Collegian RSS feed: Articles in Press. 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 http://www.collegianjournal.com//inpress?rss=yesElsevier Inc.en Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved. Collegian1322-76962010-08-13 Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.collegianjournal.com/article/PIIS1322769610000466/abstract?rss=yesSummary: Background: One of the public health challenges during an influenza pandemic is how to rapidly access groups of high-risk individuals to ensure that they have accurate information regarding prevention and management of infection. The aim of this survey was to evaluate the level of understanding of the H1N1-09 (Swine Flu) pandemic, amongst a high-risk group of individuals with chronic lung disease. This study was conducted in Melbourne, Australia towards the end of the 2009 pandemic.Methods: Questions included in the survey were based on the consumer information sheets available from the Department of Health (Victoria) website (frequently asked questions for the general public). Participants were recruited from patients attending community-based programs for chronic lung disease.Results: Eighty participants were interviewed in August–September 2009, the majority 70/80 were aware of the H1N1-09 pandemic in Melbourne. Most participants gained their information from media reports rather than health care providers. Although they were aware of some ways to decrease the spread of infection, only 20/80 (25%) knew that there were antiviral treatments available if they did contract the infection. It is noteworthy that in a substantial minority (25%), information reported in the media caused some confusion or anxiety and it appears that there was a gap in the provision of evidence-based information to this high-risk group.Conclusion: In the context of future pandemics, respiratory-outreach nurses and educators could be used to promote pertinent information regarding infection prevention and management to high-risk individuals. Currently this appeared to be an under-utilised means of imparting pandemic information to consumers.Communicating information regarding human H1N1-09 virus to high-risk consumers: Knowledge and understanding of COPD patients in Melbourne, Australia - Corrected ProofAnastasia F. Hutchinson, Michelle A. Thompson, Leanne Clark, Louis B. Irving10.1016/j.colegn.2010.06.001Collegian (2010)2010-08-13Collegian2010-08-13http://www.collegianjournal.com/article/PIIS1322769610000235/abstract?rss=yesSummary: Background: Patient participation in handover is one aspect of patient-centred care, where patients are considered partners in care. Understanding the patient perspective provides a foundation for nurses to tailor their bedside handovers to reflect patients’ thoughts and beliefs and encourage their active involvement in decision-making.Aim: This study examined patients’ perspectives of participation in shift-to-shift bedside nursing handover.Methods: A descriptive case study was conducted with 10 patients in one Queensland hospital who had experienced bedside handover during their hospitalisation in 2009. Participants were asked their views about bedside handover including its benefits and limitations, their existing and potential role in handover, the role of family members, and issues related to confidentiality. Data were analysed using thematic content analysis.Findings: Four themes emerged from the analysis. First, patients appreciated being acknowledged as partners in their care. Second, they viewed bedside handover as an opportunity to amend any inaccuracies in the information being communicated. Third, some preferred passive engagement rather than being fully engaged in the handover. Fourth, most patients appreciated the inclusive approach of handover as nurse–patient interaction.Conclusions: Bedside handover provides an opportunity for patients to be involved as active participants in their care. They value having access to information on an ongoing basis, and although not all choose the same level of interaction, they see their role as important in maintaining accuracy, which promotes safe, high quality care.Patients’ perspectives of bedside nursing handover - Corrected ProofAnne McMurray, Wendy Chaboyer, Marianne Wallis, Joanne Johnson, Tanya Gehrke10.1016/j.colegn.2010.04.004Collegian (2010)2010-07-08Collegian2010-07-08http://www.collegianjournal.com/article/PIIS1322769610000363/abstract?rss=yesSummary: The long-standing problem of overlooked and/or undertreated pain experienced by so many older people living in Australian residential care facilities condemns these people to a life robbed of quality. Such a degree of suffering experienced by older people calls into question the pain assessment skills of staff who work in residential care. However, the problem of undetected and unresolved pain experienced by older people is not simply a skill or knowledge issue. It is much broader than that.In this paper we portray pain as likened to