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1: Historical and Contemporary Nursing Practice
Historical Perspectives
Women’s roles
Gender roles in nursing may be traced back to its beginnings in the household, when nurses such as mothers, daughters, and sisters provided primary care for sick relatives and family members.
As the Industrial Revolution progressed, some men and women hired out their services as 'nurses'.
Nurses historically fell into five groups:
members of the domestic household
handywoman
private duty nurses
treatment assistants
inmates of poorhouses, asylums and prisons
Nursing became considered as a traditionally "female" occupation when gendered roles within the home and the larger society solidified in the 18th and 19th centuries.
Nursing became heavily connected with other feminine social traits like subservience, self-sacrifice, and women's presumed intrinsic capacity to "care."
Religion
Many faiths emphasize caring for the ill, destitute, and defenseless.
Many religions funded hospitals and supplied nurses.
Irish Sisters of Charity: First trained nurses to come to Australia in 1838.
They visited the sick poor around Sydney.
As in other Western nations, the Sisters of Charity saw hospitals as a good use of their resources, and St. Vincent's Hospital opened in 1856.
The New South Wales colonial administration introduced "Nightingale" nursing in the 1860s.
Self-denial, spiritual calling, and obligation and hard labour have shaped nursing from the start.
Nurses were exploited and underpaid for their beliefs.
Nurses thought it was wrong to seek financial benefit from their "vocation."
War
Great Britain protested inadequate military treatment during the Crimean War (1854-56).
Florence Nightingale's contribution is widely recognized.
Sir Sidney Herbert of the British War Department urged her to recruit female nurses to treat Crimean patients.
Nightingale and her nurses introduced hygiene measures like handwashing and clothes washing to military hospitals.
World War I and World War II nurses worked in horrendous circumstances on the front lines.
They improvised and used experimental technology to treat serious injuries and diseases.
These nurses treated and rehabilitated troops and others and took much of what they learned to civilian nursing.
Societal Attitudes
Before the mid-1800s, nursing was unorganized, uneducated, and considered under respectable women.
Victorian middle-class women's education was meant to make them good wives and mothers.
Some hospital nurses were criminals.
Past publications mirrored society's nursing view.
The doctor's handmaiden image from the early nineteenth century has also influenced nurses and the public.
When women didn't have the right to vote, family structures were mostly paternalistic, and the medical profession was employing scientific information that was considered a man's domain.
Since then, nursing has been presented in many ways, such as a heroine after World War 11 nurses' valor.
Nurse as sex object, surrogate mother, dictatorial mother, and body expert were additional late 1900s depictions.
Nurses are now seen as multifunctional team members with degrees and technical expertise.
Nursing Leaders
Florence Nightingale (1820-1910)
"Lady with the Lamp" was her nickname for improving Crimean war casualty treatment.
She was the first nurse to put political pressure on the government via her hospital reforms and public health programs.
Due to her Crimean experiences, she became the symbol of nineteenth-century nursing reforms.
She is considered nursing's first scientist-theorist for her book Notes on Nursing: What It Is, and What It Is Not.
After returning from Crimea, the English people paid Nightingale over £45,000 in gratitude.
In 1860, she founded the Nightingale Training School for Nurses with this money.
It inspired other training institutions. Its alumni managed hospitals and nurse-training programs abroad, notably Australia.
Lucy Osburn (1836-1891)
One of Nightingale's early prodigies.
She started her nursing training in 1866 at the Nightingale School of Nursing, St. Thomas's Hospital, London, but sickness prevented her from finishing.
On Henry Parkes' request, Osburn and five other trained nurses were dispatched to Sydney Hospital to establish the Nightingale style of nursing.
Osburn's dominance over her more experienced nursing colleagues was based on cultural norms that prioritised the higher classes.
Osburn was considered a "lady."
Osburn was instrumental in establishing Nightingale nurse training in Australia, and graduates from the Sydney Hospital were able to become matrons at hospitals across the nation.
Over the next 18 years, Osburn faced many challenges and clashed with medical professionals who had different nursing reform ideas.
Jane Bell (1873-1959)
She moved to Sydney in 1886 from Scotland.
