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Aim: To present and discuss our experiences of learning how to establish and maintain an international collaboration as early career nurse researchers residing in the United States and Australia. Background: International research collaborations require additional startup time given the complexities of navigating cultural differences, obtaining ethics committee approvals in different countries and collecting human subject data. International collaborations may be daunting for early career researchers given their inexperience and pragmatic focus on research projects that lead to outputs achievable on short timelines for career advancement. Design: Discussion paper. Data Sources: Evidence from international literature about global collaborations across numerous disciplines, including potential factors that could facilitate or constrain early career researcher efforts to engage in international collaborations, were combined with authors' lived experiences as early career researchers. Discussion: Our collaboration began in July 2022 through a professional introduction spurred by a call for applications to fund global nursing education collaborations. Interpersonal, logistical and organizational factors played a role in our lived experiences of beginning an international collaboration. Our experiences are consistent with published literature about the time and complexity involved in conducting international research. Conclusion: Investing time building interpersonal relationships strengthens international research and supports collaborative learning and intercultural understanding. These professional relationships can be built over time to develop significant bodies of research with international impact. Early career researchers need to be resilient, persistent and tenacious as they 'jump through hoops' to establish international research collaborations. Impact: Building relationships during international research collaborations supports collaborative learning for intercultural understanding and strengthens research to address emerging global problems. International nursing research collaborations could encourage greater curiosity, innovative ideas and solutions to international problems that could not be achieved in isolation. Patient or Public Contribution: There was no patient or public involvement in the design and development of this paper. [ABSTRACT FROM AUTHOR]

Accessible summary: What Is Known on the Subject?: There are significant issues recruiting nurses into mental health due to several reasons such as dilution of curriculum, and mental health being an unpopular career choiceTransition programs provide nurses entering mental health with orientation, academic and clinical skills, and knowledge. What the Paper Adds to Existing Knowledge?: Transition programs need to be nuanced to specialty areas (e.g. community) to ensure nurses are given the support necessary to remain working in the field.Many nurses choose to work in mental health due to a lived or personal experience and as such strengthening wellbeing supports for transitioning nurses is an important role in retention. What Are the Implications for Practice?: Tailored transition programs can help strengthen mental health nurse role clarity, and support staff retention.Transition programs should be a segue to formal postgraduate studies in mental health nursing to strengthen professional practice and retention of nurses. Introduction: Globally, there are consistent issues recruiting staff into the mental health nursing workforce. In Australia, recent efforts to expand the workforce include recruitment of a wider range of nurses in addition to new graduates into mental health transition‐to‐practice programs. Understanding the career motivations of nurses entering the field is an important element of recruitment and retention. Aim: To describe nurses' satisfaction with their mental health transition program and identify factors influencing their choice of mental health as a career. Methods: An online cross‐sectional survey with questions on program satisfaction and career choice was responded to by n = 55 enrolled and registered nurses in a mental health transition program. Results: Nurses reported overall high satisfaction with their program and identified increased time release for professional development and being supernumerary as necessary to support role development. Almost 25% of nurses reported personal experience of mental illness as an influence in choosing a mental health career. Discussion: Mental health transition programs are important in recruitment and retention and need to be tailored to the needs of a wide range of nurses and include support for staff wellbeing. Implications for Practice: Tailored transition programs can help strengthen role clarity, and support staff retention. [ABSTRACT FROM AUTHOR]

Aims: To explore the experiences of refugees who became registered nurses after arriving to Australia. Design: Qualitative description using a naturalistic inquiry framework. Methods: Between February 2018 and September 2019, the lead author conducted semi‐structured interviews with employed registered nurses (RNs) that are former refugees and English‐speaking. Interviews were 45–90 min' duration and digitally recorded. Participants provided voluntary informed consent and were sent questions beforehand. Data were collected and coded into themes. Rigor was achieved with multiple transcript readings by the research team to confirm common themes. Results: Twelve participants discussed their story. Three major themes were identified: (1) Milestone of being a refugee; (2) Milestone of resettling in Australia; (3) Milestone of becoming a RN. Conclusion: Each participant's story started at a place of disadvantage. They progressed successfully through the three milestones; despite living with traumatic experiences, they learned new skills, developed English literacy, became a RN and juggled the demands of life. This paper highlights the poorly understood pockets of the current Australian RN workforce. Impact statement: The nuanced stories of RNs with refugee backgrounds in this study move beyond trauma and struggle and demonstrate the important journey this particular group of health professionals undertake. Increasing the contextual knowledge of the complex lives of former refugees turned nursing professionals will raise public awareness of the diversity of life experiences of RNs working in Australia. [ABSTRACT FROM AUTHOR]

