This action research study involved an 'expert group' that was convened to consider issues for mature age nursing students in the Australian context and develop recommendations that could be used to strengthen mature age entry, access and success in nursing programs. Consistent with action research, the group worked through phases of planning, action, observation, evaluation and critical reflection. In developing recommendations that could be used for future planning, the group met regularly, reviewed extensive literature, and conducted two data collection activities, a questionnaire and focus group with education providers. From the action research activities, five major recommendations were generated. These focused on the value of mature age students, the need for specific information, transparent and clear processes for students entering nurse education, study support and finally, the provision of financial assistance.
The argument for integrating interprofessional education (IPE) activities into the workplace has been made concurrently with the call for collaborative clinical practice. An exploratory case study investigation of existing activities in a large metropolitan health care network was undertaken to inform the development of future IPE initiatives. Purposive sampling invited clinicians involved in the design or delivery of workplace IPE activities to participate in a semi-structured interview to discuss their existing programs and the opportunities and challenges facing future work. Interviews were audiotaped, transcribed and thematically analysed. In total, 15 clinicians were interviewed representing medicine, nursing, occupational therapy, pharmacy, physiotherapy, psychology, social work and speech pathology. The IPE programs identified included one medical and midwifery student workshop, several dedicated new graduate or intern programs combining the professions and multiple continuing professional development programs. Three dominant themes were identified to inform the development of future work: clinician factors, organisational factors and IPE considerations. In addition to the cultural, physical and logistical challenges associated with education that integrates professions in the workplace, the time required for the design and delivery of integrated team training should be accounted for when establishing such programs. Considerations for sustainability include ongoing investment in education skills for clinicians, establishment of dedicated education roles and expansion of existing education activities.
Aims To explore (1) the context in which nursing executives were working, (2) nursing's contribution to the healthcare response and (3) the impact from delivering healthcare in response to the pandemic. Design Retrospective, constructivist qualitative study. Methods Individual interviews using a semi‐structured interview guide were conducted between 12 February and 29 March 2021. Participants were purposively sampled from the Victorian Metropolitan Executive Directors of Nursing and Midwifery Group, based in Melbourne, Victoria the epi‐centre of COVID‐19 in Australia during 2020. All members were invited; 14/16 executive‐level nurse leaders were participated. Individual interviews were recorded with participant consent, transcribed and analysed using thematic analysis. Results Four inter‐related themes (with sub‐themes) were identified: (1) rapid, relentless action required (preparation insufficient, extensive information and communication flow, expanded working relationships, constant change, organizational barriers removed); (2) multi‐faceted contribution (leadership activities, flexible work approach, knowledge development and dissemination, new models of care, workforce numbers); (3) unintended consequences (negative experiences, mix of emotions, difficult conditions, negative outcomes for executives and workforce) and (4) silver linings (expanded ways of working, new opportunities, strengthened clinical practice, deepened working relationships). Conclusion Responding to the COIVD‐19 health crisis required substantial effort, but historical and industrial limits on nursing practice were removed. With minimal information and constantly changing circumstances, nursing executives spearheaded change with leadership skills including a flexible approach, courageous decision‐making and taking calculated risks. Opportunities for innovative work practices were taken, with nursing leading policy development and delivery of care models in new and established healthcare settings, supporting patient and staff safety. Impact Nursing comprises the majority of the healthcare workforce, placing executive nurse leaders in a key role for healthcare responses to the COVID‐19 pandemic. Nursing's contribution was multi‐faceted, and advantages gained for nursing practice must be maintained and leveraged. Recommendations for how nursing can contribute to current and future widespread health emergencies are provided.
This article reports on Australian research, funded by the Victorian Department of Human Services Nurse Policy Branch and conducted in two rural Victorian health services. Predicted workforce shortages in the health professions and accompanying growth in demand for services have set the scene for exploring new ways of working. Focused on Victoria's second level nurse, the division two registered or enrolled nurse, this research explored opportunities to enhance scope of practice as one mechanism to meet anticipated workforce demand and expectations. The study revealed a lack of collective wisdom as to how scope of practice may be enhanced, and an accompanying lack of organisational readiness to facilitate the broad changes needed to implement a different practice role. In response to these findings, the SCOPED model was developed as a tool to assist health services explore and implement an enhanced scope of practice for the second level nurse.
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