Between 1894 until 1898, she trained as a nurse at Sydney's Royal Prince Alfred Hospital.
In 1899, she founded the Australasian Trained Nurses' Association.
Bell worked in Australia and abroad for many years before becoming Royal Melbourne Hospital's matron in 1910.
Bell was essential in reforming nursing training at the Royal Melbourne Hospital, apart from her stint abroad in 1914 as Principal Matron of the First Australian General Hospital in the army during World War I.
These included the first Sister Tutor, the first Preliminary Training School for Nurses in Australia, the first Diet Kitchen, the first Charge Sisters in operating theatres, and the Melbourne Hospital Nursing Badge for graduates.
Bell withdrew from the Melbourne Hospital in 1934 but continued to write, talk, and occupy roles in professional nursing organisations including the Royal Victorian College of Nursing and the College of Nursing, Australia.
Elizabeth Kenny (1880-1952)
She was called "Sister" throughout her World War I nursing duty, but her training is unclear.
For years, Kenny treated polio sufferers in rural Queensland.
These methods varied from splinting, hot packs, massage, and limb mobility..
She opened Kenny clinics in Townsville and a few other locations after the Queensland government supported her therapies for years.
Her failure to persuade the medical establishment to change its attitude to polio treatment and the developing animosity between her and the local medical community drove her to take her tactics outside from 1940, where she garnered backing in the US.
She was America's Most Influential Women alongside Eleanor Roosevelt in 1951.
After her departure, the Australian medical establishment followed many of her methods, and polio outbreaks decreased as vaccination programs expanded in the 1950s.
Gwendolen Burbidge (1904-2000)
She wrote the first Australian nursing textbook, Lectures for Nurses, in 1934.
Between 1926 and 1929, Burbidge trained as a nurse at the Royal Melbourne Hospital.
By 1933, she was educating student nurses at The Alfred Hospital in Melbourne, where she founded and headed its Preliminary Training School (PTS).
Sister Tutors were overseeing trainees' curriculums as nursing training in Australia became more formalised.
Burbidge completed a teaching course with the Victorian Teachers College and studied in London, where she earned the:
First Class Certificate for Sister Tutors,
Sister Tutor Diploma, and
Diploma of Nursing from the University of London in 1938.
Burbidge became the first Australian infectious disease hospital's matron when she returned to the country.
She aggressively sought to change nurses' and the public's fear of contagious illnesses to acceptance of good treatment.
Burbidge was Australia's delegate to the International Council of Nurses and a member of professional nursing organisations including the Grand Council of the Florence Nightingale International Foundation and local groups.
Muriel Knox Doherty (1896-1988)
She founded Preliminary Nurse Training at Sydney's Royal Prince Alfred Hospital in 1936 after finishing her Sister Tutor's degree at the University of London.
After World War II, she helped reconstruct Europe.
After their escape from Bergen-Belsen, one of Germany's most infamous concentration camps, Doherty nursed and rehabilitated displaced individuals.
Doherty, as matron, had to coordinate and manage the physical and emotional rehabilitation of 10,000 Europeans with a small number of multilingual nurses, many of whom were German, and minimal resources.
She advised the Polish government on nursing reorganisation after the war.
Doherty founded
the Council of the New South Wales College of Nursing,
the Australasian Trained Nurses' Association, and
the National Florence Nightingale Memorial Committee in Australia after returning to Australia.
She authored a history of Sydney's Royal Prince Alfred Hospital, where she worked after graduating in 1925.
Vivian Bullwinkel (1915-2000)
Before joining the Australian Army Nursing Service, Australian Imperial Force, she trained as a midwife.
After being deployed to Singapore, she fled the front line in 1941.
Her boat fell under Japanese assault.
On Bangka Island, survivors surrendered to a Japanese patrol.
However, the patrol drove the gang into the water and shot them.
Only Bullwinkel survived.
After living in the forest, she surrendered and was taken prisoner.
Over the next 3.5 years, Bullwinkel and a small group of nurses survived on little food and provided care to camp inmates.
Her coworkers died under the severe circumstances.
