Development of management structures for future nursing services in the Republic of Kazakhstan requires change of organizational culture.

AIM: This study's aim was to describe the development of new management structures for nursing services in pilot public healthcare organizations in the Republic of Kazakhstan by focusing on cultural change from the former Soviet system to the modern nursing management system. BACKGROUND: Because organizational culture plays an essential role in developing nursing management processes, the challenge in Kazakhstan is to change the deep-rooted Soviet administration practices, such as top-down management and the absence of a career structure in nursing, to meet the new public management system's requirements. METHOD: Participatory method was used to generate organizational culture change in 31 pilot organizations. RESULTS: The organizational structures were reorganized with new nursing positions. Changes concerning nurses' job descriptions and educational requirements were introduced to the legislation. Workforce planning and work division between the healthcare professionals were suggested, allowing new operational functions for nurses. The implemented changes facilitate the culture change in the healthcare and nursing service system. CONCLUSION: The shift of healthcare organizations towards a modern nursing management system has started in Kazakhstan. IMPLICATIONS FOR NURSING MANAGEMENT: Good understanding and competence of cultural issues related to the change processes are critical in countries that are undergoing fundamental reforms in their healthcare systems.

Developing global citizenship online: an authentic alternative to overseas clinical placement.

BACKGROUND: This paper presents the findings of a pilot project to develop and evaluate an international nursing module delivered using a collaborative online platform between nursing programmes in Scotland, USA and Finland. The purpose of the project was to provide an authentic international nursing experience for nursing students, allowing them to explore and contrast the nursing and health care issues in an international context. METHODS: The pilot cohort ran in September 2011 with a total of 22 students with a mix of students from both undergraduate and postgraduate programmes. A mixed methods research design was used to evaluate the students' experience using an anonymous online questionnaire and the collection of testimonials from students based on their experience. RESULTS: The results demonstrated high levels of satisfaction with the learning experience. Four key themes-learning together, widening horizons, developing autonomy and learning beyond frontiers-emerged from the qualitative data. CONCLUSIONS: Developing confidence from the shared learning experience has real implications for the global mobility of the nursing workforce as it helps to prepare nurses for a career beyond their own country's borders. The pilot module has clearly demonstrated that the use of Web 2.0 technology in the forms of a wiki may effectively be employed to provide an online learning environment to allow cross institutional learning.