Em M. Pijl-Zieber

Competence and competency-based nursing education: finding our way through the issues.

The language of competence is widely utilized in both the regulation of nursing practice and curricular design in nursing education. The notion of competence defines what it means to be a professional, although it is not the only way of describing nursing practice. Unfortunately, there is much confusion about the concepts of competence, competency, and competency-based education. As well, the notion of competence, despite its global popularity, has flaws. In this paper we will disentangle these terms and critique the use of competence frameworks in nursing education.

Moral distress: an emerging problem for nurses in long‐term care?

Nurses and other professional caregivers are increasingly recognising the issue of moral distress and the deleterious effect it may have on professional work life, staff recruitment and staff retention. Although the nursing literature has begun to address the issue of moral distress and how to respond to it, much of this literature has typically focused on high acuity areas, such as intensive care nursing. However, with an ageing population and increasing demand for resources and services to meet the needs of older people, it is likely that nurses in long‐term care are going to be increasingly affected by moral distress in their work. This paper briefly reviews the literature pertaining to the concept of moral distress, explores the causes and effects of moral distress within the nursing profession and argues that many nurses and other healthcare professionals working with older persons may need to become increasingly proactive to safeguard against the possibility of moral distress.

Community health nursing practice education: preparing the next generation

Undergraduate nursing practice rotations today are quite different from what many practicing nurses experienced during their own education. This is especially true of community health practice rotations. Increasingly, non-traditional community health sites are being used as practice sites—sites such as schools, homeless shelters, non-profit agencies, and even churches. Increasingly, non-traditional practice experiences are eclipsing traditional practice experiences involving home care and public health. Why has this shift occurred, and what do these experiences offer students? Do these experiences actually prepare nursing students for clinical practice once they graduate? What does preparing the next generation of community health nurses entail?

Towards culturally relevant nursing education for aboriginal students

Aboriginal nursing students face numerous challenges in North American nursing educational programs, as reflected in the relatively high attrition rate of these students. In this paper, the authors argue that nurse educators need to create more culturally relevant curriculum and instructional approaches for Aboriginal students. Such approaches would help nursing educators to ensure that current aboriginal nursing programs--which are largely assimilative in nature--can be more successful and transformative in nature.

Caring in the wake of the rising tide: Moral distress in residential nursing care of people living with dementia

Objective Moral distress is increasingly being recognized as a concern for health care professionals. The purpose of this study was to explore the nature and prevalence of moral distress among nursing staff who care for people living with dementia. Methods This study was focused on nursing staff caring for people with dementia in long-term care and assisted living sites. The Moral Distress in Dementia Care Survey instrument was distributed to 23 sites and nursing staff rated the frequency and severity of situations that were identified as potentially causing moral distress. Results Moral distress is prevalent in the nursing staff who provide dementia care. Nursing staff reported experiencing moral distress at least daily or weekly. Both frequency and severity of moral distress increased with proximity to (amount of time spent at) the bedside. Moral distress had negative psychological and physiological effects on nursing staff, and affected intention to quit.

Nursing Students Achieving Community Health Competencies through Undergraduate Clinical Experiences: A Gap Analysis.

Abstract In Canada, it is widely believed that nursing practice and health care will move from acute care into the community. At the same time, increasing numbers of nursing students are engaged in non-traditional clinical experiences for their community health rotation. These clinical experiences occur at agencies not organizationally affiliated with the health care system and typically do not employ registered nurses (RNs). What has yet to be established is the degree to which nursing students are actually being prepared for community health nursing roles through their community health clinical rotations. In this paper we report the findings of a mixed method study that explored the gap between desired and observed levels of competence in community health of senior nursing students and new graduates. The gap was quantified and then the nature of the gap further explored through focus groups.

New Rural Acute Care Nurses Speak Up: "We're it" But We're Not Ready.

Many novice registered nurses feel ill-prepared for rural nursing practice. Using a mixed method design, an assessment of the learning needs of new graduate nurses (NGNs) working in rural hospitals in Alberta, Canada, was undertaken. NGNs in rural practice indicated that they struggle with becoming “multispecialists.” Consequently, administrators and nurse educators need to tailor workplace structures by establishing collaborative programs with urban facilities and using orientation tailored to the learning needs of NGNs.