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This paper provides insight into the work of nurse practitioners in three Australian states. Using a case study approach, the aim of the study is to give an account of some of the types of cases/patients who consult with the nurse practitioners in the states visited and to offer insight into one of the policy changes required to support the introduction of the nurse practitioner role. A snowball sampling technique was used to obtain the sample population of both 10 nurse practitioners and other health care personnel. Semi-structured interviews were conducted with the 39 respondents in both samples. The analysis of the 10 nurse practitioner interviews reported here shows that these nurses undertook a wide range of roles. The results of the semi-structured interviews with the nurse practitioners are described using four of the 10 interviews and reporting them as case studies. The results highlighted the need to address legislation issues and to prepare nurses adequately for their clinical setting and address the difficulties of continuing education of rural nurses. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to explore rural nurses' experiences of mentoring. Background. Mentoring has recently been proposed by governments, advocates and academics as a solution to the problem for retaining rural nurses in the Australian workforce. Action in the form of mentor development workshops has changed the way that some rural nurses now construct supportive relationships as mentoring. Method. A grounded theory design was used with nine rural nurses. Eleven semistructured interviews were conducted in various states of Australia during 2004- 2005. Situational analysis mapping techniques and frame analysis were used in combination with concurrent data generation and analysis and theoretical sampling. Findings. Experienced rural nurses cultivate novices through supportive mentoring relationships. The impetus for such relationships comes from their own histories of living and working in the same community, and this was termed 'live my work'. Rural nurses use multiple perspectives of self in order to manage their interactions with others in their roles as community members, consumers of healthcare services and nurses. Personal strategies adapted to local context constitute the skills that experienced rural nurses pass-on to neophyte rural nurses through mentoring, while at the same time protecting them through troubleshooting and translating local cultural norms. Conclusion. Living and working in the same community creates a set of complex challenges for novice rural nurses that are better faced with a mentor in place. Thus, mentoring has become an integral part of experienced rural nurses' practice to promote staff retention. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to examine the social discourses of nursing within health care as these produce understandings about autonomy for Nurse Practitioners, where autonomy refers to the ability of Nurse Practitioners to practise as professionals in their own right. Background. Nurse Practitioners were recently introduced to the nursing career pathways in Australia. Despite a plethora of international information, the role implementation in rural and remote Australia is slow with a number of influences emerging to hinder progress. Method. Critical discourse analysis was used to examine the differences between policy and the reality of implementation. The notion of autonomy was used to explore texts in policy documents relating to Nurse Practitioner authorization and published between 1995 and 2006, and these were compared with the experiences of nurses working in Nurse Practitioner positions. Findings. Policy texts indicate support for advanced practice and the autonomy of Nurse Practitioners. The process for authorization; however, has constraints which support nurses' progress but also hinder it. Subsequent acceptance of Nurse Practitioners has also been problematic as colleagues struggle to understand the role within the current healthcare system. Conclusions. There is a significant gap between the rhetoric of policy and the implementation of Nurse Practitioner roles in rural and remote Australia. Whilst policy supports the notion of autonomy, the experiences of nurses indicate a mere shift in the traditionally-accepted boundaries of nurses' roles. Evidence from the United Kingdom and United States of America suggests that the findings in this study are relevant internationally as well as nationally. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study of male nurses’ experiences of providing intimate care for women clients. Background. The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses’ experiences of working with women clients and within a healthcare system where they often feel excluded. Method. Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004. Findings. Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients’ personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery. Conclusions. Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations. [ABSTRACT FROM AUTHOR]

AIMS: The aim of this paper is to report a trial to investigate the feasibility of the nurse practitioner role in local health service delivery and to provide information about the educational and legislative requirements for nurse practitioner practice. BACKGROUND: Nurse practitioners have been shown to offer a beneficial service and fill a gap in health care provision. However, the lack of publications describing, critiquing, or defending the way that existing nurse practitioner roles have been developed may lead to a lack of clarity in comparing the nurse practitioner scope of practice internationally. In Australia, credible exploratory research is needed to realize the potential of nurse practitioners to bridge the divide of inequitable distribution of health services. A trial of nurse practitioner services in the Australian Capital Territory provided an excellent opportunity to investigate these scope and continuity issues. METHODS: This was an observational analytic study using multiple data sources. Four models of nurse practitioner service were chosen from a competitive field of applications that were evaluated according to efficacy, feasibility, and sustainability across specified selection criteria. Each model in the trial included a clinical support team, with the nurse practitioner candidate 'working-into-the-role' and collecting demographic, clinical practice, patient outcome, and health service and consumer survey data over a 10 month period. FINDINGS: The trial identified the broad potential of the nurse practitioner role, its breadth and limitations, and its impact on selected health services in the Australian Capital Territory. Data from individual models were compared highlighting generic elements, and formed the basis for the development of the scope of practice for the Australian Capital Territory nurse practitioner models. CONCLUSIONS: This study has validated a research-based, iterative process for initial development of nurse practitioner scope of practice for any Australian specialization. Importantly, the study concluded with the scope of practice as a finding, rather than commencing with it a priori. Although general areas of health care need and under-servicing were identified at the outset, the process tested both the expansion and parameters of the roles. [ABSTRACT FROM AUTHOR]