After the war, Bullwinkel worked as a civilian nurse at Heidelberg Repatriation Hospital and was Fairfield Infectious Diseases Hospital's Director of Nursing from 1961 to 1977.
In her numerous public appearances, she promoted nursing and helped establish a monument for the Australian Army Nursing Service personnel who died on Bangka Island.
Mary Evans (1915-2004)
In the 1960s and 1970s, she led district nursing in Australia.
Evans was a seamstress before becoming a nurse at Mareeba Babies Hospital.
She finished her general training at the Royal Adelaide Hospital.
Queen Victoria Memorial Hospital trained her as a midwife in 1940.
In 1943, she joined the Home Midwifery team of the Melbourne District Nursing Service (later Royal District Nursing Service).
In 1959, she received a scholarship to study health visitors and tour district nursing services in the UK, Canada, and the US.
This experience gave Evans many ideas, which she applied as Deputy Matron in 1961 and Matron in 1963.
In particular, she promoted district nurses' in-service and postgraduate education and home rehabilitation and patient education.
In 1970, Evans helped organise Melbourne's first international domiciliary nursing conference. She installed district nursing's first computers.
In the Australian Family Physician publication, Evans wrote about district nursing and travelled the nation to promote it.
She resigned from the Royal District Nursing Service in 1978.
Sally Goold
Australia's Indigenous nursing pioneer.
The youngest of seven children, Goold was born in Narrandera in rural New South Wales and relocated to Sydney with her family when she was small.
Goold, who was hospitalised many times, aspired to be a nurse since childhood.
At 16, she was admitted to study nursing at Sydney's Royal Prince Alfred Hospital.
After being recruited by Fred Hollows and Dulcie Flower, she helped establish Redfern's Aboriginal Medical Service in 1971.
Academic and government positions are in Goold's resume.
However, her passion and commitment to nursing, particularly her support and inspiration of Indigenous nurses, stand out.
Contemporary Nursing Practice
Nursing
Florence Nightingale defined nursing as 'the act of utilizing the environment of the patient to assist him in his recovery.’
Virginia Henderson defined nursing was ‘concerned with both healthy and ill individuals, acknowledging that nurses interact with people even when recovery may not be feasible and mentioned the teaching and advocacy roles of the nurse.’
Themes of Nursing Definitions:
Nursing is caring.
Nursing is an art.
Nursing is a science.
Nursing is person centred.
Nursing is holistic.
Nursing is adaptive.
Nursing is concerned with health promotion, health maintenance and health restoration.
Nursing is a helping profession.
Australian Peak Nursing Forum
This document highlighted nursing as a 'combination of skills and knowledge to provide physical, mental and emotional care to people who are trying to:
improve their health;
prevent illness and disability;
respond to events such as childbirth; or
recover their health following an illness or disability.
Nurses also support people who are dying, and their families'
Recipients of nursing
The term ‘person’ is more used than the traditional term ‘patient.’
This is in recognition of a shift towards 'person-centred care ' and illustrates the holistic nature of nursing practice.
Extent of nursing care
Nurses provide care for individuals, families and communities.
Nursing practice involves promoting health and wellness, preventing illness, restoring health and caring for people who are chronically ill and those who are dying.
Promoting health and wellness
Health and wellness promotion is a fundamental role within nursing.
Wellness: A process that people engage in to maximise their quality of life and achieve full potential.
Nurses promote wellness both in people who are healthy and people who are ill.
Preventing illness
The goal of illness-prevention programs is preventing illness.
It generally refers to actions that are done to, for and with people.
Nursing activities that prevent illness include research, immunisations, prenatal and infant care, health education and health program planning and evaluation.
Restoring health
It focuses on the person who is unwell and extends from early detection of disease, illness and/or disability through to helping the person during the recovery period.
Nursing activities include the following and incorporate nurses undertaking evaluations of how effective their interventions were and are:
giving direct biopsychosocial care to the sick individual
doing diagnostic and evaluation procedures
talking with other health care specialists about their issues
teaching therapeutic exercises to help individuals recover from disease, injury, or addiction.
Caring for the person who is dying
This nursing specialty entails soothing and caring for dying persons of all ages and their loved ones.
