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Background The global COVID-19 pandemic has escalated the prevalence of mental illness in the community. While specialist mental health nurses have advanced training and skills in mental health care, supporting mental health is a key role for all nurses. As front-line health care professionals, primary health care (PHC) nurses need to be prepared and confident in managing mental health issues. Aim To critically analyse and synthesise international literature about the knowledge gaps and learning needs of PHC nurses in providing mental health care. Design and methods An integrative review. The quality of papers was assessed using the Mixed Methods Appraisal Tool. Data were extracted into a summary table and analysed using narrative analysis. Data sources CINAHL, Ovid MEDLINE, Web of Science and EBSCO electronic databases were searched between 1999 and 2019. Papers were included if they reported original research which explored mental health education/training of nurses working in PHC. Findings Of the 652 papers identified, 13 met the inclusion criteria. Four themes were identified: preparedness; addressing knowledge gaps, education programs, and facilitators and barriers. Discussion Despite increasing integration of physical and mental health management in PHC, there is limited evidence relating to knowledge gaps and skills development of PHC nurses or their preparedness to provide mental health care. Conclusion Findings from this review, together with the global increase in mental illness in communities arising from COVID-19, highlight the need for PHC nurses to identify their mental health learning needs and engage in education to prepare them to meet rising service demands.

Background Emotional wellbeing is essential for mental and physical health. Although all university students are vulnerable to psychological distress, nursing students are particularly susceptible, and recognised at higher risk due to the stressful nature of the nursing program. Aim The aim of this cross-sectional study was to compare the demographic characteristics and emotional wellbeing with regard to levels of anxiety, depression, behavioural control, positive affect and general distress of preregistration nursing students in Australia, Saudi Arabia and South Africa. Design Cross-sectional design. Methods A total of 1381 pre-registration nursing students from two universities in Saudi Arabia and one university in both Australia and South Africa completed the self-report measurement tool, the Mental Health Inventory. A one-way analysis of variance was used to compare well-being among pre-registration nursing students in these three countries. Findings The results revealed that when compared to the Australian and South African cohorts, the Saudi Arabian cohort had significantly higher anxiety (Australia M = 26.79, SD = 8.15; Saudi Arabia M = 33.12, SD = 8.24; South Africa M = 29.48, SD = 7.54), depression, (Australia M = 10.15, SD = 3.65; Saudi Arabia M = 13.10, SD = 4.49; South Africa M = 11.83, SD = 3.72), and lower scores in the Mental Health Inventory (Australia M = 152.44, SD = 28.60; Saudi Arabia M = 138.11, SD = 30.09; South Africa M = 145.67, SD = 26.32). Conclusion There were statistically significant differences in overall psychological distress and well-being among students in the three countries. Strategies to improve emotional wellbeing and reduce the negative aspects of mental health such as anxiety and depression of preregistration nursing students are needed.

Background Early career registered nurses (ECRNs) are those in the first five years of practice and are at increased risk of leaving the profession. There is limited research investigating the experiences and approaches of ECRNs who have chosen to stay, which can, in turn, shed light on strategies to assist future ECRNs. Aim This article reports on the findings of a study that explored the disorienting dilemmas of ECRNs and asked the question, how do ECRNs stay working in the profession of nursing. Methods A qualitative methodology, employing a staged narrative approach was used to collect, develop and analyse the stories of 13 ECRNs. Transformative learning theory provided the theoretical framework for the study. Findings The disorienting dilemmas experienced upon commencing work as RNs, required ECRNs to question the premise for their disorientation. Through this questioning, they discovered a misalignment between what they imagined it would be like to work as an RN and what they experienced once registered and in the workforce. Supportive but ad hoc relationships facilitated participants’ abilities to transform their frames of reference and begin to develop effective and authentic ways of being in the world, leading to their decision to stay. Conclusion Learning for ECRNs must be a shared responsibility and the findings highlight the importance of relational and ontological learning for ECRNs. Workplaces must be safe, conducive to learning where uncivil and unprofessional behaviours are rejected.

Background Clinical placements are essential in preparing students for professional practice. Given the serious negative impact of stigma on people with lived experiences of mental illness, it is essential to explore whether the educational setting of a clinical placement can influence mental health stigma. Aims Using a Self-Determination Theory lens, this study aimed to examine whether the educational setting of a clinical placemen influences the stigma of undergraduate nursing students toward people with lived experiences of mental illness. Design Quasi-experimental; pre-test post-test. Methods Ninety-nine undergraduate students enrolled in an accredited nursing program within Australia completed two surveys pre- and post-clinical placement. The surveys measured the educational setting (learning climate) and mental health stigma (social distance). Findings Students who partook in an Autonomy-Supportive mental health clinical placement reported a significant decrease in stigma from pre-to-post placement, whereas the Balanced/Neutral group reported a significant increase in stigma from pre-to-post-placement. Discussion The findings of this research have considerable implications for nursing facilitators and preceptors. Those that support autonomy amongst future nursing professionals are more likely to positively influence students’ mental health stigma. Those who do not promote an autonomy-supportive setting may actually worsen mental health stigma. Conclusion The educational setting in which a clinical placement occurs can influence nursing students’ mental health stigma.

