Written by Cynthia van Ammers (Co-Editor), Diana Kaniki, Elizabeth Lethaby, Millie MacGibbon, Lydia Macrea
The provision of safe and effective healthcare is underpinned by evidence-based practice. The importance of the continual application of evidence-based findings to practice is fundamental in achieving this goal. It is evident in the articles presented in this volume of the School of Nursing Online Journal that students utilised evidence from research and applied these findings to nursing practice in a variety of different healthcare environments.
Ennis and Murphy (2016) discuss suicide in the context of suicide prevention strategies, namely gatekeeper training as a protective strategy. Globally suicide is identified as a serious public health issue which causes 800,000 deaths per year, proportionate to 1 death every 40 seconds (World Health Organisation, 2015). In New Zealand, rising rural suicide rates are attributed to falling dairy prices, drought, and other contributing social factors. Billings (2016) also discusses mental health, through the lens of the senior person. The many challenges facing senior persons, such as physical, psychological, and social roles adjustments, which impact on sense of identity and can affect the senior population’s mental health. A significant health issue going forward as our senior population swells.
O’Rouke (2016) has identified cyber bullying as an emerging problem within New Zealand, affecting the mental health of youths. Cyber bullying can be relentless, as it can happen at any time, so the victim is always vulnerable (Hornbeck & Moreno, 2011). Research shows that there is a relationship between cyberbullying and depression, low self-esteem, self-harm, and suicidal ideation. Youths who had been bullied described feelings of anxiety, fear, and sadness. O’Rouke (2016) recommends strategies to decrease cyberbullying such as supervising online activities, open discussions with children and banning mobile phones during breaks.
Issues at the other end of the age spectrum are also considered. Nurses strive to achieve the best outcomes for patients through health promotion, education, and the best evidenced maternal and infant interventions. Kangaroo care that promotes a healthy attachment and wellbeing in this vulnerable group, is one such issue. Dooley (2016) discusses the benefits of kangaroo care including physiological, behavioural, and maternal-infant bonding. The author identifies that barriers to providing kangaroo care on preterm infants being lack of confidence, resources, and education all of which are urgently recommended to overcome these barriers. Nurses are well placed to promote infant health and support parents to give their pepi (baby, infant) the best possible start to life. Mackenzie (2016) identifies breastfeeding as a preferred feeding method, for the growth and development of infants. This affirms the current recommendation that mothers breastfeed until their infant is six months of age. It acknowledges that breastfeeding has developmental benefits and has been proven to reduce the risk of mortality in infants, reduce the morbidity of infections, enhance the immune system of infants and reduce the chance of infant atopic diseases.
Another important element of nursing is the provision of nutritional care. Malnutrition of older adults in acute hospital settings throughout New Zealand and Australia is an issue that can be overlooked by nurses in acute care areas. Hogan (2016) asserts that malnutrition has an impact on the length of hospital stay and identifies barriers that exacerbate this problem, including lack of feeding assistance, lack of flexibility of food service, lack of choice due to special dietary needs, boredom due to length of stay and limited variety.
Hoar (2016) address nutrition for another vulnerable population, focusing on first year university students living in residential halls. The contributing factors of weight gain at university are addressed. Hoar (2016) asserts that new habits are formed due to the change in environment, effecting ideas and behaviour around food, and recommends providing nutritional education to first year of university students, to address this growing problem.
It is impossible to discuss healthcare without considering the socio-political context in which New Zealanders live. Thompson (2016) addresses the relationship between housing and health in New Zealand. Damp, cold and mouldy housing is strongly linked to respiratory symptoms resulting in incidences of absentia from work and school, increased visits to the doctor and hospital admissions for respiratory illness.
Foster (2016) also reviewed environmental factors and health. The assertion is made, that climate change will affect ecological, biological, and physical systems and impact on individual’s health (Brednorfer, Hay & Head, 2015). Foster (2016) suggests that education on the threats presented by climate change would enable student nurses, nurses, and nurse educators, to be responsive to growing health needs.
Access to health care is discussed by Collis (2016). Colorectal cancer (CRC) is the second highest cause of cancer related death with approximately 2800 people diagnosed each year (Shah et al., 2012). Although equitable health services should be available for all New Zealanders, Robson, Purdie, and Cormack (2010) reported poorer survival rates from cancer in rural areas when compared to urban centres due to delays in diagnosis, challenges of traveling long distances, and limited access to oncology services. This continues to be a resource and socio-political issue which nurses should provide discourse on.
The future of a robust health care system lies in the ongoing employment and development of New Graduate Registered Nurses. The rural setting is complex and a lack of employment of new graduate nurses exacerbates the shortage of health professional. Stevenson (2016) explores the challenges of providing safe nursing care and sustainable work environments in rural nursing for new graduate nurses.
The articles provide the reader with evidenced based research on a wide range of specialties. Suicide and mental health, both of which are major public health issues in New Zealand, are set to remain key areas worthy of ongoing research. The rural context of health and issues such as suicide, colorectal cancer care, and retaining a workforce, provide interesting insights into the New Zealand perspective. Addressing fair access to appropriate services despite where you live and the provision of support for new graduate nurses in order to maintain a rural health workforce, are socio-political issues which require a strong nursing perspective, if we are to effect positive change.