Shantala Mohan

Continuing connections: the experiences of retired and senior working nurse mentors

AIMS AND OBJECTIVES This paper reports the benefits and challenges of a mentoring programme through which retired and senior nurses continued to support and nurture nurses and midwives currently working in the health system. BACKGROUND Nursing has an ageing workforce and faces significant loss of expertise because of retirements. Previously, mentoring programmes have been instituted in a range of nursing contexts and they have been a retention strategy for older nurses and midwives. DESIGN Mentors and their mentees worked together towards mutually agreed on professional and personal goals. They were asked to meet or speak together a minimum of twice per month for at least six months. METHOD As part of a collective case study, 15 mentoring dyads were established. Participants and mentors took part in qualitative, semi-structured interviews about their perceptions and experiences of the mentoring programme. Interviews were audio-taped, transcribed and analysed thematically. RESULTS Mentors reported the mentoring experience to be rewarding experience that enabled them to re-connect with nursing-related activities and brought new challenges in retirement. They perceived the mentees were visibly helped by their support and influence. CONCLUSIONS The mentors studied reinforced a positive self-concept as nurses and midwives in their mentees and assisted their development. Retired nurses and midwives in particular may have several characteristics that make them effective mentors. RELEVANCE TO CLINICAL PRACTICE Potential benefits are demonstrated for nurses and midwives vulnerable to workplace adversity, especially those new to Australia who may have limited professional and social networks. For health organisations, mentoring programmes may be an innovative method of retention that engages both mid-career nurses and midwives and those recently retired.

Workplace conversations: Building and maintaining collaborative capital

Abstract Heavy, pressured workloads are a feature of health workplaces internationally, presenting challenges to communication and contributing to tension and negative emotions. This paper explores supportive and unsupportive workplace conversations between nurses and midwives and their colleagues. The findings focus on qualitative interviews of ten nurses and midwives that were audio-taped and analysed for perceptions about the role of workplace conversations. Conversations between colleagues were significant for building and maintaining collaborative capital, but unsupportive conversations also threatened it. Findings suggest the need for considering the impact of co-worker conversations on workplace culture. Nurse managers and management may play a pivotal role in establishing and maintaining supportive conversations. Recognising the role and potential of workplace conversations for building capacities for support, conflict resolution, job satisfaction and the personal resilience of nurses and midwives can raise the collaborative capital of the workplace.

Coronary heart disease in Asian Indians: perspectives of family members.

Abstract Despite the high prevalence rate and significant mortality and morbidity from coronary heart disease in Asian Indians (irrespective of their religious background), very few studies have reported on family members’ experiences of caring for a person with coronary heart disease. This paper reports on family members’ experiences of coronary heart disease in Asian Indians residing in Australia, and is part of a larger study that explored the experiences and/or understanding of coronary heart disease in Asian Indians from the perspective of patients,family members and ‘healthy’ participants. Using a constructivist approach semi-structured in-depth interviews were conducted with five family members. Findings are represented under the following main categories: 1. A period of complexity for family members;2. Indian culture: Its influence on health/health behaviour and illness experience;3. Impact of migration and societal discrimination;4. Disappointment with health care services and the health system; and5. Strategies to prevent cardiac illness and attain optimal health. Cultural factors had both positive and negative influences not only on the illness experience but also on health behaviour and attitude. The impact of Indian culture in relation to coronary heart disease needs to be understood not only at the cultural level by providing culturally sensitive health care, but also by educating Asian Indians to change their health attitude and behaviour and improve their lifestyle. Asian Indians need education and advice to become more resilient and adaptable to a Western society and also to become aware of the acculturative effects of a Western lifestyle.

Close observation by ‘specials’ to promote the safety of the older person with behavioural disturbances in the acute care setting

Abstract This paper reports a two-phased pilot study that explored the concept of ‘specialling’ older patients with challenging behaviours in acute ward situations. Previous research suggests that the nursing workforce is not equipped with the skills and resources required to provide quality care for these patients. The hospital in which this study was conducted, instigated a model where these patients were closely observed by ‘specials’. Phase 1 of the study involved a retrospective analysis of de-identified ‘Specials’ Observation Charts’ and ‘Request for Patient Special’ forms of patients aged 65 years and above, over 12 months in 2006. Phase 2 involved in-depth interviews with the nurses caring for these patients. Findings revealed inadequacy of the forms, gaps in service provision for this vulnerable group of patients and the need for education of specials and ward staff, with suggestions to improve care for this patient group. Findings suggest the necessity to design and structure the observation forms more efficiently. It is important to formulate clear assessment criteria for these patients and incorporate in-service education programmes for ‘specials’ and ward staff and adequately prepare and support them to meet the challenges of caring for older persons with behavioural disturbances in ward situations.

Health status of patients with chronic pain attending a pain center

This study aimed to determine whether the health status of patients with chronic pain improved after attending the pain center. The study used a pre-post survey design and was conducted at a pain center in Western Sydney. A convenience sample of patients with chronic pain who attended the pain center between December 1998 and February 2000 were involved in the study. The Medical Outcomes Study Short-Form 36 measured health status of the participants in eight general areas, including physical functioning, role limitations resulting from physical health problems, bodily pain, general health, vitality, social functioning, role limitations resulting from emotional problems, and mental health. A significant improvement in bodily pain was demonstrated by the total group. The other variables measured remained unaffected. The study sample was divided into subgroups based on gender, age, and presenting symptom. Within the subgroups, a significant improvement in bodily pain was shown by the male participants, patients younger than 65 years of age, and those who presented with different types of chronic pain other than back pain. This preliminary study was done to monitor the health status of people with chronic pain. A holistic approach to improve the health status of people with chronic pain seems to be necessary. Further studies should use a combination of generic outcome measures and disease-specific indicators to measure health outcomes.

Coronary heart disease in Indians: A review of literature

A literature review utilising literary databases, World Wide Web and hand checking of written articles was conducted to determine the magnitude of the problem of coronary heart disease (CHD) in Indians with a particular emphasis on those in Australia. Health care professionals need to be aware that Indians have a higher than average risk of CHD at an earlier age and poorer survival and this is impacted on by genetic, social and cultural factors. The experiences of Indians with CHD needs to be researched so that prevention and rehabilitation programs can be individualised for this well developed community group in Australia.