Chronic pain in the rural arena.
Explore the source record for details and available documents.
Australia↗
Biomedical subjects
Kim Usher
Publications and source records attributed to Kim Usher.
Case study: a bridge across the paradigms.
Case study as a teaching and research tool has an extensive history in health and social sciences. Despite its suitability for many of the research questions that face nurses, nurses have not fully embraced case study as a comprehensive approach for research. The vagaries of the real-life clinical setting can confound methodologically purist researchers. Case study provides a milieu in which nurse researchers can respond to these vagaries and move towards a paradigmatic openness. In this paper, we argue that case study offers, as yet, under-explored and under-utilised potential as a bridge across the traditional research paradigms. We argue that case study has broad research application and epistemological, ontological and methodological flexibility. When used as a research approach, case study is both the process and end product of research. It provides a delineated boundary for inquiry, and a structural process within which any methods appropriate to investigating a research area can be applied.
Attitude of Health Personnel↗
Carspecken's five-stage critical qualitative research method: an application to nursing research.
In this article, the authors provide an account of Carspecken's (1996) five-stage approach to "doing" critical ethnography, or what he has termed critical qualitative research (CQR). They provide the reader with an overview of the concepts presented in Carspecken's book Critical Ethnography in Educational Research and describe how they applied several of his ideas within a research project that explored renal nurses' decision making using a critical ethnographic approach. They briefly describe the five stages of CQR and incorporate within the article an example of how they applied the stages. They propose this approach as a useful method for nursing and other health-related research.
Anthropology, Cultural↗
Survival of the fittest, or socially constructed phenomena? Theoretical understandings of aggression and violence towards nurses.
Violence is an issue that is attracting increasing attention in the nursing literature. There is general agreement that nurses are exposed to unacceptable levels of violence and aggression in the workplace, and that levels of violence are increasing. Despite this attention and awareness, however, violence does not have a standard definition, and theoretical explanations of violence are seldom considered when discussing it in relation to nursing. This paper discusses current issues associated with defining violence, and presents an overview of some of the traditional and contemporary theories of aggression and violence in relation to nursing and the health context. Conflicting issues surrounding predictors and precipitators of violence are examined. We explore the notion that violence is 'part of the job' in nursing. In conclusion, we assert that the current discourses on aggression and violence maintain the status quo, and argue that new explanatory positions on aggression and violence towards nurses are needed.
Aggression↗
Meeting the health needs of Indigenous people: how is nursing education meeting the challenge?
Australian Indigenous people continue to have health outcomes that are near to the worst in the world but similar to those of the Indigenous peoples in countries such as Canada and New Zealand. Numerous policies and strategies have been implemented in Australia in an attempt to rectify this situation. This paper provides an overview of the issues directly related to the provision of a skilled workforce prepared for delivery of appropriate health services to Indigenous people. It includes an overview of the need for Indigenous people in nursing and the issues facing them when they enrol in undergraduate nursing courses. It also proposes changes necessary to ensure non-indigenous nurses are better prepared to work effectively with Indigenous people in the future.
Curriculum↗
An innovative nurse education program in the Torres Strait Islands.
As the most numerous and geographically dispersed professional group, registered nurses in Australia work with Aboriginal and Torres Strait Islander health workers and other members of the multidisciplinary team in a variety of practice contexts to provide health care to Indigenous and non-Indigenous people. Despite the introduction of a variety of recruitment and proactive support strategies by employers, universities and State and Commonwealth governments, few Indigenous people in Australia enrol in, and graduate from, entry level higher education courses in the health professions. The reasons for this are complex and, as yet, not well understood or described; however, it is clear that the well-documented execrable health status of Indigenous Australians demands a response from universities, which are largely responsible for the education of health professionals. An innovative model of registered nurse education in the Torres Strait region of Australia is reported in this paper. A satellite campus established by James Cook University (JCU) on Thursday Island delivers the undergraduate nursing course by mixed mode, supplemented by specific strategies designed to improve Indigenous student recruitment and retention and thus increase the likelihood of graduation. The course and the strategies implemented are discussed in this paper.
Adult↗
Meeting the challenges of recruitment and retention of Indigenous people into nursing: outcomes of the Indigenous Nurse Education Working Group.
It has been recognised internationally that increasing the number of Indigenous people working as health professionals is linked to the improved health status of Indigenous people. When comparing Australian Indigenous and non-Indigenous populations, Indigenous people continue to have poorer health standards and are much less likely to be involved in employment in health professions than other Australians. In 2000, the Indigenous Nurse Education Working Group (INEWG) was formed by government with the mandate to work collaboratively with universities and important professional nursing bodies across the nation in an attempt to increase the number of Indigenous registered nurses and to prepare nursing graduates with better understanding of, and skills to assist with, Indigenous health issues. This paper describes the work of the INEWG from 2000 to mid-2003; firstly in developing and implementing strategies aimed at increasing the recruitment and retention of Indigenous people into undergraduate nursing programs; and secondly by helping university schools of nursing increase faculty and student understanding of Indigenous culture, history and health issues through educational processes. Lastly, it summarises the INEWG's 2002 recommendations to achieve a higher rate of Indigenous participation in nursing. The results of research into the success of these recommendations will be the subject of a later paper.
Australia↗
Adolescent drug abuse: helping families survive.
