The Development of Nursing and Nursing Education in Australia and New Zealand – Care Example

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"The Development of Nursing and Nursing Education in Australia and New Zealand" is a delightful example of a paper on care. Professional nursing is very instrumental in the healthcare system of any given country. Nurses form members of the largest profession in healthcare working in diverse settings and expertise often front lining the provision of services in health. Even though most nurses appear to work in acute care hospital settings, nurses' skills give them the ability to work in areas beyond the hospital setting. They provide health care education, primary health care related services, counseling, and provision of health advice (Daly, Speedy & Jackson, 2013).

The increasing significance of nurses has seen nursing transform into a valuable, indispensable profession in this era. Even though nursing was thought to have been incepted by the late Briton Florence Nightingale, it was existent before been practiced in form of familial care and as religious orders in hospices (Daly, Speedy & Jackson, 2013). With the entrance of modern medical practice, nursing was reformed to cater to the increasing needs of the sick as envisioned in modern medicine.

Diligence and literacy were a necessity for nurses to achieve the goals of nursing care advanced in modern medicine (Daly, Speedy & Jackson, 2013). In this article, the development of nursing and nursing education including the currently registered nurse competency standards, code of ethics, and professional conduct shall be compared and contrasted between two countries, that is, Australia and New Zealand.   Nursing as an art has been in existence virtually since the time of the human race. The Nursing practiced in the 21 century which can be labeled as modern nursing has evolved and gotten more sophisticated compared to that practiced in the pre-modern era described as part of the 19th century.

Some scholars have postulated that modern nursing is not any different from pre-modern nursing except that it’ s just “ the new way of doing old things” (Daly, Speedy & Jackson, 2013). Familial care form of nursing was commonly practiced by women as it was envisaged in their roles as mothers and wives in both New Zealand and Australia (Maclean, 2015). In the old era, nurses had diverse backgrounds based on experience in a given field of nursing even though these fields had not been clearly distinguished.

Most of these nurses were not trained before the last quarter of the 19th century both in Australia and New Zealand. Childbearing and rearing experience was instrumental for nurses practicing in these fields in the early and mid-19th century. It was through Florence Nightingale’ s success in the management of soldiers in the Crimean War that the enhancement of cleanliness and training of nurses was embraced in both countries (Health Times, 2015; Daly, Speedy, and Jackson, 2013).

In New Zealand, this transition occurred from around 1883 (Health Times, 2015). During this time, the number of regular hospitals had increased taking over the roles played by the informal basic cottage kind of hospitals in New Zealand. 1988 saw lectures have been offered to students who were expected to finish their course successfully by excelling in an exam 12 months after initiation of the training (Health Times, 2015; Maclean, 2015). In the 20th century especially during the early 1900s, registration of nurses in New Zealand was possible.

This happened in 1901 where New Zealand had nurses registered under Nurses Registration Act enabling them to be titled Registered Nurses (RN) (Maclean, 2015). Both male and female nurses were registered as RNs, but men were only allowed to serve male patients and female RN could only be allowed to serve female patients. However, this later changed allowing female nurses to provide nursing services to male patients attributable to the former's settling effect on such patients (Health Times, 2015). The early 1900 also saw the rise of a form of nursing referred to as Karitane nursing entailing the care of neonates.

The first quarterly issue of the nurse’ s journal in New Zealand was published in 1908 titled Kai Tiaki, a major milestone in the professionalization of nursing (Maclean, 2015). The first association for trained nurses in New Zealand was formed in 1909 – New Zealand Trained Nurses’ Association. It underwent name changes to the current New Zealand Nurses’ Organization (NNO) (Health Times, 2015). By 1960 Nurses were been trained in hospitals in a three-year training program. In 1970, nursing education was incorporated into tertiary education enabling students to train in polytechnics or universities.

By 1995, all polytechnics in New Zealand could offer a three-year Bachelor's degree in Nursing with studies comprising equal ratios of theory and practical experience (Health Times, 2015). Just like in New Zealand, Australian States also continued with the Nightingale form of apprenticeship training that was also hospital-based (Australian Government Department of Health [AGDH], 2013). The trained nurses were then registered as per the Nurses Registration Act established in 1920. State bodies representing nurses had been established as early as 1899 in the New South Wales labeled the Australasian Trained Nurses Association and the Australia Nursing Federation (ANF SA) in South Australia (Australian Nursing and Midwifery Federation [ANMF] (SA Branch), 2012).

These culminated in the establishment of a federal body, the ANF in 1924. In 1955, it changed its name to Royal Australian Nursing Federation. During this time, most States also introduced statutory bodies to govern the hospital-based nurses' training (Russell, 2009). The enrolled nurses were introduced in the 1960s after there was increased professional attrition with decreased retention and even recruitment of RN and trainee nurses (Russel, 2009).   Towards the late 20th century, there was increasing pressure to switch nurses training to a tertiary level to be undertaken in colleges and universities (AGDH, 2013).

