Role In Australia Research Articles

Cycles of reflection and challenge: Using sequential blended learning strategies to enhance student understanding of, and transition to, the Nurse Practitioner role in Australia

Summary Aim This paper describes and discusses the development and implementation of sequential blended learning strategies in one Australian post-graduate nursing program designed to support student transition to the Nurse Practitioner (NP) role. Background Despite the availability of NP practice standards and role descriptions, the diversity and complexity of NP practice can make it difficult for students commencing post-graduate NP programs to comprehend what ways they need to develop to meet professional expectations. Scholarly critique This paper examines this contemporary post-graduate education issue. Blended learning strategies provided an opportunity to address the requirements, diversity and complexity of NP practice early in the NP program. Students were confronted with the gap between their current level of competence and NP competence, and supported to plan and travel the transitional and developmental pathway to achieve competence. Conclusion Working with students from early on in their degree enables them to progressively and more clearly envision the gap between their current level of competence and that required of the Australian NP role. Adopting a sequential blended learning approach is one way to engage students in preparing for their future role. Consideration of design elements integral to blended learning approaches is important, including a need for authenticity and support. Preparing NPs who fully comprehend the nature and scope of their practice is both vital for safety and of strategic importance to the nursing profession. Examples of how to facilitate student understanding of the NP role are needed to inform educational practice.

Australia’s submarine technology cooperation with Japan as burden-sharing with the USA in the Asia-Pacific

Australia, Japan and the USA are all facing dual pressures that require them to do more with less. Internationally, they deal with the challenge of managing China’s rapid rise. However, domestically, they must cut government spending and reduce government debt. With internal balancing effectively ruled out as a long-term solution, the three states are seeking ways to optimise external balancing, or cooperation with like-minded states. This article focuses on Australian motivations regarding the recent proposal for submarine cooperation with Japan, and places it in the context of longer trends that poise the USA, Australia and Japan for even greater trilateralism in the future. Australia’s proposal to buy submarines from Japan, should it go through, would cement Australia and Japan’s fledgling security relationship in steel and coin. For Australia, it would help it to overcome its undersea capability gap, and Japan could set a precedent to re-enter the global weapons market if all goes well. Furthermore, Australia can use defence-technology cooperation with Japan to signal to the USA the seriousness of its commitment to burden-share in pursuit of regional security and determination to politically support the USA’s ‘Pivot’ to the Asia-Pacific. However, domestic politics have begun to play an important role in Australia, with a ‘spill’ motion against Prime Minister Tony Abbott barely overcome by a backroom deal with the opposition to build the submarines domestically, and this is an important development to keep an eye on.

Modelling the meat consumption patterns in Australia

Meat plays an important role in Australia's food intake as Australians currently allocate 40% of their food expenditure on meat. This paper attempts to model the demand for the various types of meat in Australia using data from 1962 to 2011 and the system-wide approach to modelling. The paper considers a number of alternate models, verifies the validity of the demand model hypotheses and selects a preferred model using the information inaccuracy criterion. The paper then uses the preferred model to forecast meat demand in Australia under various economic policy scenarios. The results show that between 1962 and 2011, meat budget share has more than halved and that consumer taste plays a significant role in shifting the meat consumption in Australia to chicken and pork at the expense of beef and lamb. Beef is a luxury, while mutton, lamb, chicken and pork are necessities. Demand for mutton is price elastic and, beef, lamb, chicken and pork is price inelastic.

Assessment of direct normal irradiance and cloud connections using satellite data over Australia