Drug use and abuse carries risk in people of all ages. However, adolescents are particularly vulnerable to substance misuse. Adolescent drug use continues to be an area of concern with a number of adolescents developing problems associated with the use of various drugs. Negative sequelae associated with adolescent drug use include areas such as schooling, health, and family relationships. Difficulties with the legal system, schooling, or within the family are commonly the triggers for recognition of substance misuse problems in a young person. However, problems are usually well-established before they are recognized. The challenge of dealing with these problems will fall on families, particularly parents. This is a crisis for families, and ongoing support is needed if they are to overcome the challenges. Health workers (including nurses) are well-positioned to support families who are dealing with adolescent drug problems. In this paper we propose the adoption of a strengths approach as a strategy for developing resilience in families.
Adaptation, Psychological↗
Psychotropic PRN: a model for best practice management of acute psychotic behavioural disturbance in inpatient psychiatric settings.
PRN, or 'as needed', medications are administered frequently by mental health nurses in psychiatric inpatient settings to manage difficult and disturbed behaviour when other strategies fail. Research indicates that approximately 50% of psychiatric inpatients receive a PRN medication at some stage of their treatment. Although evidence indicates that traditional antipsychotics and benzodiazepines are equally effective in managing acute agitation and other psychotic symptoms, it has been recommended that benzodiazepines should be the first-line of action because they do not cause the serious side-effects that are common with the traditional antipsychotics. Unfortunately, research indicates that doctors and nurses are not taking advantage of the latest evidence to guide their practice. This paper reviews the limited research available in the area and makes recommendations for evidence-based practice.
Drug Administration Schedule↗
PRN psychotropic medications: the need for nursing research.
This paper highlights the inadequacy of existing research for the purposes of evidence-based prn (Latin, pro re nata or 'as needed') medication practice in psychiatric settings and notes the absence of relevant evidence-based clinical practice guidelines and policies, both nationally and internationally. The professional, ethical and legal importance of PRN medication practices is also discussed, and shown to add to the urgency of developing a research agenda which will serve as an adequate basis for good clinical practice. This paper summarises the relevant research and identifies problems that can arise for clinicians involved in the administration of prn medications in mental health settings. It concludes by highlighting key issues which urgently require empirical investigation.
Adolescent↗
The nurse practitioner role in Fiji: results of an impact study.
The Nurse Practitioner role, a relatively new role in Fiji, was introduced by the Ministry of Health in order to increase local access to adequate health care for people living in remote areas. Both developed and developing countries have introduced Nurse Practitioner or similar roles in order to provide a cost effective and sustainable health workforce. This paper provides the results of a qualitative, descriptive study undertaken to explore the introduction of this role and its impact on health service delivery in Fiji. It involved semi structured and focus group interviews with nurse practitioners, key stake holders and community members. The findings demonstrate the positive impact of the role and its benefits to people living in the remote areas of Fiji. It also outlines the satisfaction of villagers with Nurse Practitioners and the extensive scope of practice undertaken by these practitioners. Issues related to the introduction of the role are also discussed. Finally, recommendations for future research and practice are offered.
Attitude of Health Personnel↗
Challenges faced by Indigenous nursing students and strategies that aided their progress in the course: a descriptive study.
Marked improvements in Indigenous health can be achieved by increasing the participation of Indigenous people in the health professions. Currently in Australia the participation by Indigenous people in the health professions is low and the Indigenous people of Australia continue to have poor health outcomes. This qualitative study utilised interviews with 22 Indigenous students enrolled in undergraduate nursing degrees across Australia, to explore the challenges they faced and uncover the strategies they had found helpful to their progress in the course. The findings indicate that students are challenged by financial hardship, staff insensitivity to cultural issues, discrimination, lack of Indigenous mentors, poor study skills, lack of adequate educational preparation, lack of resources, and ongoing family commitments. Strategies identified as particularly helpful to tenure within the course include specific Indigenous support units, adequate financial support, interested academics, Aboriginal Tertiary Assistance Scheme (ATAS) tutors, support from family and friends, and support from other students.
Acculturation↗
The use of psychotropic medications with breastfeeding women: applying the available evidence.
Breastfeeding women may be prescribed a psychotropic medication to treat a pre-existing illness such as bipolar disorder or schizophrenia, or to treat an illness that develops as a direct result of pregnancy and childbirth, such as depression. Mental health nurses are often not aware that many psychotropic medications are considered relatively safe for the infant as well as the breastfeeding woman. This paper provides the clinician with an overview of the major psychotropic medications for breastfeeding women and outlines their potential impact on the infant. Guidelines for the use of these medications are also provided for mental health nurses based on the available evidence.
Adult↗
Developing the future nurse leaders of Fiji.
BACKGROUND: Nurse leaders in Fiji are currently involved in meeting the challenges of being at the forefront of an AusAID supported Health Sector Improvement process. Fiji is experiencing the same shortages of health professionals (including nurses) as is occurring internationally, while simultaneously striving to improve the quality of its health services. PRIMARY ARGUMENT: This paper provides information about the current situation in relation to health services in Fiji, and describes strategies being undertaken by the nurse leaders of Fiji to meet the challenge of leading an exciting reform process. James Cook University, School of Nursing Sciences, has been privileged to support the provision of contemporary leadership and management education for current and future nurse leaders in the Fiji Health Sector as a component of a current education program to educate registered nurses to bachelor level. This paper will provide an overview of the current Fiji Health Sector Improvement Program, with a particular focus on the preparation of nurse leaders. CONCLUSION: There is an ongoing need to understand beliefs and values, and styles of interaction and communication, and indeed, ideas about time. With collaboration between Australian academics and Fiji tutors from the Fiji School of Nursing, the program appears to be remarkably successful.
Culture↗