Search

Background: The issue of dual diagnosis continues to be a global health concern. There is a lack of empirical research on mental health nurses' attitudes toward consumers with dual diagnosis., Objective: This study aimed to answer the following research question: How do mental health nurses describe their attitude toward consumers with co-existing mental health and drug and alcohol problems?, Design: This qualitative study employed purposive sampling to recruit participants. Semi-structured interviews were conducted to explore mental health nurses' attitudes toward consumers with dual diagnosis., Setting: This study focused on mental health nurses employed in mental health settings. It placed a particular emphasis on mental health nurses who had experience in caring for consumers with dual diagnosis. Seventeen mental health nurses participated in the interview., Methods: Interviews were transcribed verbatim and coded using NVivo™ 12 Plus software. Thematic analysis was used to generate codes and themes inductively., Results: Three major themes with a total of eight sub-themes were identified: (1) satisfaction and connection, with three subthemes; (2) combating negativity in others, with two subthemes; and (3) working to improve outcomes, with three subthemes., Conclusions: Participants were concerned about their peers' sense of fear and frustration, stigmatized language, and lack of consistency in providing dual diagnosis training for mental health nurses. There is a need to investigate effective strategies to address mental health nurses' stigmatized attitudes, fear, and frustration toward consumers with dual diagnosis.

National mental health policies accentuate the importance of having positive attitudes, skills, and knowledge among mental health professionals to facilitate recovery-oriented practices in all areas of mental health care. However, evidence suggests that mental health professionals' negative attitudes towards mental illness are still evident and that recovery-oriented practice in acute inpatient units may be poorly implemented. At the same time, there is also a paucity of research to understand Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice specifically. Therefore, this non-participant observation study aimed to explore Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient units by observing the interactions between the consumers and nurses. The Mental Illness Clinicians Attitudes Scale-v4 and The Recovery Attitudes Questionnaire inspired the development of a non-participant observation chart for this study and the observations were recorded on the chart. Six observations were conducted in three acute inpatient units. Observations focused on Mental Health Nurses' knowledge about mental illness, communication, dignity, respect, anxiety, fear, punishment, facilitation of real choices for consumers, physical care, cooperation with consumers' families and others and recovery orientation. Interpretive descriptive analysis was used to analyse the data. The results show that Mental Health Nurses generally have positive attitudes towards mental illness and recovery-oriented practice. Some deficits in the physical care of people with mental illness in the acute inpatient units were observed. Therefore, future research could address the adequate preparation of Mental Health Nurses to provide physical care to people with mental illnesses., (© 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Aim: To investigate the associations between perceived overqualification, organisational commitment and work passion of nurses., Background: Few studies have considered the effects of perceived overqualification and organisational commitment on work passion of nurses, especially in developing countries., Methods: This is a multicentre cross-sectional study. A total of 4511 nurses from eight tertiary hospitals were recruited. The Scale of Perceived OverQalification (SPOQ), the Organizational Commitment Scale (OCS) and the Work Passion Scale (WPS) were used to collect the data. Hierarchical multiple regression were employed., Results: Perceived overqualification and organisational commitment were the main predictors for both harmonious and obsessive passions (each p < .001). The unique effect of organisational commitment (β harmonious  = .608, β obsessive  = .556) on work passion were six to eight times larger than these of perceived overqualification (β harmonious  = -.079, β obsessive  = .085)., Conclusion: Our findings indicate that high perceived overqualification clearly reduces nurses' harmonious passion and increases their obsessive passion, whereas high organisational commitment significantly promotes nurses' harmonious and obsessive passions., Implications for Nursing Management: Nurse managers should distinguish the different effects of perceived overqualification and organisational commitment on work passion. Effective intervention should be developed to release nurses' potential abilities and improve their organisational commitment and work passion. Chinese Clinical Trial Registry: ChiCTR2100047974., (© 2022 John Wiley & Sons Ltd.)