Australia has some of the best solar energy resources on the planet. With a Renewable Energy Target (RET) scheme designed to ensure that 20% of Australia’s electricity comes from renewable sources by 2020, these resources are rapidly being developed. Although not yet widespread, Concentrating Solar Power (CSP) plants are expected to play a significant role in Australia’s future solar-derived electricity. The variability of Direct Normal Irradiance (DNI) is largely responsible for the fluctuations in solar energy outputs from CSP plants. The temporal and spatial variability of DNI over Australia provides an assessment of the solar resource for future deployment of CSP plants. As such, this study analyses recent trends in the hourly solar DNI resource using data from 1990 to 2012 obtained from the Bureau of Meteorology (BOM). The deseasonalized DNI anomaly trends were significant over the west, southeast and northeast of Australia for all seasons. Knowledge of these trends is extremely important for siting and the prediction of CSP plant outputs. DNI increased by 50Wm−2 over west and southeast of Australia, whereas it decreased by 100Wm−2 over northeast of Australia – representing approximately +5% and −12% deviations from the long-term averages, respectively. Seasonal analysis also showed significant DNI trends, especially during the summer and winter. Most of the changes seen in DNI over Australia were modulated by changes in cloud amount over the region. The cloud amount obtained from the International Satellite Cloud Climatology Product (ISCCP) showed high negative correlations associated with DNI anomalies over Australia. The anomaly in cloud amount is highly correlated with the Southern Oscillation Index (SOI) obtained from BOM. The strengthening convective activity over Indonesia associated with strong La Niña events modulates cloud coverage teleconnecting towards northern Australia. This increases cloud cover and lowers the DNI significantly over these regions during the summer and autumn season. Although the change in DNI associated with cloud amount is clear, the effect of change in aerosols over these years still needs to be investigated.

Advanced musculoskeletal physiotherapy clinical education framework supporting an emerging new workforce.

A project, funded by the Department of Health and Human Services, was conducted with the aim of developing a clinical education framework that included an agreed competency standard and credentialing process to support advanced musculoskeletal physiotherapy roles. This paper describes the process undertaken to achieve this and presents the outcomes of implementation. A multistep approach was taken. Initial steps included conducting a scoping review of the literature and focus groups of advanced musculoskeletal physiotherapists. The project team mapped out the structure of the framework. This was followed by a working party of subject matter experts developing an agreed competency standard. The framework was implemented at six hospitals across Australia and formally evaluated by an external evaluator. The clinical education framework developed includes a competency-based training and assessment program supported by learning resources and a mentoring program. It was successfully implemented across a diverse range of hospitals and received a positive evaluation. As the prevalence of musculoskeletal conditions increases, a new workforce of advanced musculoskeletal physiotherapists is emerging. A clinical education framework has been developed to address the specific needs of the population, organisations and experienced musculoskeletal physiotherapists recruited to these roles. A competent workforce has direct benefits for the community, healthcare organisations and the physiotherapy profession.

Quantifying carbon sequestration on sheep grazing land in Australia for life cycle assessment studies

The sheep industry has played an important role in Australia’s development and economy over the 220 years since European settlement and remains an important land use in Australia, occupying an estimated 85 million ha of continental land mass. Historically, deforestation was carried out in many sheep-rearing regions to promote pasture growth but this has not occurred within recent decades and many wool producers have invested in planting trees as well as preserving patches of remnant vegetation. Although the limitations of single environmental impact studies are recognised, this paper focuses on the contribution of carbon sequestration in trees and shrubs on sheep farms to the global warming potential impact category in life cycle assessment of wool. The analysis represents three major wool-producing zones of Australia. Based on default regional yields as applied in Australia’s National Inventory model, FullCAM, CO2 removals in planted exotic pines and mixed native species were estimated to be 5.0 and 3.0 t CO2 ha–1 year–1, respectively, for the Northern Tablelands of New South Wales in the ‘high-rainfall zone’ and 1.4 t CO2 ha–1 year–1 for mixed native species in the ‘sheep-wheat zone’ of Western Australia. Applying modified factors allowing for the higher measured growth rates in regions with rainfall >300 mm, gave values for native species reforestation of 4.4 and 2.0 t CO2 ha–1 year–1 for New South Wales and Western Australia, respectively. Sequestration was estimated to be 0.07 t CO2 ha–1 year–1 over 100 years for chenopod shrublands of the ‘pastoral zone’ of South Australia but this low rate is significant because of the extent of regeneration. Sequestration of soil organic carbon in improved permanent pastures in the New South Wales Northern Tablelands was evaluated to be highly uncertain but potentially significant over large areas of management. Improved data and consistent methodologies are needed for quantification of these benefits in life cycle assessment studies for wool and sheep meat, and additional impact categories, such as biodiversity, need to be included if the public and private benefits provided by good management of vegetation resources on farms are to be more fully recognised.

Cross-sector, sessional employment of pharmacists in rural hospitals in Australia and New Zealand: a qualitative study exploring pharmacists' perceptions and experiences.

