To present findings from a study that explored nursing students' experiences of bullying in clinical and academic settings, the strategies used to negotiate bullying and recommendations for empowering future students.Nursing students are identified as a group who are at particular risk of bullying. Numerous studies have examined students' experiences of bullying in clinical contexts by qualified nurses; however, there has been far less attention to the bullying that occurs in academic settings where the perpetrators are university staff and other students.The qualitative findings presented in this paper form one component of a mixed-methods, multisite study that examined the nature and extent of bullying in one cohort of nursing students.A convenience sample of 29 first-, second- and third-year undergraduate nursing students from one semimetropolitan Australian university was recruited for semistructured interviews in 2014. Interview data were analysed using NVivo.Participants described multiple examples of bullying occurring in both clinical and academic settings. Perpetrators included clinicians, facilitators, academics and fellow students. Bullying ranged from incivility to physical attacks. The impact of the bullying was profound; it caused many of the participants to feel anxious and distressed, it undermined their confidence and perception of competence, and it often led them to question their career choice. Strategies described by participants to cope with or manage the bullying included avoidance, trying to "just survive" and seeking support from trusted academic staff, family and friends. No episodes of bullying were formally reported.Bullying remains a pervasive phenomenon occurring in both clinical and academic settings. Students are, in many respects, a vulnerable and disempowered population who often fear the consequences of making a formal complaint. Thus, reporting structures and support strategies need to be re-examined, and resilience training is...

The mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and healthcare professionals who deliver, lead or research nursing care. The CNCF produces Cochrane Corner columns, summaries of recent nursing-care-relevant Cochrane Reviews that are regularly published in collaborating nursing-related journals. Information on the processes CNCF has developed can be accessed at: cncf.cochrane.org/evidence-transfer-program-review-summaries. This is a Cochrane review summary of: Hall DP, Estcourt LJ, Doree C et al ( 2016 ) Plasma transfusions prior to insertion of central lines for people with abnormal coagulation. Cochrane Database of Systematic Reviews. Issue 9. CD011756. doi: 10.1002/14651858.CD011756.pub2.

The premature rupture of membranes, colloquially known as the 'waters breaking', in pregnant women is associated with risks to both the mother and foetus and these risks are complicated by the gestational age of the foetus. The aim of care is to mitigate these risks while maximising the benefits of further foetal maturity. There are two ways of managing these patients and both have associated risks.
Planned early birth is a strategy that as its name suggests plans for the early delivery of the baby as soon as possible after the membranes have ruptured, typically within 24 hours. This can involve a vaginal delivery following induction or a caesarean section. The risks of this method are linked to the risks typically associated with the prematurity. These complications can include respiratory distress, sepsis, necrotising enterocolitis (an injury to the bowel of the newborn), intraventricular haemorrhage, difficulty with thermoregulation and with breastfeeding, and increased hospitalisation. While these risks decrease after 32 weeks gestation, it is important to note that babies born between 34 and 37 weeks are still physiologically immature and as such do have significantly increased morbidity and mortality compared to infants born at term.
The second management strategy is expectant management. Here pregnant women are observed and managed with the aim of delaying delivery for as long as possible to maximise the changes of foetal development and ideally until full term has been reached, barring any complications.
The risks of expectant management are associated with longer exposure to the complications caused by the premature rupture of the membranes and include ascending infection, cord prolapse (through the cervix), intrapartum foetal distress and abruption (premature detachment of the placenta from the uterine wall). Some treatments can be used to reduce the risk of these complications including corticosteroids and antibiotics

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.

The National Institute for Occupational Safety and Health (NIOSH) defines occupational stress as 'the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker' (NIOSH, 2008). Healthcare workers have been identified as being at high risk for occupational or work‐related stress due to exposure to stressors at work. For example, in the United Kingdom, the healthcare sector has the highest estimated prevalence of work‐related stress (Health and Safety Executive, 2013). This stress is a consequence of organizational factors and a mismatch between demands, skills, and social support at work, or any combination of these. Factors that have been shown to increase the risk of stress include increasing workload, emotional response to contact with suffering and dying patients and organizational problems and conflict (McNeely, 2005; Payne & Firth‐Cozens, 1987). A European survey on working conditions revealed that the healthcare sector rated highest on two significant causes of stress: hiding ones' own emotions and adverse social behavior (Eurofound, 2012).