Research has found that training health care professionals can enhance the access of the culturally diverse community to appropriate mental health services. Yet, little research has been conducted that explicitly focuses on improving nursing knowledge, skills, attitudes, and behaviours that can enhance the access of the Culturally and Linguistically Diverse (CALD) community. This scoping review aims to locate, summarise, and recap what is known in the academic literature about educational interventions and programs to improve mental health nurses' cultural competence. Examining how educational interventions and programs can improve mental health nurses' knowledge, skills, attitudes, and behaviours to facilitate Culturally and Linguistically Diverse (CALD) community access to mental health services can also identify gaps in knowledge to report future research areas. Fifteen studies included in the review reported a positive effect of cultural competence interventions; however, it was difficult to establish a single effective intervention method due to the significant heterogenicity in cultural competence intervention strategies. Most studies in this scoping review included nurses as participants. However, only one study solely focussed on cultural competence intervention for mental health nurses. Two other studies included mental health nurses as participants, along with other mental health professionals. Henceforth, there is a prerequisite for more research focussing on enhancing mental health nurses' cultural competency. Additional research is required to evaluate educational interventions' impact on improving cultural competence attributes on specific practitioner behaviours and the effects on health care and health care outcomes. This review can form a basis for future research studies that will emphasise the impact of cultural competence interventions for mental health nurses.

Consumers with co-existing mental health and drug/alcohol problems are exposed to more stigma than those with any other health problems. This scoping review aimed to systematically map the available literature regarding mental health nurses' attitudes, empathy, and caring efficacy towards consumers with a dual diagnosis. Twenty studies reported outcomes regarding nurse attitudes; however, none reported nurses' empathy or caring efficacy towards consumers with a dual diagnosis. Further research is required to advance the evidence on the impact of mental health nurses' attitudes, empathy and caring effectiveness, and the outcomes should lead to improved service delivery for consumers with a dual diagnosis.

Background: Few studies have considered functions of nurses' positive personality and behaviours on addressing their turnover intention., Aims: To explore the effects of WeChat-based 'three good things' (3GT) on burnout nurses' turnover intention and coping styles., Methods: A randomized controlled trial. 73 nurses were included in the intervention group (n = 33) and the control group (n = 40). The intervention group received WeChat-based 3GT. Turnover intention and coping style were measured before and after the intervention., Results: WeChat-based 3GT effectively reduced turnover intention and negative coping style (each p < .05). Positive coping style was promoted after the intervention (p < .05). Time effects as well as intervention and time interactions were significant in turnover intention and negative coping style (each p < .05)., Conclusion: Benefits of WeChat-based 3GT on turnover intention and coping style in burnout nurses were found. Nurses experienced lower levels of turnover intention and negative coping style and increased the usage of positive coping style after the intervention., Implications for Nursing Management: Nurse managers should incorporate 3GT intervention with popular social communication programmes to improve nurses' coping strategies towards clinical issues and maintain the stability of nursing teams., (© 2020 John Wiley & Sons Ltd.)

