An Overview of Issues in Nursing Education

Dick Johnson
Barbara Preston
The Australian Council of Deans of Nursing

01/12
October 2001

Evaluations and Investigations Programme
Higher Education Division

© Commonwealth of Australia 2001
ISBN: 0 642 77222 3 (Internet copy)
DETYA No. 6761HERC01A

This work is copyright. It may be reproduced in whole or in part for study or training purposes subject to the inclusion of the source and no commercial usage or sale. Reproduction for purposes other than those indicated above, require the written permission from the Commonwealth available through ausinfo. Requests and inquiries concerning reproduction and rights should be addressed to the Manager, Legislative Services, ausinfo, GPO Box 1920, Canberra ACT 2601.

This research was commissioned by the National Review of Nursing Education funded by the Department of Education, Science and Training and the Department of Health and Ageing.

The views expressed in this report do not necessarily reflect the views of the Department of Education, Science and Training or the Department of Health and Ageing

Contents

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Abbreviations and acronyms

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Acknowledgments

This project was funded by the Evaluations and Investigations Programme of the Department of Education, Training and Youth Affairs. It was under the auspice of the Australian Council of Deans of Nursing and was based in the School of Nursing at Deakin University which provided administrative support and assistance.

The advisory team for the project comprised:

• Associate Professor Pauline Nugent, Head of School of Nursing, Deakin University and Chair of the Australian Council of Deans of Nursing;

• Professor Jill White, Dean Faculty of Nursing and Midwifery, University of Technology Sydney and Executive member of the Australian Council of Deans of Nursing;

• Ms Elizabeth McDonald, Department of Education, Training and Youth Affairs, Higher Education; and

• Ms Christianna Cobbold, Assistant Secretary, Health Capacity Development Branch, Department of Health and Aged Care.

The advisory team was appointed by the Department of Education, Training and Youth Affairs as a consultative body to work in an advisory capacity on matters such as scope of the project and methodology. Advisory team meetings were held 3 monthly.

Appreciation is expressed to members Australian Council of Deans of Nursing who contributed to the project through assistance with identification of appropriate reports and participation in discussion groups.

Appreciation is expressed to Ms Kate Duyvestyn, Ms Carmen Mills, Ms Helen Hamilton for the production of this report.

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Executive summary

Soon after the complete transfer of registered nurse education into the higher education sector in 1993, Professor Janice Reid led a review of nurse education (1994)¹. Seven years later, two national reviews have been initiated, one into nursing generally, by a Senate committee, and one into nurse education by the Federal Government. Between these two dates a large number of smaller studies were carried out, partly into aspects of nurse education and partly into questions of supply and demand.

This project commissioned by the Department of Education, Training and Youth Affairs, (DETYA) provides an overview of the more recent of these reports and aims to synthesise the outcome to provide a national picture of the issues. The project was overseen by a Steering Committee comprising representatives from DETYA, Commonwealth Department Health and Aged Care and Australian Council of Deans of Nursing, (ACDN). A number of issues come up frequently in the reports, either as the specific focus of a report or as an aspect of a wider ranging study. These are:

• The changing context of nursing—increasing complexity, pressure; changes of clientele—the aged, the community;

• Dissatisfaction with conditions of work—shift work, frequent changes, overloads, lack of appreciation by superiors and colleagues, lack of child care. Pay is an issue, but not as big as several others;

• Transition from university to employment—the first year, especially the first few months of employment;

• The practicum—finding clinical placements, and funding them. Clinical supervision. Different expectations of academics and clinical supervisors; lack of communication;

• Specialisation—training for it, credentialling of it, specialist and advanced practice; and

• The supply of nurses; issues of recruitment and retention. Why do people enter nursing, and (more urgently) why do qualified nurses leave the profession?

The numerous reports which have focussed on workforce emphasise the need for a national approach to nursing workforce strategies. State and Territory reports have been insular in their recommendations for:

1. Consistency and accuracy of data collection in relation to workforce numbers;

2. Family friendly and flexible work environment;

3. Partnerships between universities and health services in relation particularly to clinical practice and successful graduate transition programs; and

4. Recruitment strategies.

Reports from speciality areas have highlighted the need for career enhancement strategies including postgraduate courses. The sheer volume of work in this area and its segmental and insular nature further emphasise the importance of a national approach.

Some issues are not addressed in the reports:

• Leadership development, management, interpersonal relations - what sort of person is the good supervisor or the good director of nursing? How are they to be developed?

• Evaluation of on-line education for nurses;

• Indigenous issues evaluation of education of indigenous nurses, and education of nurses to care for indigenous clients;

• Education of nurses for multicultural society; dealing with minority groups;

• Issues in education for rural and remote area nursing: limited opportunities for continuing education, staff development, acquiring further qualifications; range of expectations put on the rural/remote area nurse;

• The trend towards specialisation and specialist credentialling;

• Quality of graduates; this is usually seen as a matter for registration boards, but some boards simply accredit universities on the basis of documents and do not assess the quality of the graduates;

• Teaching quality in schools/faculties of Nursing. That does not mean this issue is not addressed; such reviews are carried out within the school or faculty and would not be published by it or the university. There are also many reports of quality teaching within the Australian Universities Teaching Committee (AUTC) and its antecedents;

• Expectations/attitudes of incoming students; comparison with new graduates;

• Links between nursing and non-traditional medicine; and

• Evaluation of double degree programmes.

The workforce studies are usually carried out by government agencies rather than by universities, and focus on estimating and achieving an adequate supply of nurses to meet predicted needs, both for general nurses and in special fields of nursing. These studies are hampered by some inconsistencies of approach and inadequacies in the data.

1. Nursing Education in Australian Universities Report of the National Review of Nurse Education in the Higher Education Sector - 1994 and beyond. AGPS 1994

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