BackgroundMany rural hospitals in Australia and New Zealand do not have an on-site pharmacist. Sessional employment of a local pharmacist offers a potential solution to address the clinical service needs of non-pharmacist rural hospitals. This study explored sessional service models involving pharmacists and factors (enablers and challenges) impacting on these models, with a view to informing future sessional employment.MethodsA series of semi-structured one-on-one interviews was conducted with rural pharmacists with experience, or intention to practise, in a sessional employment role in Australia and New Zealand. Participants were identified via relevant newsletters, discussion forums and referrals from contacts. Interviews were conducted during August 2012-January 2013 via telephone or Skype™, for approximately 40–55 minutes each, and recorded.ResultsSeventeen pharmacists were interviewed: eight with ongoing sessional roles, five with sessional experience, and four working towards sessional employment. Most participants provided sessional hospital services on a weekly basis, mainly focusing on inpatient medication review and consultation. Recognition of the value of pharmacists’ involvement and engagement with other healthcare providers facilitated establishment and continuity of sessional services. Funds pooled from various sources supplemented some pharmacists’ remuneration in the absence of designated government funding. Enhanced employment opportunities, district support and flexibility in services facilitated the continuous operation of the sessional service.ConclusionsThere is potential to address clinical pharmacy service needs in rural hospitals by cross-sector employment of pharmacists. The reported sessional model arrangements, factors impacting on sessional employment of pharmacists and learnings shared by the participants should assist development of similar models in other rural communities.

Clarifying Clinical Nurse Consultant work in Australia: A phenomenological study

The Clinical Nurse Consultant role in Australia is an Advanced Practice Registered Nurse Role (APRN). This role has been conceptualized from the discrete pillars of research, education, practice, system support and leadership, articulated in the Strong Model of Advanced Practice. This conceptualization has been manifested in job descriptions, workforce. planning and course design. This paper explored whether there was a more refined way of conceptualizing the unique 'value add' of the role. A hermeneutic phenomenological approach was employed to explore the lived experience of the role. It was identified that the pillars of education, practice, leadership and research are interconnected and expressed in the system work of the Clinical Nurse Consultant. The findings have implications for education and workforce planning.

Factors influencing the development and implementation of advanced radiographer practice in Australia - a qualitative study using an interpretative phenomenological approach.

IntroductionThe purpose of this study was to explore the factors influencing the implementation or the lack of implementation of advanced practitioner role in Australia.MethodsThis study uses an interpretative phenomenological approach to explore the in-depth real life issues, which surround the advanced practitioner as a solution to radiologist workforce shortages in Australia. Research participants are radiographers, radiation therapists and health managers registered with the Australian Institute of Radiography (AIR) and holding senior professional and AIR Board positions with knowledge of current advanced practice.ResultsIn total, seven interviews were conducted revealing education, governance, technical, people issues, change management, government, costs and timing as critical factors influencing advanced practice in Australia.ConclusionsSeven participants in this study perceived an advanced practice role might have major benefits and a positive impact on the immediate and long-term management of patients. Another finding is the greater respect and appreciation of each other's roles and expertise within the multidisciplinary healthcare team. Engagement is required of the critical stakeholders that have been identified as ‘blockers’ (radiologists, health departments) as well as identified allies (e.g. emergency clinicians, supportive radiologists, patient advocacy groups). The research supports that the AIR has a role to play for the professional identity of radiographers and shaping the advanced practice role in Australia.

Profiling emergency nurse practitioner service: an interpretive study.

The aim of this study was to investigate the practice profile of emergency nurse practitioners across Australia. Nurse practitioners have been providing health service in the emergency setting internationally for more than 30 years, and evidence supports the value of this role in terms of patient satisfaction, effectiveness in improving service indicators, and acceptability of the role. The introduction of this service model has been instrumental in reducing waiting times for low-acuity patients and impacting positively on emergency department service delivery. Recent rapid uptake of this role internationally has outpaced development of the service model to inform education and ongoing service development. This was a national study that used interpretive research methods to identify the practice profile of emergency nurse practitioners. Data were collected from December 2012 to February 2013 through in-depth interviews. An inductive approach was used in data analysis to identify conceptual themes and develop an analysis framework. The study participants worked in a range of service models and managed patient presentations across all levels of acuity and complexity. The findings show that although there is no single definable model of the emergency nurse practitioner role in Australia, there are practice features that are common across all service models; these have been conceptualized as "modes of practice." This study has produced new knowledge about the practice profile of emergency nurse practitioners. The findings will inform development of practice standards for education and continuing professional development for emergency nurse practitioners and facilitate standardized operational definitions for ongoing research into this growing service model.