shacklock k. & brunetto y. (2012) The intention to continue nursing: work variables affecting three nurse generations in Australia. Journal of Advanced Nursing 68(1), 36-46. Abstract Aims. The aims of the study were to examine how seven variables impacted upon the intention of hospital nurses to continue working as nurses and to investigate whether there are generational differences in these impacts. Background. There is a critical shortage of trained nurses working as nurses in Australia, as in many other Organisation for Economic Co-operation and Development member countries. The retention of nurses has been examined from the traditional management perspectives; however, this paper presents a different approach (Meaning of Working theory). Methods. A self-report survey of 900 nurses employed across four states of Australia was completed in 2008. The sample was hospital nurses in Australia from three generational cohorts - Baby Boomers (born in Australia between 1946 and 1964), Generation X (1965-1979) and Generation Y (1980-2000). Results. Six variables were found to influence the combined nurses' intentions to continue working as nurses: work-family conflict, perceptions of autonomy, attachment to work, importance of working to the individual, supervisor-subordinate relationship and interpersonal relationships at work. There were differences in the variables affecting the three generations, but attachment to work was the only common variable across all generations, affecting GenYs the strongest. Conclusion. The shortage of nurses is conceptualized differently in this paper to assist in finding solutions. However, the results varied for the three generations, suggesting the need to tailor different retention strategies to each age group. Implications for management and policy planning are discussed. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to estimate the proportion of acute care nurses witnessing end‐of‐life dreams and visions or having these reported by a patient or relative, and to canvass their related attitudes and beliefs. Design: A cross‐sectional survey study was conducted from February 2023 to May 2023. Setting/Participants: Participants were medical and surgical nurses from a 200‐bed acute care hospital in metropolitan Australia. Results: Fifty‐seven nurses participated from a workforce of 169 (34% response rate), of whom 35 (61%) reported they had encountered end‐of‐life dreams and visions. The nature of end‐of‐life dreams and visions encountered was similar to those reported in previous studies by patients and clinicians. Nurses generally held positive attitudes towards end‐of‐life dreams and visions but identified an unmet need for education and training on this aspect of end‐of‐life care. Conclusion: Our results suggest that nurses in acute care encounter end‐of‐life dreams and visions in a similar proportion to oncology and long‐term care but lower than in palliative care settings. Education and training regarding end‐of‐life dreams and visions are needed to ensure the provision of comprehensive, patient‐centred end‐of‐life care. Patient or Public Contribution: No patient or public contribution. Impact: Research in sub‐acute and long‐term care settings suggests that end‐of‐life dreams and visions are a common accompaniment to the dying process. No research has yet focused on the acute care setting, despite this being the place of death for the majority of people in most high‐income countries. This study demonstrates that acute care nurses encounter end‐of‐life dreams and visions in similar proportions to oncology and long‐term care nurses but lower than palliative care nurses. Acute care nurses would benefit from education and training regarding end‐of‐life dreams and visions to enable the provision of holistic person‐centred end‐of‐life care. Reporting Method: This study was reported using the STROBE Checklist for cross‐sectional studies. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Consumer participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goalInvolving mental health "Experts by Experience" in the education of nursing students demonstrates positive attitudinal change What this paper adds to existing knowledge?: More detailed understanding of nursing students' experiences and perspectives about being taught mental health nursing by "Experts by Experience"An international focus, extending understandings about how Experts by Experience might be perceived in a broader range of countries What are the implications for practice?: Positive attitudes towards people labelled with mental illness are essential for quality nursing practiceNurses have an important leadership role in facilitating consumer participation within health services. It is critical that their attitudes are professional and optimistic. Introduction: Consumer participation is central to mental health policy. Negative attitudes of health professionals are barriers to realizing policy goals. Evidence suggests consumers (Experts by Experience) can influence positive attitudes in nursing students. Research in this area to date is limited and primarily from Australia and New Zealand. Aim: To enhance understanding of nursing students' perspectives and experiences of being taught mental health by an Expert by Experience. Method: A qualitative exploratory approach was used. Focus groups were conducted with nursing students from seven universities in Australia and Europe. Data were analysed thematically. Results: Student participants described how exposure to Experts by Experience challenged their views and attitudes and provided a mechanism for reflection, critique and change. The main theme "changing mindset" includes two subthemes: exposing stereotypes and reflection. Discussion: This unique international study demonstrates the capacity for Experts by Experience to contribute to positive attitudinal change towards mental illness in nursing students. This changed mindset must occur for policy goals to be realized. Implications for practice: Nurses in all areas of practice will work with people labelled with mental illness and experiencing mental distress. Overcoming stereotypes and adopting more positive attitudes is essential to deliver quality mental health care. [ABSTRACT FROM AUTHOR]

Aim: This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people. Design: Integrative review. Data Sources: An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted. Results: Forty‐two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person‐centred cancer care services that address practical needs. Conclusion: Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs. Patient or Public Contribution: Our team includes both First Nations people, non‐First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work. Implications for Nursing Practice: Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up‐to‐date cultural safety training and stand together with Indigenous and non‐Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP. [ABSTRACT FROM AUTHOR]

Aims To synthesize evidence and knowledge from published research about nurses' experiences of nurse-patient relationships with adult patients in general, acute inpatient hospital settings. Background While primary research on nurses' experiences has been reported, it has not been previously synthesized. Design Meta-ethnography. Data sources Published literature from Australia, Europe, and North America, written in English between January 1999-October 2009 was identified from databases: CINAHL, Medline, British Nursing Index and Psyc INFO. Review methods Qualitative studies describing nurses' experiences of the nurse-patient relationship in acute hospital settings were reviewed and synthesized using the meta-ethnographic method. Results Sixteen primary studies (18 papers) were appraised as high quality and met the inclusion criteria. The findings show that while nurses aspire to develop therapeutic relationships with patients, the organizational setting at a unit level is strongly associated with nurses' capacity to build and sustain these relationships. The organizational conditions of critical care settings appear best suited to forming therapeutic relationships, while nurses working on general wards are more likely to report moral distress resulting from delivering unsatisfactory care. General ward nurses can then withdraw from attempting to emotionally engage with patients. Conclusion The findings of this meta-ethnography draw together the evidence from several qualitative studies and articulate how the organizational setting at a unit level can strongly influence nurses' capacity to build and sustain therapeutic relationships with patients. Service improvements need to focus on how to optimize the organizational conditions that support nurses in their relational work with patients. [ABSTRACT FROM AUTHOR]