This study aimed to understand what post-operative patients perceived was important about the nursing care they had experienced. The participants were nine women recovering from total hip replacement surgery which had been performed in a large public, acute care hospital in south Australia. Participants volunteered to be involved in the study and were interviewed pre- and post-operatively and interviews continued in their home environment following discharge. The study took place during 1995 within a 10-month time frame. Methodological guidance was sought from the phenomenology literature, with the ideas from Husserl and Heideggar providing shape for the interpretive framework. The analysis of data utilized Colaizzi’s (1978) seven procedural steps. For the purposes of this paper the authors have selected to focus only on the findings of this study. Two major themes emerged from the conversations with women. Patients described nurses as being engaged or detached with their nursing care. These themes will be explicated in this paper. In the light of these dominant themes the nursing literature around engagement and detachment are examined. The implications for nursing practice are discussed. [ABSTRACT FROM AUTHOR]

In this very critical evaluation of the value and effectiveness of nursing audits, the author shares information about the state of nursing in Australia, gleaned from a recent study. Some myths about nursing practice are debunked. The stark reality is discussed and analysed and a direction for the future is suggested. Although the paper relates exclusively to Australia, its contents will undoubtedly ring true in many other countries. The dichotomy between nursing education and nursing service is considered at length. As are the resulting conflicts of nursing students, clinical instructors and nurse tutors. Teachers of nursing appear to decry the need for them to be clinically involved, as a result nursing education is less meaningful. A particularly strong plea is made for adequate inservice education programmes and a more flexible and thorough approach to change, free from undue commitment to the past. [ABSTRACT FROM AUTHOR]

This article presents information on developments in the field of nursing and health care. The Lynly S. Aitken Fellowship for 1978 was awarded to Margaret M. Overell, a nurse at the Coburg Centre, Royal Melbourne Hospital, Australia. She used the award to study the nursing services in Great Britain and North America and observed community nursing care programmes with particular interest. The third biennial report of Edinburgh University's nursing research unit for the period January 1976 to December 1977 has recently been published. The report contains details about research projects completed, ongoing research and educational activities and future plans.

The article presents information on various developments in the field of nursing. The third edition of the "Directory of Nursing Research in Australia" has recently been published by the nursing branch of the Commonwealth Department of Health, Australia. Kenneth Clarke, the minister for health, launched the Asian Mother and Baby Campaign at the Council House in Birmingham on December 14, 1984. Eleven campaign linkworkers are now in investigations into the use and misuse of a washing bowl, and into a routine nursing procedure, the bed bath.

kenny a. & duckett s. (2003) Journal of Advanced Nursing 44(6), 613–622 Educating for rural nursing practice Rural hospitals in Australia, as in many countries, face challenges in ensuring that appropriate, quality services are provided. The overall aim of this study was to explore the issues that impact on the ability of rural hospitals to provide effective health care. We used a qualitative descriptive method and purposive sampling, and conducted interviews in hospitals in rural Victoria, Australia. The data collected enabled major issues that impact on hospital service delivery to be identified. Using thematic analysis, global themes were extracted and organized around a thematic network. The workforce was an important theme. Whilst the impact of medical shortages on hospital function has been considered in other studies, little consideration has been given to the rural nursing workforce. The need to maintain an appropriately educated rural nursing workforce emerged as one of the major issues that impact on rural hospital service delivery. In Australia, there has been a great deal of discussion about the educational preparation required for rural nursing practice, with the emphasis on postgraduate study. However, the majority of rural nurses do not have postgraduate qualifications and face significant barriers in obtaining them. Although the vast majority of literature claims that postgraduate preparation is vital for rural nursing practice, this research suggests that the future rural nursing workforce will be recruited from undergraduate courses in regional universities. However, there is a need to include specific theoretical and operational preparation in undergraduate education, to enable nurses to make the transition to rural practice more readily. Rural nurses are central to the delivery of health services in rural hospitals. Future rural nursing recruitment and retention hinges on ensuring that they have the confidence, knowledge and skills to deliver safe, appropriate and effective care. [ABSTRACT FROM AUTHOR]

BACKGROUND: Advances in medical science and improved lifestyles have reduced mortality rates in Australia and most western countries. This has resulted in an ageing population with a concomitant growth in the number of people who are living with chronic illnesses. Indeed a significant number of younger people experience more than one chronic illness. Large numbers of these may require repeated admissions to hospital for acute or episodic care that is superimposed upon the needs of their chronic conditions. AIM: To explore the issues that circumscribe the complexities of caring for people with concurrent chronic illnesses, or comorbidities, in the acute care setting and postdischarge. METHODS: A literature review to examine the issues that impact upon the provision of comprehensive care to patients with comorbidities in the acute care setting and postdischarge. FINDINGS: Few studies have investigated this subject. From an Australian perspective, it is evident that the structure of the current health care environment has made it difficult to meet the needs of patients with comorbidities in the acute care setting and postdischarge. This is of major concern for nurses attempting to provide comprehensive care to an increasingly prevalent group of chronically ill people. CONCLUSION: Further research is necessary to explore how episodic care is integrated into the on-going management of patients with comorbidities and how nurse clinicians can better use an episode of acute illness as an opportunity to review their overall management. [ABSTRACT FROM AUTHOR]

The article presents information on the "Third International Conference on Cancer Nursing," that was held during March 18-23, 1984 in Melbourne, Australia. The Third International Conference on Cancer Nursing, organized by the Royal Melbourne Hospital and the Cancer Institute/Peter McCallum Hospital in association with Nursing Mirror, attracted 900 delegates from five continents. The opening keynote address was delivered by Margaret Bennett, deputy director of nursing, Royal District Nursing Service, Melbourne. Her theme was "Cancer nursing-in which direction?" The title, she said, implied that cancer nursing was on the move but she was concerned at what she called the vivid negative imagery of cancer because of its association with death and dying.