Medical acceptance of the nurse practitioner role in Australia: a decade on.

In Australia, nurse practitioners (NPs) were first endorsed in 2000. After more than a decade, the number of NPs remains relatively small with previous research suggesting medical resistance as a key reason for this. This article presents a selection of narratives from a study that explored the transition experiences of newly endorsed NPs with particular attention to relationships with their medical colleagues. A critical ethnographic approach was undertaken to explore the experiences of 10 Australian NPs who were interviewed three to four times for up to an hour throughout their first year of practice. Participants' narratives provide insight into their transition to practice and the barriers and facilitators to their new role. In contrast to previous research, medical colleagues were generally supportive and collegial while resistance was demonstrated most often by senior nurses yielding positions of power. This study provides insight into the influences that key health professionals have over the transition of NPs. Despite the fact there are still negative attitudes being expressed by some medical associations, in this study medical colleagues were largely supportive of the NP role and that integral to the development of these interprofessional relationships was mutual respect and effective communication.

The role of the prostate cancer nurse co‐ordinator: nurses' perspectives of barriers and challenges

ABSTRACTThe prostate cancer nurse co‐ordinator (PCNC) is a relatively new role in Australia. Although a post graduate prostate cancer nursing specialist training course has been established, within the clinical setting the role is still poorly defined and understood. This study aimed to investigate the perceptions and experiences of PCNCs regarding: (i) the challenges of their role, and (ii) the interaction of job demands and job resources in determining the impact of their role on their level of work‐related stress and delivery of care, using the job‐demands and resources (JD‐R) model. Qualitative study was designed involving thematic analysis of telephone interviews with PCNCs. Structured interviews were conducted with 15 PCNCs recruited through the Australian and New Zealand Urological Nurses' Society membership. Interview structure was guided by The JD‐R model. Respondents reported a wide range of role descriptions and activities, reflecting a lack of clarity in role definition. They also reported high demands in an environment of limited resources. However, at least in part, these stressors were mediated by high levels of job satisfaction and reward from high levels of patient care. These findings highlight the need for clear role definition and implementation of guidelines to establish case‐loads. To facilitate role clarity and a sustainable, professionally trained workforce, adequate training and competency are essential. Organizational autonomy through the implementation of nurse‐led clinics might further enhance the role.

Chasing the Pictures: Press and Magazine Photography

For over a century, press and magazine photography has influenced how Australians have viewed society, and played a critical role in Australia's evolving national identity. Despite its importance and longevity, the historiography of Australian news photography is surprising limited. This article examines the history of press and magazine photography and considers its genesis, the transformative technological innovations, debates about images of violence, the industrial attitudes towards photographers and their treatment, the use of photographs and the seismic recent changes. The article argues that while the United States and United Kingdom influenced the trajectory of press and news photography in Australia, there are significant and illuminating differences.

The Perioperative Nurse Surgeon's Assistant: Issues and challenges associated with this emerging advanced practice nursing role in Australia

The aim of this study was to obtain Perioperative Nurse Surgeon's Assistants' views about their emerging new role in contemporary nursing practice in Australia. Internationally advanced practice nursing has led to a range of specialist roles aimed at delivering higher quality, efficient nursing care. In 2005 an Australian university developed the Perioperative Nurse Surgeon's Assistant graduate education and training program to provide nurses with an opportunity to gain advanced practice knowledge and extended skills specifically in the perioperative setting. This study was a qualitative research design that used online surveys and in-depth interviews to explore the issues and challenges associated with the introduction of the (currently non-accredited) Perioperative Nurse Surgeon's Assistant role in Australia. Experienced Australia perioperative nurses who had undertaken graduate education and training in this field were recruited for this study. Data were collected between August and October 2011. An inductive thematic analysis was used to interpret the findings. Eighteen nurses completed the online survey and six were interviewed (n = 24). Nurses cited their commitment to professional development and the delivery of high quality patient care, along with surgeons' encouragement for them to complete specialist clinical training, as key reasons for undertaking Perioperative Nurse Surgeon's Assistant education and training. The Perioperative Nurse Surgeon's Assistant role led to greater job satisfaction and autonomy, and assisted nurses to better meet the needs of patients, surgeons and clinical perioperative teams. Without formal recognition of the Perioperative Nurse Surgeon's Assistant role its future in the Australian health care system is under threat.

