Dr Debra Palesy is a lecturer in the Faculty of Health at UTS. She has 30 years’ experience in clinical nursing practice, curriculum development and education for a range of health professionals in both acute care and community-based health care settings.
Debra is particularly interested in teaching and learning in socially-isolated health care settings, where workers, such as home care workers and rural nurses, do not have access to direct supervision and support.
Can supervise: YES
- Workplace learning
- Practice-based learning
- Knowledge and skills transfer
- Paid care workers
Acute care nursing; nursing leadership
Palesy, D & Jakimowicz, S 2019, 'Health literacy training for Australian home care workers: Enablers and barriers.', Home health care services quarterly, vol. 38, no. 2, pp. 80-95.View/Download from: UTS OPUS or Publisher's site
The rapidly expanding Australian home care workforce represents an untapped resource for improving health literacy (HL) and health outcomes of their clients. Nine home care workers (HCWs) were interviewed for this study to gain data around their experiences of providing HL support to their clients, key HL needs and priorities, and training that would best these needs. Findings indicate that HCWs are providing HL support, and identify a number of enablers and barriers to providing this support. Core inclusions for a HL training checklist are suggested. Implications for future research are considered.
Saunders, CM, Palesy, D & Lewis, J 2019, 'Systematic review and conceptual framework for health literacy training in health professions education', Health Professions Education, vol. 5, no. 1, pp. 13-29.View/Download from: UTS OPUS or Publisher's site
Palesy, D 2018, 'Developing manual handling skills in relative social isolation: A case study of Australian home care workers', Journal of Adult and Continuing Education, vol. 24, no. 1, pp. 37-57.View/Download from: UTS OPUS or Publisher's site
Cook, JJ, Palesy, D, Lapkin, S & Chenoweth, L 2018, 'Older Patient Specialling: A Call for a Consistent Approach', Australian Nursing and Midwifery Journal, vol. 25, no. 9, pp. 14-15.View/Download from: UTS OPUS
People over 65 years of age are now the major consumers of acute health services (Australian Institute of Health and Welfare 2017). This population presents with multiple co-morbidities and is susceptible to further complications during hospitalisation
Lapkin, S, Levido, D, Palesy, D, Mamo, A, Perez, M, Dutchak, D & Fernandez, R 2018, 'What's the plan? Supporting individualised care for hospitalised patients with stomas', Journal of Stomal Therapy Australia, vol. 38, no. 2, pp. 12-18.View/Download from: UTS OPUS
Background: Nurses play a pivotal role in providing nursing care and ongoing support to assist patients in adapting to a normal life with a stoma. While stomal therapy nurses have high levels of clinical expertise, little is known about ward nurses' experiences and understanding of their role in caring for patients with a stoma.
Aim: To explore ward nurses' understanding of their role in caring for patients with a stoma.
Methodology: One face-to-face focus group interview was conducted with nurses (n= 6) from the colorectal ward in a large metropolitan hospital. Data analysis was undertaken using a general inductive approach.
Findings: Two main categories and 13 themes emerged from the focus group data. Participants reported a lack of stomal therapy nursing knowledge and skills, and they strongly advocated for a documented multidisciplinary, individualised care plan for the patient with a stoma.
Conclusion: The findings from this study can be used to inform the development of strategies to support regular in-service training programs for nurses and to guide the implementation of individualised plans for stoma care. Further research is warranted to investigate how these approaches can be translated into clinical practice to improve the outcomes for patients with a stoma.
Smith, J & Palesy, D 2018, 'Technology Stress in Perioperative Nursing: An Ongoing Concern', ACORN: the journal of perioperative nursing in Australia, vol. 31, no. 2, pp. 25-28.View/Download from: UTS OPUS
This article explores the impact of technology on perioperative nursing roles and the development of the phenomenon coined 'technology stress'. It begins by reviewing the ongoing debate of technical versus caring nursing practices. The impact of advanced technology on perioperative nursing roles is explored, highlighting the development of technology stress. The article concludes with some recommendations for further research.
Palesy, DL, Jakimowicz, S, Saunders, C & Lewis, J 2018, 'Australian Home Care Work: an Integrative Review', Home Health Care Services Quarterly, vol. 37, no. 2, pp. 113-139.View/Download from: UTS OPUS or Publisher's site
The home care sector comprises one of Australia's fastest growing workforces, yet few papers capture the overall landscape of Australian home care. This integrative review investigates home care work with the aim of better understanding care recipients and their needs, funding and regulation, care worker skills, tasks, demographics, employment conditions and training needs. Over 2,700 pieces of literature were analysed to inform this review. Results suggest sector fragmentation and a home care workforce who, although well placed to improve outcomes for care recipients, are in need of better training and employment support. Suggestions for future research regarding Australian home care include studies that combine both aged and disability aspects of care, more research around care recipients, priority needs and strategies for addressing them, and how best to prepare home care workers for their roles.
Palesy, DL & Billett, S 2017, 'Learning manual handling without direct supervision and support: A case study of Australian home care workers', Social Work Education, vol. 36, no. 3, pp. 273-288.View/Download from: UTS OPUS or Publisher's site
How home care workers (HCWs) adapt their classroom training to their workplaces is central to their own safety and that of their care recipients. A case study approach was adopted for this inquiry into HCW training in Australia, where new workers were directly observed and interviewed in their workplaces following classroom training. Findings from the study advance four contributions: (a) learning is person-dependent, (b) artefacts in the form of written materials afford a valuable form of learning support; (c) opportunities for these workers to meet, share and refresh their knowledge are important for further development of occupational capacities; and (d) more organisational support for such socially isolated workers' learning is needed.