This paper reports the benefits and challenges of a mentoring programme through which retired and senior nurses continued to support and nurture nurses and midwives currently working in the health system. Nursing has an ageing workforce and faces significant loss of expertise because of retirements. Previously, mentoring programmes have been instituted in a range of nursing contexts and they have been a retention strategy for older nurses and midwives. Mentors and their mentees worked together towards mutually agreed on professional and personal goals. They were asked to meet or speak together a minimum of twice per month for at least six months. As part of a collective case study, 15 mentoring dyads were established. Participants and mentors took part in qualitative, semi-structured interviews about their perceptions and experiences of the mentoring programme. Interviews were audio-taped, transcribed and analysed thematically. Mentors reported the mentoring experience to be rewarding experience that enabled them to re-connect with nursing-related activities and brought new challenges in retirement. They perceived the mentees were visibly helped by their support and influence. The mentors studied reinforced a positive self-concept as nurses and midwives in their mentees and assisted their development. Retired nurses and midwives in particular may have several characteristics that make them effective mentors. Potential benefits are demonstrated for nurses and midwives vulnerable to workplace adversity, especially those new to Australia who may have limited professional and social networks. For health organisations, mentoring programmes may be an innovative method of retention that engages both mid-career nurses and midwives and those recently retired. [ABSTRACT FROM AUTHOR]

Aim and objectives: To explore the family's experience being offered memory making during end‐of‐life care in the adult intensive care unit and its use in early bereavement. Background: Family members of individuals who develop a critical illness requiring emergency hospitalisation are unlikely to be prepared for a possible death. This places them at increased risk of poorer bereavement experiences. One potential intervention is memory making, which is an act that provides tangible objects such as a handprint, footprint, lock of hair, or teddy bear, that allows connections with and provides meaningful memories about a person. Families in the adult acute population reportedly have positive reactions regarding the objects, but it is unknown the object's effects on early bereavement experiences. Design: Descriptive qualitative study utilising inductive reflexive thematic analysis. Reporting adheres to the COREQ checklist. Methods: Between May 2019‐December 2020, a purposeful, convenience sample of 21 participants from a tertiary referral, adult intensive care unit in Australia were recruited to explore their experiences being offered memory making during end‐of‐life care and the objects use in early bereavement. Interviews were conducted using a semi‐structured format and occurred at the participants' location of choice. Results: Data analysis generated three themes: guidance during end of life by healthcare professionals that recognises the autonomy of the family; object used as a trigger to access memories; and storage and preservation of the object as an indication of its sentimental value and use in early bereavement Conclusion: Memory making objects such as handprints, locks of hair, or teddy bears received in the adult intensive care unit were valued and utilised during early bereavement by most recipients. Relevance to clinical practice: Findings inform practice evidence gaps regarding the family's experiences of memory making received as a bereavement intervention in the adult acute population. Patient or public contribution: Participants contributed through sharing their first‐hand experiences of receiving memory making in the adult intensive care unit. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore culturally and linguistically diverse men's experiences of support after perinatal death, including barriers and facilitators to support and how healthcare providers, systems and policies can best support families. Background: Many groups of culturally and linguistically diverse families in Australia are at higher risk of experiencing perinatal death. Culturally sensitive bereavement services are essential; however, there has been no previous research specifically examining culturally and linguistically diverse men's experiences of support following perinatal death. Design: Individual semi‐structured interviews were completed with healthcare providers, community leaders and culturally and linguistically diverse men who had experienced a perinatal death in Australia (n = 16). Data were analysed using Thematic Analysis and COREQ guidelines were followed. Results: Men's need for support following perinatal death was associated with stigma, and shaped by culturally‐relevant religion and ritual, and connection to community and family. Significant barriers to men seeking and gaining support included challenges with self‐advocacy and navigating the woman‐centred nature of perinatal care in Australia. Conclusions: Culturally and linguistically diverse men's specific needs should be included in the development of policy and practice surrounding perinatal death. While perinatal bereavement care guidelines acknowledge the importance of culturally informed care following perinatal death, there remains a lack of culturally specific supports available, particularly for culturally and linguistically diverse men. Relevance to clinical practice: Specific recommendations from this research include increasing community liaison officers or cultural consultants in hospitals and support organisations; providing culturally and linguistically diverse support groups; adopting family‐centred and father‐inclusive language in all perinatal death support services and ensuring clear communication and targeted assistance for culturally and linguistically diverse men to self‐advocate for their baby and access to support. Patient or public contribution: This study came out of consultation with community members and member checking of results was conducted to ensure adequate representation of participants' views. [ABSTRACT FROM AUTHOR]

