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Nursing documentation is often perceived as a tiresome chore. Although this perception of
documentation is understandable, Nursing Documentation in Aged Care: A Guide to Practice is
written from a different perspective. The title of the book is carefully chosen. All of the
contributors to this book firmly believe that nursing documentation in aged care—if performed
with pride and professionalism—is truly a guide to practice.
In striving for the highest standards of professionalism in all that they do, nurses are increasingly
recognising that documentation is a wonderful opportunity to record and reflect upon all that is
good in nursing. In addition to their ethical and professional responsibilities, caring nurses are
aware of the personal satisfaction to be gained from documenting their holistic and reflective
nursing practice.
As another volume in Ausmed’s growing and popular ‘Guide to Practice’
series of textbooks and audiobooks, Nursing Documentation in
Aged Care: A Guide to Practice is an essential text for all aged-care
nurses who wish to enhance their documentation skills and deliver
higher quality care to the elderly.
This book shows how nursing assessments, care plans, and progress notes can allow nurses to
share their knowledge, observations, and skills—and thus make a crucial contribution to their
own professional lives and to the quality of life of those in their care.
This is more than a ‘how-to-do-it’ workbook. With contributions from a range of experts, this
comprehensive evidence-based textbook explores the issues surrounding documentation and
reveals the importance of professional communication within multidisciplinary teams.
Christine Crofton
Christine Crofton is a registered nurse who has been involved in aged care for many
years in a variety of roles—including senior management of aged-care facilities. She is
currently a nurse educator who believes that older people must be valued, respected,
and cared for in accordance with the highest professional standards. If this is to be
achieved, Christine believes that documentation must be undertaken effectively and
efficiently. If aged-care nurses are empowered and confident in their own abilities,
positive resident outcomes and excellence in documentation will be assured.
Gaye Witney
Gaye Witney is registered nurse who has had a passionate interest in aged care for
longer than she wishes to admit! Her interest in documentation arose from her work
with the Australian government on documentation validation and standards
accreditation. Gaye is now a nurse educator who encourages her students to take pride
in being nurses—enthusing them to achieve high standards of documentation in their
preparation of nursing assessments, nursing-care plans, and progress notes.
24355_AP_Nursing Documentation Book
C M Y KC M Y K C M Y K
A Guide to Practice
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Other titles by Ausmed Publications
Nurse Managers: A Guide to Practice
Aged Care Nursing: A Guide to Practice
Dementia Nursing: A Guide to Practice
Palliative Care Nursing: A Guide to Practice
Lymphoedema
Communicating with Dying People and their Relatives
How Drugs Work
Evidence-based Management
Communication and the Manager
’s Job
Assertiveness and the Manager
’s Job
Renal Nursing A Practical Approach
Ageing at Home Practical Approaches to Community Care
Complementary erapies in Nursing and Midwifery
Keeping in Touch with someone who has Alzheimer’s
Geriatric Medicine a pocket guide for doctors, nurses, other health professionals and students
Living Dying Caring life and death in a nursing home
Caring for People with Problem Behaviours
Practical Approaches to Infection Control in Residential Aged Care
Nursing the Person with Cancer a book for all nurses
Caring for the Person with Faecal Incontinence a compassionate approach to management
Spirituality the heart of nursing
Nursing Documentation writing what we do
inking Management focusing on people
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A Guide to Practice
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Copyright ©Ausmed Publications Pty Ltd 2004
Ausmed Publications Pty Ltd
Melbourne – San Francisco
Melbourne office:
277 Mt Alexander Road
Ascot Vale, Melbourne, Victoria 3032, Australia
ABN 49 824 739 129
Telephone: + 61 3 9375 7311
Fax: + 61 3 9375 7299
email: <>
website: <www.ausmed.com.au>
San Francisco office:
Martin P. Hill Consulting
870 Market Street, Suite 720
San Francisco, CA 94102
USA
Tel: 415-362-2331
Fax: 415-362-2333
Mobile: 415-309-2338
email: <>
Although the Publisher has taken every care to ensure the accuracy of the professional, clinical, and
technical components of this publication, it accepts no responsibility for any loss or damage suffered
by any person as a result of following the procedures described or acting on information set out in this
publication. The Publisher reminds readers that the information in this publication is no substitute for
individual medical and/or nursing assessment and treatment by professional staff.
