Soap Box
Your say about nursing issues
Susan Tregoning
School of Nursing and Midwifery, University of South Australia, SA
PP: 089 - 092
Article Text
Enrolled Nurse Education
Peter Berry RN, RM, Orth Cert, BEd (Nsg Studies)
I wish to share concerns for the future of quality, cost-effective nursing care provided by enrolled nurses.
Enrolled nurses are valuable members of the nursing team and need to have an educational preparation to enable them to adjust to changes to health care. These pre-enrolment needs in time may be provided fully by DTAFE (Department of Technical and Further Education), the tertiary sector, or remain hospital-based. It may be a combination of some or all of the approaches.
It is interesting that in the publication 'Hospital and Health Care', October 1991 (Volume 22(10)) an article reads; 'Sydney's Prince Henry and Prince of Wales Hospitals recommenced training enrolled nurses last year'. A concern is that the eastern state has TAFE conducting enrolled nurse courses, so why are they re-commencing hospital-based programmes and in large acute hospitals?
Whoever conducts the programme needs to ensure that an appropriate balance and integration of theoretical and clinical experience is made. The curriculum should promote a flexible approach towards teaching, learning and assessments, thereby ensuring competent enrolled nurses. From this one may hope that the programme-based institution is one which exposes nursing students to other facets of health education.
The lectures/educators need to have a 'working knowledge and understanding' of the 'art and science' of nursing and of the health care system. They will hopefully be able to assess competencies and be competent themselves in establishing and maintaining credibility with the students.
While we still have enrolled nurses in our current nursing labour-force, let's make the right decisions for provision of optimal health-care.
How Nursing Research Resolved My Professional Identity Crisis
Anne Fry RN, RM, M Litt
You might wonder how a nurse can have a professional identity crisis. It's easy! If you trace the career path of most nurses you will find a multitude of professional experiences. My clinical career went from general to psychiatric nurse, community psychiatric nurse to community project officer. My academic path went from tutor to lecturer and the acquisition of two pieces of paper that could open a different career door altogether. Which then, of these valuable components of my career are salient now?
The answer is all of them because they enhance my ability to pursue nursing research. Now I have a new set of questions. Who does it? What are the gaps between practice, theory and education? Which aspects of nursing practice need observation, prediction and understanding? What are the priorities in nursing research that will best enhance the knowledge base and practice of nursing in Australia? The seven nursing research priorities set in the USA are; AIDS, low birth-weight infants, long-term care, symptom management, information systems and the effects of technology on care.
Some of these queries will be resolved if we agree with Professor Alan Pearson when he states that nurses should research whatever it is that nurses do best. Nursing research is about the process and the concerns of nursing. What is it that is unique to nursing? It is up to clinicians and academics in collaboration to seek the answers. I am a Nurse.
Nurses for Peace and the Environment
Anne Both RN, RM, Dip T (N Ed), B Nsg (Ed), Grad Dip (Health Ed), Cert TEFOL
Never heard of us? I wonder why not as we have been on the scene in South Australia since September 1985 when the group was formed as a special interest group of RANF (now ANF) under the name of Nurses for Peace engaging in political lobbying, letter writing, organising and attending seminars on peace issues, participating in rallies and presenting proposals at RANF Conferences. Since disaffiliation with the ANF at the request of nurses who expressed interest but who were not ANF members and were unable to become members of NFP, the group has broadened its perspective and its philosophy to incorporate concern for the environment, believing that the concept of peace is inextricably linked to that of environment. Thus NFPE came into being. The group is now affiliated with the Australian Peace Committee and the Conservation Council of SA.
Why did we come together in the first instance?
We were concerned about the proliferation of arms in many parts of the world, especially nuclear arms with their potential to destroy and their long-term effects on the environment. We were concerned about the allocation of funds to non-peaceful activities such as the arms trade to less developed countries many of which were suffering extreme health problems and social injustice as a result of war. And we were also concerned at the creation of Australia as a target in any war in which it might become involved as an ally of the United States of America through the existence of the Pine Gap and Nurrungar early warning systems.
Why should nurses become involved in such matters?
The reasons are twofold. First the 'dangers of nuclear war and nuclear accidents constitute an unprecedented threat to the health and well-being of the human race and second, the money invested in defence is often at the expense of health and community services. An example of this second point was the spending by the military worldwide in 1981 of one million per minute. Two minutes worth would vaccinate the 5 million children who die each year from preventable diseases.
At the inception of the group, a nucleus of members worked towards peace promotion at personal and national levels. Although membership has changed, a nucleus of members remains to carry the banner and to keep the concept of peace before the profession. We aim to remind nurses in particular that anything which endangers health and well-being requires intervention by health professionals and it is our belief that nurses have a professional obligation to engage in activities which promote health and prevent such wholesale calamities as war and the violent resolution of conflict. It is also our belief that peace is grounded on the principles of social justice, responsible use of resources and protection of the environment, locally, nationally and globally. To this end, we support the actions of others who seek to change government policies through lobbying and direct action. We participate as much as possible in the Palm Sunday and Hiroshima Day Rallies, protests at Parliament House and peace demonstrations such as occurred in response to the Gulf War. Additionally, we are involved in petition signing, letter writing and networking with groups such as Conservation Council of SA with whom we are affiliated. We strongly believe that nurses must be prepared to exercise their political voice to ensure that scarce financial resources are allocated to areas of need to redress social injustice, and that these not be squandered on the provision of armaments which have the potential to devastate peoples lives, health and to perpetuate the status quo.
