Dealing with end of life-New graduated nurse experiences.

AIMS AND OBJECTIVES: This article explores the perceptions of new graduate nurses around their readiness for practice when faced with death and dying within the workplace, particularly in rural hospital and community nursing settings. BACKGROUND: An essential consideration for nurses in the care of people with life-limiting illness is the extent of their preparation for this area of practice. Nurses need to be aware of a multitude of compounding factors that will influence how and where the person is cared for. Despite significant literature about how to provide end of life education to undergraduate nurses there is little in the literature that explores the experiences of new graduate nurses. DESIGN: This paper reports on a qualitative interpretative study with data collected in seven semi-structured interviews. METHOD: Participants were invited to be interviewed with an online mail-out to Alumni who had graduated between 1-2 years earlier. A thematic analysis of the interviews was then conducted. RESULTS: Four themes emerged from the thematic analysis of the interviews. These were; the role of the new graduate in palliative care, preparation for palliative care in undergraduate nursing curricula, readiness for dealing with death and dying, and gaps in educational preparation. CONCLUSIONS: While palliative care is viewed as an important aspect of undergraduate nursing education, it is recognised as an area of practice that undergraduate nurses feel they are not adequately prepared for. This study identifies the need to incorporate skills such as having conversations and communicating effectively with patients and families experiencing end of life issues. RELEVANCE TO CLINICAL PRACTICE: Graduate nurses feel they are not adequately prepared for end of life care which demonstrates the need for quality end of life care education in undergraduate nursing curricula.

A REVIEW OF AGED CARE PROVISION IN MULTIPURPOSE SERVICES (MPS).

The MPS model has been in place for over 20 years in NSW as a way to address the ongoing healthcare needs of small rural communities.

PARTNERSHIPS FOR LEARNING AND MENTORING IN AGED CARE.

It is well known that the Australian population is ageing (Australian Bureau of Statistics, 2013). This ageing population has led to an increase in chronic and complex diseases, leading to a range of challenges for healthcare providers (Hunter & Levett-Jones, 2010), yet 75% of residential aged care facilities report skills shortages.

STUDENT PERCEPTIONS OF PRIMARY HEALTHCARE.

Reviews of undergraduate nursing courses reveal variability in what is being taught regarding primary healthcare (Betony & Yarwood, 2013; Keleher et al. 2010). In an investigation of the perceptions of final year students and recent graduates about underlying conceptual frameworks. Anderson et al. (2015) found students and graduates value primary healthcare as part of their curriculum.

UNDERGRADUATE NURSING EDUCATION RELATED TO EUTHANASIA.

Euthanasia is a subject that has been debated in health ethics courses for many years. With the increase in quality palliative care and emphasis on 'dying well', in response to the increased number of people living with life limiting conditions (Swerissen & Duckett, 2014), it has not been so prevalent in public forum discussions of late.

Identifying student knowledge and perception of what is valuable to professional practice: A mixed method study.

BACKGROUND: Bachelor of Nursing programmes are designed to prepare Registered Nurses for professional practice. The Bachelor of Nursing curriculum under discussion was shaped by the conceptual framework of primary health care philosophy, including themes of social justice, Indigenous health, caring philosophy, and the advancement of the discipline through research, scholarship and application of nursing knowledge and evidence-based practice. OBJECTIVES: This study was designed to identify what students and graduates found valuable in a Bachelor of Nursing curriculum conceptual framework and what value they placed on a conceptual framework and underpinning themes. DESIGN: A small study was designed to identify the student perceptions of themes which may be valuable to the new curriculum of the Bachelor of Nursing. A mixed methodology was selected as being appropriate to allow students to indicate the value that previous and completing students placed on each of these items and to explore their perceptions. SETTINGS: The setting for this small study was a regional university in NSW, Australia. PARTICIPANTS: Previous and completing (final year) students were invited to complete the online survey and any who were willing to be interviewed were asked to provide their contact details. METHODS: The research was conducted via a questionnaire through Survey Monkey, using a Likert scale and open responses and follow up interviews were conducted with willing participants. RESULTS: A total of 128 responses to the survey were received and ten were interviewed. Overall responses were positive. Students were aware of and valued all aspects of the current and proposed conceptual framework. There were some themes; however which were better understood than others. CONCLUSIONS: The majority of graduated students indicated that they were well prepared for the workforce. All aspects of the conceptual framework of the curriculum were valued by the majority of students.

