Marc Broadbent

Supporting bachelor of nursing students within the clinical environment: Perspectives of preceptors

UNLABELLED Student learning in the clinical environment is a cornerstone of pedagogy for students undertaking a Bachelor of Nursing in Australia. METHOD This paper presents the results of a survey that was conducted with registered nurses who preceptor students for universities in Australia. FINDINGS Findings reveal that some preceptors do not hold the qualification they are preceptoring students to obtain, that university involvement in preparation of preceptors is scant and that resource provision and communication from universities to preceptors is considered problematic. Registered nurses choose to act as preceptors for reasons that are both altruistic and professional. They are often employed in senior positions and as such find it difficult to manage time and resolve role conflict. CONCLUSION This paper concludes that the registered nurses who preceptor students generally have a positive experience but require greater involvement by universities in their preparation, particularly when they are responsible for the direct assessment of students. The paper posits this may be best achieved by universities creating effective lines of communication and ongoing support. This will sustain collaborative and meaningful engagement with registered nurses who preceptor undergraduate students.

Constructing a nursing identity within the clinical environment: The student nurse experience

Abstract Background: Nursing identity is an important element of being a nurse. Student nurses begin the construction of their nursing identity during their clinical placements. Aim: The aim of this research was to examine how the student nurses of a regional Australian university construct their identity when on off-campus clinical placement. Methods/ Design: Using a constructivist approach an online survey was used to elicit data in response to the question ‘What elements are needed during the work integrated learning experience to enable undergraduate nursing students to construct their nursing identity?’ Results/Findings: Findings reveal five key elements to the construction of students’ nursing identity; positive role models, belonging, peer support, critical thinking abilities and confidence. Conclusion: Such findings are important as they provide information for student nurses, preceptors and educators in guiding clinical placement experiences that are able to facilitate the development of the nursing identity.

Implications of the emergency department triage environment on triage practice for clients with a mental illness at triage in an Australian context

BACKGROUND The practice environment of the emergency department (ED) refers to both the people and physical factors (architecture) in the environment in which health care is provided. ED triage practice environments are the very places where caring or the delivery of health care often begins. This paper examines the implications of the emergency department triage practice environment on the triage practice of nurses who triage clients with a mental illness. METHODS An observational ethnographic approach inclusive of participant observation, formal and informal semi structured interviews, examination of documents and the collation of field notes were the means of data collection. Data was analysed through constant comparison and theoretical coding. RESULTS Nurses who work in ED triage are cognisant of environmental impacts as they undertake rapid client assessment and manage busy and noisy waiting rooms. The triage environment does influence the ED triage assessment and the management of clients who present seeking mental health care. CONCLUSIONS Tensions arise when the architectural environment of an ED triage area affects client behaviour, the capacity to provide optimal client care and the ability to conduct a triage assessment that obtains the best data possible. Understanding the impact of the ED triage practice environment on people with a mental illness facilitates an understanding of how people from this client group can be better supported in a complex and busy ED environment.

Collegiate presence: explaining homogenous but disparate nursing relationships.

Accessible summary This paper contends that interdisciplinary relationships have an intercultural component to them. A lack of understanding of cultural differences between interdisciplinary groups can lead to fragmented service delivery. Collegiate presence may improve relationships, where cultural differences between disciplines are not understood. Collegiate presence may improve service delivery when interdisciplinary groups function more cohesively. Abstract This paper examines the notion of collegiate presence. Collegiate presence is defined as a mutual connection between two or more professional individuals or groups who share a common work focus and who are mindful of cultural differences. This concept emerged as a result of an ethnographic study of two groups of triage nurses; emergency department, and mental health nurses. Data analysis exposed a number of concepts and themes including collegiality and presence. These two concepts were seen to be so closely connected that the term collegiate presence was constructed. This paper explores the notion of collegiate presence and examines factors that affect this phenomenon between what are homogenous (nurses) but disparate cultural groups (emergency department nurses and mental health triage nurses) in a health-care organization. Findings indicate that culturally disparate groups are challenged to develop functional and collaborative working relationships without a deep understanding of, and appreciation for, each others culture. Developing collegiate presence requires effective communication, social and professional conversations, and physical presence.This paper examines the notion of collegiate presence. Collegiate presence is defined as a mutual connection between two or more professional individuals or groups who share a common work focus and who are mindful of cultural differences. This concept emerged as a result of an ethnographic study of two groups of triage nurses; emergency department, and mental health nurses. Data analysis exposed a number of concepts and themes including collegiality and presence. These two concepts were seen to be so closely connected that the term collegiate presence was constructed. This paper explores the notion of collegiate presence and examines factors that affect this phenomenon between what are homogenous (nurses) but disparate cultural groups (emergency department nurses and mental health triage nurses) in a health-care organization. Findings indicate that culturally disparate groups are challenged to develop functional and collaborative working relationships without a deep understanding of, and appreciation for, each others culture. Developing collegiate presence requires effective communication, social and professional conversations, and physical presence.