Nursing Documentation in Aged Care: A Guide to Practice
ISBN 0-9750445-4-0.
First published by Ausmed Publications Pty Ltd, 2004.
Without limiting the rights under copyright reserved above, no part of this publication may be reproduced,
stored in, or introduced into a retrieval system or transmitted in any form or by any means (electronic,
mechanical, photocopying, recording, or otherwise) without the written permission of Ausmed
Publications. Requests and enquiries concerning reproduction and rights should be addressed to the
Publisher at the above address.
National Library of Australia Cataloguing-in-Publication data
Nursing documentation in aged care : a guide to practice.
Bibliography.
Includes index.
ISBN 0 9750445 4 0.
1. Nursing records - Handbooks, manuals, etc. 2. Geriatric
nursing - Handbooks, manuals, etc. I. Witney, Gaye. II.
Crofton, Christine, 1947- .
610.7365
Produced by Ginross Publishing
Printed in Australia
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Contents
Dedication and Acknowledgments
Foreword
Preface
About the Authors
Chapter 1
Understanding Nursing Documentation 1
Christine Crofton and Gaye Witney
Chapter 2 Clinical Reasoning 19
Bart O’Brien
Chapter 3 Professional Communication 31
Christine Crofton and Gaye Witney
Chapter 4 Nursing Care Plans 45
Shirley Schulz-Robinson
Chapter 5 Progress Notes 63
Joanne Hope and Pamela Bell
Chapter 6 Clinical Pathways 79
Jenni Ham, Ann-Maree Conners, and Angela Crombie
Chapter 7 Documenting Behaviour and Emotion 97
Felicity Humble
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vi
Contents
Chapter 8 Documenting Complementary Therapies 109
Sue Forster
Chapter 9 Documenting Pain Management 123
Michael Cully
Chapter 10 Documenting Restraint 137
Sue Forster
Chapter 11 Incident Reports 151
Adrian Cross
Chapter 12 Documenting Evaluative Criteria 169
Sue Forster
Chapter 13 Documenting Staff Issues 181
Sue Forster
Chapter 14 Effective Design for Documentation 193
John Collins
Chapter 15 A Systems Model for Documentation 209
Christine Crofton and Gaye Witney
Appendix 1 Faecal Incontinence 249
Janette Williams
Appendix 2 Behavioural Management 255
Robyn Daskein
Appendix 3 Diabetes 261
Victoria Stevenson
Appendix 4 Nausea 267
Robyn Millership
Appendix 5 Stomal Care 273
Heather Hill
Appendix 6 Leg Ulcer Management 279
Sue Templeton
Appendix 7 PEG Nutrition 285
Patsy Montgomery
Appendix 8 Wandering 289
Beverly Smith
References 293
Index 299
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Dedication
Acknowledgments
vii
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Foreword
Rosalie Hudson
Documentation has come alive! In Nursing Documentation in Aged Care:
A Guide to Practice, the drudgery and monotony are taken out of an
important aspect of nursing that has become, for many, a dreaded necessity.
Nurses will be inspired to take a fresh look at the many positive aspects of
documentation and to enjoy the professional rewards of improved practice.
The issues are presented in ways that reinforce current good practice,
encourage reflection on practice, and offer new ideas to guide improved
practice.
The rewards of good documentation are to be found not only in
professional pride, but also in creating more time for resident care.
The book is therefore timely in addressing the frustration expressed by
many aged-care nurses: ‘How can we achieve a good balance between
documentation and resident care?’.
The various models of documentation described throughout this
book will help to identify the unique details of each resident
’s care. What
does this record convey about the care of this particular resident? Who is
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x
Foreword
this person in the context of his or her significant relationships? It is this
personal and relational emphasis that makes this book on documentation
come alive.
The practical examples provided will inspire nurses with confidence
to try new approaches. To allow for creativity and flexibility to suit
local circumstances, a variety of options is presented. Each component
of documentation is described and distinguished from others—showing
clearly how to avoid the duplication evident in contemporary practice.
Helpful case studies based on everyday experience make this an enjoyable
book of practical learning.
