Although the complexity of the working environment of Registered Nurses has been acknowledged, the relationship between the social context of work and perceptions of professional development have not been systematically studied. This research was designed to identify and explore the attributes of effective learning environments in clinical settings. Following an initial exploratory study of perceptions and experiences of registered and student nurses, a conceptual framework was developed and tested. The findings of the study ware based on responses to a questionnaire (n = 516) which was developed as a tool for assessing organisational and social factors associated with perceived professional development in clinical settings. There was a significant and positive correlation between professional development and six independent variables: Autonomy and Recognition, Role Clarity, Job Satisfaction, Quality of Supervision, Peer Support and Opportunities for Learning. These variables accounted for almost 40% of the variance in perceived professional development. There were differences between hospitals and wards on most of the independent variables suggesting that some wards and institutions are more conducive to learning than others. The implications of the findings in terms of further research and practice are discussed.

Research indicates that empathy, a quality regarded as fundamentally important to nursing practice, is a teachable skill. Because empathic nurse-patient relationships are particularly important in the care of the terminally ill, this has direct relevance to the professional development of palliative care nurses. This article discusses the place of empathy as a criterion variable in the evaluation of a professional development program for palliative care nurses introduced at the Centre for Mental Health Nursing Research at Queensland University of Technology, Brisbane, Australia. A modified version of the Staff-Patient Interaction Response Scale (SPIRS) was used as a pre- and postintervention measure to assess the expressed empathy of the participating nurses. The modifications to SPIR and its coding system to make it suitable for palliative care nursing, and the mechanisms for improving and evaluating the reliability of this instrument will be discussed. The full description of this particular modification of SPIRS for palliative care research is provided as an example of how this instrument could be used in projects for which nurses undertake the difficult task of providing compassionate care to the terminally ill.

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The nursing literature suggests that talking and listening to patients about issues associated with death and dying, is both important and difficult, and may be improved with training. This discussion presents the results of recent nursing research to confirm, and elaborate on, this theme. In this research participants touched on many central issues in communicating with patients that included articulating a sense of discomfort and inadequacy about the whole process, detailing the innumerable blocks to open communication [e.g., interference, denial, unrealistic optimism, resistance, collusion and anger] and sharing their sense of success and failure. The insights of nurses who participated in this research testify to the ongoing need to prioritize the development of nursing skills and support in this challenging but important area.