http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:11436 In this age of technological competence and efficiency, the knowledge and skills embedded in caring practices are often overlooked. Phillips and Benner (1994) identified a 'crisis in caring' across our society, especially involving members of the helping professions, such as nursing. Caring is central to all helping professions and enables people to create meaning in their lives. Caring means that people, relationships and things matter (Benner & Wrubel 1989). 2012-09-04T03:06:55.553Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:11434 Client teaching and peer teaching are major aspects of nursing practice and important nursing roles. The Australian Nursing and Midwifery Council (ANMC) (2005) emphasises this in the Competency Standards for the Registered Nurse where it is stated that nurses must contribute to the professional development of others (Competency Statement 4.3) and educate individuals/groups to promote independence and control over their health (Competency Statement 7.7). Client education is multifaceted and involves promoting, protecting and maintaining health. It involves teaching about reducing health risk factors, increasing a person's level of well ness and taking specific protective health measures. 2012-09-04T03:06:11.764Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7089 Aim: This paper profiles a study that explored nursing students’ information and communication technology competence and confidence. It presents selected findings that focus on students’ attitudes towards information and communication technology as an educational methodology and their perceptions of its relevance to clinical practice. Background: Information and communication technology is integral to contemporary nursing practice. Development of these skills is important to ensure that graduates are ‘work ready’ and adequately prepared to practice in increasingly technological healthcare environments. Methods: This was a mixed methods study. Students (n = 971) from three Australian universities were surveyed using an instrument designed specifically for the study, and 24 students participated in focus groups. Findings: The focus group data revealed that a number of students were resistant to the use of information and communication technology as an educational methodology and lacked the requisite skills and confidence to engage successfully with this educational approach. Survey results indicated that 26 per cent of students were unsure about the relevance of information and communication technology to clinical practice and only 50 per cent felt ’very confident’ using a computer. Conclusion: While the importance of information and communication technology to student’s learning and to their preparedness for practice has been established, it is evident that students’ motivation is influenced by their level of confidence and competence, and their understanding of the relevance of information and communication technology to their future careers. 2012-01-30T05:02:50.565Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7385 This article presents the findings from a study examining midwives’ interactions with women who smoke in pregnancy. The aim of this study was to find out how midwives currently interact with women who smoke in pregnancy, in relation to the women’s health and wellbeing. The study used an interpretive interactionism design. There were two major findings: there is incongruity between midwives’ internal discourses and expressed discourses when working with women who smoke in pregnancy and smoking cessation advice interactions typically do not involve a dialogue. Smoking cessation advice interactions are predictable, monotonous and non-productive. This type of interaction is best understood as a game with set rules and roles. Midwives need a woman-centred discourse from which to engage in an effective dialogue with women who smoke in pregnancy. Recommendations for practice and education are discussed. 2012-01-30T04:59:11.339Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7386 Aim: This paper seeks to help midwives more fully understand smoking in pregnancy, particularly from a midwifery partnership perspective. Method: Using the midwifery philosophy of partnership as a framework for reviewing literature on smoking in pregnancy, we explored the literature on nicotine metabolism and addiction in general, and the changes that occur in pregnancy. Quit smoking interventions commonly used were examined to see if knowledge about addiction and the physiological adaptations of pregnancy are incorporated into anti-smoking efforts aimed at pregnant women. Results: Quitting is harder for the pregnant woman because the physiological adaptations of pregnancy increase the clearance of nicotine thus lowering nicotine levels and increasing the desire to smoke. Women who continue to smoke generally have fewer external sources of pleasure and satisfaction in their lives, which, when combined with the physiological and emotional challenges of pregnancy, means that they are less likely to quit smoking and remain abstinent. These factors do not appear to be taken into account for pregnant smokers. The concept of partnership between women and midwives during anti-smoking interactions is lacking. Conclusion: Midwives are in a position to support women and their families in all health related issues, including smoking cessation. We recommend that midwives ask permission before making enquires about sensitive issues such as smoking. When discussing smoking with pregnant women, midwives work within the philosophy of midwifery, with the emphasis on building trust and maintaining relationships. Great sensitivity is required and as much as possible the conversation should be a dialogue, not a monologue. 