This quasi-experimental study aimed to evaluate the positive psychological intervention of recording three good things on alleviating nurses' burnout. Eighty-seven nurses with burnout were recruited. Nurses in the study group recorded three good things using communication tool WeChat for six months, no records were made in the control group. After intervention, the score of exhaustion decreased considerably for nurses in the study group. Nurses recording three good things on average twice a week returned the lowest score of exhaustion. This intervention combined with appropriate surveillance and encouragement is recommended to reduce nurses' burnout and create a positive work environment., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Aims and Objectives: To investigate burnout among nurses from Australia and China and explore the effects of resilience and turnover intention on nurse burnout between the two countries., Background: Nursing shortages and burnout have become serious problems worldwide in recent years. In both developed and developing countries, such as Australia and China, nurse burnout levels are high and therefore attract concern from nurse managers, hospital administrators, nurse educators and researchers. However, few studies have been conducted exploring the differences in burnout and its predictors between Australian and Chinese nurses, particularly investigating the differences in the effect sizes of the predictors., Design: A comparative cross-sectional design was employed., Methods: A total of 100 Australian nurses and 197 Chinese nurses participated in the study. Australian participants completed an online questionnaire, while Chinese participants completed a hardcopy questionnaire. Burnout, resilience and turnover intention were measured., Results: Burnout was worse for Australian participants than Chinese participants. Only having turnover intention significantly predicted burnout in Australian participants, while low resilience, having turnover intention and low level of regular exercise strongly predicted burnout in Chinese participants. The effect size of turnover intention on burnout in the Australian group was almost twice that of the Chinese group., Conclusion: The findings of this study show that there are differences in burnout between Australian and Chinese nurses. The effects of resilience and turnover intention on burnout between the two groups are also identified., Relevance to Clinical Practice: The differences in nurse burnout and the effects of resilience and turnover intention on burnout should be better understood by nurse managers from Australia and China. Moreover, developing effective strategies relevant to their own country to reduce nurse burnout is recommended., (© 2018 John Wiley & Sons Ltd.)

Aims and Objectives: To determine, from the perspectives of enrolled nurses and registered nurses, the current scope of enrolled nurse practice and to identify the activities that most enrolled nurses frequently performed in their workplace., Background: Enrolled nurse scope of practice in Australia has evolved and expanded over the past decade. However, the unclear role, function and competency differentiation between enrolled nurse and registered nurse leads to role confusion and ongoing professional debate., Design: Exploratory Descriptive Study., Methods: A cross-sectional online survey of enrolled nurses and registered nurses across Australia was conducted examining their levels of agreement on statements related to the scope of practice and the clinical and nonclinical activities that enrolled nurses were required to perform in their workplace., Results: Valid responses were received from 892 enrolled nurses and 1,198 registered nurses. Enrolled nurses mostly agreed that they understood their scope of practice; did not undertake roles for which they were unprepared; sometimes undertook activities other than direct patient care; and believed that they operated equally to many registered nurses. The majority of enrolled nurses reported that they performed tasks mostly related to basic patient care in their workplace. There were a number of significant differences between perspectives of registered nurses and enrolled nurses., Conclusions: Clarifying the roles and scope of practice between the registered nurse and the enrolled nurse is important, and explicit differences in responsibility and accountability between their roles must be clearly articulated to harmonise perceptions about role and capability. Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned., Relevance to Clinical Practice: Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned., (© 2017 John Wiley & Sons Ltd.)

Aims: To explore the state of resilience and its predictors among nurses in mainland China., Background: Resilience is considered as an important ability to influence the prevention of job dissatisfaction and burnout. There are few studies on resilience in Chinese nurses, particularly investigating the predictors of resilience., Methods: A cross-sectional survey was employed and 1061 nurses from six three-level hospitals in Hunan responded to participate in the study. Data were collected using self-reported questionnaires., Results: Nurses experienced moderate levels of resilience and self-efficacy and tended to use a positive coping style. Multiple linear regression showed that a high level of self-efficacy and education, having a positive coping style rather than a negative coping style, exercising regularly and not using cigarettes predicted a high level of resilience (P < 0.01)., Conclusion: This study shows a moderate level of resilience among nurses and suggests that a high level of self-efficacy and education, as well as having a positive coping style and choosing a healthy lifestyle may increase nurses' resilience., Implications for Nursing Management: Hospital administrators and nursing managers need to explore the resilience state among nurses and understand the predictors of resilience. Then, scientific and evidence-based interventions for improving resilience should be adopted., (© 2017 John Wiley & Sons Ltd.)