Recently our philosophy has seen us become more involved in matters related to the environment for example, responding to requests for comment on such issues as the Multi Function Polis, 2020 Vision, Contaminated Land issues, Toxic Waste Management and recycling. We act as an advisory group on issues related to peace and the environment for the ANF and provide comment on health aspects of these issues to other groups.
Without peace, there will be no future worth contemplating or ability to plan for ourselves or our children. 'Every armament made, every warship launched, every rocket fired signifies in a final sense a theft from those who are hungry and are not fed, who are cold and are not clothed ,.' (Dwight Eisenhower).
Please consider peace and care for the environment as high on your personal list of priorities in the future. If you would like further information about the group, please contact the Chairperson, Anne Both on (08) 302 2712(W) or (08) 332 1257 (H) or the Secretary/Treasurer Lisa Hockley on (08) 333 9139 Ext 207 (W) or (08) 2892348 (H) or leave a message at Conservation Council, 120 Wakefield Street, Adelaide where group meetings are held on a regular basis.
What's Right in University Writing?
Peter Lumb BA, DipEd, Med
The rain had barely abated for three days. The parklands were churning underfoot. Smudgy clouds puffed above the plane trees and the palms. Cars glistened on the black parade-ground while the office workers, umbrellas in hand, dashed down from North Terrace. The bookshop-in-the-tent drained.
Oliver Sacks had an audience of a thousand or so. He spoke and read for over an hour about mind and memory, about awakenings and seeing ears, about culture and community, about meanings and wellness and illness. It was an exciting, entertaining time replete with laughter, interest, challenge, stimulation, learning and words chosen with rigorous clarity. The applause from the Festival of Arts audience was prolonged and vigorous. This was a satisfying encounter.
No-one doubted Oliver Sacks' authority. Here was a scholar, passionate about his work and speaking out of his own years of study, reflective thought and experience. A written academic paper, carefully distributed by Writer's Week workers, to the relaxed throng, would simply not have done the job. What the crowd wanted was a good talking to. But in addition to this talk, in other places and at other times Sacks struggles to create clear, thoughtful, and often referenced prose, in his books.
Back to University and away (a long way) from the hubbub.
We believe there is scope for a more varied nursing literature which will inform, provoke, develop insights and a sense of professional purpose ........ An extensive and varied literature is only developed if there are places to practise writing and an audience 10 address.
This in part, was the message a colleague and I had for our post-registration students when they received their outline for a unit called Ethnicity and Health Care. Students were to write an essay. They were to keep a 'log' of reflections about any aspect of ethnicity and health care, class notes, reading notes and so on. But beyond that we wanted these practising nurses and the social (health) science students, to make themselves clear to their peers about issues that engaged them as the unit unfolded.
We did not want them to write just for us in an imposing style, and for many students, an imposed style. We wanted them to try out different writing styles which complemented their content and which had in mind a wider audience than one lonely, office-bound academic. We also allowed ample opportunity for students to talk to each other - about books and other media and about what was happening at work, providing of course, they were connecting with the content of the unit.
Oliver Sacks is a great thinker and writer, and I now know he is more than competent as a speaker-entertainer. As a neurologist, he not only writes journal articles. He contributes to rigorous 'discussion' on a range of issues connected to his neurological expertise, and he does this in a range of communicative forms. His most acclaimed works look nothing like a high quality university essay. He has written an autobiographical study and frequently is personally reflective.
I'm not concerned with Sacks' authority, and to compare him to students in that regard is silly. What impresses me in his process. He constantly shapes meanings based on his own involvement with himself as person/patient, with others as doctor/therapist, or with others and issues, simply because he must make sense of things. He must make meaning. Sacks is into life-long learning in a big way, and studying his form gives an indication of how it might be done.
Oliver Sacks makes plenty of opportunities for himself to learn by using language carefully in speech and a variety of written forms. I like to think that in universities we can use a similar process.
I'm also impressed with the range of profound issues with which nurses contend - issues which confront our abilities to untangle 'truths', and issues which deeply confront feelings. There are also those issues which come from the self in the face of life's big issues and those which come from interacting with others in varying degrees of crisis. Nurses also need simply to know many things. I believe nurses need to carefully shape and share their experiences using many forms of writing and speaking, so that they, like Sacks, become truly 'reflective practitioners' and shape knowledge which can then be called 'nursing knowledge'. Where does this happen in our courses?
However, I do not just have a concern for the person as a shaper of meanings and as an individual practitioner. If all we do as teachers, is push students to write essays and reward them when they talk like essays in tutorial presentations, then we can grade and sort with relative ease. We serve ourselves.
Our ease though is the wider world's loss. With our focus on the individual student, their essay and their grade, I believe we limit communication with others - those 'out there' who are not inducted into our style. We collude with the professions to establish barriers between the public and expert. The university becomes a credentialing body, while the professions nicely develop their remoteness. What is our responsibility as teachers to work with a meaning-making process and to reward a range of meaningful expressions?
I prefer universities whose staff and students practise and join all kinds of debate, in a range of forums, and use a multitude of communicative styles. I especially prefer a profession which communicates well, in often tough dialogue, which those who seek its help. Context defines 'good' communication.
This is why we gave time, within a unit heavy with content, to a process which supported students in writing in non-traditional academic forms. The students' topics range widely but there is no doubting the relevance of them to their authors, and in most cases to colleagues. What is more, they are a good read. They represent some of the possibilities which I think need fostering. But these papers don't lend themselves to grading and sorting. In all, nine students contributed to what my colleague and I hope is a beginning for some professionals to engage more richly and fully with the big issues of health in our time. Move over Oliver!
eContent Home