It helps individuals live peacefully till death and deal with dying.
These nurses must respect religious and cultural norms in homes, hospitals, and extended care institutions.
Hospices specialize in this.
Professional Standards
In 2009, the Nursing and Midwifery Board of Australia (NMBA) was established under the Health Practitioner (Administration Arrangements) National Law Act 2008.
The NMBA has a number of functions:
registration of nurses, midwives and students; developing standards, codes and
guidelines for nursing and midwifery;
handling notifications, complaints, investigations and disciplinary hearings;
assessing overseas-trained practitioners who wish to practise in Australia; and
approving accreditation standards and accrediting courses of study
One such function of the NMBA is to provide codes and guidelines to provide guidance to the nursing professions such as:
codes of ethics and professional conduct,
competency standards,
decision-making frameworks and
a number of other guidelines for practice.
In 2013, codes and guidelines began to be rebranded to no longer include the name Australian Nursing and Midwifery Council (ANMC) and to include the NMBA.
NMBA Registered Nurse Standards for Practice (NMBA 2016): Describe the responsibilities for which nurses are accountable and provide for the practice of nursing regardless of the area of specialisation
NMBA Registered Nurse Standards for Practice
Standard 1: Thinks critically and analyses nursing practice
RNs make decisions and provide safe, excellent nursing care using a range of thinking processes and the best available information within person-centered and evidence-based frameworks.
Standard 2: Engages in therapeutic and professional relationships
RN practice is based on purposefully engaging in effective therapeutic and professional relationships.
This includes collegial generosity in the context of mutual trust and respect in professional relationships.
Standard 3: Maintains the capability for practice
RNs, as regulated health professionals, are responsible and accountable for ensuring they are safe and have the capability for practice.
This includes ongoing self-management and responding when there is concern about other health professionals' capability for practice.
RNs are responsible for their professional development and contribute to the development of others.
They are also responsible for providing information and education to enable people to make decisions and take action in relation to their health.
Standard 4: Comprehensively conducts assessments
RNs accurately conduct comprehensive and systematic assessments.
They analyse information and data, and communicate outcomes as the basis for practice.
Standard 5: Develops a plan for nursing practice
RNs are responsible for the planning and communication of nursing practice.
Agreed plans are developed in partnership.
They are based on the RN's appraisal of comprehensive, relevant information and evidence that is documented and communicated.
Standard 6: Provides safe, appropriate and responsive quality nursing practice
RNs provide and may delegate quality and ethical goal-directed actions.
These are based on comprehensive and systematic assessment and the best available evidence to achieve planned and agreed outcomes.
Standard 7: Evaluates outcomes to inform nursing practice
RNs take responsibility for the evaluation of practice based on agreed priorities, goals, plans and outcomes, and revises practice accordingly
Roles and Functions of the Nurse
Caregiver
It helps physically, spiritually, and psychologically.
Full care for the wholly dependent, partial care for the partly dependent, and supportive-educative care to help individuals achieve their best health, wellbeing, and rehabilitation may be needed.
It has physical, emotional, developmental, cultural, and spiritual aspects.
Registered nurses may offer or delegate care.
It generally entails caring for loved ones.
Collaborator
Recognize others' roles and expertise and collaborate with others to assess, plan, coordinate, administer, and evaluate care.
Attain objectives and health outcomes, the nurse collaborates with others, including the patient.
Builds, maintains, and ends therapeutic connections with individuals, families, caregivers, and communities.
Collaborate with other health professionals in the multidisciplinary health care team.
Communicator
Build a trustworthy, therapeutic connection with the patient, identify their issues, and express them to the health team.
Nurses' communication is crucial.
Must communicate empathically, clearly, and precisely.
Communicate objectively.
Teacher
Educates patients on health care processes, treatments, and interventions.
Analyses learning needs and preparedness, develops learning objectives with the individual, implements teaching tactics, and evaluates learning.
Nurses instruct Assistants in Nursing (AINs) and Enrolled Nurses, whom they transfer care and competence to.
Nurse advocate
Communicates the patient's requirements and wants to other health experts, such as the doctor, physiotherapist, or social worker, and ensures that the patient understands the information.
