases with usable data from the 1,174 sampled facilities in the National Nursing Home Survey. The analysis on DON tenure included 1,048 cases. Job tenure was measured in number of months. Regression models on NHA and DON tenure were analyzed. FINDINGS: Among NHAs, and to a lesser extent among DONs, higher education was significantly associated with shorter tenure rather than longer tenure. Ownership status was a notable predictor. PRACTICE IMPLICATIONS: For owners of nursing homes, our findings may raise a hiring dilemma. Hiring the best educated NHA and DON may be advantageous, but the retention for these same top managers may be the shortest. Initiatives to hire NHAs and DONs with better educational training may need to be coupled with initiatives designed to promote greater retention.

Alunos de graduação em enfermagem - perfil, expectativas e perspectivas profissionais: relatório / Graduation students in nursing - profile, expectations and professional perspectives: report

INTRODUÇÃO: Nas últimas décadas tem-se observado um crescente aumento das Escolas de Enfermagem no país e do interesse cada vez maior pela graduação em Enfermagem. Assim, este estudo buscou identificar o perfil do aluno que está cursando a graduação, os motivos que o levaram a escolher aprofissão, e quais eram as expectativas e perspectivas profissionais e de inserção no mercado de trabalho. OBJETIVOS: Selecionou-se como objetivo geral: Delinear o perfil dos alunos de graduação de enfermagem e analisar a motivação dos mesmos para a procura desta graduação bem como suas perspectivas presumidas para a inserção no mundo do trabalho. E como objetivos específicos: Estabelecer a diferença entre o perfil de alunos de instituições de ensino de natureza pública e privada. Qualificar o tipo de emprego a que estão submetidos os estudantes de enfermagem Qualificar o que motiva a escolha por esta graduação. Investigar a perspectiva presumida de inserção profissional dos alunos da graduação de enfermagem.MATERIAL E MÉTODO: A proposta metodológica deste estudo está apoiada em uma abordagem quantitativa de natureza exploratória -descritiva.Os cenários da pesquisa foram o 58º Congresso Brasileiro de Enfermagem realizado pela Associação Brasileira de Enfermagem (ABEn) na cidade de Salvador ­BA e o 9º Congresso Brasileiro dos Conselhos de Enfermagem realizado pelo Conselho Federal de Enfermagem (COFEN) na cidade de Porto Seguro ­BA, no mês de novembro de 2006. Os sujeitos desta pesquisa foram os alunos de graduação de enfermagem presentes nos referidos Congressos e que aceitaram participar da pesquisa. Utilizamos como instrumento de coleta de dados, um survey aplicado por meio de questionário a estes alunos, tendo sido preenchidos 1097. O questionário é composto por 66 questões objetivas e estruturadas, contendo perguntas informativas e opinativas, agrupadas em cinco blocos. RESULTADOS: mercado de trabalho do enfermeiro no Brasil é apontado com boa empregabilidade, baixo desemprego e predomínio de emprego formal para esta categoria. CONCLUSÃO: Embora a pesquisa aponte uma sensibilização vocacional para a profissão de enfermagem e a perspectiva de inserção no mercado de trabalho, diversas questões permanecem não respondidas. Discute-se por um lado, o redirecionamento de atividades para o trabalho em equipe, a incorporação tecnológica e aevolução da sociedade ­envelhecimento-que demandam novas habilidades, por outro como garantir acesso, formação e trabalho em um país desigual e de dimensões continentais, por exemplo. O debate ainda é um processo em curso e está aberto para novas análises e considerações.

Educational mobility of RNs in North Carolina: who will teach tomorrow's nurses? A report on the first study to longitudinally examine educational mobility among nurses.

OBJECTIVE: Affected by the current nursing shortage, schools of nursing cite a lack of qualified nursing faculty as a primary barrier to program expansion. We sought to identify patterns in how nurses' entry-level degrees and other individual characteristics correlated with the timing and achievement of subsequent advanced nursing education. METHODS: Using longitudinal analysis of data gathered as part of North Carolina's licensing renewal process, we studied the educational mobility of newly graduated RNs with a variety of entry degrees in this state. We followed one cohort of 3,384 new graduates who were licensed in 1984 (2,850 remained active and in the study at the 10-year point, and 2,418 remained active and in the study at the 20-year point) and another cohort of 5,341 new graduates who were licensed in 1994 (4,211 remained active and in the study at 10 years). Demographic data for a third cohort of 5,400 new graduates who were licensed in 2004 were included and considered along with data gathered by the National League for Nursing for nursing education research, to assist us in making comparisons between North Carolina and other states. RESULTS: Only 26% of the 2,418 members of the 1983-84 cohort at 20 years and 17% of the 4,211 members of the 1993-94 cohort at 10 years pursued higher degrees, and just 19% and 12% of the respective cohorts did so in nursing. More than 80% of all nurses in either cohort who attained a master's degree in nursing or a doctorate in any field began their nursing career with a bachelor's degree. Younger age at entry into nursing, male sex, and belonging to a racial or ethnic minority were associated with being more likely to pursue higher academic degrees. CONCLUSIONS: Based on our findings, we suggest that increasing the number of graduates with a bachelor of science in nursing degree, especially those who are men or members of a racial or ethnic minority, will have the most immediate effect on increasing the potential nursing faculty pool.

