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‘Our voice is not dead...our voice lingers in the air’. (Geia,2021, p. 38)What does the referendum on the Indigenous Voice to Parliament mean for the Australiannursing and midwifery professions? This editorial is intended to inform Australian nurses, mid-wives, educators and students about the Voice referendum and invite them to join Aboriginal andTorres Strait Islander Peoples on our shared journey to healing as a nation. . . .

Background: Mandatory placement-based work-integrated learning (WIL) poses challenges for nursing students who work whilst studying. The financial burden of WIL links to other known direct and indirect challenges, yet no Australian study has quantified the financial challenges resulting from attending mandatory WIL placements. Placement-based WIL costs may preclude some students from completing WIL, which may impact student attrition and the future health workforce. Aim: To investigate Australian nursing students’ financial challenges related to mandatory WIL. Methods: An online cross-sectional survey conducted with nursing students from nine Australian universities across five Australian states. The 28-question survey investigated the location of, and travels to, the most recent WIL placement; and students’ employment, accommodation, financial support, expenses and debts, and financial strain pertaining to WIL placements. Results: Overall, 2,359 students participated. The majority were employed (84%); 65% of these reported that they were unable to work during WIL, affecting their employment. One-third incurred a financial liability from their placement, 79% reported financial hardship, and 73% found their placement stressful due to financial strain. Financial issues affected 62% of students’ health and wellbeing. Discussion: Financial pressures related to WIL impact nursing students. While students have strategies to reduce these pressures, universities can also better manage their placement preferencing and support of students to reduce financial impacts of placement-based WIL on students. Conclusions: Nursing students face substantial financial challenges related to placement-based WIL. Scholarship programs and other forms of support are required to assist nursing students to undertake WIL.

Ensuring students develop person-centred practice for diverse groups of people across health care settings is an important outcome of undergraduate nursing education. This paper presents the development and evaluation of a learning innovation, an integrated virtual patient case study and complementary online resources for person-centred nursing practice. The virtual patient case study of an Australian Aboriginal woman diagnosed with breast cancer was integrated within four core subjects of a Bachelor of Nursing program, for a total of 600 second-year students. The evaluation of this learning strategy was encouraging. Students reported that the online learning activities were engaging, particularly due to the level of realism, their understanding of Aboriginal Peoples’ healthcare needs increased, and they developed therapeutic communication skills, applicable in a variety of healthcare contexts. Staff concerns about student wellbeing when learning sensitive content online were unfounded. When carefully planned, a virtual patient case study and online learning resources can support students to enhance their person-centred nursing practice. Further evaluation, including student outcomes through assessment, is an important next step.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

Like other Westernised countries, Australia’s history of colonisation, racism and oppression has impacted upon Indigenous Peoples’ health and well-being. It is also evident that institutional racism and ongoing colonisation are present in the Australian health system. Better preparation of health professionals to work in a culturally respectful way can contribute to addressing health disparities and prejudices. One approach to enabling the development of cultural respect is through embedding an Indigenous graduate attribute (IGA) across curricula and ensuring the process is thoughtfully developed and assessed. This paper describes and discusses the process of developing an assessment criteria template (ACT) to assess Indigenous cultural respect in an undergraduate nursing degree programme. Critical to the project was meaningful engagement with Indigenous stakeholders and Indigenous leadership to inform the development and implementation process. Although the context will vary globally due to the diversity of Indigenous Peoples and each country’s history of colonisation, by publishing this work, we intend to provide transparency into the process we undertook to embed and assess an IGA ACT in an undergraduate nursing curriculum. We hope this is helpful for other tertiary institutions internationally who are also engaging in this space.

