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Introduction: Nurse Navigators were introduced in Queensland, Australia, in 2016. Nurse Navigators coordinate person‐centred care, create partnerships, improve care coordination and outcomes and facilitate system improvement, independently of hospital or community models. They navigate across all aspects of hospital and social services, liaising, negotiating and connecting care as needed. People stay with Nurse Navigators for as long as required, though the intent is to transition them from high‐care needs to self‐management. Nurse Navigators are a working model in rural and remote areas of Queensland. Objective: To describe where the rural and remote Nurse Navigator position fits within the Rural Remote Nursing Generalist Framework and to define the depth and breadth of the rural and remote Nurse Navigator's scope of practice. Design: Using template analysis, data from focus groups and interviews were analysed against the domains of the recently released National Rural and Remote Nursing Generalist Framework. Navigators working in rural and remote areas across Queensland Health were invited to an interview (n = 4) or focus group (n = 9), conducted between October 2019 and August 2020. Findings: Rural and remote Nurse Navigators are proficient in all domains of the framework and actively champion for their patients, carers and the communities where they live and work. Discussion: This research demonstrates that rural and remote Nurse Navigators are a working model of advanced nursing practice, acting as 'champions' of The Framework. Conclusion: The Nurse Navigator model of care introduced to Queensland exemplifies proficient registered nurse practice to the full extent of their knowledge and skill. [ABSTRACT FROM AUTHOR]

The research employs a single embodied case study design with the aim to examine the discourse of men accessing and receiving mental health support alongside those who are the providers of the support. Three groups of adults were interviewed: men who had experienced mental health problems and had attempted to access mental health support; lay people who supported them, such as partners and non‐mental health professionals and professionals, such as mental health nurses, social workers, clinical psychologists and general practitioners. Critical discourse analysis (CDA) is used to identify discourses around three emergent themes: well‐being, power and dominance and social capital. Participants seeking mental health support often referred to mental health services as not listening or that what was offered was not useful. A lack of belonging and community disconnectedness was apparent throughout all participant interviews. The study is reported according to the COREQ guidelines. [ABSTRACT FROM AUTHOR]

The global COVID‐19 pandemic challenged the world—how it functions, how people move in the social worlds and how government/government services and people interact. Health services, operating under the principles of new public management, have undertaken rapid changes to service delivery and models of care. What has become apparent is the mechanisms within which contemporary health services operate and how services are not prioritising the person at the centre of care. Person‐centred care (PCC) is the philosophical premise upon which models of health care are developed and implemented. Given the strain that COVID‐19 has placed on the health services and the people who deliver the care, it is essential to explore the tensions that exist in this space. This article suggests that before the pandemic, PCC was largely rhetoric, and rendered invisible during the pandemic. The paper presents an investigation into the role of PCC in these challenging times, adopting a Foucauldian lens, specifically governmentality and biopolitics, to examine the policies, priorities and practical implications as health services pivoted and adapted to changing and acute demands. Specifically, this paper draws on the Australian experience, including shifting nursing workforce priorities and additional challenges resulting from public health directives such as lockdowns and limitations. The findings from this exploration open a space for discussion around the rhetoric of PCC, the status of nurses and that which has been lost to the pandemic. [ABSTRACT FROM AUTHOR]

Purpose: To explore levels of Navigator resilience, well‐being, burnout, and turnover intent. Design: A longitudinal, multi‐methods study concurrently collected quantitative and qualitative data over three years. Methods: A survey and Action Learning Groups. Findings: No statistically significant change in resilience, well‐being, burnout, or turnover intent. Supports, self‐care and leaving the position, were used to maintain well‐being. Conclusions: While quantitative measures did not change, qualitative data demonstrated how adaptive coping mechanisms maintain well‐being. Recommendations for nurses working in Navigator, or similar community/public health roles include work‐based programs targeting support, good leadership, governance systems including their impact on turnover intent. Clinical evidence: Job turnover intent can be used as a mechanism to monitor resilience and well‐being. [ABSTRACT FROM AUTHOR]