The consequences of occupational stress on healthcare workers include severe distress, burnout, or psychosomatic diseases and a corresponding decline in quality of life and their quality of care or service provision (Weinberg and Creed, 2000). There is also an economic impact of occupational stress on healthcare organizations through increased rates of absenteeism and turnover (Jacobson et al., 1996; Raiger, 2005) and compensation claims (Williamson, 1994).

Three strategies to combat occupational stress are acknowledged (Ruotsalainen, Verbeek, Marine, & Serra, 2015). First, cognitive‐behavioral training (CBT) provides new ways for the person to feel, think, and act in stressful situations. Second, mental or physical relaxation techniques work by diverting attention away from unpleasant and stressful thoughts and feelings and help...

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.

© 2017 International Nursing Association for Clinical Simulation and Learning Background Innovations in simulation in nursing and health care continue to be developed as creative and committed educators respond to challenges of providing pedagogically sound, engaging and effective learning experiences for large student cohorts. Time-pressed educators may find it difficult to network with others working in simulation-based learning, and thus, it is useful to provide summaries or snapshots to provide a brief overview of activities in various countries using simulation in a variety of ways. Method The purpose of this paper is to profile a diverse range of innovative, cost-effective, and tested simulation approaches that have been implemented in healthcare programs by nursing educators from a range of countries to spark creativity. Each strategy was designed to address contemporary and critical practice issues. Results They facilitate immersion in authentic clinical scenarios, increase students' awareness of cues in the environment that may compromise health and safety. Conclusion These snapshots of simulation prepare students for cultural or clinical realities that they may not routinely encounter because of the inherent restrictions associated with clinical placements.

© 2017 College of Emergency Nursing Australasia Introduction Workplace violence is one of the most significant and hazardous issues faced by nurses globally. It is a potentially life-threatening and life-affecting workplace hazard often downplayed as just 'part of the job' for nurses. Methods A cross-sectional design was used and data were collected using a purpose developed survey tool. Surveys were distributed to all members of the College of Emergency Nurses' Australasia (CENA) in 2010 and 537 eligible responses were received (RR = 51%). Results Patient-related violence was reported by 87% of nurses in the last six months. Precipitants and antecedents for episodes of violence were reported in three categories: nurse-related; patient-related and emergency-department specific factors. Triaging was identified as the highest risk nursing activity, and the triage area identified as the highest risk location in the department. Patients who presented with alcohol intoxication, substance misuse or mental health issues were identified as the groups at greatest risk for potential violence. Discussion Patient-related violence was reported by the majority of emergency nurses surveyed. A number of precipitants and antecedents perceived to be risk factors by participants were found to be significant and are unavoidable in the working lives of emergency department nurses.

Although empathy is an integral component of professional practice and person-centred care, a body of research has identified that vulnerable patients groups frequently experience healthcare that is less than optimal and often lacking in empathy.The aim of this study was to examine the impact of an immersive point-of-view simulation on nursing students' empathy towards people with an Acquired Brain Injury.A convenience sample of 390 nursing students from a cohort of 488 participated in the study, giving a response rate of 80%. Students undertook the simulation in pairs and were randomly allocated to the role of either a person with Acquired Brain Injury or a rehabilitation nurse. The simulated 'patients' wore a hemiparesis suit that replicated the experience of dysphasia, hemianopia and hemiparesis.Characteristics of the sample were summarised using descriptive statistics. A two-group pre-test post-test design was used to investigate the impact of the simulation using the Comprehensive State Empathy Scale. t-Tests were performed to analyse changes in empathy pre post and between simulated 'patients' and 'rehabilitation nurses'.On average, participants reported significantly higher mean empathy scores post simulation (3.75, SD=0.66) compared to pre simulation (3.38 SD=0.61); t (398)=10.33, p<0.001. However, this increase was higher for participants who assumed the role of a 'rehabilitation nurse' (mean=3.86, SD=0.62) than for those who took on the 'patient' role (mean=3.64, SD=0.68), p<0.001.The results from this study attest to the potential of point-of-view simulations to positively impact nursing students' empathy towards people with a disability. Research with other vulnerable patient groups, student cohorts and in other contexts would be beneficial in taking this work forward.

