Senior nurse role expectations of graduate registered and enrolled nurses on commencement to practice

Objective: This paper reports on a project to examine the expectations of senior nurses regarding graduate roles of registered and enrolled nurses educated in Victoria, Australia. Methods: Participants completed an online survey to indicate whether predetermined competencies were in the roles of graduate enrolled or registered nurses or not in the role of either nurse. Chi-squared analysis was used to identify differences between participant groups. Results: Participants expressed variations in role expectations for the different level of graduate nurse. Although basic nursing care was undertaken by both graduate enrolled and registered nurses, no specific role was identified for enrolled nurses. Differences were found in the opinions of senior nurses over the roles of graduate nurses, demonstrating considerable variation in expectations. Management, education and research roles were not identified as the role of either nurse on graduation. Differences were found in the expectations of the different senior nurse groups regarding the roles of the enrolled nurse, particularly in the new skills taught in the enrolled nurse diploma program. Conclusions: Confusion exists regarding the roles of both types of nurse on graduation. Further research across Australia is required to clarify the roles of the different level of nurse in different practice contexts

Senior nurse role expectations of graduate registered and enrolled nurses in Australia: Content analysis of open-ended survey questions

Changes to educational preparation and scope of practice for enrolled nurses (ENs) in Australia have impacted on role expectations. This paper reports results of a survey of senior nurses in Victoria, Australia, regarding opinions of the differences in role expectation and scope of practice for graduate registered and ENs. Content analysis of open-ended survey questions was used to identify themes in the written data. Results identified education, skill level and responsibility as differences between the levels of graduate nurses despite many respondents perceiving there to be no or little difference in graduate roles

Similarities and differences in educational preparation of registered and enrolled nurses in Australia: An examination of curricula content

Background: Variations exist internationally in the types and numbers of nurses registered to practice. Whilst the United Kingdom has phased out second level nurses, countries such as Australia, New Zealand, Singapore and the United States have maintained a two level system. In Australia, the two levels of nurse authorised to practice are the registered nurse whom complete an undergraduate nursing degree, and enrolled nurse (EN) whom complete either a certificate or diploma programme. Recent changes to educational preparation and resulting scope of practice for ENs have resulted in increased confusion between roles and expectations of the different levels. Aim: This paper reports on findings of a study aimed at identifying differences in educational preparation of the different levels of nurse in Australia. Method: Course coordinators from nine organisations offering pre-registration nursing programmes completed self-reporting questionnaires designed to obtain information on types and lengths of courses, and details of curricula including course objectives, teaching and assessment methods and content areas. Results: Comparative analysis of survey responses identified similarities and differences between registered and EN programmes. Common areas included teaching and assessment methods, core theoretical units and general nursing skills. The diploma and degree programmes appear aligned in most theory and clinical skills. The main difference identified existed between skills taught in the two EN programmes. Conclusions: Findings further add to confusion regarding registered and ENs in Australia. Further research is required to determine expectations of employers and other major stakeholders with regard to the differences

Role expectations of different levels of nurse on graduation: A mixed methods approach

Aim: To explore graduating registered and enrolled nurses\u27 perceptions of what roles they were educationally prepared for and what their roles would include. Background: Defining nursing roles can be challenging, with studies from many countries identifying role confusion and overlap as issues with employing two levels of nurse. Australia has two levels of nurse registered for entry to practice: registered and enrolled nurses. Recent changes to increase the educational level of enrolled nurses have resulted in increasing similarities in skills and knowledge being taught to these and degree-prepared registered nurses, causing role ambiguity and confusion between the two levels of nurse. Design: Mixed methods research. Method: The research utilised a cross-sectional survey of completing nursing students (n=57) from both levels of nursing programme in Australia in 2012. Analysis involved Mann-Whitney U tests and content analysis. Results: Similarities were expected by students between the levels of nurse in basic patient care skills. Registered nurse graduates were expected to care for patients of higher acuity and take on increased levels of responsibility. Conclusion: Despite similarities in graduate role expectations, differences remain in the expected level of practice with graduate registered nurses expected to be prepared to care for patients of higher acuity and undertake higher levels of responsibility than graduate enrolled nurses. Nurse managers need to take into account the differences in education preparation and role expectations when allocating patients for nursing care and determining skill mix for patient care

Comparisons of the educational preparation of registered and enrolled nurses in Australia: The educators\u27 perspectives

Similar to the USA, New Zealand and Singapore, Australia registers two levels of nurse, the degree or postgraduate entry prepared registered nurse and diploma or certificate-prepared enrolled nurse. Over the past decade, significant changes have occurred in educational preparation of enrolled nurses. This has resulted in enrolled nurses undertaking many roles and responsibilities previously undertaken only by registered nurses. An exploratory qualitative research study using interviews with educators of both registered and enrolled nurses was undertaken to investigate differences in educational preparation of registered and enrolled nurses in Australia. This paper describes perceptions around how participants viewed educational approaches and different cohorts, types and levels of students. Similarities included topics covered and the majority skills taught, although high acuity skills remain a difference between the levels of nurse. Differences were also found in type of student, educational background and teaching method

Angiotensin II receptor imbalance associated with neonatal cardiac growth restriction is a prelude to adult cardiac hypertrophy

The Hypertrophic Heart Rat (HHR) displays spontaneous cardiomyocyte hypertrophy in association with an apparent reduction in myocyte number in adulthood. This suggests the possibility of reduced hyperplasia or increased apoptosis during early cardiac development. The angiotensin AT1 and AT2 receptor subtypes have been implicated in both cellular growth and apoptosis, but the precise mechanisms are unclear. The aim of this study was to determine the relationship between cardiac AngII receptor expression levels and neonatal cardiomyocyte growth and apoptotic responses in the HHR compared with the Normal Heart Rat (NHR) control strain. Cardiac tissues were freshly harvested from male HHR and NHR at several developmental stages (p2 and 4, 6, 8, 12wks). HHR cardiac weight indices were considerably smaller than NHR at day 2 (4.330.19 vs 5.010.08 mg/g), but &lsquo;caught-up&rsquo; to NHR by 4 weeks (5.100.15 vs 5.160.11 mg/g). By 12 weeks, HHR hearts were 27% larger than NHR. Tissue AT1A and AT2 mRNA expression levels were quantified by real-time RT-PCR. Relative to NHR, HHR neonatal hearts exhibited a 4.6-fold higher AT2/AT1 mRNA expression ratio. Cultured neonatal cardiomyocytes were infected with AT1A and/or AT2 receptor-expressing adenoviruses to achieve a physiological level of receptor expression (150 fmol receptor protein/mg total cell protein). In addition, to emulate receptor expression in neonatal HHR hearts, cells were co-infected with AT1A and AT2 receptors at a 4:1 ratio. Apoptosis incidence was studied by morphological analysis after 72 hours exposure to 0.1 M AngII. When infected with the AT1A receptor alone, a higher proportion of HHR myocytes appeared apoptotic than NHR (22.7 4.1% vs 1.1 0.6%, P 0.001). This implies that intrinsic differences predispose HHR cells to accentuated AT1-mediated apoptosis. Interestingly, the bax-1/bcl-2 mRNA expression ratio was significantly higher (50%) in HHR neonatal hearts. When cells were co-infected with AT1A and AT2 receptors, evidence of apoptosis in HHR cells virtually disappeared (0.4 0.1%). These findings suggest a novel capacity of AT2 receptors to counteract accentuated AT1A receptor-induced apoptosis in the HHR in early cardiac growth.<br /