Background: Within the context of the increasing prevalence of prolonged critical illness, a situation intensified by the COVID‐19 global pandemic, advancing understanding of the experiences of families of survivors that are discharged home is important in understanding the complexity of life for these people. Aims: To examine research related to the experiences of families of survivors of prolonged critical illness that are discharged home. Study design: This review was conducted using the Whittemore and Knafl framework for integrated literature reviews. A literature search was conducted using the electronic databases of Web of Science, CINHAL, Scopus, and PubMed for English language studies published between January 2002 and October 2021. Article titles and abstracts were screened in view of finding a selection of articles that focussed on the experiences of families of people who have survived a prolonged intensive care stay that are discharged home. Study quality was assessed using the CASP (Critical Appraisal Skills Programme) tool. Data analysis of nine peer‐reviewed articles was informed by the Braun and Clarke approach to thematic analysis. The PRISMA guidelines were used to report the review process. Results: Nine articles were included in the review. Three major themes were identified, namely, (i) the negative impact on family caregiver health and well‐being, (ii) caregiver burden, and (iii) unmet support needs. Conclusions: Families of prolonged critical illness survivors that are discharged home face complex challenges that make their experience difficult and demanding. Family support needs once patients are discharged home are largely unrecognized in this population. Relevance to clinical practice: This review evidences the need to investigate further the experiences of families of survivors of prolonged critical illness. Further qualitative research has the potential to help inform service provision and support for these people. [ABSTRACT FROM AUTHOR]

Background: Improved survival of critically ill people has increased the number of patients who experience an extended stay in intensive care units (ICU). Evidence suggests the complexities, vulnerabilities, and traumas created by critical illness are substantial for both patients and their support people with a number experiencing devastating impairments across multiple domains of health and function including physical, mental, cognitive, and social health. However, research on survivors predominantly focuses on those who have experienced a relatively short length of stay; only a limited number of studies seek to explore the experiences of survivors and their support people who have had a prolonged stay in intensive care. Aims: To describe the experiences of survivors of prolonged critical illness (invasively mechanically ventilated in ICU for ≥eight days) and their support people during the first 12 months following hospital discharge in New Zealand. Study design: This research will be a multi‐centre study recruiting from three intensive care units in New Zealand. A narrative inquiry methodology will be used to interview 6–8 former long stay patients and 6–8 support people of a former long stay patient. Each participant will be interviewed at 3‐, 6‐, 9‐, and 12‐months following hospital discharge. Data will be collected via narrative inquiry interviews. Data analysis will combine two theoretical frameworks: the Clandinin and Connelly narrative inquiry three‐dimensional space and the Fairclough situation, discourse and context framework. Results: The phenomenon of investigation will be experiences after prolonged critical illness explored longitudinally across the first‐year post‐hospital discharge. Relevance to clinical practice: This protocol provides a methodological framework for exploring the lived experiences of survivors of prolonged critical illness and their support people. Data analysis will support understanding of the human journey of ICU survivorship and add to the body of knowledge on how to support post‐ICU recovery in this population. The barriers and enablers of survivorship at the micro, meso, and macro levels of the health service will also be illuminated. [ABSTRACT FROM AUTHOR]

Health literacy is a contemporary term used in health services, often used to describe individuals requiring additional support to access, understand and implement health service information. It is used as a measure of self‐efficacy in chronic disease models of care such as the nurse navigator service. The aim of the research was to investigate the concept of health literacy in the nurse navigator service, particularly in relation to the defined role objective of person‐centred care. Fairclough's critical discourse analysis was used to analyse the experiential, relational and expressive elements of texts, investigating the hidden truths which are represented in discourse. Texts from a variety of health service micro‐, meso‐ and macro‐hierarchical sources were selected for analysis using the nurse navigator evaluation data set and other associated texts. Health literacy in the nurse navigator service is a technology of government used to increase participation of individuals in their own health and well‐being. The discourse suggests that health literacy responsibilises both individuals and nurses and is discursively formed within a matrix of rational choice. In this context, health literacy contributes to structural vulnerability. [ABSTRACT FROM AUTHOR]