AIMS AND OBJECTIVES: To explore preparedness of end-of-life care planning among community-dwelling older persons of culturally and linguistically diverse background. BACKGROUND: To improve end-of-life care through advance care planning, the key concept 'Planning ahead' has been promoted in Australia. However, since the introduction of the model in 2008, it is not known whether 'Planning Ahead' practice by older people from culturally and linguistically diverse backgrounds has improved. DESIGN: A cross-sectional survey. METHODS: A total of 453 community older adults (65+) who attended 17 day care centres in a region were invited to participate in the study. A total of 229 people completed the survey with a response rate of 50·5%. The questions relevant to this study include: (1) awareness of enduring guardian, advance care directive and advance care planning, (2) the preference for substitute decision-makers and (3) the challenges experienced with advance care planning. RESULTS: Awareness of advance care planning was low, and completion of advance care directive was very low. 37·5% of Anglo Celtic group had an enduring guardian, compared with 15·5, 24·1 and 13·3% from Mediterranean, Eastern European and Asia/Pacific group, respectively. Children were the most preferred substitute decision-makers more for Asia/Pacific group than Anglo Celtic, Mediterranean and Eastern Europeans. The various difficulties experienced included being time-consuming, difficult to understand terms and forms, and do not know how to do it. CONCLUSION: Regardless of cultural and ethnic backgrounds, a low level of 'Planning ahead' practices was apparent because of a lack of understanding of the concept, the forms and the processes involved. The gap identified between the existing legal/ethical frameworks and the preferences of older people as substitute decision-makers adds new knowledge for further discussion. RELEVANCE TO CLINICAL PRACTICE: Nursing professionals are provided with an opport...

Learning outcomes: On completion of this continuing professional development (CPD) activity, participants will be able to: * identify strategies to support undergraduate students and new staff working in a supernumerary role; * define the roles and responsibilities of the mentor and mentee; * identify key attributes of successful mentors; * discuss the stages of the mentor-mentee relationship and the key elements of each; * describe a suitable strategy for engaging mentees and developing a mutually beneficial mentor-mentee partnership; * enable staff to reflect on their current approaches to providing feedback to mentees and identify areas that may require change; and * identify barriers to a successful mentor-mentee relationship;.

© 2015 The Cochrane Collaboration. This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness of education and training interventions that aim to prevent and minimise workplace aggression directed toward healthcare workers by patients and patient advocates.

Aim: This paper describes a structured approach for documenting a search strategy, prior to the scholarly critique and review of the retrieved literature. Background and context: There has been a shift in publication expectations when it comes to the presentation of a literature review, from the more traditional narrative review to a more systematic approach, following a specific framework. Methods: This paper presents a 12 step framework for documenting the search strategy prior to undertaking a critique and synthesis of the retrieved literature. The authors provide a worked example about potential sources of cross contamination including hospital bath basins and soap and water bathing. Discussion: An overview of the 12 step framework is presented. This includes step-by-step instructions on how to conduct and write a search strategy for a literature review. A number of resources available for creating reviews and critiquing reviews are referenced, but these are not exclusive. Conclusion: Reviews can be an important and valuable contribution when undertaken well, providing the reader with evidence of a clear structure. This paper provides a 12 step framework that will be of benefit to students, educationalists, and researchers required to embark on a review. © 2012 Elsevier Ltd.

In a finding that reflects international experiences, nurses in Australia have been identified as the occupation at most risk of patient-related violence in the health-care sector. A search of the literature was undertaken to explore this concept, with a focus on the emergency department and triage nurses. Significant findings included the fact that nurses are subjected to verbal and physical abuse so frequently that, in many instances, it has become an accepted part of the job. This attitude, combined with the chronic under-reporting of violent incidents, perpetuates the normalization of violence, which then becomes embedded in the workplace culture and inhibits the development of preventative strategies and the provision of a safe working environment. Nurses are entitled to a safe workplace that is free from violence under both the occupational health and safety legislation and the zero-tolerance policies that have been adopted in many countries including Australia, the UK, Europe, and the USA. Therefore, policy-makers and administrators should recognize this issue as a priority for preventative action. © 2010 Blackwell Publishing Asia Pty Ltd.