Aims: To examine the relationships between challenges, coping and resilience among immigrant parents caring for their children with disabilities; and to explore their coping and resilient experiences and the service centre providers' perspectives on these. Design: A sequential explanatory mixed methods study. Methods: The participants were recruited from seven centres of disability service in Australia between May 2019 and February 2020. Phase 1 consisted of a cross‐sectional survey. Data were collected from 134 immigrant parents. Phase 2 consisted of semi‐structured interviews. Data were collected from nine immigrant parents and nine service providers. The findings from each phase were analysed separately and then integrated to answer the research aims. Results: Immigrant parents experienced challenges such as overwhelming caretaking responsibilities, lack of supportive social networks and feeling embarrassment over their children's behaviours. They used a variety of coping strategies, including reframing and mobilizing family to acquire and accept help from others to overcome their challenges. They had positive gains from the parental experience. Immigrant parents had a reasonable level of resilience. Those with a higher level of perceived challenges had a lower level of coping and resilience. Perceived barriers to parental coping included barriers to establishing social networks and utilizing available disability services. Services from competent service providers and the availability of social support networks were factors facilitating immigrant parents' coping. Conclusion: Sensitive communication and culturally appropriate care provided by service providers and healthcare professionals can facilitate service utilization and reduce perceived stigma over children with disability. Impact Findings from the study support that special training provided to healthcare providers about the challenges of immigrant parents raising children with disabilities may enhance awareness of the experience of these parents. Information and instrumental support may help to enhance parental coping, reduce isolation and promote their mental health. Patient or Public Contribution: We thank the immigrant parents and the service providers who have been instrumental in the conception of this study. [ABSTRACT FROM AUTHOR]

Background: The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved. Design: Indigenist review of the evidence of Aboriginal young people's health and well‐being. Methods: This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA‐ScR reporting guidelines. Results: Culture and connection are critical components of Aboriginal young people's health and well‐being. Aboriginal young people describe feeling of powerlessness to influence health and well‐being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well‐being. Conclusion: By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people. Relevance to clinical practice: Most of the currently available evidence about Aboriginal health and well‐being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength‐based approach which emphasises the strength and resilience of Aboriginal young people. [ABSTRACT FROM AUTHOR]

Aims: To explore the perceptions of women with lived experience of domestic and family violence on accessing healthcare and to identify how nurses can facilitate and support women experiencing domestic and family violence to receive the care they need. Design: A qualitative single site study. Methods: As part of an evaluation of a nurse‐led domestic and family violence service, a 2‐h focus group was conducted with four women with lived experience of domestic and family violence on 14 December 2021. The Levesque Framework provided a novel approach to identify barriers and facilitators to healthcare access. The focus group guide included eight open‐ended questions. The audio recording was transcribed and analysed using Braun and Clark's thematic analysis process. Results: The Levesque Framework helped highlight individual and structural challenges in accessing healthcare faced by women experiencing domestic and family violence. Dominant themes were first contact, comprehensiveness of services and domestic violence awareness. Conclusion: The growing incidences of domestic and family violence are confounding communities worldwide. Despite the high profile of domestic and family violence in Australia, access to healthcare remains problematic. These preliminary findings suggest that nurses have opportunities to facilitate access in relation to the approachability, acceptability and appropriateness of services. Realizing these opportunities requires education that enables nurses' capacity to provide an effective first contact and facilitate comprehensive care by embodying a no wrong door culture. We intend to explore these concepts in future focus groups. Impact This study explored the factors impacting access to healthcare for women experiencing domestic and family violence. Accessing healthcare when experiencing domestic and family violence in Australia is problematic. Findings suggest that nursing has opportunities to facilitate the approachability, acceptability and appropriateness of services. These findings will be valuable to nurses across all healthcare settings, nursing education providers and health workforce planners. [ABSTRACT FROM AUTHOR]

Aim: To explore transition experiences of Middle Eastern qualified midwives into practice in Australia. Design: This was a qualitative study using multiple case narrative approach underpinned by structuration theory. Methods: A total of 19 Middle Eastern qualified midwives from different states of Australia participated in this study. Individual semi‐structured interviews were conducted between November 2020 and September 2021, digitally recorded and then transcribed. Transcriptions were analysed in three stages, with three main categories generated in the second stage and a core category that was developed in third. Results: Entering the Australian workforce, Middle Eastern qualified midwives had to reframe their professional identities to fit the new system by adjusting to three aspects of the practice, including preparation for practice, scope of practice and context of practice. While they were prepared by medically oriented curricula, worked in systems that had limitations for midwives to practise in antenatal and postnatal and lacked regulation standards, they learned to practise autonomously in their full scope in a standardized context in Australia. Conclusion: Middle Eastern qualified midwives in Australia re‐evaluated their practice in their home countries, realized the gaps and adjusted to new ways of practising in Australia. Impact To effectively use the potential of Middle Eastern midwives for workforce sustainability in Australia, support should be available to enable them to develop the necessary competencies for safe practice in Australia including provision of context‐specific transition programmes prior to registration and supporting mentorship after their integration into the Australian healthcare workforce. Patient or public contribution: Patient or public contribution does not apply to this study as its purpose was to explore the transition experiences of Middle Eastern qualified midwives themselves. [ABSTRACT FROM AUTHOR]

