The HNE Nursing community are very proud to recognise the achievements of Sue Denison, Nurse Practitioner at the Nundle Community Health Centre, who has recently been awarded an AOM for outstanding services to nursing and the community of Nundle. This richly deserved honour recognises Sue's many years of tireless work and dedication to improving the health of the members of her community. A true trailblazer in nursing, Sue was one of the first two Nurse Practitioners to be authorised in Australia. She achieved this advanced clinical position through recognition of her significant knowledge, skill and contribution to health promotion, education and service delivery over many years. Her ability to function in a multidimensional, autonomous capacity is derived from her experiences working with communities and built on qualifications in general nursing, midwifery, aged care, remote area nursing, intensive care, child and family health and first line emergency care.

Contact with family and friends, in the form of visiting, is very important to the quality of the lives of rural nursing home residents. However, there has been little recent research that examines the frequency and determinants of visits to rural nursing homes and none in the rural Australian context. This study aimed to address this gap in the literature. A telephone survey with a close family member (N=257) of each participating resident in the rural New England area of New South Wales, Australia gathered data about 3,738 people who formed the potential social networks of these residents. This study found that the wider, potential, social networks of rural nursing home residents comprised approximately 17 people and involved a wide range of family and friends. However, their actual social networks consisted of approximately two females, daughters and friends, who had high-quality relationships with the resident and who visited at least once per month. In contrast to previous assertions that nursing home residents have robust support from their family and friends, the actual social networks of these residents have dwindled considerably over recent years, which may place them at risk of social isolation. This study has implications for nursing home policy and practice and recommendations for addressing the risk of social isolation that rural nursing home residents face are made.

There is paucity of research studies from Saudi Arabia on 'end-of-life' (EOL) care regarding hospitalised patients after a 'do-not-resuscitate' (DNR) decision has been made. The aim of this research study was to describe the lived experiences and explore the meaning of these experiences and the extent of nurses' involvement as team members in EOL care, in the context of a physician-led health care team. The research site was a large tertiary-level teaching hospital in Riyadh, Saudi Arabia and the research location was the general medical units that are frequent sites of death in EOL care after a DNR decision had been made. The research problem focused on involvement of nurses, who were largely non-Muslim, multinational and non-Arabic speaking, and local patients who were mainly Muslim and speak Arabic as their primary language. The research study design embraced qualitative, exploratory and descriptive approaches utilising aspects of phenomenology. Congruent with qualitative inquiry, the literature review commenced at the beginning of the research study and continued in an iterative manner after data collection, throughout data analysis, and during the thesis generation. Purposive sampling was used to recruit registered nurse participants who met the participation criteria in relation to direct experiences in EOL care after the DNR decision on general medical units. A total of twenty-six (26) registered nurses participated in this study by informed consent. Reflective journalling technique was selected as the most appropriate data collection method owing to its congruency with the professional nursing practice context of the hospital setting. Ethical research principles were upheld to maintain the rights of the participants, and in keeping with organisational permission to conduct the study.

Aim. To describe women's experiences of sexuality and body image following treatment for early-stage vulvar cancer. Background. There is limited information available on sexual function following treatment for early-stage vulvar cancer. A review of the literature has shown a lack of qualitative investigation into this topic. This study was undertaken to address this deficiency and to add to the existing body of knowledge describing the psychosexual outcomes for these women. Design. Qualitative interview study. Methods. A qualitative approach based on interpretive phenomenology was used to interview a purposive sample of 10 women (mean age 58 years) who had previously been treated for an early-stage vulvar cancer. Interviews were conducted from June–October 2009. Data were generated from verbatim transcription of the semi-structured in-depth interviews. Thematic analysis of these data revealed themes that were common to the women's experiences of sexuality and body image. Findings. Four themes were identified that described the structure of the experience. Only two of these themes, sexuality and body image, will be discussed in this paper. Conclusions. Findings from this study indicated that the majority of women experienced little to no long-term disruption to sexuality and body image following conservative treatment for early-stage vulvar cancer. Intimacy and relationship status were more closely linked to women's sexual satisfaction than physical arousal. Factors contributing to women experiencing negative emotions were radical vulvar excision, multiple vulvar procedures and/or the development of lymphoedema.

After completing this chapter, you will be able to: • List the measures used to maintain the confidentiality of patient records. • Discuss reasons for keeping patient records. • Compare and contrast different documentation methods: source-oriented and problem-oriented medical records, PIE, focus charting, charting by exception, computerised records, and the case management model. • Explain how various forms in the patient record (e.g. flow sheets, progress notes, care plans, critical pathways, discharge/transfer forms) are used to document steps of the nursing process (assessment, diagnosis, planning, implementation and evaluation). • Compare and contrast the documentation needed for patients in acute care, home health care and long-term care settings. • Identify and discuss guidelines for effective recording that meets legal and ethical standards. • Identify essential guidelines for reporting patient data. • Explain the reason for limiting the use of abbreviations in clinical documentation.