Aim. The aim of this study was to assess student nurses’ knowledge of and attitudes towards pressure injury prevention evidence-based guidelines. Background. Pressure injuries are a substantial problem in many healthcare settings causing major harm to patients, and generating major economic costs for health service providers. Nurses have a crucial role in the prevention of pressure injuries across all health care settings. Design. A multi-centered, cross-sectional study was conducted using a paper-based questionnaire with undergraduate nursing students enrolled in seven universities with campuses across five Australian states (Queensland, New South Wales, Western Australia, Victoria and Tasmania). Methods. Data were collected from nursing students using two validated instruments (Pressure Ulcer Knowledge Assessment Instrument and Attitude Toward Pressure Ulcer Prevention Instrument), to measure students’ pressure injury prevention knowledge and attitudes. Results. Students reported relatively low pressure injury prevention knowledge scores (51%), and high attitude scores (78%). Critical issues in this study were nursing students’ lack of knowledge about preventative strategies to reduce the amount and duration of pressure/shear, and lower confidence in their capability to prevent pressure injury. Level of education and exposure to working in a greater number of different clinical units were significantly related to pressure injury prevention knowledge and attitude scores. Conclusion. The study findings highlight the need to implement a comprehensive approach to increasing Australian nursing students’ pressure injury prevention and management knowledge, as well as ensuring that these students have adequate experiences in clinical units, with a high focus on pressure injury prevention to raise their personal capability.

Family dynamics and parenting styles are influential on children’s wellbeing. Additionally, childhood experiences and how an individual experienced being parented can impact on how individuals as mothers and fathers choose to parent their own children. However, growing up in a home with an absent parent may create challenges associated with parenting for individuals due to not having these experiences themselves. Therefore, the aim of this paper is to report findings on men who grew up in a father absent household and how their experiences influenced their understanding of fatherhood and becoming a father. Twenty-one men participated in this qualitative study. Findings revealed that although men felt unprepared for fatherhood they attempted to learn to be a father and expressed the importance of not wanting their children to experience father absence. The study findings provide important insights in the provision of support for fathers who have experienced father absence.

AIMS AND OBJECTIVES: This paper reports on women's experiences of weight gain and obesity as they became acculturated to the Australian diet and lifestyle. BACKGROUND: Migrants from sub-Saharan Africa have a much higher risk of obesity than the native population when settling in industrialised countries. METHOD:Qualitative. RESULTS: Women in this study reported weight gain post-migration. This was attributed to increased access to a wide variety of food including takeaway food and more sedentary lifestyles. CONCLUSIONS: Obesity has long-term consequences for health and well-being. Further research is needed to support a healthy transition to life in Australia. RELEVANCE TO CLINICAL PRACTICE: Gaining insight into the underlying reasons that West African immigrants to Australia become obese could contribute to assisting health professionals design culturally appropriate interventions and health education programmes to support new arrivals.

Aims and Objectives The aim of this paper is to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses’ understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications. Background Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management. The skills associated with medication administration are most often taught to, and performed by, undergraduate nurses in a controlled environment. However, the clinical environment in which nurses are expected to administer medications is often highly stressed and nurses are frequently interrupted. Design/Methods This study used role play simulation and written reflections to facilitate deeper levels of student self-awareness. A qualitative approach was taken to explore students’ understanding of the effects of interruptions on their ability to undertake safe medication administration. Convenience sampling of second year undergraduate nursing students enrolled in a medical surgical subject was used in this study. Data were obtained from 451:528 (85.42%) of those students and analysed using thematic analysis. Results Students reported increasing consciousness and the importance of reflection for evaluating performance and gaining self-awareness. They described self-awareness, effective communication, compassion and empathy as significant factors in facilitating self-efficacy and improved patient care outcomes. Conclusions Following a role play simulation experience student nurses reported new knowledge and skill acquisition related to patient safety, and new awareness of the need for empathetic and compassionate care during medication administration. Practicing medication administration in realistic settin

Learning to parent sensitively and safely can be challenging for adults with childhood abuse and neglect experiences. Such childhood experiences are prevalent among incarcerated parents whose ability to parent their own children is also limited by separation from them. Several prisons have developed programs to foster pro-social parenting skills among incarcerated mothers and fathers to assist them on release. This paper reports a qualitative research study that explored the factors affecting the delivery and outcomes of parenting programs in correctional facilities in New South Wales Australia from the perspective of individuals involved in developing and implementing the programs. Thematic analysis of nineteen interviews identified two main themes: supporting parents’ learning in correctional settings and providers’ learning about parent education in correctional settings. Respondents reported the benefits of providing creative learning opportunities enabling parents to build on their strengths and to develop relationships. These factors contributed to changing prisoners’ attitudes and supporting them to consider alternative parenting approaches. The co-productive approach to parent education supported enhanced parenting knowledge amongst parents and greater insights amongst educators. Parenting education can be successfully delivered in correctional settings and can assist incarcerated parents build on existing knowledge and adapt it for their own needs.