Tollefson J, Usher K, Foster K. International Journal of Nursing Practice 2011; 17: 478-485 Relationships in pain: The experience of relationships to people living with chronic pain in rural areas The aim of the study was to develop new understanding of the lived experience of relationships for rural people living with chronic pain. Rural residents have greater difficulty accessing health services and providers. This is especially important to those living with chronic pain who often find themselves isolated from professionals who could potentially offer support. A phenomenological study with seven participants who had experienced chronic non-malignant pain for 2-29 years (Mean = 13) was recruited via a number of approaches and data analyzed using van Manen's framework. The themes that emerged from the analysis were as follows: pain as silence; privacy as a way of protection; no place out here to get support; and dealing with health-care professionals who do not understand. Lack of specialist services and support in rural areas means people with chronic pain are placed in even more vulnerable situations. Nurses remain at the forefront of service delivery in rural areas; hence, their role in management of people with chronic pain is vital in supporting them to maintain meaningful contact with others, including health professionals. [ABSTRACT FROM AUTHOR]

Background: The physical isolation of patients colonised or infected with multi‐drug resistant organisms is a requirement in hospitals considering the risk of infecting other patients, healthcare workers and visitors. However, how these patients experience isolation in the current environment is not fully understood from the literature. Aims: To explore and interpret the lived experience of the source isolation in patients infected with MDROs within an Australian setting. Design: Hermeneutic phenomenology was utilised as the philosophical framework. Methods: Unstructured in‐depth face to face interviews were conducted with 20 patients infected with multi‐drug resistant organisms who were physically isolated. Data was collected from February‐2018 to January‐2019 at two large teaching hospitals in the Sydney metropolitan area. The interviews were recorded, transcribed verbatim, analysed using thematic analysis by three researchers, and then subsequently interpreted, drawing insights from the relevant phenomenological notions. Results: Three key findings emerged from the study as: Living in a changed space ‐ developed from the participants' struggle to cope with being physically confined to a room that made them feel imprisoned. Living in a changed body ‐ emerged from the participants who described their bodies as 'different' because of bacteria that conventional medicine could not destroy permanently but kept relapsing. Striving to survive ‐ developed from participants who spoke about means of enduring some unfavourable experiences. Conclusion: The essence of the lived experience of the phenomenon of source isolation from the perspectives of patients who become infected with MDROs emerged as Being‐in‐a‐changed‐world. Impact: While source isolation is an important procedure for preventing and controlling transmissible infection; it often results in adverse psychological experiences. An understanding of this finding from the patients' perspectives is essential for nurses and other healthcare workers involved in their care to maintain a balance between infection control isolation and psychological needs. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study sought to explore undergraduate nursing students' perceptions of the role and value of their bioscience tutors in a blended learning curriculum. Background: Blended learning approaches typically have reduced face‐to‐face contact with tutors—particularly in bioscience subjects which nursing students have traditionally found difficult, and the move to more web‐based learning resources may compound this difficulty. Design: Qualitative descriptive study. Methods: This qualitative study was conducted with 19 undergraduate nursing students enrolled in bioscience subjects, at a large university in outer metropolitan Sydney, Australia in 2016. Semi‐structured interviews were conducted over the telephone or face‐to‐face. Duration of interviews ranged from 13 to 71 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied. Results: Two main themes with accompanying sub‐themes were identified. The first theme identified the importance of the tutor in bioscience, including their qualities, expertise and contextualisation of learning. The second theme provided insights into students' perceptions of what they considered good and poor approaches to learning. Conclusions: This study has clearly shown that while nursing students appreciated the flexibility offered by the online component of a blended learning curriculum, they still wanted an experienced bioscience tutor with clinical experience for their face‐to‐face classes. While the tutor was seen as crucial to providing clarification and context for content that was often challenging, they also played a key role in engaging and motivating students and creating a learning environment where students felt empowered to ask questions and debate issues with their peers. Given the increased use of online learning, further research could determine if the current study findings are also applicable in nonscience areas of study. Relevance to clinical practice: The importance of students having a sound understanding of the biosciences for safe, effective clinical practice cannot be underestimated. [ABSTRACT FROM AUTHOR]

