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The outbreak of coronavirus disease in 2019 (COVID-19) in Wuhan has led Chinese health authorities to recruit healthcare providers from the least-affected areas to provide care to the infected patients in Wuhan. We took further steps to explain some plausible reasons for their experiences. We used interpretative phenomenological analysis (IPA) to understand the subjective experiences, as well as the reasons for these experiences among the healthcare providers who had traveled from the least-affected parts of China to render aid during Wuhan’s COVID-19 outbreak. Using purposive and snowball sampling, healthcare professionals were recruited from three major hospitals in Jiangsu province. Semi-structured interviews were conducted from 1 September to 14 November 2020 in face-to-face contexts. Ten nurses and four doctors provided their informed consent for the study. The primary superordinate theme from the responses highlighted how social identity and individual needs were challenged by each individual’s professional ethics. COVID-19 not only presents significant risks to the health of nurses and medical doctors, it further challenges their emotional and psychosocial wellbeing. Care should be taken in allocating support and help, with the careful deployment of professional values and beliefs, so that any human resource as precious as medical doctors and nurses can be protected.

Background:Adult community nursing services are evolving around the world in response to government policies and changing patient demographics. Amidst these changes, recruitment and retention of community nursing staff are proving a challenge. An integrative literature review has identified multiple factors that influence nurse retention in adult community nursing with sparse information on recruitment factors. Although factors impacting retention of community nurses have been identified, their generalisability around the world is a challenge as they are context and co-dependent. Indicating the need for this area of study to be explored at a local level, as the same factors present with different findings globally.Aim:To establish factors influencing recruitment and retention of registered nurses in adult community nursing services.Design:Integrative literature review.Data sources:Four electronic databases were searched in August 2019 from January 2008 to December 2018: CINAHL Complete, Web of Science, MEDLINE and PROQUEST. Both qualitative and quantitative studies focusing on factors influencing community nursing recruitment and retention were included.Review methods:An integrative literature review methodology by Whittemore and Knafl (The integrative review: updated methodology. Journal of Advanced Nursing 52, 546–553) was followed, supported by Cochrane guidelines on data synthesis and analysis using a narrative synthesis method. The Center for Evidence-Based Management (CEBMa) critical appraisal tools were used for study quality assessment.Results:Ten papers met the study inclusion criteria. Data synthesis and analysis revealed individual and organisational factors influencing the retention of community nurses with the following three dominant themes: (1) work pressure, (2) working conditions and (3) lack of appreciation by managers.Conclusion:The review identified context-dependent factors that influence adult community nurses’ retention with limited generalisability. There is a lack of data on factors influencing recruitment into adult community nursing; further research is needed to explore factors affiliated to community nursing recruitment.

In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice. The findings based on student surveys indicated a statistically significant reduction in the overall level of caring behaviour in first to final year students. When compared with the findings of lecturers and nurses, less variance to lecturers than to nurses was found amongst the first years' score, and the lowest variance to nurses was demonstrated amongst the final year. A greater reduction was evidenced amongst Singaporean students, which was exaggerated with exposure to pre-enrolled nursing education and magnified with caring job experience. This study indicates more effort is necessary to harness student caring attributes in students' entire educational journey so that expressive caring is not subsumed in the teaching of students to meet demands of complicated contemporary care.

Caring is discussed within this chapter as a useful tool for embedding sustainability concepts into nursing education. Many nursing schools and faculties form an important part of higher education institutions and are significant contributors to the promotion of sustainability. When pressure for universities to pursue sustainable development increased, social and political changes were inevitable consequences. However, these pertinent changes have been perceived as attributes of poor nursing care in some parts of the world. Entangled with this conception, nursing care continued to be subsumed by the driving or restraining forces of social and political changes. Consequently, nursing education may not necessarily be informed by sustainability concepts. Instead of allowing the near absence of sustainability concepts in nursing education, this chapter discusses the need for shared beliefs and values of caring in nursing to promote student nurses’ awareness of the need to care beyond patients’ bedsides. It does so by exploring the potentials for a reconceptualised caring concept to advance student nurses’ learning of sustainable development.

