Faculty of Education - Theses
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ItemClinical congruence : where graduate nurse clinical reality meets organisational clinical requirements( 2004)In the mid 1980s, education associated with the requirement for registration as a Nurse in the State of Victoria moved from a hospital-based system into the university setting. This move brought with it many and varied requirements for change within the health care setting. The students of nursing were now no longer a part of the workforce, they were transient visitors in the patient care setting with very specific clinical requirements to be met; and they were there for less time! This research project is not about whether this change in preparation should have occurred. It is well accepted amongst the profession that this was necessary to raise the status of the nursing professional. We now have registered nurses with a primary degree in nursing or health science. The question here however, is what clinical capacities do the newly graduates and registered nurses have when they enter the clinical workforce, and what clinical capacities are required by the health care institutions that are employing them. Have these institutions an accurate and realistic knowledge of the clinical capacities of the newly graduated registered nurses they employ? This research concentrated on the self-perceived and reported clinical capacities of newly graduated registered nurses as they entered the clinical environment and the clinical capacities required by the clinical areas that employed them. Clinical congruence was then measured between these two sources. The findings demonstrated that in a supported environment, where graduates can expect and receive clinical support and mentorship, clinical congruence:is likely to be achieved. However, in an environment where clinical skills are required to be undertaken at an unsupervised level, there were a significant number of distinct clinical skills for which the graduates report unpreparedness. Graduates and Nurse Managers alike agreed that increased clinical experience during the undergraduate preparation time is optimal, but the universities indicated that the fiscal and chronological constraints of a three-year degree program, in an environment where there is a cost incurred for the clinical experience, is difficult to achieve. This research demonstrates, in a tangible way, the need for a supported Graduate Transition Program to facilitate the consolidation and / or achievement of clinical competency for the graduates as they enter the workforce. This support will assist in ensuring the maintenance of a dynamic nursing workforce into the 21st century to meet the needs of the Victorian community at a time when it is most vulnerable during the period of ill health.
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ItemFactors that encourage and discourage registered nurse participation in in-service education( 2004)The nursing literature advocates lifelong learning through continuing education as a means to respond to the rapid changes in health care delivery and to ensure continued competence of registered nurses. With the rapid changes in scientific, technological and social environments, basic pre-registration nursing education is said to become obsolete within three to five years. Continuing education is a lifelong process that encompasses systematic, planned learning experiences beyond pre-registration education. In-service education is one component of continuing education that occurs in the workplace and focuses on providing the skills and knowledge the nurse requires to fulfil their current role. The purpose of this research was to identify the factors that encourage and discourage participation in in-service by the registered nurse. Health care agencies have an important role in providing in-service education is an important means to update and up skill registered nurses of constant changes in the nursing profession and the health care industry. The individual registered nurse has a professional obligation to the profession, community and themselves to participate in in-service education sessions for the in-service sessions to be effective and for quality patient care to be delivered. Currently there is very little literature on in-service education, thus it is imperative that further research is conducted on the topic, so in-service providers can plan effective, quality in-service programs that attract high participation from nurses. An explanatory multi-method approach was utilised to identify the factors that encourage and discourage nurses' participation at in-service education. The study found that nurses are usually influenced by a number of factors and not just one single factor in making their decision to participate in in-service education. The primary factors influencing participation are professional issues, topic relevance to practice and better meeting the needs of the patient, whilst discouraging factors include staff shortages, skill mix, inconvenient scheduling and busy shifts. The results of this study have important implications for in-service providers in planning and implementing an in-service education program that draws high levels of participation.
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ItemOf secrets, sorrows, and shame: undergraduate nurses' experiences of death and dying( 2007)This phenomenological study explores the lived experiences of undergraduate nursing students who cared for the dying and deceased whilst on clinical placement. To this point, studies on this phenomenon have focused on the experienced, qualified nurse. The purpose of this study was to gain an understanding of the impacts of caring for the dying and deceased, on the student-nurse, and the implications for nursing education. The ten study participants were undergraduates enrolled in the Bachelor of Nursing program at a metropolitan-based university in Melbourne. The study of their experiences, from the perspectives of the student-nurses, was conducted using a semi-structured interview for data collection. Analysis of the data, using a Miles and Huberman (1994) style matrix, revealed four emergent themes: intensity of emotion; perceptions, growth and awareness; and opportunities. These themes were explored to yield results which established there were often profound, and sometimes disturbing, impacts of grief for both the student-nurse, the patient, and others. This study contributes to the This phenomenological study explores the lived experiences of undergraduate nursing students who cared for the dying and deceased whilst on clinical placement. To this point, studies on this phenomenon have focused on the experienced, qualified nurse. The purpose of this study was to gain an understanding of the impacts of caring for the dying and deceased, on the student-nurse, and the implications for nursing education.
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ItemToward rational reflective nursing practice: a conceptualisation of key elements of a professional development process( 1994)This paper outlines key elements of Rational Reflective Nursing Practice together with the development and refinement of a conceptual model. An overview of professional development processes is also featured. The key elements of Rational Reflective Nursing Practice are identified as caring, practice dimensions, thinking, intuitive praxis, mentoring, learning and a new gender paradigm. Relevant aspects of each of these key elements are addressed. Rational Reflective Nursing Practice recognises and values "wise nurses" and nursing experience. Wise nurses are talented practitioners with extensive knowledge, skills and experience. Within the current context of clinical nursing practice, there is the potential for these wise nurses to be marginalised by younger, "better educated" nurses. Rational Reflective Nursing Practice may resolve this dilemma as it requires the co-existence of both learning and experience. Rational Reflective Nursing Practice can be viewed as an evolutionary, enabling and dynamic process which may inform and transform aspects of nursing practice.