Don Gorman

Retaining rural and remote area nurses - The Queensland, Australia experience

Because higher-than-average turnover rates for nurses who work in remote and rural areas are the norm, the authors conducted a study to identify professional and personal factors that influenced rural nurses’ decisions to resign. Using a mail survey, the authors gathered qualitative and quantitative data from nurses who had resigned from rural and remote areas in Queensland, Australia. Their findings, categorized into professional and rural influences, highlight the importance of work force planning strategies that capitalize on the positive aspects of rural and remote area practice, to retain nurses in nonmetropolitan areas.

Collaborative voices: ongoing reflections on nursing competencies

Abstract In a rapidly changing Australian health care environment, providers of undergraduate nursing programs are continually upgrading their assessment methods to ensure that graduates are competent and safe to practice. Competence assessment is based on the existing Australian Nursing & Midwifery Council (ANMC) Competency Standards for Registered Nurses. It is acknowledged that there are issues surrounding the validity and reliability of current assessment methods, primarily due to organisational constraints both at the University and the service provider level.There are a number of highly reliable tools available that enable assessment of nursing students in the psychomotor domain. Assessment in other domains is less precise.This paper explores some of the issues relating to competence assessment processes in order to promote discussion and discourse between educators, facilities and policy makers. It is envisaged that increased debate will result in an enhanced level of academic and clinical preparation for the upcoming nursing workforce in this country.

Enhancing the knowledge and skills of advisory and extension agents in mental health issues of farmers

Objectives: The aim of this study was to increase knowledge and skills of Advisory and Extension Agents (AEAs) in recognizing the symptoms of mental disorders, providing initial help, and offering the referral pathway for appropriate professional help. Method: Mental Health First Aid (MHFA) training was provided to AEAs and knowledge and skills pre-training were compared to 6-months post-training. Results: The MHFA training improved the AEAs’ ability to recognize a mental disorder, it increased their confidence level in providing help to someone with a mental health problem, it decreased social distances and positively changed their beliefs about treatment. Conclusion: MHFA training is effective in enhancing the mental health knowledge and skills of AEAs. The agents, who are a main line of contact of farmers, are able to recognize mental disorders of people and help them appropriately. They are more willing to work with stigmatized people and know who to refer people to for help.

Nursing student's perceptions and understanding of intimate partner violence.

Intimate partner violence (IPV) is a significant health issue in the Australian population and nurses have a role in assessment, intervention and support of families. World Health Organization Statistics indicate that as many as 61% of women, under the age of 50 have been physically abused by their partners. As nurses are in a unique position to identify, assist and support women living with IPV a greater understanding of student nurses knowledge and attitudes may assist undergraduate programs to ensure better preparation of nurses for this role. A nurses readiness to manage IPV may be influenced by their knowledge, attitudes, beliefs and behaviors, largely related to their self-efficacy in identifying these women (i.e. via screening procedures) and providing effective interventions. Students from all levels of the undergraduate program of an Australian regional university were invited to participate in focus groups and a subsequent survey that explored their perceptions, attitudes and knowledge of IPV. The results showed students had limited and stereotypical beliefs regarding what constitutes IPV and who perpetrates it. They indicated that they were under prepared to deal with IPV situations in clinical practice but did identify communication as a core skill required. Nursing students may not understand the significance of the issues of IPV nor fully understand the social, economic and health impacts at an individual and societal level. This may result in further under detection of the problem. The results of this study indicate a number of important implications for undergraduate nursing education curricula.

Impact of the mining industry on the mental health of landholders and rural communities in southwest Queensland

Objective: We aimed to ascertain the extent of mental health problems in rural communities of southwest Queensland. Methods: Twelve workshops were conducted within this region, asking community members about the issues which were affecting their mental health, the gaps in services and facilities, and suggestions as to how to strengthen their capacity to deal with mental health problems. Results: The participants highlighted the higher cost of living through increased rental and goods and services costs. Non-resident workforces, putting a strain on housing availability and succession planning, were among key concerns. The rapid increase in population has also put strains on health services within these communities, highlighting the need for mental health resources and a greater clarification and coordination of available health services. Conclusions: The rural communities in this region are under sustained stress resulting from the incursion of the mining and coal seam gas industries. This has an impact on community mental health and wellbeing.