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Aims and objectives: To explore the experiences of first‐year nursing students, their motivations for working and how they juggled study and other commitments while engaging in paid work. Background: There has been a global rise in the number of students balancing full‐time study, paid work and other commitments, with the main antecedent financial reasons. Design: Qualitative exploratory study. Methods: Drawn from a larger Australasian sequential exploratory mixed‐method study, this qualitative study was conducted with fifty first‐year undergraduate nursing and midwifery students who commenced their nursing studies in 2017. Telephone or face‐to‐face interviews were conducted with purposively selected students engaged in either nursing or non‐nursing fields of work. Interviews were conducted from April–July 2017. Interviews lasted from 15–40 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied. Findings: Two main themes and accompanying subthemes were identified. The first theme explored students' motivation behind combining work and study and identified the need for financial security and "me time". The second theme "Juggling many balls" provided insights into the benefits students perceived, how they kept the "balls" in the air and at times dropped "balls" while balancing work, study and other commitments. Conclusions: The motivation behind paid work was mainly financial; however, students also reported work allowed an escape and time for self which had social and health benefits. Working provided a range of positive benefits, including a sense of achievement, improved self‐esteem and financial independence. Relevance to clinical practice: Being able to juggle and multi‐task improved skills such as organisation and the ability to prioritise, all skills that have applicability for the role as registered nurse. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to identify and describe the experience of parents of children diagnosed with early onset scoliosis living in Australia. Background: Chronic childhood disease has a major impact on health‐related quality of life. Caring for a child with a chronic illness is well documented but the specific experiences of parents who care for children with early onset scoliosis, a rare but devastating illness, has not been explored. Numerous studies have described the interrelated psychological, financial, social, physical and logistical factors that impact the experience of the caregiver role with various diseases, but in the case of early onset scoliosis, limited studies have been conducted about the parental experience. Methods: A qualitative descriptive design was used. A snowball sampling technique assisted in the recruitment. Parents invited to the study included mothers, fathers and guardians. Data were collected through semistructured interviews and transcribed verbatim. Transcripts were analysed thematically. Data collection complied with the Consolidated criteria for reporting qualitative research guidelines. Findings: Twelve mothers of children with early onset scoliosis were interviewed, as only mothers consented to participate. Four major themes emerged: emotional rollercoaster ride, a lack of resources, money talks and pervasive burden. Factors that impacted on the participants’ ability to confront, manage and endure caring for a child with early onset scoliosis emerged from the data. Conclusion: The findings suggest there are multiple factors that influence the experience of mothers’ caring for a child with early onset scoliosis. The recognition and appropriate management of these factors by healthcare professionals have the potential to improve the quality of life of parents who care for a child with early onset scoliosis. Relevance to clinical practice: Healthcare professionals have first‐line contact with parents of children with early onset scoliosis and are well placed to provide parents with evidence‐based education and increased support. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the experiences of chronic obstructive pulmonary disease ( COPD) amongst individuals who have a high frequency of presentations to the Emergency Department and their carers. Background Patients with COPD are amongst the most frequent attenders in the Emergency Department despite the chronic nature of their condition. Good self-management has previously been identified as a key to maintaining health and reducing COPD exacerbations. There has been limited investigation of those with COPD who frequently attend the Emergency Department. Design Descriptive qualitative phase of a mixed methods study. Methods Individuals who had attended an Emergency Department within a single health district at least three times in the previous year for COPD were invited to participate in semistructured face-to-face interviews. A total of 19 individuals consented to participate, of whom 12 were male. Half of the interviews included both those with COPD and carers. Data were audio-recorded and transcribed, before being analysed using thematic analysis. Results Five main themes emerged from the data, namely (i) a sense of grief, loss and guilt, yet hope for the future; (ii) the impact on carers; (iii) the end point of self-management; (iv) the healthcare experience; and (v) the primary care experience. Conclusion The experience of individuals with COPD who frequently present to the Emergency Department and their carers highlights the complexity of living with this disease. Providing effective intervention to manage exacerbation requires an understanding of the issues that are faced by patients and their carers. Clear systems and skills for sharing information are essential to decrease avoidable use of the Emergency Department. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim was to explore the experiences of people with dementia in subacute geriatric rehabilitation hospitals to critically evaluate the care received by such patients. Background Globally, the number of people with dementia is growing and is expected to impact progressively more on health systems. People with dementia can become deconditioned and deteriorate in cognitive function while in hospital. The unfamiliar environment and people can cause the person to become disorientated, which then leads to behavioural symptoms which complicate care. Design Critical ethnography. Methods Methods included observation with field notes and 30 audio-recorded conversational interviews with patients with dementia in an Australian subacute care setting. Data were collected in May-December 2014, transcribed verbatim and analysed using thematic analysis. Results The central theme identified that patients with dementia described a liminal experience and felt like outsiders in the hospital environment. This was supported by the subthemes of not understanding why they were being kept in hospital, feeling lost in the space, bored, anxious about discharge plans and lacking intersubjective relationships. Many felt imprisoned by the locked wards. There was little evidence of nursing care delivered in an empathetic person-centred way. Nurses were busy and engaged with the patients only superficially. Conclusions People with dementia can have a liminal experience and feel like outsiders in this environment, which does not cater for the specific needs of this patient group. It should be acknowledged that people with dementia require additional resources. A caring nurse-patient relationship is fundamental to the patient experience. Nurses require further support and education about dementia in order to deliver quality care to this patient group. Relevance to clinical practice These findings will influence nurse leaders to advocate for improved resources for nurses to provide appropriate care for patients with dementia in subacute geriatric hospitals. The clinical practice of nurses needs to be supported with education, pyschological and material support to improve the therapeutic environment for patients with cognitive impairment resulting from dementia. [ABSTRACT FROM AUTHOR]

The article explores the recent literature on the efficacy of Peer Workers (PW) and discusses the mechanisms influencing their roles such as the therapeutic relationship. It notes that mental health nurses (MHNs) who often work with PWs has to engage in critical discussions around the potential implications for the mental health workforce as PWs become an increasingly established component of the workforce. It cites the need for MHNs to critically consider existing PW programmes.