Throughout this book,
communication is the cornerstone of
effective documentation. In communicating with their colleagues,
nurses do more than merely record facts and details; they also evaluate
responses to specific episodes of care and thus learn from one another.
Good communication promotes continuity of care as each person takes up
the story
—thus capturing the essence of holistic care. By making explicit
the link between the care and the writing, the documented record is a
profoundly insightful expression of professional holistic care.
Nursing Documentation in Aged Care: A Guide to Practice
challenges nurses to regard quality documentation as a reflection of
quality care. Good documentation is presented as the key to evidence
—not
only for legal and regulatory purposes but also for improved professional
practice. Evidence of quality leads to expanded knowledge, and provides
a rich, fertile ground for future research. This book therefore has enduring
qualities. It has the potential to influence the whole of aged-care practice.
Written by people committed to the cause, there is something in every
chapter that will inspire nurses to replace outmoded habits and attitudes
with innovation and clarity of purpose. The purpose of documentation
is clearly articulated throughout the book
—to communicate the essence
of resident care in a way that encourages professional pride and paves
the way for best practice to be achieved. Nurses are prompted to write
their documentation in a way that makes nursing visible
—thus placing on
record the difference that good nursing makes to the care of residents.
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Nurses will be encouraged by the enduring qualities in this important
and timely book. It not only answers immediate needs but also promotes
documentation in aged care as a model worthy of wider attention by all
nurses.
Rosalie Hudson
Dr Rosalie Hudson is a registered nurse who holds bachelor’s degrees in applied science
and theology, a master’s degree in theology, a graduate diploma in gerontic nursing, and
a PhD. After a long and distinguished career in clinical and academic nursing, including
12 years’ experience as the director of nursing of a 50-bed nursing home, Rosalie is now
a private consultant in aged care and palliative care, and an honorary senior fellow in
the School of Nursing, University of Melbourne. Rosalie has presented and published
numerous papers and articles internationally on the subjects of spirituality, palliative
care, dementia, pastoral care, and ethics at the end of life. Rosalie edited Dementia
Nursing: A Guide to Practice (Ausmed Publications 2003). She has also co-authored
two other Ausmed books, and has contributed chapters to several others. Rosalie enjoys
family life with her husband, adult children, and grandchildren.
xi
Foreword
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Preface
Christine Crofton and Gaye Witney
A guide to practice
Nurses constantly complain that they have insufficient time for proper
documentation. In many ways this is understandable. Nursing is
essentially about
caring, and many aged-care facilities today are under-
staffed and under-resourced. In
these circumstances it is hardly
surprising that many nurses
feel that caring comes first and
documentation comes second—that
they have time to care or time to
write, but do not have time for
both.
Documentation can be perceived as being primarily an administrative and
legal requirement that takes up valuable time—time that might have been
otherwise spent on resident care.
Although this perception of documentation is understandable,
Nursing Documentation in Aged Care: A Guide to Practice is written from
‘The title of the book is carefully
chosen … nursing documentation
in aged care—if performed with
pride and professionalism—is
truly a “guide to practice”.’
DocumPrelimsFinalProofs.indd 13 26/03/2004 1:06:25 PM
a different perspective. The title of the book is carefully chosen. All of
the contributors to this book firmly believe that nursing documentation in
aged care—if performed with pride and professionalism—is truly a ‘guide
to practice’.
In most jurisdictions, registered nurses are required to adhere
to codes of
ethics and codes of professional conduct. They have ‘ … a
responsibility to the individual, society and the profession to provide
safe, competent nursing care which is responsive to individual, group
and community needs
’ (ANCI 2000). A nurse’s professional practice with
respect to documentation should reflect such safe, competent nursing
care. Each nurse is responsible for his or her own nursing practice
—and
documentation is a part of that responsibility.
In addition to their
ethical and professional responsibilities, caring
nurses are aware of the personal satisfaction to be gained from
holistic
and reflective nursing practice. In this respect, nurses are increasingly
recognising that documentation
is a wonderful opportunity to
record, share, and reflect upon
all that is good in nursing.
