Nursing Career Pathways Project
- 3.4.4 Ongoing Learning options
- 3.4.5 Integration of nursing practice - A career pathway focussed on the needs of consumers
- 3.4.6 Diversity of educational practice placements
- 3.5 Marketing Nursing's diversity
3.4.4 Ongoing Learning options
In relation to ongoing learning, there was agreement amongst participants that this was a necessity, as is stated by the Royal College of Nursing, Australia in the Position Statement Continuing Professional Development.
Continuing professional development for nurses is essential to ensure that nursing practice is congruent with the health needs of contemporary society. Competence to practice is dependent upon updating knowledge and skills and the personal and professional growth of practitioners within a discipline. Professional development is a career long process. It is stimulated by experiential and other learning, which may occur in a variety of ways and includes, but is not limited to, formal award educational programs.
There was also agreement to ensure support to ongoing learning options for nurses not only because of the technological advances in which many work, but also as retention strategy.
Nursing is a strategic asset and the whole hospital's reputation really lies in the quality of the nursing staff, we need to value that, we need to promote that and that si what we need to sell. (extract from interview with key stakeholder participant)
The valuing aspect is two fold. The valuing of nurses by themselves and their colleagues and from a professional organisation's point of view. I would see that it all ties in with the continuing confidence and continuing professional development. As you know we have no mandatory continuing education for nurses so it is very much left at the moment to the individual nurse to engage in those activities. (Extract from interview with key stakeholder participant)
In relation to enrolled nurses, stakeholder participants supported the maintenance of the enrolled nurse role. The view of many enrolled nurses that entry into a Bachelor of Nursing (or however titled) was only one possible career pathway was also strongly supported by participants. Development of educational, research and scholarship opportunities for ENs was discussed and it was highlighted that:
Unlike registered nurses they get all sorts of points and things for doing courses and can become CNs and those sorts of things. For enrolled nurses it is basically just educating yourself and a lot of enrolled nurses are very happy to do that to keep up to date with the current trends and to do whatever. I would actually like to see a pathway that there could be a system for those extra courses that there is at least some recognition because all you get is certificates of attendance. (Extract from interview with key stakeholder participant)
Enrolled nurses have been neglected in terms of encouragement to pursue professional activities. The NSWNA has for many years offered sponsorships to enrolled nurses wishing to attend and/or present papers at their professional organisation conference at both State and Federal levels. ... Problems of national consistency in enrolled nurses courses is a major problems, as is the expectation that enrolled nurse traineeships are equivalent to a full year of the undergraduate nursing degree. Misconceptions about equivalency such as this can only lead to professional rifts between different segments of the nursing workforce. (General Secretary, New South Wales Nurses' Association)
A view that was expressed identified that ENs were an accepted professional group.
We started out six years ago and we went to conferences, peak nursing forums where we sat and six years ago if we opened our mouths at any of the meetings we were actually howled down and now I have just been to the nurses association conference and I have actually noticed such a change in focus and acceptance of us as a profession. Now I have health service managers that come up and seek me out for advice for things re enrolled nurses. (Extract from interview with key stakeholder participant)
In relation to the types of ongoing learning options a nurse could undertake, these may include professional development courses / sessions conducted by professional nursing organisations or employers, personal ongoing learning contributions of each nurse, vocational educational and tertiary educational options. There was a lot of discussion amongst participants about the need to highlight the difference between vocational and professional education, as much as the difference in learning contributions from the different sectors (e.g. vocational and tertiary sectors).
3.4.5 Integration of nursing practice - A career pathway focussed on the needs of consumers
One career pathway that was discussed by participants was an attempt to make visible the concept of health care teams that are formed to address different contexts in which health care is provided in a team orientation. This approach to nursing careers pathways is innovative in its design and forces attention on career pathways from the focus of consumers' needs. In saying this, it is acknowledged that there are initiatives like for example the Enhanced Primary Care MBS items for 75 plus year olds that are an attempt to build collaborative team concepts.
