Kathleen Peters

‘Part of the team’: professional identity and social exclusivity in medical students

Medical Education 2011: 45: 1220–1229

Factors contributing to the shortage of nurse faculty : a review of the literature

There is an abundance of literature documenting the shortage of nurse faculty, both in Australia and internationally. This shortage has repercussions for the next generation of nurses, contributes to the overall nursing workforce shortage, and holds implications for the development of nursing research and continued practice development. The literature suggests a multitude of factors contributing to the shortage, including the ageing of current nurse faculty, and an undersupply of doctorally prepared nurses to take their place. To date, most nurse academics come from a clinical background with little preparation for the complex faculty role; despite this there is little exploration of their experiences transitioning to academia. The limited available evidence suggests that this new role may be accompanied by feelings of uncertainty, anxiety and isolation associated with changed responsibilities, an emphasis on scholarly activities and teaching, and the unique culture of the academic environment. The aim of this paper is to provide a critical review of the literature, identify issues relevant to the nurse faculty shortage and provide direction for further research.

An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice

AIM To identify facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general (family) practice. BACKGROUND Internationally, a shortage of doctors entering and remaining in general practice and an increasing burden of chronic disease has diversified the nurses role in this setting. Despite a well-established general practice nursing workforce, little attention has been paid to the ways doctors and nurses collaborate in this setting. DESIGN Integrative literature review. DATA SOURCES CINAHL, Scopus, Web of Life, Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews and Trove (dissertation and theses) were searched for papers published between 2000 and May 2014. REVIEW METHODS This review was informed by the approach of Whittemore and Knafl (2005). All included papers were assessed for methodological quality. Findings were extracted, critically examined and grouped into themes. RESULTS Eleven papers met the inclusion criteria. Thematic analysis revealed three themes common to the facilitators of and barriers to collaboration and teamwork between GPs in general practice: (1) roles and responsibilities; (2) respect, trust and communication; and (3) hierarchy, education and liability. CONCLUSION This integrative review has provided insight into issues around role definition, communication and organizational constraints which influence the way nurses and general practitioners collaborate in a team environment. Future research should investigate in more detail the ways doctors and nurses work together in general practice and the impact of collaboration on nursing leadership and staff retention.

Trial and retribution: a qualitative study of whistleblowing and workplace relationships in nursing

Abstract This paper reports a study aiming to present and describe the effects of whistleblowing episodes on nurses’ workplace relationships. Eighteen participants with direct experience of whistleblowing were recruited into the study, which was informed by a qualitative narrative inquiry design. Findings were clustered into four main themes, namely: Leaving and returning to work—The staff don’t like you; Spoiled collegial relationships—Barriers between me and my colleagues; Bullying and excluding—They’ve just closed ranks; and, Damaged inter-professional relationships’I did lose trust in doctors after that. Findings suggest a need to facilitate a climate in which it is safe for nurses (and others) to raise concerns about patient care or organisational wrongdoing, and to eliminate the existing belief that whistleblowing is a negative act fuelled by revenge or sedition.

Nursing student feedback on undergraduate research education: implications for teaching and learning

Abstract Teaching research to undergraduate students presents many challenges to nurse academics. Yet facilitating students to develop skills in critically analysing and interpreting research is vital if we are to achieve evidence-based nursing practice. This paper explores student feedback from a research unit undertaken by Australian undergraduate nurses in order to highlight the challenges for academics trying to engage students in this material. Three hundred and sixty nine (83.5%) second year nursing students provided qualitative and quantitative feedback at the completion of a research unit using a standardised student feedback form. From a combination of the qualitative and quantitative feedback, the most positive aspects of the unit were the teaching staff, the group work and interaction in the class room and the online assessment item. Participants were least satisfied with the way in which the unit was presented, the written assessment items and assessment feedback and the perceived relevance of the unit. The implications of these findings are discussed in the context of the theoretical underpinnings of adult learning and teaching in the development of future course materials.