Advocates help individuals speak out and use their rights.
Crucial when talking for vulnerable, stigmatised, and marginalised persons.
Counsellor
Counselling helps people recognize and manage difficult psychological or social issues, strengthen relationships, and grow personally.
Supporting emotionally, intellectually, and psychologically.
By fostering reflection and decision, counselling may help the individual build coping mechanisms.
Due to their training and specialisation, some mental health nurses are psychotherapists.
Change agent
Helping employees change their behaviour, changing rules and procedures, establishing models of care, and improving workplace culture.
When they critically reflect on practice and determine that it is not helping a patient recover, nurses adjust clinical care.
The ever-changing healthcare system challenges nurses.
Nurses face technological, demographic, and pharmacological changes everyday.
Leader
Individuals, families, groups, coworkers, and communities may lead.
Effective leadership requires awareness of people's motivations, leadership abilities, and interpersonal skills.
Should learn their leadership styles.
Manager
Individuals, families, and communities are tended by nurses.
Oversees and assesses auxiliary employees and nurses who perform nursing duties.
Managing needs understanding of organisational structure, dynamics, authority and responsibility, leadership, change theory, advocacy, delegating, supervision, and assessment.
Must compare management and leadership.
Care coordinator
Monitor results and evaluate the patient's health care plan with the multidisciplinary team.
Should involve the patient from the start.
Roles vary by agency or unit. In certain facilities, the care coordinator supervises a particular group of patients alongside other nurses and personnel.
In mental health settings, care coordinators often give direct care to patients and families.
Respect dignity, culture, ethnicity, values, and beliefs to centre care on the individual.
Researcher
Nurses often use research to improve care-this ensures care is evidence based. All nurses need to:
have some awareness of the process and language of research and be sensitive to issues related to protecting the rights of research participants
participate in the identification and conduct of researchable problems
be a discriminating consumer of research findings.
Expanded career roles
Nurse Practitioner: A nurse who has an advanced education, usually at master's level, and is a graduate of a Nurse Practitioner program.
Endorsed by the NMBA and have standards for practice which build upon those of a Registered Nurse.
Have the capability to provide high levels of clinically focused care in a variety of contexts in Australia.
Clinical nurse specialist: A nurse who has an advanced degree or expertise and is considered to be an expert in a specialised area of practice.
Provides direct care, educates others, consults, conducts research and manages and coordinates care.
Midwife: Provides prenatal and postnatal care, and care during labour and birth.
In Australia, he/she has completed a program in midwifery and is registered by the NMBA.
A separate profession to nursing and has a separate registration with the Australian Health Practitioner Regulation Agency.
Nurse researchers: They investigate nursing and health problems to improve nursing and health care and to refine and expand nursing and health knowledge.
They are employed in academic institutions, teaching hospitals and research centres.
They have advanced education level attainment.
Nurse administrator: Manages care of the person, including the delivery of nursing services.
Leading and managing services and health staff, budgeting, planning and delivering health care.
Nurse educators: They are employed in nursing programs at educational institutions and also in hospital and community staff education positions.
They usually has a degree in nursing or more advanced preparation, and frequently has expertise in a particular area of practice.
They are responsible for classroom teaching and, often, clinical teaching.
Nurse entrepreneur: A nurse who usually has an advanced degree and manages a health-related business.
Criteria of a Profession
Profession: Defined as an occupation that requires extensive education or a calling that requires special knowledge, skill and preparation.
A profession is generally distinguished from other kinds of occupations by:
its requirement for prolonged, specialised training to acquire a body of knowledge pertinent to the role to be performed
an orientation of the individual towards service, either to a community or to an organisation
ongoing research
a code of ethics
autonomy
a professional organisation.
Professionalism: Refers to professional character, spirit or methods. It is a set of attributes; a way of life that implies responsibility and commitment.
Professionalisation: The process of becoming professional; that is, of acquiring characteristics considered to be professional.
Specialised education
Registered Nurses undertake a degree at a university
Enrolled Nurses complete an associate diploma or diploma
AINs generally complete a shorter certificate
Governance: The establishment and maintenance of social, political and economic arrangements by which practitioners control their practice, self-discipline, working conditions and professional affairs.