Background To prepare nurses for a role in knowledge generation they need to engage in research training. Bachelor of Nursing (Honours) programs are a first step in this training. Developing a better understanding of current programs, their challenges and outcomes will provide an evidence base to inform curriculum development and policy making. Aim The aim of this study was to explore current Australian Bachelor of Nursing (Honours) programs in terms of their composition, delivery and number of enrolments/graduates. Methods Bachelor of Nursing Honours Coordinators or Heads of Schools of Nursing and Midwifery at Australian Universities were emailed an invitation to participate in an online survey. Findings Of the 19 academics who responded to the survey, 15 (78.9%) reported currently offering a Bachelor of Nursing (Honours) program in their institution. A steady decline in mean enrolments was evident over recent years. There were clear differences in course delivery and assessment tasks between courses. Conclusion This paper highlights the need to further explore Bachelor of Nursing (Honours) programs across Australia to ensure consistency in outcomes and to explore innovations in course delivery and project development. Such changes should incorporate feedback from students, supervisors, curriculum developers and professional stakeholders to ensure that programs address their various needs.

Problem Pre registration nursing students do not always feel supported by Registered Nurses during their clinical placements. To help develop and refine clinical skills, in order to deliver safe, competent nursing care, nursing students rely on Registered Nurses to teach and support them in their clinical learning. Background Pre-registration nursing students in Australia must undertake a minimum of 800 clinical placement hours as part of their undergraduate nursing education. Registered Nurses are required to provide professional development and to teach and support students during these clinical placements. Little is known about Registered Nurses' understanding of this nursing standard requirement. Aim To explore Registered Nurses' understanding of the nursing standard requirement to provide professional development to pre-registration nursing students during their clinical placements. Methods A Grounded Theory study was used involving in-depth semi-structured individual interviews to gather data from fifteen Registered Nurse participants. Constant comparative analysis was used to analyse the data and it was from this data analysis that the substantive theory emerged. Findings The substantive theory developed as a result of this research is titled, Doing the Right Thing. The core category, the right thing to do, is informed by four elements; sense of responsibility, an added extra, choice, and nursing standard. Conclusion Registered Nurses are motivated to teach and support nursing students on clinical placements because they believe it is the right thing to do.

Background Mental health recovery is still largely clinically defined and as such can lack person centeredness. To address this, recovery oriented experiences are required which recognise the holistic and diverse needs of individuals. Aim The aim of the study was to examine the experiences of people living with a mental illness who participated in a recovery oriented program called Recovery Camp. The study aimed to examine how the program may have related and contributed to their mental health recovery. Methods A descriptive phenomenological approach guided the study. Consenting participants ( n =5) were interviewed and asked about their subjective experience of Recovery Camp . The interviews were digitally audio recorded and transcribed verbatim. Data were analysed using van Kaam's Psychophenomenological method. Findings This paper presents the perspective of consumers regarding the ways in which Recovery Camp facilitated mental health recovery. Data analysis revealed five themes (Self-determination, Participation, Extending Self, Relationships and Positive change) and a core essence of meaning (Empowerment). Conclusions Personal mental health recovery for people living with mental illness can be enhanced through recovery oriented mental health care approaches. Findings contribute to existing literature regarding therapeutic recreation and its link to mental health recovery.

The growing demands of an aging population, a looming nursing shortage, widespread fiscal constraints and the growing complexity of a dynamic healthcare landscape means that graduate registered nurses (GRNs) are increasingly expected to be practice ready. This term, also known as fitness to practice, has long been used to describe a concept that is actually unformulated. Indeed, what does being practice ready actually mean and who are the appropriate stakeholders to define it? The prevalence of the ongoing debate about practice readiness, which has now been around for decades, indicates the issue is still at the fore of nursing discourse. Such debate is partly reflective of a difference in opinion between nurses in education and those within clinical practice sectors, as to whether new GRNs are in fact practice ready. This paper describes the findings of a grounded theory (GT) study, which examined the notion of practice readiness from the perspective of Nurse Unit Managers (NUMs) from the acute care practice sector and Bachelor of Nursing Program Coordinators (BNPCs) within the Australian context. Semi-structured interviews were undertaken with sixteen BNPCs and NUMs from across the country. Findings suggest that as a result of contextual influences and varying system drivers, BNPCs and NUMs in Australia inhabit disparate realities. When it comes to practice readiness, these cohorts view new graduates through different lenses and as such, have different perspectives and expectations of what it means to be practice ready. Practice readiness is indeed a nebulous concept. There is no clear definition and the concept means different things to different people. These findings have implications for policy, education and practice to consider a new world where all stakeholders involved in preparing the future nursing workforce have an equal say and a shared understanding of what practice readiness means.