Across the world, hospital nurses experience a high level of burnout. Exploring biochemical markers of burnout could help to understand physiological changes and may provide useful evidence for preventing burnout symptoms. The current study included 94 female nurses from one Chinese third-level hospital. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to investigate burnout symptoms: emotional exhaustion, cynicism, reduced professional efficacy, as well as the burnout average. The HPT axis was tested by checking blood levels of thyroid-stimulating hormone (TSH), thyroxin (T 4 ) and triiodothyronine (T 3 ). Nonparametric tests showed that no significant difference in biochemical markers was found between the burnout and non-burnout groups. Spearman correlation analysis found that biochemical markers had no significant association with burnout symptoms, except weakly negative associations between reduced professional efficacy and blood pressure and heart rate. These findings show a rather poor correlation of the HPT axis on burnout symptoms. Expanding the biochemical index of the HPT axis, comparing well-defined samples and using longitudinal studies are recommended for further studies., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Aim: To evaluate an aged care program in developing self-efficacy of newly graduated registered nurses., Methods: An evaluation of the program was conducted using a mixed methods approach. Twenty-four nurses completed the pre- and post-survey of aged care nursing self efficacy and attended one of three focus groups held to gain in-depth understanding of their insight into the program., Results: There was an increase in nurses' self-efficacy post-program. The increased self-efficacy and new knowledge gained enhanced nurses' confidence and enabled them to critically appraise their workplace practices., Conclusions: The improved confidence resulting from increased self-efficacy and new knowledge gained from the aged care program enabled nurses to critically appraise the practices in their workplace, demonstrating the program's effectiveness. Aged care service providers should support continuing education for aged care nurses to ensure sustainability of a competent workforce to manage the increasing aged care population., (© 2014 ACOTA.)

Concern regarding the low numbers of graduate nurses expressing interest in entering the psychiatric field leads to the question: who would be a psychiatric nurse? In this interpretative, phenomenological study, the lived experiences of seven veteran psychiatric nurses were examined in order to gain understanding of the reasons why they had remained in the field of psychiatric nursing. Each of these participants had more than 10 years' clinical practice in psychiatric nursing and shared a wide range of thoughts, memories, and experiences. The major emergent theme, 'being different', revealed what it is like for the participants being psychiatric nurses. These participants felt and saw themselves as different in many ways from other nurses and from society in general. Related to and an aspect of that difference was the high level of satisfaction they achieved from their role and the striving to achieve harmony.

Aim of the Study: The aim of this study was to gain insight into the experience of being a nurse with a substance misuse problem., Rationale: Several members of the research team work in a withdrawal programme specifically designed for nurses by nurses. Gaining insight into nurses' experiences will contribute to the development of appropriate guidelines to assist with prevention, identification and intervention strategies., Background: Published research is almost exclusively from North America. Much of it represents work completed in the 1980s, with very few research-based accounts from the perspective of nurses, highlighting that this is a poorly researched and understood problem in Australia., Research Methods: This phenomenological study used in-depth, unstructured interviews either face to face or via the telephone with a purposive sample of 12 nurses who had experienced problem substance use., Findings: Five major themes were identified: nurses' justification for using substances, the fear surrounding being 'discovered', the personal meaning for nurses, the professional impact and the turning point in their road to recovery., Discussion: The five themes derived from the data are inextricably linked to the nature of nursing and of the nursing workplace. Information about potential risk factors and the experiences of nurses with substance misuse problems is critical to the development of prevention and treatment strategies., Conclusions: Issues of occupational health and safety are raised due to the increasingly demanding and often traumatic nursing work environment. Fears about stigma and loss of their nursing identity highlight nurses' perceptions that treatment programmes are often punitive in nature. Guidelines for the workplace addressing issues such as confidentiality, stress reduction and strategies for handling situations where a colleague is suspected of having a problem are beginning steps that will help address the problem of substance misuse in the nursing profession.