Socialisation to nursing
Socialisation can be defined simply as the process by which people:
learn to become members of groups and society, and
learn the social rules defining relationships.
The goal of professional socialisation is to instil in individuals the norms, values, attitudes and behaviours deemed essential for the survival and growth of the profession.
Benner's stages of nursing expertise
Stage I: Novice
No experience (e.g. nursing student).
Performance is limited, inflexible and governed by context-free rules and regulations rather than experience.
Stage II: Advanced beginner
Demonstrates marginally acceptable performance.
Recognises the meaningful 'aspects' of a real situation.
Has experienced enough real situations to make judgments about them.
Stage Ill: Competent
Has 2 or 3 years' experience.
Demonstrates organisational and planning abilities.
Differentiates important factors from less important aspects of care.
Coordinates multiple complex care demands.
Stage IV: Proficient
Has 3 to 5 years' experience.
Perceives situations as wholes rather than in terms of parts, as in Stage II.
Uses maxims as guides for what to consider in a situation.
Has holistic understanding of the person, which improves decision making.
Focuses on long-term goals.
Stage V: Expert
Performance is fluid, flexible and highly proficient; no longer requires rules, guidelines or maxims to connect an understanding of the situation to appropriate action.
Demonstrates highly skilled intuitive and analytical ability in new situations.
Is inclined to take a certain action because 'it felt right'.
Factors influencing contemporary nursing practice
Economics
Medical diagnosis determines hospital and doctor payments and reimbursement costs.
Pre-treatment diagnostic billing categories need precise evaluation.
With this approach, patients in hospitals are more seriously ill and those who were hospitalised are being treated at home, but health care expenses continue to climb and nurses who manage money and budgets are becoming more conscious of the need for austerity.
Pre-admission testing, outpatient same-day surgery, early release, home health care, health maintenance, physical fitness programs, and community health education initiatives are changing the health care sector from inpatient to outpatient treatment.
Community-based health facilities are hiring more nurses.
These job shifts affect nurse education, research, and practice.
Consumer empowerment
Consumers also realise others require care.
The ethical and moral concerns posed by poverty and neglect have made the public increasingly outspoken about the needs of minority and vulnerable groups, the poor, and Indigenous Australians, whose health condition is substantially poorer than other Australians.
Health and nursing care choices increasingly include consumers.
Community nursing planning groups often include consumers.
Many state and territory nursing organisations and regulatory bodies include consumer representatives on their boards, acknowledging public participation.
Family Structure
Australia has more nuclear families and less extended families.
Single parents and two-parent households often both work.
Young parents often live far from their parents.
Young families require childcare and health services.
Young moms may also require specialised nursing care during and after pregnancy.
Teenage moms often have new mother and adolescent needs.
Teenage women sometimes raise their kids without fathers' help.
Motherhood compounds adolescent challenges, making this sort of single-parent household susceptible.
Poverty puts many of these families at risk for nutritional and other health issues.
Science and technology
Advances in health science and technology as a result of research mean that there have been and will continue to be great changes in genetics/genomics, nanotechnology, biotechnology, artificial intelligence, robotics and pervasive computing.
It is postulated that robots that lift and reposition people could also perform duties such as transferring, bathing and dressing.
Information and telecommunication technology
Nurses must be mindful of the "informed" patient's preconceived notions before treating them.
Nurses may need to analyze online sources for such persons and become information brokers to assist them find high-quality, reliable websites, interpret the material, and assess its value.
Telehealth: The information, technology, education and clinical services that provide long-term wellness, self-management and health services for people distant from the health provider.
Telenursing: A practice of nursing from a distance, using information and telecommunication technologies, such as the telephone, computer, video transmission and direct connection to instrumentation.
Legislation
Changes in legislation relating to health also affect nursing.
These laws, which in many institutions are implemented by nurses, affect the nurse's role in supporting individuals and their families
Demography
Demography: The study of population, including statistics about distribution by age and place of residence, mortality (death) and morbidity (incidence of disease).
The needs of the population for nursing services can be assessed from demographic data.