Condom negotiation : experiences of sexually active young women

AIM This paper is a report of a study of sexually active young womens experiences of negotiating condom use both before and after diagnosis of a sexually transmitted infection. BACKGROUND The male condom is the most efficient method in preventing and reducing the transmission of sexually transmitted infections. However, condom use can be hindered by factors including societal norms and gender roles, which can create difficulties for women in initiating and negotiating condom use in heterosexual partnerships. METHODOLOGY A feminist narrative approach was used, and ten womens stories were collected via online interviews in 2007. FINDINGS None of the women initiated or negotiated use of the male condom for various reasons. Some relied on their male partners to initiate condom use, some were unable to practise safer sex due to the abuse and unequal gender dynamics that existed in their sexual relationships, and some thought that condom use was not necessary because of a belief that they were in safe and monogamous relationships. Even following diagnosis of a sexually transmitted infection, some women said that they were not empowered enough to initiate condom use with subsequent sexual partners, resulting in continued high-risk sexual behaviour. CONCLUSION Successful condom promotion relies on the recognition of the gender factors that impede young womens condom negotiation and use. Strategies that overcome gender dynamics and empower women to negotiate condom use have the ability to promote condom use among this group.

Casualisation of the teaching workforce: Implications for nursing education

Internationally, nursing faculty shortages have been reported and there is a potential for them to worsen into the next decade as existing faculty age. To, in part, address this issue, across disciplines there is clearly an international trend towards the increasing casualisation of the higher education workforce. Despite the potential impact of this two-tiered workforce structure, there has been limited examination of the discipline specific issues related to the employment of a growing number of sessional nursing staff. This paper provides a critical review of the literature related to the employment of sessional teachers in higher education. The paper advances the discourse around the role and implications of employing sessional teachers in undergraduate nursing schools. Recommendations for supporting sessional staff and further research are presented.

If you haven't got a PhD, you're not going to get a job: The PhD as a hurdle to continuing academic employment in nursing

This paper is drawn from a larger study that sought to identify and examine issues around the employment of sessional academic staff in baccalaureate nurse education. Twelve sessional teachers and 12 continuing academics participated in the interviews. Examination of the data revealed the PhD was perceived as a hurdle to continuing employment in nurse education in the university sector. In the current climate, sessional teachers continue to be an essential part of the nursing academic workforce and are necessary to meet the teaching and learning demands associated with implementing nursing curricula. Findings suggest a need for scrupulous processes in relation to the recruitment of sessional staff, and highlight the difficulties that sessional teachers may have in securing continuing academic employment. We provide recommendations to facilitate the appointment of appropriate individuals into sessional roles and highlight the need to mentor and support sessional teachers wishing to pursue a career as nurse academics. Questions are raised about how nursing can plan for future academic workforce needs in a context of an aging academic workforce, the demand for doctoral training for nurse academics, and widespread casualisation of the nursing academic workforce.

Understanding avoidant leadership in health care: findings from a secondary analysis of two qualitative studies

AIM To illuminate ways that avoidant leadership can be enacted in contemporary clinical settings. BACKGROUND Avoidance is identified in relation to laissez-faire leadership and passive avoidant leadership. However, the nature and characteristics of avoidance and how it can be enacted in a clinical environment are not detailed. METHODS This paper applied secondary analysis to data from two qualitative studies. RESULTS We have identified three forms of avoidant leader response: placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant. CONCLUSIONS Through secondary analysis of two existing sets of data, we have shed new light on avoidant leaderships and how it can be enacted in contemporary clinical settings. Further work needs to be undertaken to better understand this leadership style. IMPLICATIONS FOR NURSING MANAGEMENT We recommend that organizations ensure that all nurse leaders are aware of how best to respond to concerns of wrongdoing and that mechanisms are created to ensure timely feedback is provided about the actions taken.

Practice nurses experiences of mentoring undergraduate nursing students in Australian general practice

Internationally, the delivery of health services has shifted from secondary to primary care, necessitating an exponential growth of the nursing workforce and expansion of the nursing role in general practice. This growth, and the subsequent need to develop this workforce, has created a need to expose undergraduate nurses to general practice nursing as a viable career option. Concurrently, universities are struggling to find sufficient clinical places for their undergraduate students to gain clinical experience. It is logical, therefore, to increase the number of undergraduate nursing student placements in general practice. Through qualitative research methods, this paper seeks to explore the experiences of practice nurses mentoring undergraduate students on clinical placements within the general practice setting. Findings are presented in the following three themes: (1) Promoting Practice Nursing: We really need to get students in, (2) Mentoring future co-workers: Patience and reassurance, and (3) Reciprocity in learning: Its a bit of a two way street, which show the benefits of such placements. Clinical placements in general practice settings can be mutually beneficial in terms of providing quality teaching and learning experiences for students. Conversely, the experience provides an impetus for practice nurses to maintain currency of their clinical skills and knowledge through mentoring student nurses.