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AIM: To identify leadership factors for clinicians during in-hospital cardiopulmonary resuscitation. DESIGN: Systematic review with synthesis without meta-analysis. METHODS: The review was guided by SWiM, assessed for quality using CASP and reported with PRISMA. DATA SOURCES: Cochrane, EMBASE, PubMed, Medline, Scopus and CINAHL (years of 2013-2023) and a manual reference list search of all included studies. RESULTS: A total of 60 papers were identified with three major themes of useful resuscitation leadership; 'social skills', 'cognitive skills and behaviour' and 'leadership development skills' were identified. Main factors included delegating effectively, while being situationally aware of team members' ability and progress during resuscitation, and being empathetic and supportive, yet 'controlling the room' using a hands-off style. Shared decision-making to reduce cognitive load for one leader was shown to improve effective teamwork. Findings were limited by heterogeneity of studies and inconsistently applied tools to measure leadership. CONCLUSION: Traditional authoritarian leadership styles are not wanted by team members with preference for shared leadership and collaboration. Balancing this with the need for team members to see leaders in 'control of the room' brings new challenges for leaders and trainers of resuscitation. IMPLICATIONS FOR NURSING PROFESSION: All clinicians need effective leadership skills for cardiopulmonary resuscitation in-hospital. Nurses provide first response and ongoing leadership for cardiopulmonary resuscitation. Nurses typically display suitable skills that align with useful resuscitation leader factors. IMPACT: What were the main findings? Collaboration rather than an authoritarian approach to leadership is preferred by team members. Nurses are suitable to 'control the room'. Restricting resuscitation team size will manage disruptive behaviour of team members. TRIAL REGISTRATION: PROSPERO Registration: CRD42022385630. PATIENT OF PUBLIC CONTRIBUTION: No patient of public contribution.

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AIM: The inquiry explored immigrant informal caregivers' experiences and perceptions about engaging with professional services in the host country. BACKGROUND: The number of informal caregivers is rising, with more people providing home caring. Nurses and other health services are crucial in supporting informal caregivers. Research needs to focus more on immigrants, not just other caregivers. DESIGN: This was a scoping review. DATA SOURCES: Five databases (January 2017-December 2022) were searched, and 16 articles were included in this inquiry. REVIEW METHODS: This scoping review used the Joanna Briggs Institute Scoping Review methodology. This inquiry asked one question: What is the current knowledge about immigrant informal caregivers' experiences and perceptions when engaging mainstream professional services? Themes were identified using a thematic analysis approach. RESULTS: Three themes emerged from the review: 'finding cultural bridges: culturally connecting with services'; 'building cultural bridges: addressing "them and us" and "acculturation-sensitive services"'. CONCLUSION: Professional service providers are currently not meeting immigrant caregivers' needs. New knowledge is presented, that nurses and health professional services must provide acculturation-sensitive care, commencing with an assessment of the individual's acculturation status. By understanding acculturation status, nurses are more likely to customize person-centred care. Acculturation status refers to the degree that the individual has adapted to the new culture while retaining some traditional cultural beliefs and practices. Acculturation-sensitive care is more likely to provide authentic holistic care that optimizes well-being.

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AIM AND OBJECTIVE: To delineate contemporary practice of registered nurses working in rural and remote areas of Australia. BACKGROUND: Despite the implementation of strategies to address challenges reported by rural and remote nurses, concern remains over safety and quality of care, the well-being of nurses and retention of the nursing workforce. Twenty years on, geographically dispersed nurses still experience scarce human and material resources. DESIGN: A multiple case study design was implemented. METHODS: Nurses were recruited from 240 sites. The study comprised three phases of data collection. First, a content analysis of 42 documents relating to the context of nursing, specifically rural and remote nursing; second, a content analysis of an online questionnaire (n = 75); and third, a thematic analysis of semi-structured interviews (n = 20). COREQ reporting guidelines were used. RESULTS: Each phase of data collection informed subsequent data collection and analysis within the study. Following triangulation of data from each phase of the study, the major themes reported are "a medley of preparation for rural and remote work"; "being held accountable"; "alone, with or without someone"; and "spiralling well-being." CONCLUSIONS: Regardless of strategies, challenges of nursing in rural and remote areas persist. Issues of isolation, stress, burnout and a lack of organisational commitment to employees affect the retention of rural and remote nurses. While useful, professional development courses and graduate certificates are yet to make an impact on reducing these issues. RELEVANCE TO CLINICAL PRACTICE: Registered nurses argue for more experience rather than more education to facilitate transition into this nursing area. The finding that experience is perceived as more valuable than education suggests the need for innovative ways to gain experience to practice in rural and remote nursing. Lack of organisational commitment requires attention to promote the well-being of nurses and patient safety.