a story; a narrative that only the older person, as the author, can impart and one in which only they can communicate their experience of pain. Nevertheless, as opposed to seeking the older person's pain narrative, nurses attempt to measure the immeasurable. In part, their actions relate to the confusing terminology which envelops pain assessment. However, political policy and economic discourse also influences nurses’ pain assessment practises to the detriment of older people and the profession of gerontological nursing.Discussion in this paper includes the experience of pain for the older person, an overview of the specific role of pain-screening tools compared with the requirements of a person-centred pain assessment, and person-centred pathways to help nurses and others interpret and heed the older person's pain story. Analysis also incorporates the argument that current and previous Federal Government funding tools for residential care subtly impact on holistic pain assessment causing confusion for caregivers and fragmentation of the older person's pain story.The fragmented story of pain: A saga of economic discourse, confusion and lack of holistic assessment in the residential care of older people - Corrected ProofKim Wylie, Monica Nebauer10.1016/j.colegn.2010.05.005Collegian (2010)2010-07-05Collegian2010-07-05http://www.collegianjournal.com/article/PIIS1322769610000181/abstract?rss=yesSummary: Contemporary health care increasingly dictates that consumers of services should become active participants in the health care system. This has placed responsibility on administrators, managers and clinicians to include consumers in key strategic and decision making initiatives. However, this direction has not been accompanied by clear policies or guidelines. Consequently confusion about selecting consumers able to provide valuable input is identified as a barrier to active consumer involvement. The purpose of this paper is to address some concerns raised in the quest to find the “right” consumer, including: finding a consumer without an axe to grind; ensuring the consumer is representative of broader views; health professionals as consumer representatives. While these concerns are common they have not yet been extensively debated and discussed in the broader literature. Strategies necessary to support consumers in participatory roles are also considered and the controversial subject of financial remuneration for consumers is also explored.Facilitating consumer participation: An approach to finding the ‘right’ consumer - Corrected ProofBrenda Happell10.1016/j.colegn.2010.03.001Collegian (2010)2010-06-04Collegian2010-06-04http://www.collegianjournal.com/article/PIIS1322769610000223/abstract?rss=yesSummary: Background: As the proportion of survivors from breast cancer increases it is possible that follow-up care could be delivered wholly by generalists to relieve over subscribed hospital clinics. However, guidelines seldom take into account the nature of interactions between patients and health care professionals involved in hospital-based follow-up.Methods: Consultations between four Specialist Breast Nurses (SBNs) and 21 consecutive women attending a hospital-based breast cancer follow-up clinic in Western Australia were audio recorded and subjected to a thematic analysis. Recording of consultations ceased with saturation of themes. We analysed the data with reference to theoretical frameworks which postulate that social support is a powerful factor in determining positive health outcomes. We also drew on theories focusing on biographical disruption, biographical reinforcement and biographical reinvention.Results: The majority of participants were Australian born, married women in their sixties. The mean duration of the consultations was 19min (SD=7.5, min=8, max=43.5). A core theme was the established relationship between the woman and her SBN. Overall, the SBNs played an important role in facilitating the transition of patients by supporting the woman in adjustment to a new self-image and bodily functioning. The SBN accompanies each woman through this phase in her life, while supporting a new narrative, promoting her ‘rebirth’ as someone with ideas, concerns and expectations that have altered significantly after the diagnosis of cancer. Five key themes emerged to demonstrate this supportive role: normalising; facilitating access to services; prevention; promoting self-esteem and promoting a proactive approach.Conclusions: Many women with breast cancer claimed a new perspective on what was now possible, acceptable or desirable in a host of life domains. Our data suggest that the follow-up care of cancer patients is more than just dealing with a checklist of symptoms but requires an understanding of the biographical disruption occasioned by a diagnosis of breast cancer.How do Specialist Breast Nurses help breast cancer patients at follow-up? - Corrected ProofMoyez Jiwa, Georgia Halkett, Kathleen Deas, Paul Ward, Moira