A recurring theme amongst participants was collaboration and multidisciplinary health teams as displayed by the following quotes:
We need to look at it from a health workforce approach and not do an isolated review of medical workforce, allied health force. But look at not asking for a nursing workforce advisory committee but a health advisory committee which doctors, nurses, allied health sit around a table. Whenever I have done research it is multidisciplinary or sat down to solve problems with lots of different disciplines in health, you get wonderful outcomes. (Extract from interview with key stakeholder participant)
When I am talking about contemporary health care practice I am talking about the context in which we are working and the future directions. The enormity of change which is taking place means that the roles and boundaries of health professionals need to be in tune with these changes to ensure the very best outcomes for the patient or client. (Extract from interview with key stakeholder participant)
I would like to see a lot more collaboration. Realistically we need to start crossing each other's boundaries a bit more and realise we are doing very similar things. Well we have to work with them anyway, so we should integrate with them. (extract from interview with key stakeholder participant)
We cannot remain an isolated profession. We have to personally be unique at nursing but be part of the multidisciplinary trend because there is no one area that can work in isolation. We all need to be working together to the common good. (extract from interview with key stakeholder participant)
Discussion amongst participants was on the focus for the health care teams. That is, in what contexts are health care teams required? It was agreed that the contexts would reflect contemporary or population based health care needs (see Figure 7). Currently, these needs would include acute, aged, chronic, primary, indigenous and rural/remote health care needs. What is needed is agreement about the cluster or shared competencies of health professionals in the health care teams. There remains much work to be done in this regard.
Figure 7 Health Care Teams
As participants discussed, this concept of working together in health care teams needs to be commenced in the educational context in regard to student registered nurses learning together with other health professionals during their undergraduate preparation.
3.4.6 Diversity of educational practice placements
As one participant indicated:
I think for so long everyone in nursing has talked about "you've got to get in there and consolidate your clinical before you go off and do anything else". Well, there is no real need. There is no real reason why that should be. (Extract from interview with key stakeholder participant)
Not surprisingly, amongst the diverse group of stakeholders who consented to participate in this study, there was much discussion around what type of educational practice placements, and how best to refer to placements, that student RNs and student ENs undertook in order to complete their particular program of study. Points raised by some participants focussed attention to the reason for career pathways - that is, from what perspective should career pathways be developed? In general, stakeholder participants were not of the view that career pathways be developed based on workforce requirements. Though there was acceptance to the view that attracting potential RNs and ENs into the workforce would require changes to the health systems (eg. shiftwork) so as to make nursing an attractive career option for younger people.
In addition, as an access and equity consideration, stakeholder participants focussed attention on the possibility for education programs to consider offering educational pathways for persons currently precluded from undertaking a Bachelor of Nursing (or however titled), like for example, persons with a disability.
The view expressed, was that persons not wanting to undertake work in for example an acute care hospital or residential care setting, that this be acceptable and other options to enable completion of their program of study provided. In addition, that student RNs who do not want to undertake clinical placement in for example an acute care hospital or a residential care setting, that they not be required to work in these areas if it is not their choice to do so. There was general agreement that RNs should be able to progress through their educational program and along a particular career pathway that did not require or mandate acute care hospital or residential care experience. Therefore, what is needed is the articulation of both clinical and non-clinical career pathways for nursing preparation to enable access to educational and career opportunities currently not available.
3.5 Marketing Nursing's diversity
There was consensus that there needs to be an active and integrated marketing campaign to address the nursing shortage as well as the ongoing long term recruitment and retention of nurses. The concept of developing nursing career pathways material presented in this report into a website was proposed with key stakeholder participants and unanimously supported. What is envisaged, is the presentation of the developed content and diagrams, with associated vignettes and profiles of nurses and nursing as a professional career in a website dedicated to market and describe nursing to nurses, potential nurses, educationalists, policy makers and the wider community. This mode of marketing would provide a diverse and personalised method of recruitment of nurses.
What would be made available is easily understood, reliable, timely information that provided appropriate guidance to the variety of persons seeking assistance. As well, employment opportunities would be made available. The website would become a showcase of nursing's talents and a means to give recognition to nursing's diversity. It is possible to seek from visitors to the website specific information, and collate together this information, into the expectations, needs and attitudes related to pre-determined questions of which findings would provide valuable insight into the recruitment and retention of nurses.