The vital blend of clinical competence and compassion: How patients experience person-centred care

Background: Person-centred care is a policy priority for health services seeking to assure the public they provide safe, high-quality care, in keeping with rising consumer expectations. However, study of person-centred care rarely includes acute-care patients’ perspectives. Methodology: In 2013, semi-structured interviews were held with 10 former patients of an Australian regional health service and examined via thematic analysis to understand patients’ experiences of nursing care, interpret findings in the context of person-centred care principles and identify ways to enhance and support compassionate, person-centred care in everyday nursing practice. Results: Clinically competent care, delivered compassionately through a positive nurse–patient relationship, resulted in personal, emotional or spiritual responses that were the catalyst for patient empowerment and participation in care, and a positive outlook toward recovery. Implications for practice: Nurses wishing to implement person-centred care need to recognise the importance of prioritising human connection and compassion in conjunction with clinical competence.

Perinatal data collection: current practice in the Australian nursing and midwifery healthcare context

The collection of perinatal data within Queensland, Australia, has traditionally been achieved via a paper form completed by midwives after each birth. Recently, with an increase in the use of e-health systems in healthcare, perinatal data collection has migrated to an online system. It is suggested that this move from paper to an e-health platform has resulted in improvement to error rates, completion levels, timeliness of data transfer from healthcare institutions to the perinatal data collection and subsequent publication of data items. Worldwide, perinatal data are collected utilising a variety of methods, but essentially data are used for similar purposes: to monitor outcome patterns within obstetrics and midwifery. This paper discusses current practice in relation to perinatal data collection worldwide and within Australia, with a specific focus on Queensland, highlights relevant issues for midwives, and points to the need for further research into the efficient use of an e-health platform for perinatal data collection.

Providing support to nursing students in the clinical environment: a nursing standard requirement

Aim: This discussion paper poses the question ‘What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?’. Background: Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners. Results: Contributing factors that enable and deter Registered Nurses from fulfilling this expectation to support nursing students in their clinical learning include; workloads, preparedness for the teaching role, confidence in teaching and awareness of the competency requirement to support students. Conclusion: Factors exist which can enable or deter Registered Nurses from carrying out the licence requirement to provide clinical education and support to nursing students.

Comparing Novice and Expert Nurses in Analysing Electrocardiographs (ECGs) Containing Critical Diagnostic Information: An Eye Tracking Study of the Development of Complex Nursing Visual Cognitive Skills

Nurses operate in dynamic health-care environments. They are often in positions where they are required to undertake rapid diagnosis, provide emergency health-care responses and make instant risk assessments. Often, these activities occur in real-time, high-risk health-care environments and emergency situations in conditions that can be characterised as time pressured, complex and ambiguous.

Shared responsibility for electronic records: governance in perinatal data entry.

This paper presents research undertaken as part of a larger research project to examine the factors that influence midwives when entering perinatal data. A grounded theory methodology was used to undertake qualitative interviews with 15 participants from 12 different hospitals across Queensland, Australia using three different systems for perinatal data collection. The findings surrounding accountability are presented revealing that a shift in governance relating to responsibility and accountability is not occurring in midwifery units across Queensland. Without assignation of responsibility for entries and accountability for mistakes or omissions, perinatal data records can be left incomplete or inaccurate. Increasing use of electronic health records and creation of digital hospitals indicates these issues are highly relevant in planning for these services.

Nurse-led multidisciplinary initiatives to improve outcomes and reduce hospital admissions for older adults: The Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration project

This article describes the Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration (CEDRiC) project.