Nursing Online – August 2010

AJAN update The Australian Journal of Advanced Nursing continues to provide an excellent vehicle for nurses to publish original research and scholarly papers about all areas of nursing.

Development and validation of a novel approach to work sampling: a study of Nurse Practitioner work patterns
Glenn Gardner, Anne Gardner, Sandy Middleton, Michelle Gibb, Phillip Della, Christine Duffield

This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of Nurse Practitioners’ work patterns. Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of Nurse Practitioner work activities across diverse contextual and clinical service models.

The study is part of a large funded study into Nurse Practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of Nurse Practitioner service.

Development and preparation of a new approach to describing Nurse Practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner services.

Nursing resource implications of the unoccupied bed
Bronwyn Collins, Lesley Fleming, Bette-Anne Hine, Johanna Stephenson, Kate Veach, Sue Anderson, Tim Mawson, Joan Webster

The aim of this research was to explore the specific factors that impact on nursing resources in relation to the ‘unoccupied bed’. A descriptive observational study was used to identify and classify tasks associated with an ‘unoccupied bed’.

Four project nurses held informal discussions with all levels of staff in four divisions of the hospital (surgery, internal medicine, cancer care and women’s and newborn). Field notes were made throughout the process and the project nurses met regularly to compare findings and identify similarities.

This study identified three main areas of nursing work that centre on the ‘unoccupied bed’: 1) bed preparation for admission; 2) temporary transfer; 3) bed preparation post patient discharge.

The researchers concluded that the unoccupied bed is not resource neutral and may involve considerable nursing time. The time associated with each of the reasons for the bed being unoccupied remains to be quantified.

Trends in workplace violence in the remote area nursing workforce
Tessa Opie, Sue Lenthall, Maureen Dollard, John Wakerman, Martha MacLeod, Sabina Knight, Sandra Dunn, Greg Rickard

The aim of this research was to assess incidence of workplace violence in the remote area nursing workforce and to compare present data to data collected 13 years previously. The research adopted a cross-sectional design, using a structured questionnaire.

The main outcome measure was post-traumatic stress disorder (PTSD) symptoms, as assessed using the PTSD Checklist (PCL). Findings indicate increases in all incidents of reported violence in the workplace between 1995 and 2008. Verbal aggression, property damage and physical violence are the most frequently experienced forms of violence as perpetrated directly towards remote area nurses, with statistically significant positive correlations between all types of workplace violence and PTSD symptoms.

Verbal aggression, physical violence and property damage are the most commonly witnessed forms of violence occurring between other people. Statistically significant positive correlations were also found between each type of witnessed violence and PTSD symptoms, excluding sexual abuse/assault. Nurses working in very remote regions in Australia are fearful for their personal safety.

The researchers conclude that working in fear for your personal safety can function as a major occupational stressor. The research has implications for the implementation of workplace policies that target the identification, management and prevention of violence in the remote area nursing workforce.

Historical imagination and issues in rural and remote area nursing
Pamela Wood

Using issues in rural and remote area nursing as the example, this paper explores how nurses can use their historical imagination in considering professional issues today.

Historical imagination is the creative capacity to imagine possibilities of engaging with the past. Historical imagination in nursing has the potential to help nurses address current professional issues. Points of familiarity with the past can show nurses which issues are enduring and which are transient. A sense of familiarity can bring strength, encouragement and comfort.

Points of difference can show nurses that problems are not necessarily permanent or can be dealt with differently. This paper uses aspects of the history of bush nursing in Australia to illustrate how nurses in rural and remote area nursing today could use their historical imagination in addressing current issues. It explores points of familiarity and difference between issues faced by bush nurses in the past and current issues in the international literature. Ways of using historical imagination in rural and remote area nursing recruitment are considered to illustrate the process.

As the example of engaging with the history of bush nursing in Australia attempts to demonstrate, nurses can use their historical imagination to identify points of familiarity and difference with the past to prompt a shift in thinking and strengthen creativity in addressing current issues.