Background: The continued use of high fidelity full sized human patient simulation manikins (HF-HPSMs) for developing decision making skills of nursing students has led to growing research focusing its value on student learning and decision making skills. Methods: In October 2012, a cross-sectional survey using the 24-item Nurse Decision-Making Instrument was used to explore the decision making process of 232 pre-registration nursing students (age 22.0 + 5.4; 83.2% female) in Singapore. Results: The independent samples t-tests demonstrated three significant predictive indicators. These indicators include: prior experience in high fidelity simulation based on pre-enrolled nursing course (t = 70.6, p = .001), actual hands-on practice (t = 69.66, p < .005) and active participation in debrief (t = 70.11, p < .005). A complete experience based on role-playing followed by active discussion in debrief was a significant contributor to the decision making process (t = 73.6667, p < .005). However, the regression model indicated active participation in debrief as a significant variable which explained its development (t = 12.633, p < .005). Conclusions: This study demonstrated the usefulness of active participation in simulation learning for an analytic- intuitive approach to decision making, however active participation in debrief was a more important influencing element than role-playing. In situations where resources are limited for students to experience hands-on role-playing, peer reviewing and feedback on others’ experiences could benefit students, just as much. However, further study is warranted to determine the development of HF-HPSMs as a pedagogic tool for enhancing the decision making process of nursing students.

Background: The importance of interprofessional learning to provide quality patient care has resulted in the increasing use of asynchronous computer mediated conferencing in healthcare programmes within universities. The asynchronicity based on typed-written discussions in a virtual learning environment which provided flexibility in learning was used to increase opportunities for nurses and other allied healthcare professionals to participate in interprofessional learning in higher education. However, successful online learning relies on discursive practices in the virtual learning environment, embedded within discursive exchanges in practice are power relations in nursing language use; which had a negative impact on interprofessional learning and working relationships amongst nurses, between nurses and other allied healthcare professionals. This paper presents an analysis of the discursive practices of registered nurses in interprofessional learning based on asynchronous computer mediated conferencing. It aimed to ascertain if power relations were implicit in nursing language. Methods: Fairclough’s critical discourse analysis was used to analyse eight hundred and ninety typewritten online messages created in a 100% text-based online learning module at Master’s level in a University in North England between September 2004 and September 2009. Although the messages were created by 9 registered nurses and 4 other allied healthcare professionals undertaking interprofessional learning to learn about the issues surrounding e-learning in healthcare settings, this paper is part of a larger study focused on the messages by the nurses. Results: Nurses’ messages tended to appear as the first few responses in the discussion threads and their language was formal and objectifying. The genres resembled those found either in written assignment within higher education or in nursing documentation within practice. The virtual learning environment was an alternative social space for clinical practice where dominance of nurses was created, maintained and reinforced. Conclusions: Existing literature highlighted the incidents of problematic issues of interprofessional learning. In contrast, this paper explains the way nurses, through discursive practices, construct themselves in relation to their nursing and allied healthcare colleagues. Nurses need to be aware of the power-relations embedded in their language use and future research could usefully focus on the discursive aspect of interprofessional learning.

