Nursing & Midwifery

The benefits of breastfeeding are well known and widely documented. What we are only beginning to understand is the significant impact of returning to work on the e x p e r i e n c e of breastfeeding. This article describes workplace issues, discusses current literature and examines the range of influences that impact on women's decisions about working and breastfeeding Jenni James

Breastmilk and breastfeeding are known to have significant advantages and benefits over the use of artificial formula for infants and young children[1-4]. These benefits are reflected in the increased costs related to preventable illnesses as well as the actual costs of artificial formulas[5]. Both the World Health Organization[3] and the National Health and Medical Research Council[1] Guidelines recommend exclusive breastfeeding for the first six months of a baby's life, with the gradual introduction of appropriate, complementary foods and continuing to breastfeed for two or more years. Pregnant and breastfeeding women seek support from a variety of sources, and in particular, health professionals. The medical practitioner or general practitioner (GP) is commonly the first health professional women encounter during pregnancy. The GP will continue to provide care for mother and then mother and baby after discharge from hospital. This literature review seeks to determine what is known about medical practitioners' attitudes to and levels of knowledge about, breastfeeding and human lactation. The review also considers how they initially learn and then maintain their knowledge once in general practice.

Intimate Partner Violence (IPV) is prevalent among recent mothers and negatively impacts their physical and emotional health. Furthermore, the negative influence of IPV on parenting capacity and children's development is well described. However, it is unclear whether there is any relationship between IPV and method of infant feeding. Little is known about how women who are subjected to IPV make decisions about infant feeding or whether living in this context impacts on their experience of breastfeeding. With what is known about the importance of breastfeeding, particularly for vulnerable populations, research is essential to inform clinical practice and to develop appropriate community support strategies. This paper describes an analysis of data from a pragmatic cluster randomised controlled trial: Improving maternal and child health nurse care for vulnerable mothers (MOVE). The MOVE trial was conducted in the north-western suburbs of Melbourne, Australia from April 2010-April 2...

Background: The pressures of working in contemporary health care environments can result in health professionals becoming focused on their own domain. This focus, while understandable, diminishes the ability to provide holistic care for patients and clients. This multidisciplinary project sought to introduce post graduate students to the work of three other disciplines and provided them with an opportunity to develop their communication and history taking skills in the virtual world of Second Life. The participating disciplines included: Midwifery, Mental Health, Medical Radiations and Chiropractic. Methods: Four cohorts of Post Graduate students (n=210) participated in the project through a Course in their own Program. A stand-alone program area was set up on the website which was accessible to the four disciplines. A polyclinic was developed in a Second Life island, with each discipline having its own clinic room. Students were required to undertake a pre and post survey to measure their perspective of working with other disciplines; introduce their own discipline and write up what they have learned about the other disciplines, undertake and record an intradisciplinary role play and finally, reflect on their learning. Findings: students reported that working in Second Life provided them with an opportunity to practice their communication skills in a fun and non-threatening way. As the role play formed part of their assessment, many students found the process to be on a par with the work that would be required to develop an essay or other written assignment. Conclusion: Second Life provides students with an opportunity to develop communication skills and their understanding of other disciplines.

While breastfeeding is widely acknowledged as the best way to feed babies, few studies have incorporated a holistic approach when attempting to understand breastfeeding 'success' or 'failure'. This study attempted to identify the overall experience of breastfeeding for the women who participated, describe the nature of those experiences and determine which, if any, influences can be modified or changed within the confines of health policy and practice. The study found a range of independent variables that appeared to negatively influence both the experience and the duration of breastfeeding. These variables included antenatal influences such as employment status, education and social support; intrapartal influences such as type of birth, when teh first feed occurred and how the mother perceived the first feed; and postpartal influences such as introduction of other feeds, multiple problems, where the baby slept overnight and the use of pacifiers. Findings from the st...

To investigate whether the type of birth influenced breastfeeding outcomes. This study used a quantitative descriptive correlation design study in a sample of 60 primigravida  mothers. Participants were recruited over a 2-month period from June to July 2011 in the postnatal ward at King AbdulAziz University Hospital (KAUH) in Jeddah city, Kingdom of Saudi Arabia (KSA). The results of the study indicated that women who gave birth vaginally were more likely to breastfeed within the first hour, and at 24 hours after birth than those who had a cesarean section. The mothers who had cesarean section stated that pain interfered with their ability to hold, breastfeed, and care for their baby. Healthy term babies at KAUH are routinely separated from their mothers, and given infant formula supplementation. The findings in this study reinforce the importance of appropriate pain management, keeping well babies with their mothers to remain together, 24 hours a day, and avoidance of non-medically...

