21st century nursing

Preparing today’s nurses to work in a complex health system and potentially hazardous environments is a complicated issue. With the role of the nurse so vital to the contemporary healthcare system, Dr Ashley Kable and Dr Tracy Levett-Jones are researching collaboratively and individually the demands and challenges facing the profession.

"While nursing education is still about instilling a passion for the profession, it also requires a highly sophisticated level of skill and knowledge," said Levett-Jones.

"Nurses are moving into an evolving and demanding role where patient throughput is much higher than it has even been. Our graduates must be able to operate at optimum levels in an increasingly complex environment, in order to improve patient outcomes."

Often seen as the human face of the hospital system, nurses today are required to be a liaison between what can sometimes seem to patients to be a confusing blur of health professionals.

Kable said nurses were the key communicators in this constant health worker interaction and fundamentally involved in its organisation and management.

"Nurses are in a key coordinating position between the patient and other health professionals around the clock. While other professionals may deliver their services and move on, nurses are always there, keeping things ticking over."

Funded by WorkCover NSW, Kable’s broad research focuses on occupational health and safety for nurses in NSW.

There are three projects: resistance to care, workplace injury and its effects; the outcome of occupational rehabilitation of nurses; and needlestick and sharps injuries to nurses employed in NSW. These projects are being conducted in collaboration with researchers from the School of Health Sciences and the NSW Nurses’ Association.

Kable said resistance to care behaviours – which can range from a ‘No thanks’ to aggression or violence – are the subject of a state-wide survey of 5,000 members of the NSW Nurses’ Association. Participants will be asked to describe resistance to care episodes, their outcomes and how these episodes have affected them.

"Some literature suggests that, even when it seems the incidents have no impact, nurses can suffer long-term psychological effects that can develop into depressive states and post-traumatic stress disorders."

Just as important to effective nursing in a contemporary setting is the ability to work with health-related technologies.

Nursing students need to possess sophisticated information technology skills to deal with an array of applications, including healthcare technologies, monitoring devices, and data management and analyses.

Information and Communication Technology (ICT) is one of Levett-Jones’ many research interests. Recent work includes a study of nurses’ ICT competence and a project funded by the Australian Learning and Teaching Council to examine the impact of simulation technologies on clinical reasoning skills.

Preliminary results of the research indicate that the development of ICT competence has the potential to ultimately improve educational and patient outcomes in the clinical context.

The research also highlighted the disadvantages felt by nurses in rural and remote areas through limited access, support and training.

"The technological environment nurses face is dynamic and constantly changing, so we are mindful we cannot prepare students with a defined set of skills," Levett-Jones said.

"The skills nurses require today are not the same skills they will need in five years. This is why it is so important to provide a level of competence that equips them to keep on learning and with an attitude that technology will help them be a more effective nurse."

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