2012-01-30T04:59:11.268Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:8114 The following discussion builds upon a previous publication that reported on the perceptions and discourses of palliative care nurses and doctors in relation to nutrition and hydration at the end of life. The aim of this paper is to report the discourses of nurses and doctors in relation to the challenges they faced when managing the care of patients with severe brain injury vs. the clearer cut situations when caring for terminally ill patients with cancer. The objectives of the study were to explore the tensions in the discourses during end of life care, and explore the challenges regarding nutrition and hydration at the end of life. The decision to withdraw life support seems to be made more readily than the decision to withdraw nutrition and hydration at the end of life. The abatement of nutrition and hydration during the terminal phase of life is a controversial issue for a range of reasons. Indeed, whilst it is accepted practice in the palliative care setting, nurses and doctors often struggle with the idea. The design for this study used discourse analysis framed by a post structural framework. Focus groups were conducted with nurses working in palliative care units. Single interviews were conducted with doctors from a tertiary palliative care unit. The findings revealed contesting discourses involving quality of life and the prolongation of life. The provision of food and fluid has profound emotional and social meanings for patients and families. The study reported here examined these issues with health professionals. The findings point to the challenges and tensions faced by health professionals in relation to decision making and medical hydration during end of life care. The concern is that tensions arise when decisions need to be made and how best to make these. The contesting discourses for nurses and doctors when nutrition and hydration is ceased involve maintaining quality of life vs. the prolongation of life. Medical and nursing staff have different attitudes and beliefs towards end of life care. Tensions arise when decisions need to be made based on quality of life or prolongation of life. The successful merging of curative and palliative care is not without challenges. There has been little exploration of this situation. 2011-07-06T02:10:19.058Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:3715 The issue of medically administered nutrition and hydration (MN&H) at the end of life has generated public, professional and academic controversy in a number of countries. There is a dearth of published documentation of how hospice and palliative care services care for dying patients without routine recourse to these measures, as they almost universally do. This descriptive longitudinal study was therefore conducted to document practice and inform debate. Using grounded theory, it explored the experience of palliative care patients and families with regard to nutrition and hydration at the end of life. It shows that for dying patients there is neither an abrupt cessation of food and fluid nor any sign of suffering attributable to the decline in oral intake. Instead there is a gradual decrease in intake, and providing good mouth care is undertaken, patients do not suffer the ill effects of terminal dehydration. Family members in this study were, however, under the impression that any non-provision of fluid and nutrition would result in suffering for the dying person, indicating that there is an ongoing need for public education and family support regarding this aspect of palliative care. 2010-04-27T05:08:21.001Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:4587 The provision of medically administered nutrition and hydration (MNH) for the terminally ill patient is a controversial issue. A recent qualitative study in New South Wales explored palliative care nurses' and doctors' perceptions and attitudes to patient nutrition and hydration at the end of life. The researchers recommend developing clinical guidelines to ensure consistency in how issues of terminal dehydration for dying patients are managed. 2010-04-27T04:58:32.900Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5561 The provision of medically administered nutrition and hydration (MNH) for the terminally ill patient is a controversial issue and there has been much debate in the literature concerning this sensitive subject. This article reports on a qualitative research study that explores palliative care nurses’ and doctors’ perceptions and attitudes to patient nutrition and hydration at the end of life. Participants were from an urban and rural palliative care service. Three main discourses were identified: carers’ distress at the nonprovision of MNH; palliative care doctors’ and nurses’ position that terminal dehydration lessened the burden of suffering for dying patients; and polarisation between the acute care setting and the palliative care setting. Overlaying these three main discourses are contesting discourses involving cure vs comfort, and acute care vs palliative care. Importantly, the findings of this study reveal that palliative doctors and nurses believe that medically assisted nutrition and hydration at the end stage of life rarely benefits patients, and as long as adequate mouth care is given, patients do not suffer. However, family members do experience emotional distress in dealing with this situation. In caring for dying people, the nurse’s and doctor’s role is one of education and communication, involving a team approach to manage this difficult issue. 2010-04-27T04:45:55.770Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5123 The 1st National University of Singapore (NUS) and University of Hawaii at Manoa (UH) Conference: Advanced Practice Nursing in Multicultural Environments took place at the Alice Lee Centre for Nursing Studies in Singapore from 27-29 May 2008. The conference was attended by almost 200 nurses representing 19 countries. This paper reports on the keynote address and two plenary presentations from the conference. 2010-04-27T04:41:52.515Z ]]>