The Australasian Consultant Paramedic – An Idea Whose Time Has Come

Drawing on examples of paramedic practice from around the world the author describes the developing role of the Consultant Paramedic internationally and advocates for development of the role in Australia.

The Development and Application in Nineteenth Century Australia of the Prosecutor's Role as a Minister of Justice: Rhetoric or Reality?

The English notion of the proper prosecutorial role as that of the non-partisan ‘minister of justice’ was expressed in Australia by colonial legal practitioners but in practice the application of this role was to often prove a matter of rhetoric rather than of reality. Prosecutors in practice often acted as zealous and partisan advocates. This article considers the development of the prosecutorial role in Australia from 1824 to the early 20th century and, in particular, the extent to which the minister of justice model was applied in Australia. This article also examines the factors that influenced the perception and performance of the prosecutorial role in Australia. It is suggested that colonial prosecutors in practice were motivated by subjective factors such as the class or race of the accused and the nature of the crime that they were charged with. Prosecutorial zeal appears explicable, not by the tension of acting in an adversarial system, but in confronting defendants who were regarded as ‘criminals of the deepest dye’ who posed a real ‘threat’ to colonial society. Though the minister of justice role was applied in Australia on occasion, it was often reserved for ‘respectable’ defendants and to be the apparent product of class bias rather than genuine prosecutorial restraint. Nevertheless, despite the inconsistent development in Australia of the minister of justice role, as the 19th century progressed, it was increasingly applied as a matter of both rhetoric and reality, reflecting the increasing stability and confidence of the Australian colonies.

An exploration of the feasibility of radiation therapist participation in treatment reviews.

IntroductionAs radiation oncologists' (ROs') workload has increased over time, treatment review clinics have become recognized as an area of RO practice into which radiation therapist (RT) practice could extend. There has been limited utilization of RTs in this role in Australia and a paucity of data on the acceptability and opinions regarding RTs practising in this role in an Australian context. The purpose of this audit was to investigate the feasibility of RT participation in review clinics at Calvary Mater Newcastle.MethodsFeasibility was determined by two methods: an audit of 200 treatment reviews to determine medical intervention (MI) levels required and a survey of 80 clinical staff to explore attitudes towards RT participation in clinics.ResultsMedical intervention was required in 59% (n = 118) of observed reviews, with the lowest being for breast (33%) and prostate (28%) cancers. MI peaked at 73% between fractions 16–20 and was lowest early and late in the treatment period at 48%. There were 60 responses to the staff survey. All but one respondent agreed that RTs would be willing to participate in treatment review clinics, but all five consultant ROs indicated they would not be willing to delegate reviews to RTs.ConclusionsNeither feasibility measure reached acceptable levels to recommend RT participation in treatment review clinics. Further investigation and RT education are required to help meet the future RO workforce shortfall. As MI rates are lowest for breast and prostate cancer RT participation could be targeted to these clinics.

Report on calls for IBD nurse specialist role in Australia

Report on calls for IBD nurse specialist role in Australia

Domains of practice and Advanced Practice Nursing in Australia

A key component of workforce reform is the international growth in Advanced Practice Nursing (APN) roles. This study evaluated one APN role in Australia, the Clinical Nurse Consultant (CNC). All 56 CNCs employed in a tertiary hospital in New South Wales took part in the study. Demographic and work activity data were collected by an online questionnaire. Face-to-face interviews included the administration of a 50-point tool to score the level of practice of each CNC against five domains. The domains of practice did not appear to have played a central role in the design of these CNC roles despite being defined in the industrial legislation and linked to a pay structure. There was widespread variability in the level of practice both within and between the CNC grades as well as significant differences in job content. Few CNCs managed to achieve a moderate level of practice across all five domains. The findings suggest that the distinctive features of the CNC roles as articulated in the domains of practice are often not realized in practice.

Can A Theoretical Consideration of Australia's Anti-Discrimination Laws Inform Law Reform?

Anti-discrimination law in Australia is at a crossroads. After four decades of proliferation of legislation to regulate discrimination, national attention has turned from increasing regulation to legislative consolidation and reform. This article contributes a theoretical analysis to the reform debate. Two liberal theoretical justifications for prohibiting discrimination, harm and redistributive justice, are considered. This investigation assists to determine when the state should intervene in order to restrict discrimination, and whether state and territory anti-discrimination regimes have a legitimate continuing role in Australia's legislative landscape.