Positioning the individual at the centre of care (person‐centred care [PCC]) is essential to improving outcomes for people living with multiple chronic conditions. However, research also suggests that this is structurally challenging because health systems continue to adopt long‐standing, episodic care encounters. One strategy to provide a more cohesive, individualised approach to care is the implementation of the nurse navigator role. Current research shows that although PCC is a focus of navigation, such care may be hindered by the rigid, systematised health services providing siloed specialist care. In this paper, we utilised a case study method to investigate the experiences of a nurse navigator and patient. The nurse navigator and the patient participated in individual interviews, the transcripts of which were analysed using critical discourse analysis. Findings from a larger research project suggest that traditional measures (hospital avoidance, emergency department usage) which work as the service objectives of the nurse navigator service have the potential to stifle the delivery of PCC. The analysis from this case study supports the broader findings and further highlights the need for improved alignment between service objectives and the health and well‐being of the individuals utilising the services. [ABSTRACT FROM AUTHOR]

Small-scale parallel trickle-bed reactors were used to evaluate the performance of a commercial hydrodesulfurization catalyst under industrially relevant conditions. Catalyst extrudates were loaded as a single string in reactor tubes. It is demonstrated that product sulfur levels and densities obtained with the single-pellet-string reactor are close to the results obtained in a bench-scale fixed-bed reactor operated under the same conditions. Moreover, parallel single-pellet-string reactors show high reproducibility. To study the hydrodynamic effects of the catalyst-bed packing, the catalyst-bed length was varied by loading different amounts of catalysts, and crushed catalyst was also loaded. [ABSTRACT FROM AUTHOR]

Qualitative research in general and the psychoanalytically informed research interview method specifically, can be emotionally demanding on researchers as they form relationships with participants. This is especially the case when researchers and participants share particular identities and experiences. In this paper I reflect on my experience of interviewing mothers raising children with a visible physical disability about their maternal subjectivity. At times this was an emotionally demanding and ethically challenging process as participants closely identified with certain aspects of my identity, particularly with my visible physical disability and motherhood peculiarities. Often participants unexpectedly reversed our roles, asking me intimate questions. I will deliberate these dilemmas using interview material. I argue for a mindful blurring with participants when this occurs. Using certain psychoanalytic-researcher concepts of intersubjectivity, transference-countertransference and psychoanalytic-researcher thirdness helped me successfully navigate these encounters. I will also explore the rich participant psychic functioning that was generated from this intersubjective relationship between myself and the participants. [ABSTRACT FROM AUTHOR]

This article draws on the free-text commentaries from trans-Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self-effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms. [ABSTRACT FROM AUTHOR]

In this paper, we suggest a blueprint for combining bibliometrics and critical analysis as a way to review published scientific works in nursing. This new approach is neither a systematic review nor meta-analysis. Instead, it is a way for researchers and clinicians to understand how and why current nursing knowledge developed as it did. Our approach will enable consumers and producers of nursing knowledge to recognize and take into account the social processes involved in the development, evaluation, and utilization of new nursing knowledge. We offer a rationale and a strategy for examining the socially-sanctioned actions by which nurse scientists signal to readers the boundaries of their thinking about a problem, the roots of their ideas, and the significance of their work. These actions - based on social processes of authority, credibility, and prestige - have bearing on the careers of nurse scientists and on the ways the knowledge they create enters into the everyday world of nurse clinicians and determines their actions at the bedside, as well as their opportunities for advancement. [ABSTRACT FROM AUTHOR]

Purpose: The move to national registration of health professionals and the creation of the Nursing and Midwifery Board of Australia (NMBA) provides both challenges and opportunities for the regulation of nurse practitioners (NPs) in Australia. Data sources: National and state health policy documents, accessible on the Internet, concerning the regulation and endorsement processes for NPs in Australia were examined. Conclusions: The similarities between two of the previous jurisdictional NP endorsement processes in New South Wales and Victoria provide a common ground on which to build a robust national system. However, there are also key differences between these two states. These differences were mainly in the evidence required to assess competency of NP applicants and the authority to prescribe medications. All Victorian NP applicants were required to complete an approved medication subject at a master's level. Implications for practice: A consistent endorsement process that delivers NPs of the highest standard and allows for efficient use of their skills and expertise is vital. This needs to be performed with the aim of providing high-quality care in a regulatory environment that protects the public and clearly articulates the level of competence expected of all NPs. [ABSTRACT FROM AUTHOR]