University of Tasmania, Australia

Nursing preceptorship project in Tasmanian residential aged care facilities.

Project Background

  The recruitment and retention of nurses into aged care has become an increasingly important issue. For some time, peak bodies such as Aged and Community Services Australia and the Australian Nursing Homes and Extended Care Association Limited (ANHECA) have been concerned by problems with recruitment and retention of registered nurses, and the lack of promotion to entice nursing graduates to work within the industry. These problems have been compounded by negative media attention regarding of the quality of care provided in the aged care sector. In Tasmania, difficulties associated with recruitment have been aggravated by the extremely limited exposure of undergraduate nursing students to the sector. While the State has a history of nursing students participating in clinical placements in aged care organisations, such arrangements have not been ongoing. This has frustrated the ability of aged care providers to attract graduates, and has undermined the ongoing professional development of nursing staff that accrues through their association with student nurses in practice.

  The relative absence of Tasmanian undergraduate students in aged care in part reflects the need to develop links between the industry and the School of Nursing & Midwifery. Additionally, there is anecdotal evidence to suggest that like many of their colleagues in acute care, aged care nurses struggle to effectively facilitate the clinical education of undergraduate nursing students at an optimal level. These issues need to be addressed if the quality of students’ learning is to be maximised and RNs are to successfully act as preceptors to facilitate their clinical education and interest in aged care. Indeed, past experience highlights that without adequate preparation and support, registered nurses and students experience difficulty in achieving positive learning outcomes. This also impacts on recruitment later on.

  Supporting students in practice is often provided through preceptorship programs, where they are allocated a preceptor on every shift they work. In this project, the intent was to utilise a collaborative preceptorship model, as this is recognised as an effective way to facilitate teaching and learning in clinical practice. Collaborative preceptorship programs offer participants, both students and their preceptors, an opportunity to develop strategies that facilitate teaching and learning in practice in ways that account for local and contextual needs (Robinson, McInerney, Sherring and Marlow 1999). In the context of this study this was important, because there is little information that addresses the issues around promoting a positive learning environment for undergraduate students in aged care. As such, this project has a focus on exploring the experiences, issues and concerns of students and their preceptors during a clinical practicum in a residential aged care context. The intent is to articulate a set of principles that will inform the development of structures and processes to facilitate effective undergraduate teaching and learning in aged care contexts. With this in mind, two groups of second year nursing students, of mixed ages and with variable experience in caring for elderly people, participated in a three–week clinical practicum in two residential aged care facilities. The first group were involved in Stage One of the project and began their practice in Semester One, 2001. In general the members of this student group had not been engaged in a clinical practicum prior to commencing work in one of the aged care facilities participating in the project. Prior to participating in this project, the second group of students, who were involved in Stage Two of the project, had already completed a three–week clinical practicum in an acute hospital.