Scott J A, Binns CW et al 2009, Predictors of the early introduction of solid foods in infants: results of a cohort study. BMC Pediatr 9: 60. Symon B,Bammann M 2012, Feeding in the first year of lifeemerging benefits of introducing complementary solids from 4 months. Aust Fam Physician 41(4): 226-229. WHO 2003, Global strategy for infant and young child feeding. Geneva, World Health Organization. Williams A, Prentice A 2011, RESPONSE Scientific Advisory Committee on Nutrition replies to Mary Fewtrell and colleagues. BMJ 342: d980.

The Bachelor of Nursing (BN) program at Central Queensland University requires students to complete industry based clinical practicum in each of the 3 years of their program. Students spend 40-60% of their week off campus in clinical practicum. The Bachelor of Nursing Program Gateway (BNPG) is the application of the traditional Blackboard course management system from a single course to a whole program. It has pushed the boundaries of online course management creating an online learning community that consists of students, lecturers, clinical laboratory managers, administration staff, program advisors and industry clinical staff from three Central Queensland University campuses (Rockhampton, Mackay and Bundaberg), one hub (Noosa) and Flexible delivery. This paper will adopt Wenger, McDermott, and Synder's (2002) seven principles of communities of practice to discuss development strategies that have proved successful, as well as some of the pitfalls experienced and lessons learned that will save valuable time for program coordinators hoping to adopt this technique. This article has been peer-reviewed and accepted for publication in SLEID, an international journal of scholarship and research that supports emerging scholars and the development of evidence-based practice in education. © Copyright of articles is retained by authors. As an open access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.

After their attempts to have patient safety concerns addressed internally were ignored by wilfully blind managers, nurses from Bundaberg Base Hospital and Macarthur Health Service felt compelled to 'blow the whistle'. Wilful blindness is the human desire to prefer ignorance to knowledge; the responsibility to be informed is shirked. To provide an account of instances of wilful blindness identified in two high-profile cases of nurse whistleblowing in Australia. Critical case study methodology using Fay's Critical Social Theory to examine, analyse and interpret existing data generated by the Commissions of Inquiry held into Bundaberg Base Hospital and Macarthur Health Service patient safety breaches. All data was publicly available and assessed according to the requirements of unobtrusive research methods and secondary data analysis. Ethical considerations: Data collection for the case studies relied entirely on publicly available documentary sources recounting and detaili...

This study reports a comparative survey of mature students undertaking pre-registration undergraduate nursing education in Australia and Scotland. The study aimed to explore comparisons between the course-related and course-related financial difficulties faced by mature students in two very different educational and funding systems. Financial stress is a predictor of both physical and mental health problems. A similar pattern of course-related problems were reported by both Australian and Scottish students with the exception that Scottish students experienced more problems with childcare and caring for elderly relatives. Course-related problems may be inherent in the nature of undergraduate nursing education although the relatively time-intensive nature of Scottish curricula may explain the childcare and elderly relatives difference. Scottish students reported higher overall financial-related problems but Australian students reported more problems with funding placements. These find...

Objective The purpose of this paper is to describe the Practice‑Based Simulation Model (PBSM) as a pedagogical framework that enables the integration of simulation in a way that ensures critical thinking skills are explicitly taught as part of the processes and outcomes of students’ learning. Setting The PBSM is an innovative pedagogical strategy that offers greater flexibility; one that can be applied to various types of educational contexts and delivery modes, while simultaneously ensuring desired learning outcomes. Primary argument The use of simulation has been gaining popularity because of its capacity to provide effective experiential learning as a method of enhancing learners’ critical thinking skills. Despite ample literature that highlights the need for the integration of simulation into nursing curricula, there are few papers demonstrating simulated learning experiences that are underpinned by sound pedagogy. This paper asserts that simulated learning experiences need to b...

