Journal of Research in Nursing

Abstract

Cardiac rehabilitation is an integral component of comprehensive cardiac care and is effective in reducing morbidity and mortality and improving quality of life. However, despite a 50-year-history and extensive evidence base attesting to its clinical and cost-effectiveness, including adding years to life and life to years, and exhortations that its implementation should be a key priority, the majority of cardiac patients do not receive rehabilitation. There is a comparative dearth of funding and wide variation in service provision, with a health care system that often fails to address issues such as sub-optimal referral, enrolment and completion, particularly amongst certain potential user groups that could benefit. This paper reviews these issues and suggests ways of overcoming the obstacles identified. It also highlights some of the knowledge gaps and areas that warrant further research.

Abstract

Cardiac rehabilitation and secondary prevention can promote recovery, reduce coronary events and improve quality of life in many people with heart disease. Traditionally provided for people with coronary heart disease, there is scope to have provision for a range of people, both young and old, and including those with heart failure, valve disease or with an internal cardiac defibrillator. At its best, cardiac rehabilitation spans the whole pathway of care, beginning before admission to hospital and continuing long after, with ongoing management of lifestyle changes. Guidelines are available based on best evidence, and programmes focus on the whole person and address physical, psychological and social well-being. They incorporate health education, risk factor modification, social support and exercise. Programmes can be run in the community, home or hospital. To ensure effective cardiac rehabilitation for each patient, members of the multi-disciplinary team are challenged to work together to meet the individual needs of patients and their family. The standard of care should be monitored through audit so that improvements can be made.

Abstract

Nurse teacherhood is composed of many factors. It includes nurse teachers’ tasks and different multidimensional roles and also nurse teachers’ individual experiences of being a nurse teacher. Nurse teachers’ experiences of nurse teacherhood depend on the meanings they give to the different factors. In other words, there are not only one but also several interpretations of what nurse teacherhood is. These interpretations affect what is important for each nurse teacher in their own nurse teacherhood and how satisfied they are with their profession. This paper is part of a larger study examining how Finnish nurse teachers experience their nurse teacherhood in polytechnics. The purpose of this paper was to describe nurse teacherhood during the years 2003 and 2004, when polytechnics and thus also nurse education were actively being developed in Finland. Nurse teachers (N = 34) were interviewed and the data were analysed using the grounded theory method. The categories describing nurse teacherhood were: process of change in the organisation, operating culture of the health care working community, professional self-esteem, focus of competence, relationship with students, the future in one’s profession and requirements for staying in the profession. The core category was commitment to nurse teacherhood. Nurse teachers’ individual experiences of the significance of the categories describing teacherhood were reflected by their level of commitment to teacherhood. Nurse teachers, whose commitment to nurse teacherhood was weak, were especially unsatisfied with changes related to their teacherhood. Nurse teachers’ conceptions of their future as nurse teachers were significant in terms of the direction in which they were developing their own teacherhood. Some nurse teachers who were weakly committed to nurse teacherhood considered it unlikely that they would continue in the profession in the future.

Abstract

Several national and state-based inquiry documents have reported long-standing and major concerns about mental health service provision in Australia. In particular, accounts of the difficult circumstances that surround the recruitment and retention of high-quality mental health nurses have clearly emerged, independent of jurisdiction. However, the privately experienced cost of working and coping in contemporary mental health settings, especially when the resilience of nursing staff is tested remains poorly understood. Clinical supervision (CS), a structured staff support arrangement, has shown promise as a positive contribution to the clinical governance agenda and is now found reflected in central policy themes elsewhere in the world. However, the concept of CS remains underdeveloped in Australia. The background to a unique randomised controlled trial (RCT), currently in progress in Queensland, Australia, has been described in this study. The efficacy of the most widely adopted model of CS that may address the promotion of standards and clinical audit issues, the development of skills and knowledge and the personal well-being of the supervisee will be tested. This study, funded by the Queensland Treasury/Golden Casket Foundation, will focus not only on the outcomes for individual mental health nurses but also examine the quality of care they provide and the effects of both on patient outcomes. This study will seek to establish a sustainable, strategically significant contribution to the knowledge base both for the mental health nursing workforce in Queensland (and beyond) and the patients they seek to serve.