Documentation is more than a
tiresome chore. Comprehensive
and accurate documentation shares astute nursing insights, reflects
the excellence of holistic aged-care nursing, and provides a record of
the professional and personal support that nurses provide every day to
residents and their families.
Nursing Documentation in Aged Care: A Guide to Practice
is
therefore written
by and for nurses who believe that documentation is
of the utmost importance as a guide to nursing practice
—practice that is
ethical, professional, holistic, and reflective.
The purpose of documentation
In documenting aged care, nurses are recording and communicating
information about many important matters. These include (among others):
• care needs—the identification and assessment of the needs of those
in their care;
‘Documentation is of the utmost
importance as a guide to nursing
practice—practice that is
ethical
,
professional
,
holistic
, and
reflective
.’
xiv
Preface
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• care plans and progress notes—the documentation of nursing-
care plans to address these needs, and the subsequent progress of
residents;
• communication and teamwork—the communication of this
information among members of the healthcare team, thus ensuring
teamwork, shared responsibility, and continuity of care;
• education and research—the professional sharing of insights,
knowledge, and trends in aged-care nursing;
• legal requirements—a legal record to protect residents, nurses, and
the organisation in which they live and work; and
• auditing and funding—a validation of the standards of nursing care
and the establishment of documented links between the level of
nursing care and the resources required to support it.
This book therefore shows how professional documentation allows
nurses to share their knowledge, observations, and skills—and thus make
a crucial contribution to their own professional lives and to the quality of
life of those in their care.
The structure of this book
The book begins with three chapters that provide comprehensive
overviews of the broad subject of nursing documentation in aged care. The
first chapter, ‘Understanding Nursing Documentation’, sets the scene with
a general discussion of the major issues. The second chapter, ‘Clinical
Reasoning’, explores how nurses make clinical decisions and canvasses
the interaction (and possible conflict) between real nursing experience
and administrative documentary requirements. This is followed by a
chapter on ‘Professional Communication’—stressing the significance
of documentation as an exercise in effective communication between
professional colleagues in a multidisciplinary team.
Having canvassed these broad introductory issues, the book then
moves on to discuss three important forms of nursing documentation—
‘Nursing Care Plans’, ‘Progress Notes’, and ‘Clinical Pathways’.
This is followed by chapters on some selected clinical issues that
can provide documentation problems—‘Documenting Behaviour and
xv
Preface
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Emotion’, ‘Documenting Complementary Therapies’, ‘Documenting Pain
Management’ and ‘Documenting Restraint’.
The book then moves onto a consideration of the documentation
of wider managerial and administrative issues—‘Incident Reports’,
‘Evaluative Criteria’, and ‘Documenting Staff Issues’.
The second-last chapter of the book provides some helpful advice
on ‘Effective Design for Documentation’—with hints on how to design
documentation forms that are functional and effective.
The final chapter in the main body of the book draws everything
together in a comprehensive ‘Systems Model for Documentation’. The
model presented here puts many of the topics of earlier chapters into
an overall context. In doing so, it provides guidance to clinical nurses
and nurse managers in how to go about establishing a comprehensive
documentation system that promotes positive attitudes and outcomes with
respect to this vital aspect of aged-care nursing.
Following the main body of the book, several case studies are
discussed in the appendices. These short case studies present common
clinical problems and provide examples of the types of documentation that
are appropriate in each case.
In keeping with the evidence-based nature of the text, the book
concludes with a list of references and a comprehensive, cross-referenced
index.
A wide-ranging, evidence-based textbook
This is therefore more than a ‘how-to-do-it’ workbook on nursing
documentation. With contributions from a range of experts, this wide-
ranging, evidence-based textbook
explores the issues surrounding
documentation, reveals the importance
of effective communication within
multidisciplinary teams, and guides
nurses in enhancing their professional
practice.
‘More than a ‘how-to-do-
it’ workbook on nursing
documentation … this wide-
ranging, evidence-based
textbook explores the issues
surrounding documentation.’
xvi
Preface
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The authors of this book trust that it can help aged-care nurses to see
documentation as more than a necessary burden. Rather, documentation
can be an exciting and valuable aspect of their shared professional lives.