Aims and Objectives To explore nurses' views of the barriers and facilitators to the use of a newly devised patient-centred pressure ulcer prevention care bundle. Background Given pressure ulcer prevention strategies are not implemented consistently, the use of a pressure ulcer care bundle may improve implementation given bundles generally assist in standardising care. Design A quality improvement project was undertaken after a pressure ulcer prevention care bundle was developed and pilot-tested. Methods Short, conversational interviews with nurse explored their views of a patient-centred pressure ulcer care bundle. Interviews were audio-taped and transcribed. Inductive content analysis was used to analyse the transcripts. Results A total of 20 nurses were interviewed. Five categories with corresponding subcategories emerged from the analysis. They were increasing awareness of pressure ulcer prevention, prompting pressure ulcer prevention activities, promoting active patient participation, barriers to using a pressure ulcer prevention care bundle and enabling integration of the pressure ulcer prevention care bundle into routine practice. Conclusions Benefits of using a patient-centred pressure ulcer prevention care bundle may include prompting patients and staff to implement prevention strategies and promote active patient participation in care. The success of the care bundle relied on both patients' willingness to participate and nurses' willingness to incorporate it into their routine work. Relevance to Clinical Practice A patient-centred pressure ulcer prevention care bundle may facilitate more consistent implementation of pressure ulcer prevention strategies and active patient participation in care. [ABSTRACT FROM AUTHOR]

Aims To explore the complex relationships between nurses' personal resources, job satisfaction and 'customer' (patient) orientation. Background Previous research has shown that nursing is highly intensive, emotionally charged work, which affects nurses' job performance and their customer orientation as well as patient or 'customer' satisfaction. This study contributes to the literature by examining how nurses' personal resources relate to their personal satisfaction and customer orientation and the relationships between them. Specifically, this study explores the effects of two facets of emotional labour (deep acting and surface acting), empathic concern, self-efficacy and emotional exhaustion on personal job satisfaction and customer orientation. We also test the moderating effects of inauthenticity and emotional contagion. Design A quantitative survey. Method Data were collected through a self-completion questionnaire administered to a sample of 159 Australian nurses, in a public teaching hospital, in 2010. The data were analysed using Partial Least Square analysis. Results Partial Least Square analysis indicates that the final model is a good fit to the data (Goodness of Fit = 0·51). Deep acting and surface acting have different effects (positive and negative) on job satisfaction and 'customer' orientation, self-efficacy has a positive effect on both and emotional exhaustion has a positive effect on customer orientation and a negative effect on job satisfaction. The moderating effects of emotional contagion and empathic concern, in the final model, are discussed. Conclusions Understanding the complex interactions between personal resources, job satisfaction and customer orientation helps to increase service providers' (nurses in this study) personal satisfaction and 'customer' orientation particularly in difficult contexts. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. Background People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). Design A national, cross-sectional and nonrandom survey study delivered online. Methods Members of the Australian College of Mental Health Nurses ( n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). Results There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). Conclusions Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. Relevance to clinical practice Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive health care of people with serious mental illness. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the Paediatric Intensive Care Unit-Nursing Knowledge and Skills Test - a multiple-choice test for measuring the key nursing knowledge and skills required for safe, competent practice. Background Intensive care graduate nurse residency or orientation programmes are key strategies in the development of safe and competent practitioners. Essential to these programmes is an evaluation of knowledge and skills. Multiple-choice examinations provide a valuable way of evaluating broad knowledge and skills; however, there has been limited work in this area to date. Design Psychometric evaluation. Methods The instrument was administered to 79 nurses from four paediatric intensive care units in Australia and New Zealand over 18 months between 2008-2010. Internal consistency using Kuder-Richardson 20, item analysis and construct validity using the 'known groups' technique were explored. Results Kuder-Richardson 20 reliability estimate for the 109-item test was 0·85. Instrument scores were significantly higher amongst nurses with postgraduate education and more years of paediatric intensive care experience. Item difficulty indices ranged from 0·08 to 1, with a mean item difficulty of 0·66. Item discrimination ranged from 0·2-0·8. Conclusion Testing of the instrument demonstrated encouraging psychometric properties. With additional refinement, this tool could provide educators and managers with an instrument to assist in the assessment of knowledge and skill acquisition. The instrument requires further testing in different samples of paediatric intensive care nurses to enable validation in other settings and cross-cultural comparisons. [ABSTRACT FROM AUTHOR]

Aim To investigate whether overlapping blood pressure and heart rate graphs improve chart-users' ability to recognize derangements in these vital signs on hospital observation charts. Background Many health professionals prefer blood pressure and heart rate graphs to overlap. One justification is the use of a visual cue called the 'Seagull Sign' to detect physiological abnormalities. Design A 3 × 2 × 2 mixed-design experiment, with three independent variables: participant group, graph format (separate vs. overlapping) and alerting system (integrated colour-based track-and-trigger system present vs. absent). Methods Over 64 experimental trials, 'Seagull-trained' nurses and novices randomly assigned to receive 'Seagull training' or remain untrained, viewed sequences of blood pressure and heart rate observations recorded on four different chart design extracts. The designs represented a crossing of the graph format and alerting system variables. For each design, eight cases contained normal data and eight contained an abnormal systolic blood pressure or heart rate observation (half of which yielded a Seagull Sign on overlapping plots). Participants (tested between January-May 2011) judged whether observations were physiologically normal or abnormal. Results Across all cases, participants from all groups responded faster and made fewer errors when blood pressure and heart rate observations were graphed separately, especially when a track-and-trigger system was present. Even for 'Seagull-trained' participants viewing 'Seagull Sign available' cases, no advantage of overlapping graphs was found. Conclusions These findings suggest that overlapping graphs do not yield the performance advantage that many health professionals assume, either for novices or experienced nurses, even when the Seagull Sign is used. [ABSTRACT FROM AUTHOR]