© 2017, Springer Science+Business Media Dordrecht. Contemporary accounts of learning emphasise the importance of immediate social partners such as teachers and co-workers. Yet, much of our learning for work occurs without such experts. This paper provides an understanding of how and why new home care workers use scaffolding to learn and enact safe manual handling techniques in their workplaces, and suggests how their learning may be supported in the absence of direct supervision. A qualitative approach was adopted for this inquiry, in which newly recruited workers were directly observed and interviewed in their workplaces following classroom training. When learning without direct supervision, these workers were found to use the scaffolding in person-dependent ways. They constructed, engaged with, and subsequently dismantled their scaffolding as personally required, rather than relying on their teacher to decide how and when these forms of learning support should be used and withdrawn. Consequently, a range of scaffolds should be provided in the workplaces of these individuals, without rigid stipulations about how and when they are to be accessed. That is, the learners themselves should be encouraged to decide on the type and frequency of their interaction with the scaffolding provided, and to access or withdraw this support as required.
© 2017 Informa UK Limited, trading as Taylor & Francis Group Classroom training sessions for new home care workers (HCWs) are often brief and ad hoc, varying in format and content. Yet the application of this training may be central to worker and client safety. A qualitative approach was adopted for this inquiry, comprising two separate but related practical studies. In the first, exploratory study, classroom training was observed, and HCWs were interviewed following their classroom training. Based on these findings, a set of interventions was implemented and evaluated in the second study. Findings from the overall inquiry suggest that brief classroom sessions are effective, however, a format which encourages the development of dispositional and procedural knowledge is most important. Learning in the classroom may also be enhanced with the provision of a range of written materials to trainees. The paper concludes with a set of recommendations for enhancing the effectiveness of brief classroom training sessions, and suggestions for future research.
How home healthcare aides (HHAs) adapt their classroom training to their workplaces is central to their own safety and that of their care recipients. A qualitative approach was adopted for this inquiry, where new workers were interviewed in-depth following their classroom training. Findings suggest a perceived lack of supervisor support for classroom training and lack of follow-up in the workplace. Moreover, the need for more peer support was contended, and more comprehensive written materials in clients' homes may also assist workers' learning and enacting safe manual handling techniques in the workplace. The article concludes with recommendations for supporting HHAs' learning, and includes suggestions for future research.
Palesy, DL 2016, 'Australian home care workers' learning of safe manual handling: environmental considerations', Home Health Care Management and Practice, vol. 28, no. 4, pp. 216-223.View/Download from: UTS OPUS or Publisher's site
How home care workers adapt what they learn in manual handling classroom training sessions to their workplaces (i.e., their clients' homes) is central to their own safety, as their musculoskeletal injuries continue to occur at unacceptably high rates. For this inquiry, new workers were directly observed in their workplaces following classroom training. Findings from these observations propose three environmental considerations for supporting new workers to learn safe manual handling techniques: (1) The physical setting for manual handling is important, (2) clients and their significant others may offer a valuable form of learning support, and (c) when initially learning the requirements for their roles, new workers should be encouraged to focus only on the manual handling tasks at hand.
Palesy, DL & Billett, SR 2017, 'Learning Occupational Practice in the Absence of Expert Guidance: The Agentic Action of Australian Home Care Workers' in Goller, M & Paloniemi, S (eds), Agency at Work: An Agentic Perspective on Professional Learning and Development, Springer, Cham, pp. 271-289.View/Download from: UTS OPUS or Publisher's site
Many kinds of workers need to both work and learn in socially isolated circumstances (i.e. in the absence of others who can provide guidance and support). Such circumstances require particular kinds of agency and agentic action by these worker-learners, and they might be described as requiring particularly agentic personal epistemologies. These epistemologies are essential for workers such as home care workers (HCWs), who, after a perfunctory classroom training, are expected to work alone in clients' homes providing a range of support, such as mobility and hygiene assistance. This chapter draws on a recent investigation into the work and learning of a small cohort of such HCWs and maps how they exercise agency in their work practice, work-related learning and development. These workers deployed, in different ways, their past personal experiences (e.g. work, life, education), the classroom training provided, opportunities to engage with other HCWs and support from other informed sources in learning the requirements for their role. Moreover, these workers exercised agentic action by 'personalising' their scaffolding or learning supports. That is, they constructed, engaged with and subsequently relinquished scaffolding as personally necessitated, rather than relying on 'experts' to decide how and when these forms of learning support should be enacted and withdrawn. What is important here is how these workers' subjectivities are found to include actions and monitoring of performance, not just ideas and dispositions. Through an account of how this particular cohort exercised agentic action, some conclusions are drawn and recommendations made for the best ways of progressing the learning and development of such socially isolated workers.
Palesy, D & Levett-Jones, T 2018, 'Advancing the Professional Disposition of Postgraduate Nursing Students: ORaRDAs and CPEGs', National Nurse Education Conference, Melbourne, Victoria, Australia.View/Download from: UTS OPUS
Palesy, D & Jakimowicz, S 2018, ''Older Person Health Literacy Support: A Role for Homecare Workers?', 51st Australian Association of Gerontology (AAG) Conference: Advancing not Retiring: Active Players, A Fair Future, Melbourne, Victoria, Australia.View/Download from: UTS OPUS