The Bachelor of Nursing (BN) program at Central Queensland University requires students to complete industry based clinical practicum in each of the 3 years of their program. Students spend 40– 60% of their week off campus in clinical practicum. The Bachelor of Nursing Program Gateway (BNPG) is the application of the traditional Blackboard course management system from a single course to a whole program. It has pushed the boundaries of online course management creating an online learning community that consists of students, lecturers, clinical laboratory managers, administration staff, program advisors and industry clinical staff from three Central Queensland University campuses (Rockhampton, Mackay and Bundaberg), one hub (Noosa) and Flexible delivery. This paper will adopt Wenger, McDermott, and Synder's (2002) seven principles of communities of practice to discuss development strategies that have proved successful, as well as some of the pitfalls experienced and lessons learn...

Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies' editorial on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations" asks the question whether whistleblowing ameliorates or exacerbates the 'deaf effect' prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage. Citation: Cleary SR, Doyle KE. Whistleblowing need not occur if internal voices are heard: From deaf effect to hearer courage: Comment on "Cultures of silence and cultures of voice: the role of whistleblowing in healthcare organisations.

Background: Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. Chiropractors are well placed to alleviate back pain, yet there is no research that considers chiropractors' readiness to treat Indigenous patients. This study explores chiropractors`experience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors' participation in Indigenous Healthcare and their willingness to engage in cultural competency training. Methods: This study used a non-representative cross-sectional design and a convenience sample. Participants were recruited via email invitation to complete an online survey and encouraged to send the invitation on to colleagues. A 17-item online-survey measured demographic data, perceived barriers and facilitators related to caring for Indigenous Australians, participants`level of comfort when working in Indigenous health, and their willingness to participate in cultural competency programs to enhance their skills, knowledge and cultural capacity when engaging with Indigenous Australians. Analysis of the data included descriptive statistics as well as thematic analysis of qualitative free text.

Getting undergraduate Bachelor of Nursing students to understand and to apply procedures accurately for calculating medication doses in the clinical setting has always been an educational challenge for nursing academics. The experience at Central ...

Background Patient engagement is a patient's capacity and willingness to participate and collaborate in their own health care. This scoping review aimed to identify tools used to measure engagement among surgical patients, the levels of engagement and the association between engagement and surgical outcomes. We hypothesise that highly engaged patients are more likely to achieve better surgical outcomes. Review methods MEDLINE/PubMed, CINAHL, SCOPUS and Embase were searched for studies that assessed adult perioperative patients for engagement. Analysis from charting the data identified the measurement tools, levels of capacity to engage and relationships between engagement and surgical outcomes. Results Twelve studies were selected out of 3975 identified; three valid and reliable tools to measure surgical patient engagement-Patient activation measure (PAM®), Patient health engagement scale (PHE-s) and Hopkins rehabilitation engagement rating scale (HRERS)-were identified, as well as levels of engagement. The capacity to engage was categorised into two, three or four levels. High levels of engagement were associated with enhanced patient satisfaction, better adherence to physical therapy, and decreased pain and disability. Conclusion There are valid and reliable tools to measure the capacity of surgical patients to engage in their post-operative recovery; PAM® is the most frequently used tool. Patients with higher engagement are more likely to report better physical health and greater satisfaction with their surgery. Using these tools could assist health care providers in the early identification of patients at risk of poor recovery and provide tailored support.

Background: After their attempts to have patient safety concerns addressed internally were ignored by wilfully blind managers, nurses from Bundaberg Base Hospital and Macarthur Health Service felt compelled to 'blow the whistle'. Wilful blindness is the human desire to prefer ignorance to knowledge; the responsibility to be informed is shirked. Objective: To provide an account of instances of wilful blindness identified in two high-profile cases of nurse whistleblowing in Australia. Research design: Critical case study methodology using Fay's Critical Social Theory to examine, analyse and interpret existing data generated by the Commissions of Inquiry held into Bundaberg Base Hospital and Macarthur Health Service patient safety breaches. All data was publicly available and assessed according to the requirements of unobtrusive research methods and secondary data analysis. Ethical considerations: Data collection for the case studies relied entirely on publicly available documentary sources recounting and detailing past events. Findings: Data from both cases reveal managers demonstrating wilful blindness towards patient safety concerns. Concerns were unaddressed; nurses, instead, experienced retaliatory responses leading to a 'social crisis' in the organisation and to whistleblowing. Conclusion: Managers tasked with clinical governance must be aware of mechanisms with the potential to blind them. The human tendency to favour positive news and avoid conflict is powerful. Understanding wilful blindness can assist managers' awareness of the competing emotions occurring in response to ethical challenges, such as whistleblowing.