Narrative pedagogy with evolving case study--A transformative approach to gerontic nursing practice for undergraduate nursing students.

Engaging nursing students in the complexities of care across community, acute, rehabilitation and residential aged care settings is challenging. Equally challenging is conceptualising and promoting diverse and comprehensive health assessments across care settings that reflect clinical reality, inform clinical decision making, traverse theory and practice, and transform clinical practice knowledge. This article describes the use of narrative and evolving case study as a teaching-learning tool utilised by the authors in a third year undergraduate gerontic nursing subject in a pre-service nursing degree at a rural university. Principles of transformative learning and strengths based nursing were drawn upon in the development of the case study. The aim of the approach was to draw on embedded knowledge and the experiences of students and academics from assorted practice settings to facilitate understanding of the lived experiences of an older community dwelling couple. Using social learning strategies students were encouraged to analyse and think critically and creatively about the situations they were presented with. They identified possible solutions that would be acceptable to the couple. Building on the older couple's strengths, achievements and personal social capital, the aim was to develop a positive paradigm for health and the way older people are viewed by nursing students.

Transfer of learning to the nursing clinical practice setting.

INTRODUCTION: The aim of this project was to identify if there is a link between what nursing students learn in simulated clinical laboratory sessions and what they experience during their clinical placements. Clinical laboratories are commonly used to assist students to develop clinical nursing skills through simulation of clinical experiences. ISSUE: Little research has been conducted into the effectiveness of clinical laboratory sessions for nursing students and whether these sessions play a role in linking theory to practice. The intent is to determine if the clinical laboratory sessions assisted students to integrate theory and practice in the rural nursing setting. METHOD: The participants were a cohort of first year undergraduate Bachelor of Nursing students at a rural campus of an Australian regional inland university during a first year clinical placement in small rural hospitals. The mixed methods utilised included a questionnaire survey and semi-structured interviews undertaken with nine first year nursing students. Questions asked related to the students' perceptions of what they were taught in the clinical laboratory sessions and what they experienced during clinical placements. RESULTS: The results reinforced the need to utilise a combination of lecture and clinical laboratory sessions while highlighting the necessity for clinical placement and 'hands on' experience. Discrepancies and differences were recognised in the area of documentation and in the practice of some skills. CONCLUSION: Parity between what is taught and what is experienced is imperative to ensure safe practice in nursing students.

Evaluation of clinical teaching models for nursing practice.

Clinical placements provide opportunities for student nurses to learn experientially. To create a constructive learning environment staff need to be friendly, approachable, available and willing to teach. There must be adequate opportunities for students to develop confidence and competence in clinical skills with a focus on student learning needs rather than service needs of facilities. A popular model for clinical teaching of nursing students is the preceptor model. This model involves a student working under the supervision of individual registered nurses who are part of the clinical staff. This model was failing to meet students' needs in acute nursing practice areas, largely due to Registered Nurse staff shortages and demanding workloads. The students' evaluations led to the trial of a 'cluster' or group model of eight students, with a clinical facilitator who is paid by the university, in each acute nursing ward. Evaluation of twenty nursing students' perceptions of their acute nursing practice clinical placements was conducted using a mixed method approach to evaluate the two models of student supervision. Results indicate that the students prefer small groups with the clinical facilitator in one area. Thus evaluation and feedback from students and the perceptions of their clinical placement is essential.