In discharging its responsibilities, the Council therefore considers that it has a legitimate claim to seek information on those who teach nursing to students, the facilities in which nursing students are taught, the nursing curriculum, and the resources available to prepare professional nurses. The analysis of such data provides the Council with a basis for determining whether graduates applying for registration or endorsement are competent to practise nursing.
Many Australian nurses transfer their employment base interstate and overseas following graduation and initial professional registration. This has an impact upon the health delivery service of other States and Territories within Australia as well as many overseas countries. The Council therefore believes that the educational preparation of nurses at degree level should remain comparable to that offered by overseas countries of similar socio-economic standing to Australia.
In addition, the potential to attract overseas students into nursing programs in Australia is reliant upon the continued quality of learning experiences and the environment of that learning.
The various arenas in which nursing practice occurs call for a generic preparation for professional practice. This preparation needs to encompass the care of individuals throughout their lifespan with varying stages of acuity and chronicity of illness. Nursing practice has also developed a health promotion focus which requires nurses and doctors work independently and collaboratively with other health care professionals and ensure that the Australian population is provided with health education and the monitoring of health status and well-being. Nurses are increasingly taking a role in the prevention of disease, specifically in teaching about health and the promotion of healthy lifestyles. Many university-based programs have included primary health care studies in nursing curricula for the past ten years.
The skills of nursing include a wide range of strategies to communicate with people of various age groups responding to numerous stressful life events. The pre-requisite competencies (ANCI Competencies, 1994)[1] for registration demand a preparation that exposes students to a variety of off-campus clinical experiences. Undergraduate and post-graduate nursing programs are structured to enable students to link academic learning with off-campus clinical experiences. Students are required to develop technical, communication, problem-solving, critical thinking and clinical judgement skills. Preparation for life long learning in a profession which must constantly respond to change is also a fundamental requirement of nurse education.
The need to ensure safe practice and the obligation to maintain a duty of care to people, mandates that students of nursing are supervised by qualified nurses during their off-campus clinical placements. In order to maintain quality, develop professional competencies, meet employer needs and achieve registration requirements, it is vital that there is adequate funding of off-campus clinical placement components of nursing programs. It should also be noted that the nature of clinical supervision of nursing students differs significantly from that of medical students. The direct costs involved are significant and can be readily accounted for.
Advances in medical and surgical technology demand the support of a nursing team which is able to respond appropriately to rapidly changing and critical situations. Failure to recognise subtle changes in a client's condition can occur through inadequate interpretation of clinical diagnosis. This may contribute to increased morbidity and/or mortality. Preparation for advanced practice, therefore requires in-depth knowledge of physiological processes and haemodynamics.
The specialised nature of knowledge required for advanced and specialist practice can not be accommodated within undergraduate nursing programs. These needs and are more appropriately addressed at the post-graduate level.
Such research needs to be conducted in an environment that supports a rigorous approach to research so that the credibility and continuing advancement of the profession can be maintained, both within Australia and internationally. The preparation for the conduct of appropriate and relevant research must continue within an environment where there is an established culture of research. Such preparation can not be achieved in technical colleges or vocational schools, but is more appropriately achieved in an environment dedicated to higher learning and research.
Essentially the profession of nursing is a human service. Nurses come into contact with people at critical times in their lives. A philosophical basis for nursing practice has evolved which is predicated on respect for life, appreciation of the uniqueness of the human person and protection of the person who is frail and vulnerable in times of change and crisis.
To enact this philosophy the nurse requires a knowledge base which encompasses the physiological, psychological, sociological and spiritual components of the person. In the application of knowledge the nurse requires process skills in assessment, monitoring, clinical judgement, clinical operatives, problem solving, reflection and evaluation. The nursing knowledge base and process skills are integrated in the therapeutic activity of nursing.
In order to maintain and enhance its therapeutic value nursing practice needs to be informed by research and scholarship. This is most properly pursued in an environment that promotes teaching, learning, professional debate, scholarly inquiry and cultural transmission.