The authors believe that this book will assist aged-care nurses to
recognise that they have control over the philosophy and application of
documentation in an increasingly difficult work environment. If performed
with pride and professionalism, nursing documentation in aged care can
truly be a ‘guide to practice’.
xvii
Preface
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About the Authors
Adrian Cross
Chapter 11
Adrian Cross holds a diploma in production engineering, a degree in arts, and a graduate
diploma in ergonomics. Adrian worked in industry for 25 years, dealing with quality
assurance and occupational health and safety. He then worked in the public service
for 15 years specialising in facilities
’ management—including the management of
hospitals and aged-care facilities. Adrian is now a lecturer in aged-services management
and occupational health and safety at Victoria University and Kangan Batman TAFE
(Melbourne, Australia).
Pamela Bell
Chapter 5
Pamela Bell is a registered nurse who holds a bachelor of arts degree and a PhD. She
was formerly the professor of nursing at Charles Sturt University (South Australia) and
is now an honorary senior research fellow in the Faculty of Nursing at the University of
Technology (Sydney, Australia). Pam is also a registered psychologist who supervises
interns undertaking pre-registration requirements at the College of Psychological
Practice, Sydney. Before becoming an academic nurse, Pam had many years of clinical
practice in Victoria and New South Wales. Having grown up in northern Victoria, Pam
has an excellent understanding of the problems facing rural health practitioners, and she
successfully led the Charles Sturt University component of a joint venture with Monash
University in forming the Australian government
’s National Rural Health Unit.
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John Collins
Chapter 14
John Collins holds a diploma in continuing education, a bachelor’s degree in arts,
and a master
’s degree in education. He has worked as a senior bureaucrat in a
number of educational systems. This employment has involved him in the design
and implementation of a range of records and documents. John is well aware of the
importance of well-designed and user-friendly forms for documentation.
Ann-Maree Conners
Chapter 6
Ann-Maree Conners is a registered nurse and midwife who holds bachelor’s and
master’s degrees in health science. For the past five years, she has been the director of
the Collaborative Health Education & Research Centre (CHERC) of Bendigo Health
Care Group (Victoria, Australia), and has recently been appointed to the role of acting
group director of nursing at the Bendigo Health Care Group. Ann-Maree has extensive
experience in the development and coordination of education programs for registered
nurses and has been involved in health research for a number of years. Her research
interests have included (among others): video-conferencing of educational models; a
regional telerehabilitation project; post-acute-care programs in regional hospitals; care-
planning in rural areas utilising critical-pathway methodology; and community nursing
clinical pathways for providers of care to veterans.
Christine Crofton
Subject specialist editor, Chapters 1, 3, 15
Christine Crofton is a registered nurse who holds a bachelor’s degree in education and
training, diplomas in frontline management and business (community services
and health), and certificates in gerontology, training and development, assessment,
and workplace training. Christine has been involved in aged care for many years
as a registered nurse in various roles
—including senior management of aged-care
facilities. She is currently a nurse educator and is completing her master
’s degree in
education and training. Christine believes that older people must be valued, respected,
and cared for in accordance with the highest professional standards. If this is to be
achieved, Christine believes that documentation must be undertaken effectively and
efficiently. If aged-care nurses are empowered and confident in their own abilities,
positive resident outcomes and excellence in documentation will be assured.
Angela Crombie
Chapter 6
Angela Crombie is a registered nurse who holds a bachelor’s degree in nursing and
master’s degree in health science. Angela also holds additional qualifications in
psychiatric nursing and workplace assessment and training. She is employed as a
xx
About the Authors
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research officer and nurse educator with the Collaborative Health Education & Research
Centre (CHERC) of Bendigo Health Care Group (Victoria, Australia), specialising in
research and education on aged-care issues. Angela has been involved in a number of
research projects, many of which have included the design and development of care
pathways in a variety of settings. Some of these projects have included: a regional
dementia management strategy; health assessments under Medicare schedule items;
asthma management in rural Victoria; health surveillance in the elderly using a health-
surveillance screening instrument; and home and community care best-practice
projects.
