Collegian RSS feed: Current Issue. Collegian is the official journal of the Royal College of Nursing, Australia. Collegian aims to reflect the broad interests of nurses and the nursing profession, and to challenge nurses to emerging areas of interest. It publishes articles on professional, policy and practice issues. Most papers published in Collegian are peer reviewed by a double blind process using reviewers who meet high standards of academic and clinical expertise. Other papers are published at the discretion of the Editor if they contribute to nursing knowledge and debate. Collegian is distributed to members of the College and is available by separate subscription. The College is the peak national professional organisation for nurses in Australia. Its mission is to benefit the health of the community through promotion and recognition of professional excellence in nursing. To purchase books on Nursing or to browse our comprehensive range of specialised nursing titles, please visit us at shop.elsevier.com.au. Shop.elsevier.com.au/Nursing Awareded its first Impact Factor for 2010. http://www.collegianjournal.com/?rss=yesElsevier Inc.en © 2011 Royal College of Nursing, Australia. Published by Elsevier Inc. All rights reserved. Collegian1322-7696184December 2011 © 2011 Royal College of Nursing, Australia. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.collegianjournal.com/article/PIIS1322769611000540/abstract?rss=yesGlobally social and health systems are rallying to address the tsunami of chronic disease and the burden of population ageing (). Although technology and innovation have rampaged ahead in scientific advances, our health and education systems have been slower to adapt to changing times. In the scholarly literature and popular press we are continually reminded of the frailties and inadequacies of our health care system and nurses are often the target of criticism (). In particular the method and standards of educational preparation of nurses has been a focus of discussion and debate (). Current methods of nursing education in universities, have been accused of failing to prepare nurses for the challenges of contemporary health care systems. These censures can be readily challenged as they commonly fail to address the broader social, political and economic contexts that shape the role and scope of health care and specifically nursing and midwifery practice. Albeit important, nursing and midwifery education is only but one dimension of the complex mosaic of contemporary health care systems. Therefore considering methods of nursing and midwifery education in isolation from other factors influencing health care systems is futile and a disservice to the communities we serve.An open mind, discussion, debate and the testing of new ideas: The way of the futurePatricia M. Davidson, John Daly10.1016/j.colegn.2011.09.007Collegian 18, 4 (2011)2011-10-17Collegian2011-10-17184S1322-7696(11)X0004-5Editorial137138http://www.collegianjournal.com/article/PIIS1322769611000278/abstract?rss=yesSummary: Administering medication is an important function of registered nurses. It is therefore necessary that nursing students develop knowledge and skill in this field. Given the propensity for, and negative consequences of, medication errors, it is essential that nursing students are properly supervised in this role. There is currently a paucity of research examining the practices of supervising medication administration by nursing students, particularly from the perspectives of registered nurses. The aim of this study was to explore the opinions and insights of registered nurses regarding the supervision of nursing students administering medication. Focus groups were conducted with registered nurses with experience of working with students in the clinical environment. Focus groups were transcribed verbatim and data analysis was conducted using the five stage framework approach. Four main themes were identified that reflected the participants’ views of the factors most strongly influencing the provision of supervision: communication, busyness, attitudes, and pressure to conform. The participants identified the importance of providing student supervision and suggested strategies for improvement, such as a closer working relationship between the clinical facilitator and the registered nurses providing supervision.Factors influencing the supervision of nursing students administering medication: The registered nurse perspectiveKerry Reid-Searl, Brenda Happell10.1016/j.colegn.2011.05.003Collegian 18, 4 (2011)2011-07-04Collegian2011-07-04184S1322-7696(11)X0004-5Regular papers139146http://www.collegianjournal.com/article/PIIS132276961100028X/abstract?rss=yesSummary: Aim: This paper reports the first part of a case study investigation to examine the changes at King Edward Memorial Hospital (KEMH) following an inquiry established to review the quality of obstetric and gynaecological services.Background: Common findings from a range of health inquiries in recent times include that there have been inadequate adverse event reporting systems, the absence of transparent systems for staff and patients to report concerns about quality of patient care, and an ineffective medical credentialing and performance review system. The similarity of findings from many health inquiries raises the question of whether an inquiry does lead to changes to improve patient care and safety. There has been very little reported in the literature about this.Method: Using a case study strategy the areas of medical credentialing, performance review and involvement of consumers in care were chosen as the KEMH clinical governance processes to be examined for changes post inquiry. Documents, archives and interviews were used as data sources for this case study. Documents were examined using a normative analytic approach and the Miles and Huberman framework was used for data analysis of the interviews.Findings: There were significant changes in the area of credentialing and performance review evident in analysis of all sources of data. There were some improvements in the processes of involving consumers in care, but deficits were identified in regard to the provision of training and upskilling for clinicians to improve their communication skills and interactions with patients and families.Do inquiries into health system failures lead to change in clinical governance systems?Heather