This led to legislative changes in 1984 enabling the transfer of nursing education to the tertiary level (AGDH, 2013). Currently, in New Zealand and Australia, there exist three formal nursing cadres that include the enrolled nurse, registered nurse, and nurse practitioner (AGDH, 2013; Daly, Speedy, Jackson, 2013). The three have to undergo formal training and be registered in a roll for enrolled nurses and a register for RN and nursing practitioners (Daly, Speedy & Jackson, 2013). Competence standards are meant to classify the performance of nurses.

It emerged in the late20th century and was adopted by the Australian Nursing and Midwifery Council (ANMC) in conjunction with territorial and state relevant authorities in Nursing in Australia and the Nursing Council of New Zealand (NCN) in New Zealand (NCN, 2012a; Nursing and Midwifery Board of Australia [NMBA], 2010). They form part of the pre-qualifications for registration as an RN in both countries and to retain an RN’ s registration status during annual renewal in Australia and after at least three years during competency assessment for New Zealand RN (Grealish, 2012; Nursing and Midwifery Board of Australia [NMBA], 2010; NCN, 2012a).

It is also a tool for assessing nurses educated outside the countries jurisdiction, re-joining service after a break, and those affected by professional conduct issues (NMBA, 2010).   The competency standards for the two countries are virtually similar emphasizing similar issues except that the Australian is more comprehensive and detailed and has more emphasis on practicing within an evidence-based framework for all RN (NMBA, 2010). Code of ethics are developed to ensure that the rights of recipients and providers of health care and nursing care are constantly upheld while the code of conduct for nurses in both countries is a source of evaluation of nurse’ s behavior professionally (NCN, 2012b; NMBA, 2008a; NMBA, 2008b, NNO, 2010).

In addition, the code of conduct sets minimum standards of conduct for the nursing professional members and educates the community of the professional standards of conduct expected of nurses in both countries.

Both countries’ codes of ethics are based on fundamental principles of ethics with slight modification. Although the organization of the code of ethics from the two countries varies, they both advocate for the same values expected from nurses. In a summary, the values included in the code of ethics for New Zealand nurses include autonomy, beneficence, justice, maleficence, confidentiality, veracity, fidelity, being professionalism, and environmental and resources guardianship (NNO, 2010). The Australian one emphasizes on been professional, autonomous, confidentiality, the value of economic and ecological conservation, beneficence, non-maleficence, kindness, and respect for others and self (NMBA, 2008b). The codes of conduct also derive most of their principles from the principles of ethics.

New Zealand’ s version shares some principles with the Australian version such as respect for cultural needs, dignity, values, individuality, and privacy and confidentiality of health consumers, providing competent and safe care, maintenance of public confidence and trust (NNO, 2010). Others in New Zealand’ s version include working alongside health consumers and working with colleagues in a respectful manner (NNO, 2010).

The Australian version has more principles not included in New Zealand’ s version such as the need for nurses to practice ethically and reflectively as per the profession’ s standards and standards of the bigger health system, and as per the relevant laws regulating the profession and nursing practice in general (NMBA, 2008a).

References

Australian Government Department of Health. (2013). History of Commonwealth involvement in the nursing and midwifery workforce. Retrieved from http://www.health.gov.au/internet/publications/publishing.nsf/Content/work-review-australian-government-health-workforce-programs-toc~appendices~appendix-iv-history-commonwealth-involvement-nursing-midwifery-workforce

Australian Nursing and Midwifery Federation (SA Branch). (2012). Our History. A tradition of support. Retrieved from https://www.anmfsa.org.au/about-us/our-history/

Daly, J. Speedy, S & Jackson, D. (eds). (2013). Contexts of nursing: An introduction (4 ed.). Sydney: Elsevier Australia.

Grealish, L. (2012). How competency standards became the preferred national technology for classifying nursing performance in Australia. Australian Journal of Advanced Nursing, 30(2), 20-31.

Health Times. (2015). History of nursing in New Zealand. Retrieved from http://healthtimes.com.au/hub/nursing-careers/6/guidance/nc1/history-of-nursing-in-new-zealand/515/

Maclean, H. (2015). Nursing in New Zealand: History and reminiscences. Retrieved from http://nzetc.victoria.ac.nz/tm/scholarly/tei-MacNurs.html

New Zealand Nurses Organization. (2010). Code of ethics. Wellington: NNO.

Nursing and Midwifery Board of Australia. (2008a). Code of professional conduct for nurses in Australia. Melbourne: Australia Nursing and Midwifery Council.

Nursing and Midwifery Board of Australia. (2008b). Code of ethics for nurses in Australia. Canberra: NMBA.

Nursing and Midwifery Board of Australia. (2010). National competency standards for the registered nurse. Canberra: NMBA.

Nursing Council of New Zealand. (2012). Code of conduct for nurses. Wellington: NCN.

Nursing Council of New Zealand. (2012a). Competencies for registered nurses. Wellington: NCN.

Russell, L. (2009). From hospital to university - the transfer of nursing education. Retrieved from http://www.cdnm.edu.au/wp-content/uploads/2011/09/HistoryNursingEducation.pdf

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