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AIMS: The aim of this systematic review and narrative synthesis was to identify how and why health coaching is delivered by Registered Nurses. DESIGN: Systematic review and narrative synthesis. DATA SOURCES: Articles were identified through a search of CINAHL, Medline, Scopus, and PsychINFO databases. Articles published in English between 2010 and 2021 were included. REVIEW METHODS: Quality appraisal of relevant literature was independently undertaken by two authors to assess for risk of bias. The Critical Appraisal Skills Program (CASP) was used to appraise quality of potential papers. RESULTS: A main purpose of coaching by Registered Nurses is to optimise patient self-care. How coaching was conducted varied across studies, with the most common coaching approaches via telephone or online. Majority of studies highlight some effectiveness of coaching by nurses; however, some results were inconclusive. Health coaching generally reduced mental distress. Other benefits reported by patients included reduced pain and fatigue. Outcomes for changing lifestyle behaviours were mixed. However, for health coaching to be efficient greater evidence is needed to determine length of time to use coaching, number of habits to focus on to produce change, and to determine best training for coaches. CONCLUSIONS: Registered Nurses are most suitable for implementing health coaching for self-care, including preventing and managing chronic illness and recovering from situations like post-surgical needs. Nurses already promote health, and therefore, are skilled in educating people in self-care. Coaching is an additional strategy for motivating, targeting and assessing progress of self-care. Extending the scope of nursing practice to routinely coach in self-care would be ideal.

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AIM: To examine current practice of genetic counselling by nurses. BACKGROUND: Recent debate argues that genetic counselling is a specialist advanced practice role, whilst others argue it is the role of all nurses. Current evidence is required to determine if genetic counselling could be included in all nurses' scope of practice. DESIGN: Integrative literature review. DATA SOURCES: A search of electronic databases (CINHAL, Medline, PubMed, Scopus), and reference lists published between January 2012 and March 2017, was undertaken. REVIEW METHODS: Studies were critically appraised for methodological quality using the Critical Appraisal Skills Programme. Data from each study were extracted and categorized according to their primary findings. RESULTS: The inclusion criteria were met in 10 studies. Main findings were identified: role of genetic counselling, current knowledge, need for further education, and client satisfaction with nurse genetic counsellors. CONCLUSION: This paper concludes that some nurses do engage in genetic counselling, but how they engage is not consistent, nor is there consensus about what should be the scope of practice. Further investigation into credentialing, role recognition support and education for nurse genetic counselling are strongly recommended. As nurses are widely available, nurses can make a significant contribution to supporting those affected by genetic problems.

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BACKGROUND: Refugee mothers have fled from their homeland to escape persecutions with their children only to find other threats to their well-being in the new country. Building on previous research, it is known that being a new immigrant is challenging and requires adaptation. The adaptation process, known as acculturation, may not be successful leading to psychological distress. It is also known that a generation gap can occur when children acculturate faster than their parents. What was lacking was understanding about the experiences of single refugee mothers. METHODS: Interpretative phenomenological study was undertaken to explore the lived experiences of eight Burundian refugee single mothers in Australia. Data were collected by in-depth interviews. Each interviews were transcribed and analyzed using thematic analysis. RESULTS: Findings revealed three themes. First theme 'Traditional mothering practices of Burundian culture' illustrated mothering strategies as practiced prior to their arrival in Australia including mothering with sufficient social support, strong position of parents, and regular use of physical disciplining. Second theme 'Challenges identified after arrival to new country' revealed that mothers felt their children acculturated faster than themselves which led to intergenerational gap. This has also led participants to live in a continuous dilemma, experiencing inner conflicts and struggles associated with their mothering practices, especially when mothers had arrived with a lack of knowledge relating to acceptable mothering practices in a new culture. Final theme, 'Reforming family life in Australia' highlighted the decisions made by single refugee mothers which is to embrace both new and original cultures, leading to successful acculturation. However, lack of appropriate knowledge of acceptable mothering practices led to involvement of legal authorities who threatening to remove children from the mother's care. This has led mothers feeling change of power from 'mother to child, 'to child to mother', raises concerns for family wellbeing. CONCLUSIONS: A need for parenting information when entering a new country including education about any legal obligations for parents such as a Child Protection Act will assist successful acculturation. As nurses are likely to encounter refugee single mothers, they are well placed to provide support and education to new refugee single mothers.

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BACKGROUND: This paper presents a discussion related to the recent decision in Australia to introduce mandatory Continuing Professional Development (CPD) for nurses. Historically there has been international debate surrounding mandatory CPD requirements; this debate is ongoing as Australian nurses face a diverse range of CPD offerings from a variety of providers. DISCUSSION: The purpose of this paper is to examine how mandatory CPD requirements for national nursing registration in Australia have evolved and to present an analysis of what this will mean for Australian nurses. What is yet to be determined is how to measure professional development and the effectiveness of professional development education. This is important to the international community with consensus in the literature that professional development is linked to ongoing education. Contradicting arguments are presented about whether this professional development should be mandatory. SUMMARY: Presenting a contemporary discussion about the current and potential impact of mandatory CPD requirements for nurses, this discussion paper utilises the case of Australia's current national policy and CPD operation to examine the choices that nurses make in order to fulfil their legislative requirements. Additional arguments are presented about the barriers nurses face in undertaking CPD. The quest for effective CPD is complex and should incorporate different situations for nurses and individual learning styles.

