Becoming a nurse is more than just being able to demonstrate clinical skills or understand disease processes. It is about critical thinking – understanding why we do what we do and how to do it in ways that optimise quality and safety. Achieving the best outcomes for clients is always paramount. This chapter explores the foundational principles of contemporary nursing practice: evidence-based practice, person-centred care, and therapeutic and professional communication; all contributing to a safe practice environment. It also introduces the growing role of technology in health care and looks at how numerous factors come together to influence health outcomes for the individual client.

All regulated health practitioners need to be aware of the standards imposed on them by their regulatory body in order for them to be able to practise and keep the public safe. In Australia, the standards for nurses and midwives have been developed by the Australian Health Practitioner Regulation Agency (AHPRA), which regulates the Australian workforce through the Nursing and Midwifery Board of Australia (NMBA).

This chapter helps you understand your obligations to obtain and maintain your nursing or midwifery registration, and your legal, regulatory and moral obligations both as a professional and as an individual. It differentiates the scope of practice for the registered nurse, enrolled nurse and midwife.

The first section discusses general legal and regulatory requirements for nurses. Next, we turn to the Professional Practice Framework that constitutes a key part of nurses’ legal and regulatory obligations. This framework forms the overarching statement of nursing’s values contained in a number of codes and standards. The next section covers professional boundaries before we make some brief remarks relating to scope of practice.

In this chapter, you will learn how to plan your study around your existing commitments. You are encouraged to build on your strengths and improve in areas that may hold you back. You will learn how to find time to study and be kind to your future self. This chapter gives you an idea of the different kinds of academic support you may be able to access and provides some hints for using the online study environment to your advantage.

Learning at university is often self-directed, and the skills developed and employed in your nursing education can help to ensure you have acquired the graduate attributes needed to continue learning while you practice as a nurse.

This chapter provides you with strategies to enhance your study and to be successful in your learning endeavours. You will discover that you learn from your teachers and educators as well as from your peers and networks. You will be provided with hints for making both formal and informal peer support and group work function effectively for you. Finally, you will be given suggestions for using social media to help feel connected while simultaneously avoiding common pitfalls in your journey to become the best nurse you can.

In accordance with the standards for nursing and midwifery education, training and assessment, the Australian Nursing and Midwifery Accreditation Council (ANMAC) requires students to engage in professional placement experiences as part of an accredited program of undergraduate study, with mandatory hours of activity linked to successful learning outcomes and registration to practise as a nurse in Australia (ANMAC 2017, Ford et al. 2016, Schwartz 2019). Clinical placements are therefore a central component of nursing education, complementing the theoretical foundations and simulation-based learning provided at university.

Preparing you for professional practice is the overarching goal of nursing education. Your success in professional experience placements depends on your ability to effectively draw upon and translate your learning to the clinical practice context and environment. This chapter provides specific information and strategies to help you to better understand and succeed in the clinical practice component of your degree program. The chapter also introduces the rapidly expanding role of social media in nursing education and practice.

The heart of nursing is intrinsically linked to what you do as a nurse and why you do it, but it is also about how you do it – the ways in which you represent and enact the core values and intent of the profession.

While some of your views and beliefs are likely to be shared with other students and experienced nurses, your reasons for wanting to be a nurse, and what you consider to be at the heart of nursing, will vary depending on your personal perspectives and experiences. This chapter begins by considering some of the common perspectives on nursing, noting how your own perspective is likely to change as you progress through your studies and into practice. We look at why people choose nursing, the different views and influences they are likely to encounter and the diverse range of roles and settings in which they may work. We then discuss how this informs what it means to be a nurse and your emerging sense of professional identity. The chapter concludes by exploring caring, compassion and kindness – concepts that lie at the heart of nursing, even though they are likely to be understood, applied and experienced differently in the context of each nurse’s own practice.

Being a safe and ethical nurse in health care requires an understanding of the frameworks that underpin and guide nursing practice. A generalised healthcare safety system known as clinical governance is implemented to ensure the wellbeing of all those in the healthcare system.

In addition to a clinical governance framework, healthcare staff also work within ethical and legal frameworks that underpin and govern their practice. In a nurse’s daily practice, every action is based on the need to make informed decisions, which are based on the nurse’s moral and ethical principles, their knowledge and understanding of different clinical situations and the legal accountabilities underpinning nursing practice. To make informed decisions, nurses must be aware of their own ethical stance and consider this, together with legal and professional requirements such as the codes of ethics and professional conduct (ICN, 2012, NMBA 2018), and the Registered Nurse Standards for Practice (NMBA 2016).

This chapter discusses the frameworks that guide practice. It introduces the concepts of quality and safety, clinical governance, clinical risk, ethical issues and the tenets of professionalism.

Most people are familiar with the World Health Organization's (WHO) definition of health, which was incorporated in the WHO Constitution in 1946: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ Despite this decades-old definition, many governments and health services continue to take a ‘sick care’ view of health rather than focusing on wellness. In this chapter, we examine models of health and discuss the principles of primary health care in relation to the concept of health. We explore health and illness as culturally constructed experiences which reinforce the need for nurses to practice person-centred care.

A range of healthcare services are considered as the healthcare continuum is explored. We introduce the components of the Australian healthcare system and explain the fundamental aspects of Australia’s ‘universal’ healthcare coverage provided by Medicare. The concepts of primary, secondary and tertiary care are introduced and differentiated from primary, secondary and tertiary levels of health care. The chapter concludes with a discussion of the contribution of nurses and nursing to our healthcare system.