Environmental change
Environmental change and environmental hazards are a threat to public health and influence contemporary nursing practice.
Nurses may influence the adoption of policies to better prepare our health institutions and communities for the health implications of climate change and minimize its effects.
Climate change and food and water security are public health threats in Australia.
Nurses can shape policy, impact practice, and enhance energy, water, and waste management.
Factors affecting the nursing shortage
Ageing nurse workforce
High student attrition in pre-registration nursing courses.
New graduates entering the workforce at an older age and with fewer years to work.
New graduates often take up other career options.
Difficulty retaining early career nurses.
As nursing academics retire, nursing programs may have fewer staff to educate future nurses.
Reduced entry of younger people into nursing
Ageing population
Rapidly rising demand for health care driven by ageing population.
Increasing health care needs of an ageing population
Increased demand for nurses
Rapidly rising demand for nurses in health care.
Increased complexity and acuity of hospitalised people, requiring skilled and specialised nurses.
Shorter hospital stays resulting in transfer of people to long-term care and community settings, creating increased demand for nurses in the community.
Workplace issues
Inadequate staffing.
Heavy workloads.
Increased use of overtime.
Lack of sufficient support staff.
Inadequate wages.
Increased acuity of people in hospital.
Negative workplace environments.
Nursing Organisations
Australian Nursing Federation (ANF)
The first organisation to represent Australian nurses was established in 1899.
The Australasian Trained Nurses' Association (ATNA) began in New South Wales and developed branches in Queensland (1904), South Australia (1905), Western Australia (1907) and Tasmania (1908).
A separate group formed in Victoria in 1901- the (later Royal) Victorian Trained Nurses' Association (RVTNA), which had similar objectives to the ATNA.
Early professional nursing organizations focused on promoting skilled nurses, registering them, and controlling hospital training.
The
Australian Nursing and Midwifery Federation (ANMF) is the primary nursing industrial body that represents nurses at all levels of practice, from Registered Nurses to Enrolled Nurses to Assistants in Nursing and midwifery.
Australian College of Nursing
The Royal College of Nursing, Australia (RCNA) was established in 1949 with a representative from each state on the council.
Unfortunately, nurses in New South Wales had simultaneously established the New South Wales College of Nursing, so the RCNA tended to have nurses from all states other than New South Wales.
The site for the delivery of the educational programs was initially Melbourne.
In 2012, the RCNA and the College of Nursing combined to form the Australian College of Nursing (ACN).
The ACN is Australia's "major national professional nursing organisation available to nurses in all settings and at every stage of their careers."
An recognized higher education provider and licensed training institution, the organisation is presently the Australian member of the International Council of Nurses.
Australian Nursing and Midwifery Accreditation Council
A group was formed that included the main professional nursing organisations to create the Australian Nursing Council.
It produced the Code of Ethics for Nurses in Australia in 1993.
These codes and standards outline the knowledge, skills and behavioural expectations of Registered Nurses.
A Code of Professional Conduct for Nurses was also devised along with competency standards.
On 1 July 2010, the Australian Nursing and Midwifery Council (ANMC) changed its name to the Australian Nursing and Midwifery Accreditation Council (ANMAC).
International Council of Nurses
It was established in 1899 during the intersection of health care reform, social progressivism and women's rights.
Nurses from Great Britain, the United States, Canada and Australia were among the founding members.
ICN's first international Congress was held in Buffalo, New York, on 16 September 1901.
The ICN is a federation of national nurses' associations.
International Honour Society: Sigma
Sigma: The international honour society in nursing, was founded in 1922 and has its headquarters in Indianapolis, Indiana.
The society is a member of the Association of College Honour Societies.
The society's purpose is professional rather than social.
Membership is attained through academic achievement.
Students in undergraduate programs in nursing, and nurses in master's, doctoral and postdoctoral programs are eligible to be selected for membership.
Potential members who hold a minimum of a bachelor's degree and have demonstrated achievement in nursing can apply for membership as a nurse leader in the community.
The official journal of Sigma, Journal of Nursing Scholarship, is published bimonthly.
The society also publishes Reflections on Nursing Leadership, an e-magazine that is updated regularly.