Novice nurses encounter numerous factors that impact on their learning in the complex healthcare workplace. Registered nurses often work one-on-one with novices as preceptors to facilitate the development of novices' clinical skills and socialisation into the profession. This paper explores the concept of preceptorship from novice nurses' and preceptors' perspective, drawing upon data from a project between a large healthcare organisation and a university in Melbourne, Australia. The study, framed in ethnomethodology, included fieldwork observation, interviews and student surveys; this paper focuses on data collected over a series of individual interviews with nursing students (n = 28) and preceptors (n = 25). Thematic analysis yielded six key themes: "workplace socialisation," "empathy," "individuality," "willingness to engage," "changing support" and "a realisation" [by novices about the preceptor role]. Findings highlight the complexity of workplace learning that is influenced by the idiosyncrasies of the individuals involved and the social milieu in which the learning takes place. (Contains 1 figure.)

Nurses have key roles in caring for hospitalized patients. Missed nursing care can lead to adverse outcomes, from minor discomfort to patient death. Mental health nurses have a significant role in advancing knowledge and practice due to missed, delayed, or unfinished nursing care. They are identifying, escalating, and managing warning signs of mental and physical health deterioration where the risk to patients is high in terms of compromised care quality and neglect and the evidence is scant. This study aimed to examine mental health nurses' perceptions of missed nursing care in acute mental health inpatient units in an Australian regional health service. A cross‐sectional survey was undertaken using a modified Kalisch Phelan MISSCARE questionnaire and a qualitative content analysis was undertaken for narrative responses. Of 70 participants, the majority were aged 30–44 years, with >5 years of experience. The results indicated that care planning, safety audits, communication, and assessment of oral intake were perceived as care most frequently missed. Factors contributing to missed care need urgent exploration to ensure timely reduction of patient risk and enhancements to safe quality care. [ABSTRACT FROM AUTHOR]

Shared decision‐making is related to better health outcomes in serious mental illness. It is not well addressed in non‐Western cultures, for example Chinese culture. Chinese could be influenced by both paternalism and familism when making treatment decisions. However, this is unexplored. The study purpose is to explore shared decision‐making from perspectives of inpatients diagnosed with schizophrenia in China. This study adopted qualitative descriptive approach. Through semi‐structured interviews, twelve participants from the psychiatry department of a tertiary hospital shared their perceptions of shared decision‐making. An inductive thematic approach was used to analyse the transcripts. Primary results included three main themes with nine subthemes: (1) Having a positive attitude: i) wanting my voice to be heard, ii) needing my family to be involved, and iii) preferring the psychiatrist to decide; (2) Feeling excluded: i) having limited financial capacity, ii) lacking interactive communication, iii) too few psychiatrists, and iv) being unsatisfied with informed consent process; and (3) Self‐motivation in decision‐making by: i) easing the burden on the family and ii) actively collecting health information. In this context, patients have fewer treatment options and a limited role in SDM. Yet, they have preference for SDM, actively seeking health information from mental health professionals particularly nurses. [ABSTRACT FROM AUTHOR]

Involving mental health consumers in nursing handover is a recent introduction to practise in acute mental health units. However, implementation must recognize that mental health care is complex and the approach needs to include recovery‐focused philosophies of practice. Evidence shows that nurses and other health professionals consider poor handover practices may be the source of adverse events; however, the views of mental health nurses about involving consumers in nursing handover have not been previously reported. The aim of this study was to identify nurses' attitudes towards consumer involvement in handover and to measure the effect of a training programme upon these attitudes. A single‐group pre‐post‐test intervention study was undertaken. The study was conducted on the adult acute mental health inpatient unit of a major metropolitan hospital in Victoria, Australia, 2016–2017. Questionnaires were developed to capture the views of the nurses about proposed changes in the afternoon nursing handover process. A questionnaire was administered before and after the training intervention, an innovative, multi‐media education handover package. We found that training had a significant influence on mental health nurses' attitudes towards involving consumers in the handover. Therapeutic engagement improved following training and miscommunication reduced when all players are informed and have the opportunity to engage with the information. This study has demonstrated that well‐planned education can influence nurses' attitudes about involving consumers in the nursing handover processes. [ABSTRACT FROM AUTHOR]

