Nicole Coombs

501 Defluffing the ‘fluffy’ subjects: A theoretical nursing course conversion for undergraduates

Introduction

This presentation demonstrates one way that has successfully ‘defluffed’ what could have once been considered a ‘fluffy’ subject by undergraduate nursing students – often considered less appealing or of less value compared to the clinical courses within their nursing degree.

Background

In 2016, staff at the Federation University Australia, using a new Blended Online and Digital (BOLD) curriculum,   transformed the 1st year Determinants of Health course. Teaching practices changed using the new BOLD principles, including flipped classrooms, active learning sessions and a flexible student delivery mode, as well as the introduction of regular fieldwork practicum and associated assessment tasks. Student engagement and participation in this course was rejuvenated. Students were able to apply the theoretical knowledge, from both face to face teaching and the online content, to practical tasks and assessments such as, completing foot surveys and interpreting real epidemiological data from their own communities, allowing them to see their learning in real terms. This learning scaffolds into the 2nd year Health Promotion and Illness Prevention course.

Student feedback showed the change in course delivery was well received, identified what students wanted to achieve from this foundational nursing knowledge, and how they want to see it applied for assessment. Overall, the transformation has been a joint adventure for both students and teachers, which has hopefully given this traditionally ‘fluffy’ theoretical subject a new and exciting life in undergraduate nursing education.

Key words: ‘fluffy’ subjects, fieldwork, BOLD (blended online and digital), undervalued theory

Erin Wakefield

502 – Perioperative nursing simulation – the why, the how, and the results

Introduction
Simulation-based team training is an invaluable tool for the learning of Technical Skills (NTS) in a high risk environment.  Simulation of emergency events in the clinical environment gives the teams an opportunity to practice requisite psychomotor skills and knowledge, as well as communication and leadership acumen.

Background
Research shows that 70% of adverse events in the operating suite can be traced back to ‘human factors’ (NTS).  The Elaine Bromiley case supports the importance of these factors in maintaining patient safety in the perioperative environment.

Following consideration of this case, the author questioned how awareness of NTS was addressed in their workplace. There was minimal, introductory information provided to new perioperative nurses, and none at all to the regular cohort of experienced staff.  Identification of lack of information around NTS led to the development of a structured multidisciplinary simulation program to address the shortfall.

Results
The presentation will describe the use of regular in-situ simulation for the practice of infrequently occurring events in the workplace, including the barriers and enablers to this work. Additionally, the importance of creating a psychologically safe learning environment in simulation based education to enhance learning will be described.  The outcomes related to the use of regular in-situ simulation to improve nurses’ confidence in knowledge and practice of NTS will be presented.

Conclusion
By creatively utilising simulation technology to empower nurses with confidence, knowledge and NTS application emergency situations, it is envisaged that patient outcomes will be ultimately improved.  This work may inspire other nurses to explore the potential for simulation-based education in their facilities.

Key words: Simulation; nurse empowerment; education.

Rachel Marshall

503 –  Can two become one? The tale of merging two hospitals

Introduction and background

In 2010 the decision was made to develop a purpose-built facility for the rehabilitation of older people in Canterbury, New Zealand. This initiative was fast-tracked by the earthquake events of 2010/2011. In June 2016, seven Older Person Health wards from The Princess Margaret Hospital migrated to a new facility on the Burwood Hospital Campus. In this presentation we will discuss the metamorphic process we undertook through planning, preparation and ultimately moving from one hospital site to another and our role as hospital-based Nurse Educators supporting this transition.

Planning and preparation involved the merging of nursing education delivery for the two hospital sites before the move. Education commenced more than two years prior and focused on socialisation, loss and grief, the impacts of change and working together within new models of care.

We were also tasked with transitioning almost 1000 nursing and other personnel to the new facility. This process included orientation and familiarisation to the new environment, emergency procedures and training on new equipment as well as  embedding new ‘ways of working’ guided by the agreed design principles and models of care.

In this presentation we take you on our journey of reflection: on what worked well, what challenged us, and what we would do differently if we had to do it all again.

Key words: transition; transformation; reflection.

Becky Conway

504 – Thou shalt neither bamboozle nor bore: Transforming foundational education in child health

Introduction
Child Health nursing is a broad specialty area. Nurses who make the transition to this specialty in an acute hospital setting participate in a three-day foundation course.

A re-design of the course using the New Zealand Child Health Nursing Knowledge and Skills Framework lead to transformation in content, delivery and outcomes.