Michael Cully
Chapter 9
Michael Cully is a registered nurse with a degree in education, a graduate diploma in
education and training, and a master’s degree in nursing studies. He is a nurse educator
at Ipswich Hospital (Queensland, Australia) with interests in mental-health nursing,
care of older persons, and aggression minimisation. Michael has a particular interest
in the mechanics of clinical decision-making under conditions of uncertainty. In his
spare time, he listens to classical music, enjoys the company of his family, walks in the
national parks of south-eastern Queensland and north-eastern New South Wales—and
wonders whether the Carlton Football Club will ever win another premiership!
Robyn Daskein
Appendix 2
Robyn Daskein is a registered nurse who holds a diploma in nurse education, a bachelor’s
degree in applied science (nursing) and a master’s degree in health administration. She is
currently undertaking doctoral studies. Robyn is the national quality assurance manager
for the Regis Group. In this role, she maintains the company’s continuous-improvement
systems across 16 aged-care facilities in Queensland and Victoria (Australia). Robyn
has been working in aged care and has been an aged-care registered nurse adviser since
1987. As director of her own company, Health Care Essentials, Robyn has specialised
in providing education, continuous quality improvement, and management services
to the aged and community care industry. Robyn’s PhD studies are directed towards
quality outcomes in documenting challenging behaviour in residential aged care.
Sue Forster
Chapters 8, 10, 12, 13
Sue Forster completed her general nurse training in the Queen Alexandra Royal Naval
Nursing Service in the UK and abroad. She has extensive clinical, educational, and
managerial experience at senior levels gained from a long nursing career in Europe,
Australia, and Africa. For the past ten years Sue has managed her own educational
consultancy business. Her special interests include gerontic care, continuous quality
xxi
About the Authors
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improvement, and human-resource management. Sue is dedicated to the education and
empowerment of her nursing colleagues through the provision of sound evidence-based
practice within an holistic framework of quality care.
Jenni Ham
Chapter 6
Jenni Ham is a registered nurse and midwife who holds a graduate diploma and a
master’s degree in health science. Since 1994, she has worked as a project manager and
acting operations manager at the Collaborative Health Education & Research Centre
(CHERC) of the Bendigo Health Care Group (Victoria, Australia). Jenni has extensive
experience in the design and implementation of clinical pathways. Her research projects
have included the design, implementation, and evaluation of clinical pathways in acute
and rehabilitation settings, and the design and implementation of clinical pathways in
smaller rural hospitals. Jenni and her colleagues at CHERC have demonstrated that
clinical pathways can be implemented successfully for patients with complex needs.
Jenni’s work has achieved national recognition, as demonstrated by frequent invitations
for her to present at workshops and conferences.
Heather Hill
Appendix 5
Heather Hill is a fellow of both the New South Wales College of Nursing and the Royal
College of Nursing, Australia. She is also a life member of the Australian Association
of Stomal Therapy nurses and the World Council of Enterostomal Therapy. Heather
has been involved in clinical practice and education in stomal nursing since 1981. She
has lectured extensively and has written papers for nurses, allied health personnel,
doctors, and laypeople. Heather has presented at numerous international conferences
and seminars and was the onsite clinical co-educator for the inaugural stomal-therapy
course conducted by the Singapore Ministry of Health and Singapore Cancer Society.
Joanne Hope
Chapter 5
Joanne Hope graduated as a general nurse from the Royal North Shore Hospital
(Sydney, Australia) in 1973. She also holds a diploma in nurse education and a master
’s
degree in education. Joanne is currently working as a nurse administrator in the aged-
care sector. Her past positions in aged care have included executive nurse advisor,
director of care, deputy director of nursing and education, and quality and accreditation
coordinator. Before specialising in aged care, Joanne held the position of principal
lecturer of nursing at La Trobe University (Victoria, Australia). She has also been a
consultant with the World Health Organization. Joanne is passionate about continuous
quality-improvement processes and excellent care outcomes for aged-care residents.
xxii
About the Authors
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She believes that timely, accurate, and comprehensive nursing documentation is vital
to achieving such outcomes.