Gluyas, Selma Alliex, Paul Morrison10.1016/j.colegn.2011.06.001Collegian 18, 4 (2011)2011-07-29Collegian2011-07-29184S1322-7696(11)X0004-5Regular papers147155http://www.collegianjournal.com/article/PIIS1322769611000412/abstract?rss=yesSummary: This paper highlights the parallels between the journey to prescribing for nurse practitioners when the role was initially introduced in New Zealand and the journey now towards extending the prescribing framework to registered nurses. Nurse practitioners are the only nurses who can prescribe medicines, and their numbers are few. There are several thousand experienced registered nurses who meet the education requirements to be a nurse practitioner but who have not applied to the regulatory body for registration. Attention has begun to turn from this model, in which nurse practitioners are the only category of nurse who can prescribe, towards independent and supplementary nurse prescribing models. The New Zealand government is yet to fully commit to a specific plan for extending prescribing responsibilities to registered nurses, but feedback has been sought on two different proposals. Dependent prescribing arrangements used elsewhere appear to disregard the implications for professional autonomy. The proposed models of nurse prescribing for New Zealand impose oppressive restrictions, which nurse leaders over the last decade have fought hard to resist. Regulations are needed to allow nurses who have the appropriate education to be designated prescribers in their named area of specialisation. The difference between advanced practice nurses with prescribing rights and nurse practitioners must be clarified to minimise the impact of other prescribers on the nurse practitioner role. Lessons from the past and from the United Kingdom's experience could be drawn upon in order to better utilise the existing well-educated nursing workforce.Extending the prescribing framework to nurses: Lessons from the pastJill Wilkinson10.1016/j.colegn.2011.07.001Collegian 18, 4 (2011)2011-08-29Collegian2011-08-29184S1322-7696(11)X0004-5Regular papers157163http://www.collegianjournal.com/article/PIIS1322769611000424/abstract?rss=yesSummary: Background: The clinical research workforce within nursing is growing including those employed to lead studies, coordinate research and many hybrid roles. Several studies have reported high job satisfaction among research nurses. However, there have also been reports of limited options for career development and professional integration, likely reflecting typical informal, departmentally based management models. Institution-wide studies of issues related to research nurses are lacking, thus hampering the design and implementation of effective organisational frameworks to support and develop these positions.Aims: To explore experiences of nurses employed in research positions regarding organisational structures and support for research career pathways, and determine what reforms would strengthen an effective research specialisation pathway.Methods: A mixed-methods, cross-sectional approach, using a 104-item survey and semi-structured interviews of 11 staff in research roles at an acute care hospital in Queensland, Australia.Results: Research nurses lack organisational support in many job aspects that they deem important. A management model for the coordination of research nurses within a health district could maximise development of this field. Academic liaison and mentoring for nurses in research, and recognition for effort, are key areas for a management model to target.Conclusion: Nurses in research roles need individual mentorship, collective support, and the professional recognition and status that researchers in other settings are afforded. A comprehensive research management model would provide structured organisational support for nurses in research, improve professional development opportunities, ensure efficient use of human resources, synergistic working partnerships, and further contribute to a culture of evidence-based healthcare.Towards improved organisational support for nurses working in research roles in the clinical setting: A mixed method investigationClaire M. Rickard, Ged Williams, Gillian Ray-Barruel, Lyn Armit, Chris John Perry, Haida Luke, Paula Duffy, Marianne Wallis10.1016/j.colegn.2011.07.002Collegian 18, 4 (2011)2011-08-29Collegian2011-08-29184S1322-7696(11)X0004-5Regular papers165176http://www.collegianjournal.com/article/PIIS1322769611000436/abstract?rss=yesSummary: Rural registered nurses’ experiences of advanced clinical nursing practice were explored whilst they were enrolled in an advanced primary care course of study. Thirty-two nurses employed in rural health services in Victoria, Australia, studied advanced practice nursing by distance education with a clinical component. At course conclusion, focus groups and a quantitative on-line survey were conducted to explore outcomes. Nurses reported positive self-perceptions of their educational preparation with scores of >7/10 for competence, confidence, preparedness for advanced practice and job satisfaction. Focus group discussions concurred with positive survey results. The course was valuable in developing skills and knowledge, enabling more holistic patient care. The main themes that emerged related to the advancement of the nurse as a professional, and enhancement of patient care. Within their scope of practice, nurses assessed, diagnosed and treated minor patient illness presentations either independently or collaboratively with medical advice. The context of rural health services dictated practice and levels of autonomy. Nurses perceived the new role reduced an overload of medical work, whilst increasing patients’ access to care. As a result of the course 24% of participants reported a change in their work role. Nurses employed in rural health services reported positive potential for advanced collaborative practice in rural health care, in association with medical professionals. Defined role boundaries, role responsibilities and dedicated advanced practice positions will be required to achieve implementation of the role.Developing advanced rural nursing practice: A whole new scope of responsibilityRobyn Cant, Melanie Birks, Joanne Porter, Elisabeth Jacob, Simon Cooper10.1016/j.colegn.2011.08.001Collegian 18, 4 (2011)2011-09-19Collegian2011-09-19184S1322-7696(11)X0004-5Regular papers177182