Background
An original foundation course aimed to equip nurses with ’appropriate education in generic aspects of Child Health nursing’ Following the launch of a new knowledge and skills framework, educators saw an opportunity to redevelop the course with a new aim: to improve health outcomes for hospitalised infants, children and youth. The framework’s four aspects of care: context, pathophysiology and psychopathology, assessment, and intervention, were used to restructure the content with surprising results.

Results
The emphasis on context of care re-focused content onto the child and family rather than paediatric pathology. More emphasis was placed on communication, legislation and the environment in relation to family health care. Levels of nursing practice described by the framework helped educators to correctly pitch information, neither bamboozling participants with unnecessarily complex content nor wasting their time with previously learned material.  Not only did the framework help to guide course content, but it also provided a tool for participants to demonstrate newly acquired knowledge through case presentation.

Conclusion

A knowledge and skills framework can be left to gather dust, or it can be put to work to transform education and make a significant improvement to the health of a population group.

Key words: Paediatric; orientation; knowledge; skills.

May El Haddad

505 –  The time is now to define graduate nurse practice readiness

Despite the considerable reform in nursing education, the debate regarding Graduate RN (GRN) practice readiness is ongoing. This debate is in part, reflective of a difference in opinion between nurses in education and practice sectors, as to whether recently graduated RNs are in fact practice ready. But what does practice readiness mean?

In order to understand this longstanding debate, a Grounded Theory study examined the phenomenon of practice readiness from the perspectives of nurse unit managers (n=7 NUMs) from the acute care practice sector, and Bachelor of Nursing program coordinators (n=9 BNPCs) from the education sector. Semi-structured interviews were used to collect data following ethical approval. The process of constant comparative data analysis resulted in the emergence of the theory Practice Readiness: A Nebulous Construct.

Findings suggest that as a result of contextual influences and varying system drivers, BNPCs and NUMs in Australia inhabit disparate realities. When it comes to practice readiness, these cohorts view new GRNs through different lenses and as such, have different perspectives and expectations of GRNs. Practice readiness is indeed a nebulous concept as it means different things to different people. These findings have implications for policy, education and practice to consider a new world where all stakeholders involved in preparing the future nursing workforce have an equal say and a shared understanding of what practice readiness means. Perhaps it is time to define what it is that we mean by practice readiness or the debate will continue for many more decades.

Key words: Graduate nurse; practice readiness; fitness to practise; transition to practice.

Mary McMillan

506 – Direction and delegation: Does evidence and policy optimise NZ registered nurses contemporary practice?

Introduction
The purpose of this presentation is to describe, using an auto ethnographic narrative methodology New Zealand Registered Nurses (RN) guidelines, policy, and relevant evidence-based research on Direction and Delegation. This presentation explores the relevance of Direction and Delegation to the contemporary changing and diverse clinical settings and roles that RN’s inhabit.

Background
Auto ethnography is an analytic research method (Denzin, 2014) focusing on enhancing theoretical understandings of broader social phenomena, and their processes. This method is suited to exploring everyday commonalities of human phenomena. It studies cultures through close observation, reading, and interpretation. Ethnographic researchers work ‘in the field’, and are of, and in, the culture they study.

Results
The approach focuses within multiple nursing settings and practice; including working in clinical inpatient, community, nursing education, teaching direction and delegation to baccalaureate students and observation of the students understanding of such. There is a need for further support, direction, focus on the complexity of settings and clarification of RN’s practice. This is to optimise safety for practicing nurses and nursing baccalaureate students.

Conclusion
There are rapid changes in the NZ Health Strategy which present a unique opportunity for further research, discussion and review of current guidelines in order to concurrently address and meet the future needs of RN’s working in multiple practice settings. It is imperative that this research be ongoing in order to transform nursing practice. Your contribution in this presentation is essential for the practice of nurses needs to be future focused and contribute to the evolution of nursing.

Key words: Direction & delegation, contemporary practice, environmental context, registered nurses

Kiri Hunter

507 Into the wild: new graduate nurses’ experiences of professional socialisation in clinical practice

Introduction
International literature has highlighted the critical importance of how professional roles within the culture of nursing are learnt.  The reality is that the messages revealed in the language and strategies used by role models, and culturally prescribed rules and standards, can contribute positively or negatively to the learning experience.  This presentation will outline the results of a study which explored new graduate nurses’ experiences of being socialised into the profession by registered nurses in clinical practice.

Method
Data collection was carried out through semi-structured interviews, then a general inductive approach was used to guide analysis.  The meaningful descriptions gained through the use of qualitative descriptive design provided valuable insights into the experiences of the five new graduate nurse participants.