The number of Chinese immigrants in Australia has increased significantly over the past two decades, and their ageing issues have gradually become the focus of concern. This study aims to fill the literature gap by investigating older Chinese immigrants' experiences and perceptions of growing older in rural Australia in order to gain an understanding of their health-related help-seeking behaviours in this context. This study is situated in a qualitative interpretive paradigm. It uses a transcultural perspective to inform a case study methodology, and it adopts the Theory of Planned Behaviour as an interpretive framework to guide the study. A combination of purposive sampling and snowball sampling strategies was used in recruitment, and six Chinese immigrants aged 60–85 years who resided in rural Australia were invited to participate in the study. Individual semi-structured, in-depth interviews were used to gather data, and thematic analysis was applied to analyse the interview data. This study found that the older Chinese immigrants were living in two cultures, and this forced them to reconstruct their cultural beliefs, especially in relation to filial expectations and maintaining harmony in the family. Further, because of a lack of English proficiency, they had greater difficulties dealing with ageing, especially in accessing health care services in rural Australia. These findings have implications for policy and practice related to migrant health care and rural community health practice.

Effective communication between health professionals is vital to the quality of patient care. Such communication allows a free flow of information between all the members of the inter-professional team and facilitates effective, person-centred care. Generally, health personnel communicate through discussion, reports and records. A discussion is an informal oral consideration of a subject by two or more health care personnel to identify a problem or to establish strategies to resolve a problem. A report is oral, written or computer-based communication intended to convey information to others. For instance, nurses always report on patients at the end of a hospital work shift. A record is written or computer-based. The process of making an entry on a patient record is called recording, charting or documenting. A clinical record, also called a chart or patient record, is a formal, legal document that provides evidence of a patient's care. Although health care organisations use different systems and forms for documentation, all patient records have similar information. Each health care organisation has policies about recording and reporting patient data, and each nurse is accountable for practising according to these standards. Organisations also indicate which nursing assessments and interventions can be recorded by registered nurses and which can be charted by enrolled nurses or by unregulated health care workers. In addition, the Australian Council on Healthcare Standards (ACHS 2010) requires patient record documentation to be timely, complete, accurate, confidential and specific to the individual patient.

This chapter is concerned with the care of those people who are living with a chronic or life threatening illness. These scenarios illustrate situations that can occur in the chronic care and/or palliative care settings. They are designed to stimulate your thinking about the most appropriate ways of assessing patient needs and to manage care given the unique situation you are presented with. This chapter is also designed to stimulate your thinking about the guiding principles of chronic and palliative care and how a sound knowledge of these principles can help you to find the best approach to care for an individual and his/her family members.

Data supporting PhD thesis. Mixed methods sequential explanatory study design was used in this research study. In the quantitative phase, a survey with close-ended questions was conducted with both the dialysis patient and carer groups in a regional hospital of Hong Kong. The findings were then analysed and used to guide the qualitative component of the study; specifically, the questions to be asked during the focus group interviews. The qualitative data from focus groups generated different information, reflecting common versus diverse views that prepared people to deal with more sensitive issues related to end-of-life care.

Introduction: In Australia, as in many other developed countries, the current healthcare environment is characterised by increasing differentiation and patient acuity, aging of patients and workforce, staff shortages and a varied professional skills mix, and this is particularly so in rural areas. Rural healthcare clinicians are confronted with a broad range of challenges in their daily practice. Within this context, the challenges faced by rural acute care clinicians were explored and innovative strategies suggested. This article reports the findings of a study that explored these challenges across disciplines in acute healthcare facilities in rural New South Wales (NSW), Australia. Methods: A mixed method approach, involving a consultative, participatory 3 stage data collection process was employed to engage with a range of healthcare clinicians from rural acute care facilities in NSW. Participants were invited to complete a survey, followed by focus group discussions and finally facilitated workshops using nominal group technique. Results: The survey findings identified the respondents' top ranked challenges. These were organised into four categories: (1) workforce issues; (2) access, equity and opportunity; (3) resources; and (4) contextual issues. Participants in the focus groups were provided with a summary of the survey findings to prompt discussion about the challenges identified and impact of these on their professional and personal lives. The results of the final workshop stage of the study used nominal group process to focus the discussion on identifying strategies to address identified challenges. Conclusions: This study builds on research conducted in a large metropolitan tertiary referral hospital. While it was found that rural clinicians share some of the challenges identified by their metropolitan counterparts, some identified challenges and solutions were unique to the rural context and require the innovative solutions suggested by the participants. This article provides insight into the working world of rural healthcare clinicians and offers practical solutions to some of the identified issues. The findings of this study may assist rurally based healthcare services to attract and retain clinical staff.