Background: Delirium in hospitalised patients is common, and a risk factor for adverse outcomes. Health services require accurate delirium data to monitor the impact of initiatives designed to improve detection and prevention of delirium. Aim: To determine the extent to which International Classification of Disease codes represent delirium occurrence. Methods: A cross‐sectional point prevalence survey was used to audit delirium occurrence in 25 inpatient wards of an Australian health service. All adult patients were eligible. Exclusion was for coma, end of life or behaviour that posed a risk to delirium assessors. Specially trained nurses and allied health professionals (AHP) screened patients for any cognitive impairment using the 4 A's Test (4AT). Those with abnormal screen test results were assessed using the '3‐Minute Diagnostic Interview for the Confusion Assessment Method' (3D‐CAM). Delirium detected by 3D‐CAM was the reference standard. Results: Of potentially eligible patients, 559 of 667 (83.8%) patients were assessed. The mean age was 73 years (±16.4), 54.5% were female and 43.8% (245/559) had cognitive impairment (4AT score ≥1). The occurrence of delirium during hospitalisation as identified by ICD codes was 10.4% (58/559; 95% confidence interval (CI), 7.9–12.7) compared with a point prevalence of 16.2% (91/559; 95% CI, 13.2–19.1). Only 31 of 91 (34.1%) of those with delirium had ICD delirium codes assigned. Conclusion: ICD coding is inadequate to determine in‐hospital delirium incidence. Instead, a point prevalence detection of delirium using the methods described above could be used. Health services could apply the described survey method to evaluate their local initiatives for the improvement of delirium detection and prevention. [ABSTRACT FROM AUTHOR]

Identification of the attitudes to consumers admitted to hospital following a suicide attempt and the therapeutic optimism of nurses caring for this cohort is vital to ascertain the level of nursing care provided. A convenience sample of 72 Registered and enrolled nurses from a large metropolitan health service in South Eastern Melbourne, Australia, completed a demographic questionnaire, the Elsom Therapeutic Optimism Scale (ETOS), and the Attitudes to Attempted Suicide-Questionnaire (ATAS-Q). Data were analysed using SPSS (version 25). Whilst the ETOS & ATAS-Q correlate positively, themes of shame, blame, misunderstandings, and myths about suicide influence nurses' perspectives when providing suicide attempt aftercare. This may potentially lead to care that is tokenistic and task focused. To develop their professional skill set when providing suicide attempt aftercare, nurses need both formal and informal education and opportunities to reflect on their practice. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the effectiveness of education interventions provided for nurses for clinical alarm response and management. Background Some education has been undertaken to improve clinical alarm response, but the evidence for evaluating effectiveness for nurse education interventions is limited. Design Systematic review. Methods A systematic review of experimental studies published in English from 2005-2015 was conducted in four computerised databases ( MEDLINE, EMBASE, CINAHL and Scopus). After identification, screening and appraisal using Joanna Briggs Institute instruments, quality research papers were selected, data extraction and analysis followed. Results Five studies met the inclusion criteria for alarm response and no articles were concerned with clinical alarm education for management. All had different types and methods of interventions and statistical pooling was not possible. Response accuracy, response time and perceptions were consistent when different interventions were adopted. A positive effect was identified when learning about general alarms, single alarms, sequential alarms and medium-level alarms for learning as the primary task. Nurses who were musically trained had a faster and more accurate alarm response. Simulation interventions had a positive effect, but the effect of education provided in the care unit was greater. Overall, clinical alarm awareness was improved through education activities. Conclusions Nurses are the main users of healthcare alarms and work in complex environments with high numbers of alarms, including nuisance alarms and other factors. Alarm-related adverse events are common. The findings of a small number of experimental studies with diverse evidence included consideration of various factors when formulating education strategies. The factors which influence effectiveness of nurse education are nurse demographics, nurse participants with musical training, workload and characteristics of alarms. Education interventions based in clinical practice settings increase education effectiveness, although simulation can be effective. No study shows any type of intervention results in sustained improvement. Relevance to clinical practice There are workload implications in education and the matching of load, number and type of alarms with nurse demographics which should be evaluated. There also needs to be a connection between education and the clinical setting to contribute to clinical alarm awareness for undergraduate nurses and practicing nurses. Education solely supported by employers is insufficient. Patient safety and long-term effects must be further explored. [ABSTRACT FROM AUTHOR]

