Nursing Online – November 2010

Research hub

The Australian Journal of Advanced Nursing continues to provide a vehicle for nurses to publish original research and scholarly papers about all areas of nursing. Papers develop, enhance, or critique nursing knowledge. All nurses have access to this excellent journal at

Reasons for entering and leaving nursing: an Australian regional study  
Robert Eley, University of Southern Queensland; Diann Eley, University of Queensland; Cath Rogers-Clark, University of Southern Queensland.

The objective of this research was to compare and contrast the reasons that nurses and nursing students provide for entering and leaving nursing.

Among the nurses, 88.4% were female and 37% 50 years of age or older. Almost half (45.3%) of the nursing students were 30 years of age or older and 44.1% of all students were working as nursing assistants or enrolled nurses while studying. Of these working students, 32.5% had been nursing in excess of five years. Self-interest, vocation and altruism were identified by both students and nurses as the main reasons for entering nursing. Respondents above and below 30 years of age gave the same reasons for entering nursing. Choice of factors for considering leaving nursing differed between groups and ages. Compared to students, nurses were most likely to cite disillusionment with nursing. Students under 30 years of age indicated pursuit of another career and starting a family to be the major factors while older students offered disillusionment with nursing and health concerns.

The authors conclude that retention strategies may need to differ for the age of nurse. However, recruitment needs to be informed by the altruistic and vocational reasons why nurses and nursing students are drawn to nursing rather than focusing on perceived generational differences.

Casualisation in the nursing workforce – the need to make it work
Susanne Becker, University of South Australia; Prof. Helen McCutcheon, University of South Australia; Prof. Desley Hegney, National University of Singapore.

The aim of this paper is to highlight some of the challenges faced by the nursing profession in response to increased casualisation of its workforce and why the presence of casualisation needs to be viewed in a positive light.

The care-giving responsibilities of a predominantly female workforce and the ageing of the nursing workforce worldwide means some nurses are choosing or need to work as casual employees in order to remain in the workforce. Historically, casuals have been viewed in a negative light, particularly in discussions around commitment and continuity of care. Without a change in attitude towards nurses who work as casuals, a significant portion of the nursing workforce may be lost.
An ageing nursing workforce, coupled with a worldwide shortage of nurses, means that employers need to ensure options are available to accommodate nurses requiring flexible rosters in order to encourage recruitment and retention. Policies are needed to ensure that all staff, regardless of their contribution in hours, feel valued and supported and are able to contribute to their profession. Maintaining a portion of the workforce in a flexible form will allow increased staffing options and ensure that sufficient experienced staff are available in order to maintain quality patient care and outcomes.

Nurse practitioners are well placed to lead in the effective management of delirium
Deanne Burge, North-east Health; Wendy Kent, Northeast Health; Jacqui Verdon, Northeast Health; Stephen Voogt, Northeast Health; Helen M. Haines, The University of Melbourne.

This article seeks to acknowledge the detrimental impact that delirium continues to have on an individual and at the system level in an Australian acute in-patient setting and highlight the potential role that Nurse Practitioners can play in evidence-based prevention and management.
Despite extensive literature and national policy-driven initiatives delirium continues to be a neglected iatrogenic condition for elderly people. A local investigation by Nurse Practitioner candidates in an acute care hospital setting highlights the poor recognition of the problem. Delirium management must be a key part of the scope of practice for the gerontological Nurse Practitioner. Recognition and management of delirium is problematic. Leadership and continuity of care using evidence-based prevention strategies; accurate diagnosis and treatment are important aspects of the gerontology of Nurse Practitioners’ (GNP) scope of practice.

Nursing education: reducing reality shock for graduate Indigenous nurses – it’s all about time
Allison Hinton, Palmerston Health Precinct, Northern Territory; Dr. Sharon Chirgwin, Batchelor Institute of Indigenous Tertiary Education, Northern Territory.

Since the decision to transfer nurse education to tertiary institutions in 1984, there have been many follow-up inquiries to assess if the issues around training, including the inadequate preparation for the stresses of work, had in fact been addressed. This paper aims to highlight a range of specific strategies explored and implemented during the delivery of a Bachelor of Nursing program in an attempt to improve the retention of Indigenous nursing students and to generate a more enhanced educational preparation for future nursing students.

Ten years after the transition from hospital-based to tertiary sector training, the 1994 National Review of Nurse Education in the Higher Education Sector, (presented by Reid et al), acknowledged that the undergraduate curriculum was constrained by the time demands required to cover clinical education and nursing subjects. The committee suggested that the (then) changing health care environment, and in particular the health care of Indigenous Australians, would necessitate an increase in time allocation in some schools of nursing. Lack of time should never be an excuse for failing to address student needs, such as the broadest possible exposure to, and repeated practice of, key clinical skills.

A nursing curriculum focused on incorporating maximum clinical practice hours both on and off campus; limiting the time between translating theory into practice; implementing intensive theory delivery and developing a hospital-based mentoring program provides solutions to reducing much of the reality shock experienced by new graduate nurses.