Discharge planning: from the acute sector for people over the age of 65

This paper reports the findings relating to discharge planning from a larger study (Hegney et al 2001) that aimed to investigate options to improve care co-ordination between the aged, community, acute and primary care sectors for the elderly residents of a large provincial town. The data, which were collected from a wide variety of aged care stakeholders in the region, are consistent with previous Australian studies. First, it appears that inappropriate discharge from acute hospitals occurs in Toowoomba because there is a perceived lack of information regarding the available community care options and a lack of suitable models to support peoples care needs within their own homes. Second, inappropriate discharge practices from acute hospitals occur due to a lack of knowledge and communication on the part of health professionals employed in these settings with regard to the on-going health care needs of elderly people. Third, there is little discharge planning occurring that includes the general practitioner in post-discharge care. Finally, inappropriate discharge can also be attributed to the lack of sub-acute/step-down/rehabilitation options and long waiting lists for community home care services in the region.

Making sense of dementia: understanding amongst indigenous Australians.

Dementia is a growing health and social concern for all Australians. Whilst the prevalence of dementia amongst Australias indigenous people is unclear, there is some evidence that dementia rates are five times that of the general Australian population. To date no studies have examined dementia knowledge levels in indigenous communities.

Didgeridoo playing and singing to support asthma management in aboriginal Australians

CONTEXT Asthma affects over 15% of Australian Aboriginal people. Compliance in asthma management is poor. Interventions that will increase compliance are required. PURPOSE The purpose of the study was to determine whether Aboriginal children, adolescents and adults would engage in music lessons to increase their knowledge of asthma and support management of their asthma. METHODS Participants were recruited from schools and through the local Aboriginal Medical Service. All participants identified as Aborigines and were diagnosed as being asthmatic. The intervention was a 6-month program of once weekly music lessons using a culturally significant wind instrument, the didgeridoo, for males and singing lessons for females. FINDINGS High school students enthusiastically engaged and had excellent retention in what they considered to be a most enjoyable program. Respiratory function improved significantly in both junior and senior boys who also reported a noticeable improvement in their health. Similar but less significant improvement was seen in the high school girls, although like the boys, they too perceived an improvement in their asthma. CONCLUSIONS The project demonstrated that music has great potential for engaging and thus supporting asthma. Furthermore, cultural awareness was increased by those playing the didgeridoo and social skills were noticeably improved in the girls. Similar culturally appropriate activities have applications far beyond Aboriginal communities in Australia.

Farm advisors' reflections on mental health first aid training

Abstract This paper describes an evaluation of the use of Mental Health First Aid (MHFA) training with Farm Advisors. The specific objectives of the training were to: i) determine whether changes to mental health literacy were evident; ii) investigate whether changes were affected by demographic factors such as age, sex, work experience and experience with mental health problems; and iii) describe the experience of participants in terms of the relevance and ease of understanding of the presentation format. Data were collected from 32 Farm Advisors working in Southern Queensland, Australia, who attended MHFA training. Results indicated that the training had significantly improved their mental health literacy and skills in dealing with people with a mental illness. Older Farm Advisors, and younger Farm Advisors with field experience, were more knowledgeable about mental health prior to the training. However, no effects of these factors were found in post training, indicating that, irrespective of their age, sex, work experience and mental health experience, the Farm Advisors gained similar literacy in mental illness at the completion of training. The participants expressed that they now know how to recognise symptoms associated with mental illness, provide initial help, and offer a referral pathway for appropriate professional help to increase wellbeing among farming communities. They reported that the course materials were new, well presented, and relevant for them.

Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses’ perspectives

Abstract This paper presents the findings of a study that interviewed Aboriginal nurses to explore their experiences of the whiteness of nursing. Despite concerted efforts to improve the health of Aboriginal Australians, it still remains equivalent to third world countries. One strategy identified to address this is to increase the participation rates of Aboriginal registered nurses within the Australian healthcare workforce. Presently Aboriginal nurses account for only a small percentage of the nursing workforce. While there has been research into the recruitment and retention strategies dedicated to improving the numbers of Aboriginal registered nurses, this paper focus on the experiences of Aboriginal registered nurses within Australia’s mainstream healthcare system, where they are exposed and subjected on a daily basis to the ‘whiteness of nursing.’