Evidence and root causes of an inadequate pipeline for nursing faculty.

The North Carolina Center for Nursing (NCCN) examined the projected supply of nursing faculty in the state of North Carolina. Coupled with a longitudinal educational mobility study of the state's registered nurses, the forecast shows that the growing faculty shortage is real and that its root cause is a growing shortfall in the pipeline of RNs prepared educationally to pursue graduate education and assume faculty roles.

Pre-registration diploma student nurse stress and coping measures.

The aim of this study is to examine the stress experiences and coping abilities of student nurses. A survey design was employed to examine the stress experiences of Diploma student nurses in a large Dublin Teaching Hospital. A questionnaire was utilized that measured and explored five specific constructs pertinent to student nurse stress. These included clinical stress, academic stress, coping, emotions and personal factors which assist students nurses during periods of stress. Findings showed that examinations, the level and intensity of academic workload, the theory-practice gap and poor relationships with clinical staff were the leading stressors identified. Emotional reactions to stress included feeling exhausted and upset under pressure. Students adopted short-term emotion focused coping strategies when attempting to deal with stress. A sense of achievement, and determination, were personal factors, which assisted students to continue in the event of stress being present. Content analysis of the open questions shed further light in relation to the stress phenomenon, particularly in relation to clinical stress. The provision of adequate support services from a clinical and academic perspective, a lecture-practitioner model of education delivery, and curriculum changes which focus on developing student self awareness skills are the suggested study recommendations.

'Levels' of attainment in nursing practice: reality or illusion?

In earlier research based on an analysis of course documentation, it had been found that there was little consensus among nurse educators concerning the parameters which distinguish levels of practice skills, particularly those which differentiate diploma and degree qualifications in the United Kingdom. This result was confirmed and strengthened in the current study. Lecturers in nursing, when presented with a sorting task using 40 statements derived from course documentation selected from the earlier study, were unable to distinguish statements describing diploma level from those describing degree level practice. Possible reasons for the difficulty are discussed. It is concluded that the attempt to represent practice skill in a hierarchy of assessment for degree or diploma qualifications is premature since the parameters of practice remain unreliably specified.

A comparative study of stress between pre- and post-Project 2000 students.

This paper reports upon a comparative study in an English health authority of stress experiences between 146 current Diploma in Nursing (Project 2000) Adult Branch students and a prior study of a sample of 146 students who undertook a certificate course leading to Registered General Nurse (RGN) in 1988. Both groups were administered the same questionnaire. The number of stressors common to both groups were two in education and nine in the clinical environment. Three prominent feelings of stress were expressed by both groups along with two methods of coping with stress. A constellation of 11 personality type characteristics labelled 'determination', which enabled students to sustain themselves, was identified. Three characteristics of 'determination', plus a feeling of uselessness and inability to contribute to the nursing team effort, and the intense amount of academic work were statistically significantly higher for Diploma students. Six prominent clinical stressors were experienced more intensely by third-year diploma students than first- or second-year students. Stress was found to increase with the level of training. This finding replicated the picture found among 324 students in 1988. Differences in stress experiences for different age groups were not statistically significant with the exception of physical hard work. A number of stressors experienced by students in 1988 were also experienced by students in 1997.

The biological sciences in nursing: an empirical paper reporting on the applications of physiology to nursing care.

This action research study was undertaken to address practical concerns over curriculum development in nursing. The applied physiology component of a post-registration nursing diploma was evaluated in terms of its impact on patients rather than on the nurses themselves. The reported data were triangulated, all the findings indicated that patient care could be enhanced when nurses applied their knowledge of physiology to practice. Despite its limitations of scale, this study contributes to the curriculum debate in nurse education.

Applicants to B.Sc.N., R.N., and R.P.N. nursing programs: differences and predictors.

We surveyed 205 applicants to three types of nursing programs (B.Sc.N., diploma-R.N., and diploma-R.N.A.) offered in Toronto, Ontario. Applicants were predominately white, unmarried women living within commuting distance of the institutions to which they applied. Applicants to practical nursing programs tended to be older than applicants to B.Sc.N. and diploma-R.N. programs, be married, have at least one dependant, come from blue-collar families, be out of school longer, and submit fewer applications. Applicants with dependants were 11 times more likely to choose R.P.N. over R.N. programs. Recency of graduation and high school average were predictive of choosing B.Sc.N. over R.N. programs. While this 1992 cohort had some appreciation for the challenges facing the nursing profession, most applicants still expected to secure full-time employment in acute care post-graduation. The data provide an important benchmark for comparing current and future cohorts of applicants with respect to socio-demographic characteristics and expectations of nursing as a career choice.