O’Connor, Catherine O’Driscoll, Elizabeth O’Brien, Lisa Wilson, Sholeh Boyle, Jody Weir10.1016/j.colegn.2010.04.003Collegian (2010)2010-06-03Collegian2010-06-03http://www.collegianjournal.com/article/PIIS1322769609001176/abstract?rss=yesThroughout the past decades, Australian nursing has made significant advances in the clinical, research, and political arenas. Capitalising on these advances is a critical step in empowering the professions and a sound investment in the health of the nation. There remains a need to energise and empower the professions, to see our work as an enterprise that has value and a sense of worth because of our professional activities as well as for the political and economic contributions we make to health and wellbeing, quality of life and social justice. The contributions made by nurses and midwives need to be articulated in the policy arena, focused in professional decision-making and elaborated in our research agendas. Our professional organisations provide opportunities for solidarity, and the leverage we need to effect change at the bedside, the community and the whole of society. Renewed commitment to primary health care at the global, national and community level provides a timely rallying call to the professions to refine the way we articulate our position in health care, re-commit to culturally appropriate, socially just actions and embolden our professional goals to inspire the next generations of nurses for a more equitable future.Empowerment and enterprise: The political economy of nursing - Corrected ProofAnne McMurray10.1016/j.colegn.2009.12.001Collegian (2010)2010-05-24Collegian2010-05-24http://www.collegianjournal.com/article/PIIS1322769610000193/abstract?rss=yesSummary: A common complaint voiced by older people living in residential care is that the food lacks taste. When older people find food tasteless, the pleasure gained from eating and therefore, their appetite may be compromised, as will their food choices, nutrition, immune systems, functional status and well-being. However, often nurses overlook these symptoms as ‘inevitable and irreversible’ aspects of ageing, which they are not. In fact, many older people experience chemosensory (taste and smell) disorders or loss which means they lose the ability to taste the flavour of food. Commonly overlooked is the fact that chemosensory loss may well be a significant contributing factor to the high level of under-nutrition reported in residential care in Australia.Our purpose in this article is to explore important issues related to taste and smell dysfunction; the physiology of these sensations; several causes distinct from ageing; and interventions to help older people again enjoy their food with the concomitant advantages to their health and well-being. We also consider the way in which legislation related to Government funding has influenced gerontological nurses’ assessment skills and values, particularly concerning nutrition assessment to the detriment of not only older people living in residential care but also the profession of gerontological nursing. Attention is drawn to the need for nurses to up-date their clinical knowledge, assessment skills and practice including enhancing the flavour of food and the social occasion of dining for older people living in residential care.“The Food Here Is Tasteless!” Food taste or tasteless food? Chemosensory Loss and the Politics of Under-Nutrition - Corrected ProofKim Wylie, Monica Nebauer10.1016/j.colegn.2010.03.002Collegian (2010)2010-05-24Collegian2010-05-24http://www.collegianjournal.com/article/PIIS132276961000020X/abstract?rss=yesSummary: Objective: As a part of an action research project to determine a model of service to meet the needs of parents, this non-experimental study explored the role of child health nurses in supporting parents of young infants. It also examined whether changes to the service altered parents’ views of that support.Methods: Two surveys were conducted at eight month interval during which changes had been implemented in the child health service. The participants, recruited from well child health clinics, comprised 413 parents of infants younger than 12 months of age (206 in the first survey and 207 in the second survey). Data were collected by self-report questionnaires developed for the study, and analysed using descriptive and inferential statistics, factor analysis and linear regression.Results: The results showed the majority of parents (n=328, 79%) had valued the professional support from child health nurses, but there was no significant difference between the two surveys in the parents’ views of overall support they had received. Although parents reported improvement in accessibility and availability of the services, no improvement had occurred in the aspects of care most important for them. These were to be respected as a parent, have their parenting skills validated and be supported to make their own infant care choices.Conclusion: Empowering parents to make their own decisions about infant care is imperative for child health nurses in order for them to support parents effectively. The child health nurses need to build the parents’ capacity to make their own decisions through giving relevant information about care options and supporting parents in their decisions.The role of child health nurses in supporting parents of young infants - Corrected ProofRitva Eronen, Jan Pincombe, Helen Calabretto10.1016/j.colegn.2010.04.001Collegian (2010)2010-05-24Collegian2010-05-24http://www.collegianjournal.com/article/PIIS1322769610000211/abstract?rss=yesAbstract: Matching textbook descriptions of clinical situations with the reality of practice is an ongoing problem faced by members of the nursing profession and is commonly referred to as the “theory-practice gap”. This ubiquitous gap is inevitably encountered by all nurses at various times; yet it is widely agreed that it is student nurses – given their novice, rule governed status – who find themselves in the midst of the theory-practice void.This paper will discuss the nature of the theory-practice gap and skill acquisition, in relation to a personal experience of mine as an undergraduate nursing student, and its significance in relation to student anxiety levels, nurse education (specifically the roles of the classroom teacher and clinical educators), teaching methods and the responsibility of the student to become accountable for their own education. I intend to communicate how my personal situation was dealt with and evaluate that experience in relation to current nursing literature. Ultimately, this discussion will demonstrate the value of reflection underpinning the development of competency in nursing and its role in bridging the theory-practice gap.The theory-practice gap and skill acquisition: An issue for nursing education - Corrected ProofNatashia Josephine Scully10.1016/j.colegn.2010.04.002Collegian (2010)2010-05-24Collegian2010-05-24http://www.collegianjournal.com/article/PIIS1322769610000028/abstract?rss=yesSummary: The introduction of the ANMC's Continuing Competence Framework means that an increasing number of Australian Registered Nurses and Registered Midwives will be required to submit a portfolio if audited in order to maintain their registration. As several professional organisations and State regulatory authorities have already demonstrated, nurses and midwives will be supported to do this. However there is a risk that individuals commencing a portfolio for the first time will attempt to deal with the requirement by focussing on the minimum standards set by the regulatory authorities. Critics of the use of professional portfolios are quite correct, compiling and managing a portfolio can be a time consuming and irrelevant process if not well implemented. As this article will elaborate, e-Portfolios have a range of potential professional benefits including supporting individuals through a critical reflective approach to competency development, supporting professional collaboration and providing a structure for planning their career progression. This article provides an overview of the potential benefits of e-Portfolio platforms including detailing the capacities for information storage and recall and the provision of tools to support structuring and reporting information to further develop and communicate professional achievements. The objective is to entice the ambitious professional and their employers/professional associations to consider utilizing the extended capacities of e-Portfolios.E-Portfolios for the aspiring professional - Corrected ProofKate Andre10.1016/j.colegn.2009.10.005Collegian (2010)2010-03-11Collegian2010-03-11http://www.collegianjournal.com/article/PIIS1322769609001115/abstract?rss=yesSummary: Cultural safety is an important concept in health care that originated in Aotearoa (New Zealand) to address Maori consumer dissatisfaction with health care. In Australia and internationally, midwives are now expected to provide culturally safe midwifery care to all women. Historically, Australia has received large numbers of immigrants from the United Kingdom, European countries and the Middle East. There have also been refugees and immigrants from South-East Asia, and most recently, from Africa. Australia continues to become more culturally diverse and yet to date no studies have explored the application of cultural safety in Australian midwifery practice. This paper explores how cultural safety has evolved from cultural awareness and cultural sensitivity. It examines the importance of cultural safety in nursing and midwifery practice. Finally, it explores the literature to determine how midwives can apply the concept of cultural safety to ensure safe and woman centred care.Cultural safety and its importance for Australian midwifery practice - Corrected ProofJasten Phiri, Elaine Dietsch, Ann Bonner10.1016/j.colegn.2009.11.001Collegian (2010)2010-03-02Collegian2010-03-02