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AIM: This article is a report of a qualitative study of workplace health and safety issues in nursing research. BACKGROUND: Researcher health and safety have become increasing concerns as there is an increased amount of research undertaken in the community and yet there is a lack of appropriate guidelines on how to keep researchers safe when undertaking fieldwork. DESIGN: This study employed a descriptive qualitative approach, using different sources of data to find any references to researcher health and safety issues. METHODS: A simple descriptive approach to inquiry was used for this study. Three approaches to data collection were used: interviews with 15 researchers, audits of 18 ethics applications, and exploration of the literature between 1992 and 2010 for examples of researcher safety issues. Data analysis from the three approaches identified participant comments, narrative descriptions or statements focused on researcher health and safety. RESULTS: Nurse researchers' health and safety may be at risk when conducting research in the community. Particular concern involves conducting sensitive research where researchers are physically at risk of being harmed, or being exposed to the development of somatic symptoms. Nurse researchers may perceive the level of risk of harm as lower than the actual or potential harm present in research. Nurse researchers do not consistently implement risk assessment before and during research. CONCLUSIONS: Researcher health and safety should be carefully considered at all stages of the research process. Research focusing on sensitive data and vulnerable populations need to consider risk minimization through strategies such as appropriate researcher preparation, safety during data collection, and debriefing if required.

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Alcohol and drug dependency is a widespread health and social issue encountered by registered nurses in contemporary practice. A study aiming to describe the experiences of registered nurses working in an alcohol and drug unit in South East Queensland was implemented. Data were analysed via Giorgi's phenomenological method and an unexpected but significant finding highlighted the frustration felt by registered nurses regarding experiences of stigma they identified in their daily work encounters. Secondary analysis confirmed the phenomenon of stigma with three themes: (1) inappropriate judgement; (2) advocacy; and (3) education. Resultantly, findings concluded registered nurses' working in this field need to become advocates for their clients, ensuring professional conduct is upheld at all times. This paper recommends that stigma could be addressed by incorporating alcohol and other drug dependency subjects and clinical placements into the curriculum of the Bachelor of Nursing degrees, and in-services for all practising registered nurses.

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OBJECTIVE: To explore thoughts of infanticide that did not lead to the act among mothers with postpartum depression. DESIGN: A phenomenologic hermeneutic study in which women were invited to share their experiences of having thoughts of infanticide. SETTING: Community setting in a large metropolitan city, Brisbane, Australia. PARTICIPANTS: Fifteen women who had been diagnosed as clinically depressed with postpartum onset whose babies were 12 months of age or younger. METHOD: Audiotaped, in-depth interviews were transcribed verbatim. Thematic analysis commenced immediately after the first interview, and data collection continued until saturation was achieved. A questioning approach that reflected hermeneutics was facilitated by use of journals by the researchers. MAIN FINDINGS: Six themes emerged from the data: imagined acts of infanticide, the experience of horror, distorted sense of responsibility, consuming negativity, keeping secrets, and managing the crisis. CONCLUSION: Women who experienced nonpsychotic depression preferred not to disclose their thoughts of infanticide to health professionals, including trusted general practitioners or psychiatrists. These women were more likely to mention their suicidal thoughts than their infanticidal thoughts in order to obtain health care. General practitioners and other health professionals should directly ask about whether a woman has been experiencing thoughts of harming herself or her baby, regardless of the reason why she has presented.

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BACKGROUND: With 10-15 percent of mothers experiencing postpartum depression this mental health problem is a significant public health issue. One concern is that normal infant development is at risk. Understanding how Postpartum depression impacts on mothering is important knowledge in managing this health problem. OBJECTIVES: To: Explore what is it like to become a mother, and examine how postpartum depression impacts on maternal adaptation. DESIGN: A hermeneutic approach was used guided by the philosophical works of Heidegger and Gadamer SETTING: A relatively affluent metropolitan area, including surrounding rural areas within Australia. PARTICIPANTS: Via purposeful, maximum variation sampling, eleven women who had been medically diagnosed with postpartum depression following childbirth but who were not experiencing psychosis participated in the study. METHODS: In-depth interviews and reflective journaling. RESULTS: Mothers with postpartum depression become "stuck" in a liminal state, an incomplete process of the rite of passage. Therefore, adaptation to the social role of a mother was found to be delayed. Additionally, a delay in becoming competent in parenting skills was evident. A lack of maternal-infant attachment was noted, however, mothers continued to care for their infants but in an unthinking manner that was labelled "mechanical infant caring". CONCLUSIONS: The distress caused by the delay in adapting to being a mother could be addressed by providing a mentor to at-risk women. The mentor should be a mother who has previously recovered from postpartum depression and would act as a symbol of hope. Additionally, on-going education and the insight that occurs during the liminal phase can facilitate mothers with postpartum depression to adapt appropriately.

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