Nursing Online – April 2008

This month The Lamp begins a review of original research and scholarly papers about nursing. We begin with a selection of papers available on the Australian Journal of Advanced Nursing website (, produced by the ANF.

The impact of shiftwork on people’s daily health habits and adverse health outcomes
By Isabella Zhao, RN, BN (Hons), School of Nursing, The University of Queensland, Australia; and Catherine Turner, RN, BA, Grad Dip Ed, MN, PhD, Associate Professor, School of Nursing, The University of Queensland, Australia.

This paper reviews the published scientific literature for studies that analyse the association between shiftwork and people’s daily health habits as measured by diet, exercise, smoking or alcohol consumption and adverse health outcomes such as obesity.
The paper finds that shiftwork impacts negatively on daily health habits and can lead to adverse health outcomes such as a poor diet, smoking and becoming overweight. It concludes that, with a majority of Australian health care workers (in particular nurses) working rotating shifts, a greater understanding of the impact of shiftwork on our health care workforce is needed.

Income inequality and health status – a nursing issue
Peter Massey, RN, Grad Cert PH, Clinical Associate College of Nursing, Clinical Nurse Consultant, Program Manager Health Protection, Hunter New England Area Health Service, David Durrheim, BM, BS, Dip Tropical Medicine and Hygiene, Dip Community Health, Masters Public Health and Tropical Medicine, DrPubHlth, Fellow Australasian College of Tropical Medicine, Fellow Faculty Travel Medicine, Fellow Australasian Faculty Public Health Medicine, Service Director Health Protection, Hunter New England Area Health Service,

The future legitimacy and success of public health nursing depends on recognizing and appropriately addressing the social, economic and political determinants in the population served. There is an incontrovertible association between population health status, absolute income levels and income inequality. Income differentials must be a fundamental consideration when planning and delivering nursing services according to the authors.
The aim of the paper was to review the association between income inequality and health status, and consider an appropriate nursing response.

Determinants of burnout among public hospital nurses
By Dr Rebecca Spooner-Lane, B.Beh.Sci, BA(Hons), PhD, Lecturer, School of Learning and Professional Studies, Queensland University of Technology; and Professor Wendy Patton, B.Ed, BA(Hons), PhD, MAPsS, Head of School, School of Learning and Professional Studies, Queensland University of Technology.

This study extends our knowledge of the main determinants of burnout among nurses working in public hospitals and investigates the impact of work support on the stress-burnout relationship.
Overall, nurses reported moderate levels of burnout – emotional exhaustion, depersonalisation, and reduced personal accomplishment. The authors argue the results highlight the need for organisational interventions to reduce the workload placed on nurses.

Returning to nursing after a career break: elements of successful re-entry
By Janet Long, RN, BSc (Hons), Grad Cert Nurs (Clinical Studies), MRCNA, Eye Outpatients and Emergency, Sydney Hospital and Sydney Eye Hospital; and Sandra West, RN, CM, Int. Care Cert, BSc, PhD, MRCNA, Associate Professor of Clinical Nursing, Faculty of Nursing and Midwifery, University of Sydney.

The aim of this paper was to survey the literature to identify the special needs of the re-entry RN and suggest elements of a successful re-entry recruitment, training and retention policy.
The typical re-entry RN is a 40-year-old female with school-aged children. The authors say she may be unaware of re-entry opportunities in her area. She wants family-friendly shifts and an acknowledgement of family responsibilities. She wants a paid on-the-job refresher course that is relevant and that guarantees future employment as well as ongoing support to help over come anxiety and loss of confidence.

Promoting quality care for older people in meal management: whose responsibility is it?
By Julie Crack, RN, BN, MCN, Aged Care Consultant, The Park Group, Launceston, Tasmania; and Geoff Crack, RN, RM, BA (Hons), Lecturer, School of Nursing and Midwifery, University of Tasmania

The authors examine the role of registered nurses and allied health workers in meal management, assessment, safe environment and care planning for older people in residential aged care.
They argue that nurses and carers are often the first to observe and put into place strategies to prevent choking in residents with swallowing difficulties. Coroners have raised issues with regard to the role of the RN, resident autonomy and the effectiveness of speech pathologist assessments in avoiding incidents that compromise resident’s health and well being.
In the area of meal management, nurses are struggling to have their expertise and knowledge recognised and need to develop strategies to articulate and demonstrate their contribution to meal management.