Results
Three main themes emerged including: Lessons from the wilderness; Life in the wild; and Belonging to a wolf pack.  Findings highlighted that despite encountering a range of professional behaviours, attitudes, and dilemmas the new graduate nurses were capable of being moral agents and thinking critically.  However, these nurses rapidly became swept up in the acculturation process and had to adopt different strategies to cope.

Conclusion
Tensions in clinical practice need to be understood and overcome if moral distress caused by dissonance between expectation and experience is to be avoided.  The responsibility of creating a supportive learning environment lies not only with formally recognised educators and leaders, but with all clinically based registered nurses.  This study offers a number of strategies to actively support professional socialisation and ultimately, the development of a new nurse’s professional identity.

Key words: Professional socialisation, clinical practice, registered nurses

Jenny Song

601 – Ethics education in nursing: Now more complicated than ever

Introduction

Nurses face ethical challenges in their everyday practice. Difficulties getting to know ‘right’ from ‘wrong’ can result in moral distress of nurses. Nursing educators have acknowledged the critical importance of having an ethical component taught throughout the nursing curriculum in order to promote nursing students’ ethical awareness. Yet for all of this, there is very little New Zealand research available that explores what experiences and challenges nursing educators faced teaching such content.

Background

A case study of teaching nursing ethics in a New Zealand tertiary education context was therefore conducted and seven nursing educators were interviewed to ascertain their experiences of teaching ethics to trainee nurses. One of the major difficulties identified was the friction between a culturally specific perspective and universalist one where hard-and-fast principles or codes dictated ethical practice.

Results

As the interviewees agreed, the challenge in teaching ethics lies in the changing context of nursing, and the changing context of ethics itself.

Conclusions

Despite such hurdles, the nursing educators in this study were confident teachers who all had positive experiences in teaching ethics to their students.   That ethics be integrated throughout the whole nursing programme using textual narratives was a further point of consensus.

Keywords: nursing ethics; nursing education; case study

Alison Saunders & Sue Ganley

602 – Perfect practice makes practice perfect

Introduction and background

This presentation will describe the learning opportunities in 3D simulation.  NurseSim is a hands-on internet-based program that allows students to embed themselves into a virtual world of clinical practice.  The learning of a student is enhanced through the “see, try, and apply” model of the simulation.  Learners are first shown (see), then guided through (try) and then asked to carry out (apply) procedures that follow industry best practice.

Students from across the State are viewing and using consistent workplace best practice as their learning tool.  NurseSim allows students to practice and improve skills at home on their devices prior to on-campus practical workshops and clinical placements.

Lecturers report that students are arriving better prepared for clinical workshops, are more able to recall clinical practices and ask more informed and deeper questions. Students report they feel better prepared for clinical practice weeks and have a bank of knowledge to draw from when discussing the application of the clinical skills in a workshop setting.

The inclusion of 3D simulation has allowed for students to develop higher order thinking and a sense of enquiry whilst attending the clinical simulation workshop and enriching their learning experience. Students can also reinforce and perfect their skills at home at any time after on-campus workshops, and before or during clinical placements in a rich 3D environment.

An analysis of student experience and outcomes and the impact on lecturers and the classroom experience will be presented.

Key words: Clinical simulation, 3D simulation, NurseSim, higher order thinking

Nicky Davies

603 – Learning the RN role in aged residential care – the impact upon 3rd year nursing students’ attitudes

Introduction

By 2050 approximately two billion people, worldwide, will be aged 60 plus. A seemingly longstanding negativity that surrounds gerontological nursing as a planned career choice for undergraduates means that fewer graduates actively choose to work with older people.  Research suggests that interest in aged residential care (ARC) as an RN graduate placement is strongly influenced by undergraduate education and clinical placements, which are currently limited. ARC is a less preferred option for RN graduate nurses in their first year of practice.

Currently there is no New Zealand data that explores the attitudes of 3rd year nursing students towards the role of the RNs working in ARC. Implementing a 3rd year clinical placement that focuses on the role of the RN in aged care will allow for investigation of this issue.

Background

This pilot study uses a qualitative approach exploring the experiences of six nursing students, in the 3rd year of their BN programme, during an aged care clinical placement with a focus on the role of the RN. Data was collected via a focus group before and after placement, along with one individual semi-structured interview per participant.  Data collected was then reviewed using thematic analysis.

Ethical approval for this project was obtained from ARA institute.

Key words: Aged residential care, RN role, nursing attributes