The website would amplify and connect together the large amount of work that is currently being undertaken or planned in many states and territories. Additionally, links to the nursing classification structures aligned to industrial awards and agreements would be made available when explicating specific nursing career pathways. Having specific links to the various states and territories enables the differences between populations and states and territories to be maintained.
Diagrams will be replicated with appropriate changes for registered and enrolled nurses (however titled). All boxes as displayed in the diagrams illustrated in this report, could displayed as 'live' so that when 'clicked onto', they open up other informative pages. What follows, are brief introductory outlines of diagrams that may be developed in this website proposal.
An introductory 'webpage' would portray an overview of nursing careers pathways components. Directions to navigate the website and its various components and their elements would be provided. The professional career advice that would be presented by nurses themselves and maintained by the profession would ensure that effective, relevant and appropriate career advice is provided.
Webpages that a visitor to the website could proceed to would include the elaboration of nursing roles for registered nurses. What would be shown is that professional areas of nursing work are referred to as clinical and non-clinical. These areas are aligned to nursing classifications and linked to industrial agreements and awards. The nature of these alignments will be expressed through vignettes and profiles of nurses. Given the different states and territories, links will be provided to each of these, so as to provide up-to-date information. The locations for nursing roles noting organisational and geographical locations would be provided as well as elaborating examples of the different clinical nursing roles, to reflect the sixty odd clinical practice areas for nurses. Career opportunities that evolve for nurses following work in clinical and non-clinical areas would also be highlighted. As previously stated, vignettes and profiles of nurses will portray the work histories and future plans of nurses whom currently hold similar positions. Additionally, a webpage would detail educational requirements for nursing roles. In this webpage, what would also be identified is the recognition by nursing personnel that unlicensed nursing and personal care workers (however titled) is one of several entry points into enrolled nursing (however titled) and following successful completion, onto registered nursing. There would be webpages that would elaborate the multiple entry points into a Bachelor of Nursing (however titled), and the ongoing learning opportunities that will assist nurses in their career development.
Key stakeholder participants agreed that establishing a national nursing infrastructure to facilitate the exchange of appropriate information and to maintain ongoing dialogue between the federal government and nurses may assist in promoting nursing as a career option. This infrastructure could responsibility to liaise with all the professional nursing organisations to review, monitor and provide information regarding career pathways in Australian nursing. Progressing the development of a website dedicated to promoting nursing as a career option, and to informing nurses of alternative career pathways, was also considered by all stakeholder participants as an extremely positive outcome to arise from this project. A proposal has been prepared to facilitate the progression of this initiative. A participant commented:
Nursing as a profession needs to articulate the value of each nursing role and the importance of it. Not just the value of the role, but nurses need to know the meaning of things and really what they are doing in terms of the whole health system, other than in terms of being just a labour force. So they need to know apart from the labour that they are doing how they are fitting in to things. Each role needs to be differentiated sufficiently so that people will know how it all fits together. (Extract from interview with key participant stakeholder participant)
As has been identified the worldwide and agreed by participants, whatever approach is used to attract new recruits to nursing must be matched with system changes to retain these persons. To address the nursing shortage, it is imperative that system changes match those that have been circulated by the American Association of Nurse Executives, Institute for Patient Care Research and Education (Chicago, March 2000):
- Competitive compensation and flexible benefits for nurses
- Respect and recognition of nurses' efforts
- Effective and follow-up communication between nurses and management
- Adequate and flexible staffing protocols to allow nurses an appropriate amount of time to be spent with people to whom they provide care, while balancing their personal and professional lives
- Input and participation in decision-making that affects nursing practice
- Support for continuing education and professional practice development
- Strategic planning to identify issues and develop tactics regarding the aging nurse population.
Any comments or queries should be sent to: highered@dest.gov.au
This page was
last updated on Tuesday, 04 December 2001
Department of Education, Science and Training
Copyright © Commonwealth of Australia
DEST Web Site Privacy Statement
Disclaimer