In Australian acute care hospitals, two distinct educator roles exist: the nurse educator and the clinical nurse educator. Other similar positions include the ‘new graduate program coordinator’ or the ‘clinical nurse educator after hours’. For the purpose of this thesis, both the nurse educator and c linical nurse educator roles in acute care hospitals are addressed. Although there is minimal discourse regarding the role of either educator in the literature, various descriptions of roles in Australia prevail. The definition provided in the Australian and N ew Zealand Standard Classification of Occupations (2006) is one example [30]. In this instance, nurse educators are classified together with nurse researchers [30]. This in itself is problematic as it is unclear where the nurse educator descriptors end and the researcher descriptors begin, or, as the case may be, overlap.
These definitions could also be aligned to the role of the nurse academic, which may be more inclusive of all of the associated tasks listed for the educator and researcher role they assume. The broad definition states that the nurse educator conducts both clinical and t heoretical education, and pr ofessional development with nurses and midwives. Their role may include the development, management and implementation of nursing specific and/or staff development programs. Alternative titles ascribed to educators include nurse educator, clinical nurse educator and staff development nurse. Within this classification, the required skill level is equivalent or equal to a bachelor degree or higher qualification, in addition to 5 years of relevant experience [31]. The specified role tasks associated with this definition are identified in Table 2.1.
Table 2.1 Educator and researcher tasks
Nurse educator/researcher/clinical nurse educator/staff development nurse tasks [3].
Developing nursing curricula Facilitating clinical education
Educational needs assessment and monitoring of education program outcomes
Policy development and implementation
Involvement in interdisciplinary research and research dissemination Promoting evidence based practice
Supporting and teaching nurses undertaking research Resource management
The Australian Nursing Federation (2009) proposed that the scope of practice for the clinical nurse educator was within a unit/facility or higher education setting managing nurse education [31]. The role specification requires 5–10 years of postgraduate experience and e ducational requirements specify a B achelor of Nursing and postgraduate study in nursing and education [31]. An example of this role would be a nur se educator responsible for facility-wide education including mandatory education [31]. The confusion in nomenclature is apparent in this example where the term ‘clinical nurse educator’ is used and then interchanged with ‘nurse educator’. The other difference between this and t he previous description by the Australian and N ew Zealand Standard Classification of Occupations [30] is the requirement for a postgraduate qualification in education to perform the role.
Confusion in nomenclature and r ole demarcation challenges the nurse educator and clinical nurse educator to successfully establish role identity in clinical environments [3]. The overlapping roles of other clinical staff involved in clinical education, such as t he clinical nurse specialist and c linical nurse consultant, as reported by Conway & Elwin (2007), add further confusion and ambiguity in
nomenclature [3].These are listed in Table 2.2. The focus of Conway & Elwin’s (2007) work is within New South Wales and therefore may not necessarily be representative of the role in other states and territories. However, it is difficult to specify role variations as a consequence of the minimal literature available.
Table 2.2 Role clarification and associated responsibilities for nursing education.*[3]
Role title Responsibilities Clinical nurse
educators Bring clinical expertise, capacity to support learners in the clinical settings using a range of strategies that are dependent on context (e.g. direct interaction with trainee enrolled nurse/new graduate nurse or supporting others to support them, providing structure for and coordinating mandatory training
Clinical nurse
consultants Provide clinical expertise, data analysis of incidents, audits, and research. They have the capacity to guide priority setting in education and knowledge of professional directions with regard to colleges, networks, other organizations.
Clinical nurse
specialists Bring focused clinical expertise relevant to their specialty area of practice, currency of practice in direct patient care, as well as support for their learners and peers
Nurse
educators Have instructional design and curriculum skills, ability to advise regarding outcomes of educational needs analysis process, evaluation experience, knowledge of education provider (e.g. university and TAFE)** curricula, systems and processes, and an awareness of how Area-wide initiatives affect education
Note: These terms may not translate exactly to an international context but the descriptions of associated responsibilities for nurse education inherent within each role may assist the reader unfamiliar with the terminology used in NSW.
*Used with permission.
**TAFE: Technical and Further Education (TAFE) colleges provide secondary education, vocational education, and professional education courses from Certificate to Bachelor program level.
Globally, nurse educator titles and roles are also unclear as roles and functions intermingle across practice environments [3,32,33]. In the USA and the United Kingdom (UK), a nurse educator may have dual roles in academia and the hospital setting [33,34]. By contrast, the nurse educator and clinical nurse educator in Australia primarily work in hospitals [1,3].
From the introduction of nursing into Australia in 1868 until the mid-1980s, the nurse educator role was hospital based [35]. During this period, pre-registration education for nurses was undertaken in hospitals on the basis of an apprenticeship-training model [35]. The nurse educator was fully engaged in all aspects of these programs [35]. This included curriculum development, implementation and e valuation, as w ell as teaching in practice [3]. Now, undergraduate nurse education is provided in the tertiary sector [3].
Within Australian hospitals, two education roles commonly exist - the nurse educator and the clinical nurse educator [3]. Unless otherwise specified within this discussion, the term ‘nurse educator’ is used encompassing both roles. The nurse educator today is an advanced practice registered nurse [36]. An advanced practice registered nurse meets the domains of the national competency standards of the registered nurse [19] and builds on these through practice identified within advanced practice domains [36]. These domains focus on three aspects of practice – conceptualizing, adapting and leading [36]. Conceptualizing practice requires the nurse educator to use theory, research, evidence and their experience to explore, question and de velop knowledge enhancing nursing education and nursing practice [36]. By adapting practice, the nurse educator considers research and knowledge prior to modifying nursing practice [36]. The nurse educator works as a leader in education and nursing practice by promoting best practice [36]. No specific nurse educator competency standards have been developed for nurse educators in clinical practice, although ANTS has developed generic ‘nurse teacher’ competencies that may be applied across roles and sectors [37].
Nurse educators assume complex, multifaceted roles that vary in accordance with location and t he nature of the facility or service [1,3]. As expert nurses, they guide staff integrating their theoretical knowledge with practice [1,3]. They may assume responsibility for continuing professional development programs such as mentor programs or an educative focus within a specialty such as perioperative nursing [2-4].
This means nurse educators in acute care hospitals may work with students or registered nursing staff on an individual basis at the bedside, teaching, supervising or assessing competency. They may also conduct orientation and mandatory
education sessions as well as spe cific programs to address organizational education needs. On a cardiac unit, this could be conducting an in-service on the management of patients with a pacemaker. The educator could also assume broader education management functions such as undertaking needs assessment, planning, developing, implementing and evaluating a range of education programs to support the developing skill levels of new graduate nurses or registered nurses undertaking specialization [1,3].