Editorial, Volume six (1)
The health sector is challenged by patients that are older, with increasing co-morbidities, shorter hospital stays, whilst accommodating nursing shortages and skill mix complexities as never before. Increasingly complex technological, consumer orientated, and litiginous environments demand that nurses are equipped to deal with these challenges. A patient centred, but nonetheless evidence-based practice approach to health care delivery is essential (Muir Grey, 1997), and this philosophy is reflected in the varied and interesting topics researched and presented by the student writers.
As nursing continues to be strongly represented in community health settings, with growing leadership roles, primary health concerns of the population are more prominently considered. For example, the holistic view of some of the issues facing youth in the community is explored by the literature reviewed on physical, mental, and environmental factors which affect their health. Maya Wilson and Ben Rowley address the impact of the online environment. Wilson (2019) discusses the physical effects of artificial light exposure, suggesting early intervention in the lives of teenagers is the best intervention to preserve healthy sleep hygiene habits, whilst Rowley (2019) focusses on the free and easy access to the digital environment and the impact this has on mental health, through exposure to pornographic material. He asserts that pornography may impact teenager’s perception of sex and safe sex methods, increasing the risk for STD’s. He acknowledges the role of the registered nurse to effect positive outcomes through health promotion activities and the ability and willingness to engage in further research on sensitive but important topics. Huggins (2019) looks at the impact of poor diet on long-term health outcomes, suggesting that nationwide development of school nutritional polices should become a priority in public health. Sule (2019) explores the use of conductive education and its impact on the overall development of children with cerebral palsy.
Poor population mental health continues to be an area of concern for all health practitioners. Whilst New Zealand has made significant strides in improving mental health and wellbeing, clear disparities persist. Eliza Poulter and Brianna Atkins both review the context of mental health for diverse populations from the perspective of Maori and postpartum woman. Issues around cultural identity, access to care, protective factors and stigma associated with mental health are explored, providing significant insights. With Māori having reported incidence of anxiety and depression at twice the rate of non-Māori, Poulter (2019) explores barriers to Māori accessing support and resources. Atkins (2019) explores the research on exclusive breastfeeding and the protective factors this provides against postpartum depression.
The nursing profession continues to actively participate in socio-political issues from both a professional practice and community perspective. Clinically sustainable health systems require a robust workforce. Amy Wilson (2019) discusses nurse well-being and the therapeutic design features for hospital staff break areas, a highly topical issue in Otago with the imminent rebuilding of the Dunedin Hospital. She examines the effectiveness of therapeutically designed break areas on improving job satisfaction, fatigue levels, and retention of nurses. Koehler (2019) explores nursing attraction, retention and skill loss facing rural communities as a result of the ageing nursing workforce. The impact of nursing shortages in the rural healthcare workforce with nearly half of the workforce being aged over 50 years of age is addressed, and recommendations are proposed to maintain a sustainable and effective rural healthcare workforce.
On a slightly different tack, Black (2019) addresses emotional intelligence and critical thinking skills of nurses in care delivery. Nurses demonstrating a higher level of emotional intelligence are more adaptive, tend to make the correct clinical decisions, and implement these more effectively. Taking this a step further, nurse managers who use transformational leadership create an environment with a higher level of work morale, one of many vital factors contributing to positive patient outcomes.
The exploration of current topics in nursing is rounded off with clinical items. Jemma Bower (2019) looks at a modality of patient care, discussing the use of hypothermia treatments for people with terminal cancer, and addresses the role of nurses in providing support to patients investigating such treatments, where patients are in some cases balancing the hope of extension of life, with spending this time away from loved ones to seek this treatment. Unkovich-Mcnab (2019) examines the impacts of diagnostic delay for endometriosis treatment a significant issue given that endometriosis affects an estimated 130,000 girls and women in New Zealand.
It is evidenced throughout these articles that New Zealand has some significant contemporary health issues. This can be seen across the lifespan ranging from childhood to adulthood, including those working as healthcare providers. Volume 6 of the School of Nursing online journal embraces a wide scope of nursing practice, highlighting the breadth of nursing knowledge required to successfully negotiate the role of the NZ registered nurse. That our undergraduates have the skills to conduct research, is demonstrated by the wide ranging and comprehensive topics; what remains to be seen is whether they are supported to continue probing and questioning practice, and thus to effect positive patient outcomes.
Muir Gray, J. A. (1997). Evidence-based healthcare: How to make health policy and management decision. Edinburgh: Churchill Livingstone.