Summary Aims This study explored the perceptions of clinical nurses about their research knowledge and experiences to highlight any gaps in nurse education in supporting research activities in healthcare organisations. Background Nurses' research activities have been encouraged by moving hospital-based nurse education into higher education institutions whereby there is a stronger emphasis on teaching and developing nursing research at both undergraduate and post graduate levels. They were further encouraged by the introduction of advanced nurse practitioner roles, in the hope to increase opportunities for research participation. Whilst nurses' research activities have been explored in many countries, nurses in Singapore where there is a strong emphasis on evidence-based practice have not been investigated. Methods A mixed-methods exploratory descriptive design, using a questionnaire based on open and closed questions was employed to obtain the views of clinical nurses about their capacity and organisational support in conducting research. The questionnaires were distributed to convenient samples who attended one of the 4 research seminars held on separate occasions between July and August 2011 in Singapore. Results A total of 146 nurses were recruited. Whilst nurses demonstrated strong enthusiasm in conducting research, this characteristic feature was not adequate for them to embrace a research culture in organisations. Active participation as co-investigators was not possible in healthcare organisations where skewed distribution of resources towards medical and nurse researchers was perceived. Conclusions The results suggest a need for a significant shift in focus on educational training from imparting research contents to providing opportunities to experience the research process. Organisational support in terms of protected time and financial support ought to be in place for nursing research experience. The findings also demonstrated that in places where organisational support was available, awareness of research opportunities such as educational and organisational support needed to be strengthened. This in turn would enable more nurses particularly those who provide direct patient care to conduct research within the context of the competing nursing practice demands.

Background: There is an increasing important role for asynchronous text-based computer mediated conferencing as apedagogic tool in interprofessional learning for nurses in higher education. Available research studies on asynchronoustext-based interprofessional learning at post-registration level based on either users’ perspectives or the conferencecommunication provided useful information on students’ learning experience. This paper first discusses the theoreticalassumptions of asynchronous text-based interprofessional learning. The purpose is to highlight the way student onlinelearning experience might be created. Based on this knowledge, the paper goes on to describe and discuss the researchmethodologies and methods, with less emphasis on the kind of results that have been obtained in the field of study aboutasynchronous text-based interprofessional online learning within nursing education at post-registration level. Methods: The literature search focuses on papers which investigate student perspectives on the experience oneffectiveness of asynchronous text-based interprofessional online learning. Criteria for inclusion were papers about the useof computer mediated conferencing at post-registration level for interprofessional online learning by nurses and healthcareprofessionals allied to health. Results: Reviewing the body of research about student perspectives on post-registration students’ experience withinterprofessional online learning revealed that asynchronous text-based conferencing at post-registration healthcareprogrammes which involved nurses had received insufficient research attention in nurse, health and social educationresearch literature. Only seven papers were available for review. In addition, the research methods and approachesemployed have not been consistent with the pedagogic principles and ideas associated with principles of collaborativelearning through communication based on constructivism. Conclusion: Research studies to inform strategies for asynchronous text-based interprofessional online learning in postregistrationnurse education might be limiting. There is a need for more research, especially those which commensuratewith the constructivist approach in learning. Certainly, research using discourse analysis which focuses on the discursiveaspect and communication needs to be conducted to evaluate asynchronous text-based interprofessional online learning.

Context: Escalating healthcare demands combined with diminishing resources underline the importance of ensuring nurses in leading roles, having the capacity to conduct evidence-based research to inform practice. Aims: This study explored the perceptions of research knowledge and experiences of nurses in administrative, teaching and clinical specialist positions to highlight gaps in research provision within educational institutions and healthcare organisations in Singapore. Design/Methods: A mixed-method exploratory descriptive design, using a questionnaire with open and closed questions was employed to obtain the views of nurses on their capacity in conducting research. Convenience sampling was employed in 3 research seminars in Singapore between July-August 2011. Results: Forty seven nurses were recruited and they confirmed good research knowledge and skills but indicated the need for enhanced educational preparation and organisational support to fully embrace a research culture. Conclusions: Research in nursing requires prioritisation and support in educational training and healthcare settings. Otherwise, conducting research would continue to be a lesser priority for nurses, even if they were in teaching or clinical positions which provided significant opportunities to lead or facilitate research. Given that role modeling enhances research culture in nursing, within education and clinical settings, nurses in leadership positions require confidence in conducting research. However, without prioritising research, and filtering this down through the nursing hierarchical system to promote a research culture, new knowledge to improve practice will remain elusive.