Felicity Humble
Chapter 7
Felicity Humble is a registered nurse and registered psychiatric nurse who holds
bachelor’s and master’s degrees in nursing, and a diploma in applied science (advanced
psychiatric nursing). Despite being ‘in a nervous and unprepared state’ when she was
sent to the psychiatric ward for her last rotation as a student general nurse in 1975,
Felicity fell in love with this area of nursing and has remained passionately interested in
psychiatric nursing ever since. Throughout this time she has been enriched by an array
of experiences with the elderly, and has worked with aged patients in acute admission,
rehabilitation, and secure settings. She has also been part of a community mental-health
team for the aged in which she was involved in the assessment and management of
aged people in their own homes or in other accommodation settings in the community.
Over the past 12 years Felicity has worked as a clinical educator with undergraduate
student nurses—helping them make sense of their psychiatric nursing experience and
endeavouring to raise their interest in a career in mental health. She has also had several
years’ experience working with postgraduate psychiatric nurses. Felicity is currently a
psychiatric nurse educator working with nursing staff at Barwon Health Community
and Mental Health (Geelong, Australia).
Robyn Millership
Appendix 4
Robyn Millership is a registered nurse and registered midwife who holds diplomas in
nursing education, intensive care, and ward management. She also holds a certificate
in palliative care. Robyn has worked in palliative care as a nurse consultant for more
than 15 years. Her background is diverse including clinical practice, intensive care,
administration, and education. Robyn is passionately committed to providing excellence
in symptom control for patients with terminal illnesses. She believes that most people
can achieve what seem to be impossible goals if they are provided with optimal
symptom control, knowledge, encouragement, and support. Robyn was a recipient of a
Victorian Nurses Care Award in 1994. She is currently a nurse consultant in palliative
care at the Peter MacCallum Cancer Institute, St Vincent’s Hospital and Caritas Christi
(both Melbourne, Australia).
Patsy Montgomery
Appendix 7
Patsy Montgomery is a registered nurse, registered midwife, and stomal therapist who
holds a bachelor
’s degree in educational studies. She is co-founder and consultant
xxiii
About the Authors
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for the Gastrostomy Information Support Service, president of the Peninsula Ostomy
Association (Melbourne, Australia), and the coordinator and clinical nurse consultant
for the Abbott Nutrition Service, Victoria (Australia). Patsy
’s role is to provide a support
service for tube-fed people, their families, and their carers when patients are discharged
from hospital into the community. This includes information and help for managing
enteral tubes and equipment, advice about methods of feeding and nursing care, and
information regarding supplies of formula, equipment, and pumps. Patsy also provides
education and practical ‘hands-on training’ for gastrostomy-fed people and carers.
She also provides in-service training, workshops, videos, and literature for healthcare
professionals.
Bart O’Brien
Chapter 2
Bart O’Brien is registered nurse who holds a bachelor’s degree and postgraduate
qualifications in nursing. Bart has worked in a variety of position in residential aged
care since 1986—including educator, clinical nurse consultant, assistant director of
nursing, consultant, continence advisor, and quality coordinator. His PhD thesis was
on the subject of nursing praxis—what nursing does to improve care and outcomes for
residents. As a result of this and other research, Bart has contributed to the development
of a practice-based model for aged-care nursing. Bart has edited, written, and co-authored
a number of books and monographs, book chapters, refereed journal articles, and
research reports, and is frequently invited to contribute to the professional development
of aged-care nursing through participation in seminars, lectures, consultations, and
research projects. He is a member of the Royal College of Nursing, Australia, and is
currently the quality coordinator at the James Brown Memorial Trust, Belair (South
Australia).
Shirley Schulz-Robinson
Chapter 4
Shirley Schulz-Robinson has worked for 30 years as a clinician and manager in
various practice settings—including psychiatric nursing, developmental disability
nursing, medical and surgical nursing, women’s health, and community health. For
19 years she worked in nurse education, including terms as the clinical director and
assistant dean in the Faculty of Nursing at Newcastle University (Australia). Shirley’s
research interests include community-health nursing, health policy, and collaborative
health-promotion strategies with patients and communities. Her current research has
demonstrated that much of the work undertaken by nurses is hidden, and that it is
commonly attributed to the efforts of other professions. Shirley has been chairperson
of the Hunter Chapter of the Royal College of Nursing, Australia, president of the New
South Wales Community Health Association, a member of the Public Health Research
and Development Committee of the National Health and Medical Research Council
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About the Authors
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