The well-documented health disparities between the Australian Indigenous and non-Indigenous population mandates a comprehensive response from health professionals. This article outlines the approach taken by one faculty of health in a large urban Australian university to enhance cultural competence in students from a variety of fields. Here we outline a collaborative and deeply respectful process of Indigenous and non-Indigenous university staff collectively developing a model that has framed the embedding of a common faculty Indigenous graduate attribute across the curriculum. Through collaborative committee processes, the development of the principles of “Respect; Engagement and sharing; Moving forward” (REM) has provided both a framework and way of “being and doing” our work. By drawing together the recurring principles and qualities that characterize Indigenous cultural competence the result will be students and staff learning and bringing into their lives and practice, important Indigenous cultural understanding.

Background: Simulation allows students to practice key psychomotor skills and gain technical proficiency, fostering the development of clinical reasoning and student confidence in a low risk environment. Manikins are a valuable learning tool; yet there is a distinct lack of empirical research investigating how to enhance engagement between nursing students and manikins. Objective: To describe student perspectives of a layered, technology enhanced approach to improve the simulation learning experience. Educational Framework: Tanner's Model of Clinical Judgment underpins the entire curriculum. This study additionally drew on the principles of narrative pedagogy. Intervention: Across ten teaching weeks, five separate case studies were introduced to students through short vignettes. Students viewed the vignettes prior to their laboratory class. In the labs, manikins were dressed in the props used in the vignettes. Setting: The innovation was trialed in a second year core subject of a Bachelor of Nursing program in a large urban university in the autumn semester of 2014. Data Collection and Analysis: Following ethics approval, students were emailed a participant information sheet. A focus group of nine students was held. The discussion was digitally recorded and transcribed verbatim prior to being subject to thematic analysis. Students' comments (143) about the vignettes in their standard subject specific student feedback surveys were also considered as data. Results: Four themes were identified: Getting past the plastic; knowing what to say; connecting and caring; and, embracing diversity. The feedback indicated that these measures increased students ability to suspend disbelief, feel connected to, and approach the manikins in a more understanding and empathetic fashion. Conclusions: In addition to achieving increased engagement with manikins, other advantages such as students reflecting on their own values and pre-conceived notions of people from diverse backgrounds

This paper aims to explore women's experiences with healthcare providers to ascertain ways health care may be improved for women disrupted in their mothering. Women can find it difficult to relinquish care even when they are acutely unwell requiring hospitalization. Despite mothering being a priority for women, many healthcare professionals do not understand the importance of continuing to mother during maternal illness. This research used a qualitative methodology drawing on principles of feminism and storytelling. Women's stories were collected through face-to-face interviews, email and via the telephone. The twenty-seven women who participated were from either Australia or the USA, had between one and six children and identified themselves as having been disrupted in their mothering by illness. Data were collected in 2011 and were analysed thematically. The majority of participants had been hospitalized at some point in time for acute illness. A subset of participants reported feeling judged by nurses and that their efforts to continue to mother their newborn children despite their illness were misunderstood and not facilitated. Findings from this study suggest that women are more likely to remember times that health professionals failed to understand the primacy that mothering held for them or facilitate their efforts to continue to mother despite illness. Nurses and midwives should regularly reflect on their personal values in regard to mothering, validate women's attempts to mother to the best of their ability during illness and find ways to support and empower women in their mothering.

Previously there has been commitment to the idea that Indigenous curricula should be taught by Indigenous academic staff, whereas now there is increasing recognition of the need for all academic staff to have confidence in enabling Indigenous cultural competency for nursing and other health professional students. In this way, Indigenous content can be threaded throughout a curriculum and raised in many teaching and learning situations, rather than being siloed into particular subjects and with particular staff. There are many sensitivities around this change, with potential implications for Indigenous and non-Indigenous students and staff, and for the quality of teaching and learning experiences. This paper reports on a collaborative process that was used to reconceptualise how Indigenous health care curricula would be positioned throughout a programme and who would or could work with students in this area. Effective leadership, establishing a truly collaborative environment, acknowledging fears and perceived inadequacies, and creating safe spaces for sharing and learning were crucial in effecting this change.