lodewijckx c., sermeus w., panella m., deneckere s., leigheb f., troosters t., boto p.a., mendes r.v., decramer m. & vanhaecht k. (2012) Quality indicators for in-hospital management of exacerbation of chronic obstructive pulmonary disease: results of an international Delphi study. Journal of Advanced Nursing 69(2), 348-362. doi: 10.1111/j.1365-2648.2012.06013.x Abstract Aim. To report a Delphi study that was conducted to select process and outcome indicators that are relevant to study quality of care and impact of care pathways for patients hospitalized with exacerbation of chronic obstructive pulmonary disease. Background. Management of patients hospitalized with exacerbation of chronic obstructive pulmonary disease is suboptimal and outcomes are poor. To evaluate the impact of care pathways properly, relevant indicators need to be selected. Design. Delphi study. Methods. The study was conducted over 4 months in 2008, with 35 experts out of 15 countries, including 19 medical doctors, 8 nurses and 8 physiotherapists. Participants were asked to rate, for 72 process and 21 outcome indicators, the relevance for follow-up in care pathways for in-hospital management of exacerbation of chronic obstructive pulmonary disease. Consensus (agreement by at least 75% of the participants) that an indicator is relevant for follow-up was sought in two rounds. Results. Consensus was reached for 26 of 72 process indicators (36·1%) and 10 of 21 outcome indicators (47·6%). Highest consensus levels were found for the process indicators regarding oxygen therapy (100%), pulmonary rehabilitation (100%) and patient education (94·5-88·6%) and for the outcome indicators concerning understanding of therapy (91·4-85·7%) and self-management (88·6-88·2%). Conclusion. The selected indicators appear to be sensitive for improvement. Therefore, researchers and clinicians that want to study and improve the care for patients hospitalized with exacerbation of chronic obstructive pulmonary disease should primarily focus on these indicators. [ABSTRACT FROM AUTHOR]

Aim. To identify indicators of quality nursing care by identifying structures, processes and outcomes perceived as valid, feasible, reliable and suitable for Australian paediatric hospitals by nursing experts. Background. Although measuring the quality of nursing care in acute care settings is being practised, there are few indicators validated for use in paediatric nursing. Using adult indicators for quality care measures in children's nursing has inherent problems. To contribute to quality improvement and safety in the paediatric population, it is essential to identify and validate indicators that will be useful in this context. Design. A modified Delphi technique. Method. Fifty-seven indicators that potentially measure the quality of nursing care in paediatrics were identified following a review of the literature. Three online surveys where panellists rated these indicators for perceived validity in paediatric nursing, feasibility of data collection, reliability based on existing documentation and suitability in the paediatric context were completed between March-May 2010. Results. Fifty-two nurses contributed to the expert panel. Consensus of 75% for validity in paediatric nursing was reached on 42 indicators, which were then ranked for suitability of use. Nineteen indicators were deemed inappropriate, which included indicators commonly used in adult settings. Conclusion. Face and content validity were reached for 42 indicators identified as potential valid measures of quality care in paediatric nursing. Further work is required to solve issues of reliability and feasibility of data collection and to ascertain whether the indicators occur frequently enough within Australian hospitals to be clinically useful. Relevance to clinical practice. Identification of nursing-sensitive indicators that are valid in the paediatric setting is the first step in measuring the quality of care provided to children. Once established, measurement of the indicators may lead to improved patient safety and care in hospitals. [ABSTRACT FROM AUTHOR]

Aims and objectives. To highlight and illuminate the emotional sequelae of whistleblowing from whistleblowers and subjects of whistleblowing complaints. Background. Whistleblowing has the potential to have a negative impact on individuals' physical and emotional well-being. However, few empirical studies have been conducted using qualitative methods to provide an in-depth exploration of the emotional consequences for those involved in whistleblowing incidents. Design. Qualitative narrative inquiry design. Method. Purposive sampling was used to recruit participants who had been involved in whistleblowing incidents. During interviews participants' accounts were digitally recorded and then transcribed verbatim. Data were then analysed by two researchers until consensus was reached. Results. Findings revealed that participants' emotional health was considerably compromised as a result of the whistleblowing incident. Analysis of the data revealed the following dominant themes: 'I felt sad and depressed': overwhelming and persistent distress; 'I was having panic attacks and hyperventilating': acute anxiety; and, 'I had all this playing on my mind': nightmares, flashbacks and intrusive thoughts. Conclusions. While it has been previously acknowledged that whistleblowing has the potential to have a negative impact on all aspects of an individual's life, this study notably highlights the intensity of emotional symptoms suffered by participants as well as the extended duration of time these symptoms were apparent. Relevance to clinical practice. As professionals, nurses, as well as organisations, have a responsibility to identify those who may be suffering the emotional trauma of whistleblowing and ensure they have access to appropriate resources. [ABSTRACT FROM AUTHOR]