he nature of nursing work is demanding and can be stressful. Previous studies have shown a high rate of burnout among employed nurses. Recently, efforts have been made to understand the role of resilience in determining the psychological adjustment of employed nurses. A theoretical model of resilience was proposed recently that includes several constructs identified in the literature related to resilience and to psychological functioning. As nursing students are the future of the nursing workforce it is important to advance our understanding of the determinants of resilience in this population. Student nurses who had completed their final practicum were invited to participate in an online survey measuring the key constructs of the ICWR-1 model. 422 students from across Australia and Canada completed the survey between July 2014 and July 2015. As well as several key demographics, trait negative affect, mindfulness, self-efficacy, coping, resilience, and burnout were measured. We used structural equation modeling and found support for the major pathways of the model; namely that resilience had a significant influence on the relationship between mindfulness, self-efficacy and coping, and psychological adjustment (burnout scores). Furthermore, as predicted, Neuroticism moderated the relationship between coping and burnout. Results are discussed in terms of potential approaches to supporting nursing students who may be at risk of burnout. [ABSTRACT FROM AUTHOR]

Building nurses' resilience to complex and stressful practice environments is necessary to keep skilled nurses in the workplace and ensuring safe patient care. A unified theoretical framework titled Health Services Workplace Environmental Resilience Model (HSWERM), is presented to explain the environmental factors in the workplace that promote nurses' resilience. The framework builds on a previously-published theoretical model of individual resilience, which identified the key constructs of psychological resilience as self-efficacy, coping and mindfulness, but did not examine environmental factors in the workplace that promote nurses' resilience. This unified theoretical framework was developed using a literary synthesis drawing on data from international studies and literature reviews on the nursing workforce in hospitals. The most frequent workplace environmental factors were identified, extracted and clustered in alignment with key constructs for psychological resilience. Six major organizational concepts emerged that related to a positive resilience-building workplace and formed the foundation of the theoretical model. Three concepts related to nursing staff support (professional, practice, personal) and three related to nursing staff development (professional, practice, personal) within the workplace environment. The unified theoretical model incorporates these concepts within the workplace context, linking to the nurse, and then impacting on personal resilience and workplace outcomes, and its use has the potential to increase staff retention and quality of patient care. [ABSTRACT FROM AUTHOR]

A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses ( Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing. [ABSTRACT FROM AUTHOR]

This paper explores the methodological challenges associated with undertaking qualitative observation in the clinical setting at end of life. The authors reflect on their experiences of using non-participant observation to explore the nursing care delivered to dying patients in acute hospital wards. The challenges of observation as a method, clearly defining the participant group and involving vulnerable populations, such as the dying patients and their families, will be discussed. Consideration is also given to defining and working within the observational field, the researchers' dual roles, cost versus benefit, impact of culture, religion and ethnicity, and the determination of research limits/boundaries, with reflections from the authors' own experiences used to exemplify the issues. [ABSTRACT FROM AUTHOR]

The author considers the future of nurses in dealing with children and families. She explains why there is the possibility that children will have a shorter life expectancy when compared to their parents. She addresses the issue of substance abuse among the youth. She cites the mental health priorities for children and adolescents according to the World Health Organization (WHO).