Nursing Research
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Item "One of us": Exploring the Nurse Practitioner role within a surgical hospital in New Zealand(International Council of Nurses, 2021) Sadd, Roseanne; Cooke, KirstieBACKGROUND: Today’s health sector faces the challenge of providing high quality care within the constraints of increasing costs and reducing resources. Patient and consultant expectations have grown, exposing a need for advanced nursing skills and care in an environment where, in most small to medium sized private hospitals, nurses are often the only clinical staff on site. To meet these challenges our private surgical hospital introduced Nurse Practitioners (NP's). While informal feedback from patients and consultants has confirmed that the role is highly beneficial, there has been no formal review on the implementation or effectiveness of the role. PURPOSE: The aim of this research is to explore the Nurse Practitioner role within the private hospital by providing a description of NP role; identifying the impact on pre and postoperative care; and by identifying how the NP provides leadership in their role. METHODS: We used a mixed methods approach where data was collected concurrently and analysed separately. Quantitative data was collected through a patient satisfaction survey and nurse practitioner activity log. Qualitative data was collected through semi-structured focus groups and interviews involving management, nurses and consultant doctors. KEY LEARNING OR RESULTS: Initial findings and themes that have emerged indicate the NP is an integral part of the patient journey. The NP provides timely assessment and intervention and often acts as an interface between patients, family, registered nurses and specialist doctors. The nurse practitioner is seen by ward nurses as “one of us”, with management and doctors indicating they feel “secure’ knowing that a NP is in attendance when they may not be there. CONCLUSION: This presentation will present final findings once data has been fully analysed and triangulated. SIGNIFICANCE: The research has the potential to influence the development of similar NP roles within the private healthcare setting.Item Ethical Considerations of Replacing Clinical Hours with Simulation in Undergraduate Nursing Education: Means to an End, or an End in Itself?(SAGE, 2023) Sadd, RoseanneIn the current health-care environment, undergraduate nursing programs are expected to provide high-quality clinical experiences for students despite increasing difficulty accessing clinical placements. Expectations for newly graduated nurses have increased in the last few years, with an emphasis on “work-ready” graduates. At the same time, the availability of a variety of clinical practicum placements has decreased in some areas, increasing the difficulty of meeting the increasing numbers of nursing students required for future workforce planning, a situation exacerbated by the ongoing COVID-19 global pandemic. Nursing educators are caught between industry requirements for clinically prepared students and the regulatory requirements of their educational institutions. One solution being espoused internationally is substituting simulation for clinical practicum hours. Simulation offers many advantages, especially for patient safety, providing students with opportunities to link theory to practice in a controlled environment. This article discusses the ethical considerations of substituting simulation for clinical hours in undergraduate nursing education. Is this substitution justified as a means to an end or an end in itself?Item Exploring the role of virtual simulation gaming in reducing physical examination anxiety for undergraduate nurses(Unitec ePress, 2023) Sadd, RoseanneSimulated objective structured clinical examination (OSCE) assessments have traditionally evoked high levels of anxiety for students, both when learning the scenarios in face-to-face simulations and when undertaking the actual OSCE assessment. Virtual simulation gaming (VSG) is an identified method of preparation for simulation that may reduce performance anxiety for students undertaking OSCE assessment. This quantitative exploratory research utilised established satisfaction and anxiety/confidence scales to explore the impact of VSG on student perceptions of simulation experiences, anxiety and self-confidence in clinical decision-making. Summative OSCE assessments were conducted in two cohorts before an inpatient and ambulatory care clinical practicum. Cohort one undertook their summative OSCE assessment immediately following the initial teaching, with the second cohort completing a mental health and addictions clinical practicum before their summative OSCE. Descriptive and inferential statistics were used to examine the relationships between simulation satisfaction, students’ perceived anxiety, and confidence with clinical decision-making. Self-reported satisfaction with simulation levels were high and improved over subsequent simulations. Results showed that although the second cohort demonstrated higher levels of confidence in clinical decision-making, there was no significant difference in anxiety levels between the two cohorts. This suggests that OSCE-related anxiety is situational rather than directly related to self-confidence. Anxiety was reported by most students following summative OSCEs despite the introduction of VSGs in pre-OSCE clinical simulation preparation. Even though they had high satisfaction with the simulation experience and reported feeling confident, this did not allay student anxiety. Overall, the study did not identify any measurable factors that would indicate which students would score high in self-confidence and/or anxiety. While it was not possible to directly attribute high levels of self-confidence to the introduction of VSGs, student satisfaction with simulation and clinical learning that included VSGs was high, indicating the positive effect on learning.Item Taming a wicked problem through virtual pre-simulation gaming(Otago Polytechnic, 2023) Sadd, Roseanne; Hills, JacindaWicked problems are those problems that are not clearly defined or able to be stated, but which are inherent in solving the problem – issues in which changes may be made and aspects of the problem solved therefore resulting in a more acceptable outcome (Rittel & Webber, 1973). In nursing education, wicked problems arise from challenges in providing quality undergraduate nursing education in an ever-changing educational landscape affected by attrition, conflicting student commitments, and global pandemics. As a nursing educator, this means balancing the essential elements required for safe and competent practice within the confines of academic timing and process. Part of the role of nursing education is to ensure students are safe to practise at their educational (and experience) level. For second-year nursing students within a Bachelor of Nursing program, being able to respond, assess, and intervene appropriately are considered essential ‘safety to practise’ elements before entering an inpatient clinical placement. The challenge for a teaching team in a year two Bachelor of Nursing Inpatient and Ambulatory Care clinical course that has limited allocated theory hours was to provide learning opportunities and resources students are able to understand, and to use frameworks needed to develop their clinical practice to practise safely in the ‘real’ clinical environment.Item Taking it all in their stride: nursing students’ clinical placement experiences during the COVID-19 pandemic.(Otago Polytechnic Press, 2023) Lansdown, JennyThe aim of this research was to identify whether the COVID-19 pandemic, which affected nurses and nursing education from 2020 through to present times, impacted student nurses’ perceptions of their clinical experience during this time. The initial premise was based on anecdotal conversations with students who were expressing their displeasure with how they were being treated in the clinical areas, and the learning experiences which had changed with the introduction of new clinical placements. This research found that the pandemic did not impact students’ perception of the value of their clinical placement, which is reassuring for clinical and academic management.