Health care in Australia is delivered through a large, diverse and complex system (or set of systems) that is constantly evolving and changing. The system is often considered to be in a state of perpetual change, with frequent restructuring of healthcare priorities and how services are organised, funded and governed (Reynolds, Willis & Rudge 2020).Within this dynamic system and reform agenda, a chapter on contemporary health care can describe how things currently stand but these existing roles and services need to be considered in the context of the frequent changes as noted. Even similarly named roles and services can differ in design and implementation based on local needs and priorities and the varied strategic, policy and operating contexts of different organisations and settings.

We begin the chapter by briefly revisiting some of the key concepts from Chapter 4 and examining the current health landscape. We then turn to some of the current and emerging issues, trends and opportunities in health care, and explore how these might influence and shape the ways in which health, social and community services are designed, prioritised and delivered in Australia.

This final chapter weaves together some of the key focus areas that have made up this ‘journey’, using stories from practice that may provide you with some further insights to guide you on your path to becoming a skilled and experienced nurse.

The second part of this chapter focuses on the fact that, once you enter the profession as a beginning-level nurse, this is not the end of your journey; it is only the first stage of your career. There are many options and learning opportunities that can further your career and assist you to develop into an expert nurse across a range of settings.

The last part of this chapter focuses on how you can contribute to the further development of the nursing profession by role-modelling and promoting nursing, mentoring and supporting others, and developing and sharing your skills and knowledge with new generations of nurses.

Nursing is a diverse and varied profession that is at times rewarding, challenging, happy and sad. Nurses are the most vital cog in the development, delivery and leadership of health services to meet the current and future health needs of society. You have chosen a rewarding and exciting career!

Whatever your interests and motivations, nursing is certain to be a career that rewards, challenges and inspires you. It requires the seamless blending of theoretical and technical knowledge with a way of being and behaving (moral comportment), leading to clinical wisdom or deep understanding that supports the highest possible quality of care for individuals, families and communities. We present a range of nursing knowledge and perspectives that are important for professional nursing practice in contemporary Australian healt hcare, but encourage you to engage in your own reflections about what it means to be and act as a nurse, with the aim of discovering and nurturing your personal passion for nursing (Benner et al. 2010, Gottlieb & Gottlieb 2012, p. 4). This opening chapter sets the scene for your undergraduate nursing journey. We welcome you to the wonderful, dynamic and diverse profession of nursing and encourage some initial thinking about what nursing is, why you have chosen this career and the sort of nurse you hope to be. We also outline the purpose, structure and features of this book, and introduce you to the key concepts and ideas underpinning your learning journey.

One of Florence Nightingale'slegacies was her advocacy for, and establishment of, a formal system of training for nurses. This vocational or apprenticeship model of training rapidly spread, with hospital-based training schools being set up across the country.This chapter introduces you to core elements and considerations in ‘contemporary’ nursing education. We link this to the notion of ‘capability in nursing’ and provide an overview of what you can expect in your degree program, with links to other chapters where these concepts and ideas are explored in more depth. We conclude the chapter with a brief look at some of the resources and strategies that can be used to optimise your learning success.

This chapter discusses the health of Aboriginal and Torres Strait Islander peoples from a gendered perspective, considering the different health needs and outcomes experienced by men and women. It begins by unpacking the construct of gender and discussing how gender and gender variations are viewed and accepted by Aboriginal and Torres Strait Islander communities. The Indigenous understandings of women’s business and men’s business are discussed from historical and contemporary perspectives, with a strong focus on the National Aboriginal Health Strategy’s definitions of the two. The chapter then discusses the differences in health outcomes between Indigenous and non-Indigenous men and women, and how the different views they have of health may affect them, before considering how nurses can best provide gender-appropriate care to their Aboriginal and Torres Strait Islander patients. The chapter concludes by considering how Australian policies have varied in meeting the gendered needs of Indigenous Australians, and how the health of Aboriginal and Torres Strait Islander men and women is changing and will continue to do so into the future.

This chapter provides a contextual overview of Torres Strait Islander’s health and wellbeing. It begins by discussing the location and pre-colonisation history of the Torres Strait Islands and their peoples and notes that there is a shift back towards calling the region by its local name, Zenadth Kes. It considers Torres Strait Islanders connections to Country, including the sea, and Kin, and their belonging within tribes and clans. It then discusses Torres Strait Islanders’ perspectives of health and wellbeing both before and after invasion and colonisation and makes suggestions for culturally safe practice that incorporates Torres Strait Islanders’ history. It outlines the current provision of primary health care in the Torres Strait and looks at how this can holistically incorporate traditional medicine practices. The final section of the chapter considers the threat of climate change and its impact on Torres Strait Islanders’ physical and spiritual connection to their Country and consequently their health and wellbeing.

This chapter focuses on the different health needs and outcomes of Indigenous children and their families. It begins by discussing the national policies aimed at improving Indigenous child health, including the National Framework for Health Services for Aboriginal and Torres Strait Islander Children and Families, and by considering the cultural and social considerations when providing healthcare to Indigenous children. The gap between mortality and morbidity rates of Aboriginal and Torres Strait Islander children and non-Indigenous children is established as the authors call for nurses and midwives to understand the stories behind these statistics, before considering the programs and initiatives aimed at improving health outcomes of Indigenous children. The chapter discusses ways to promote health, and considers common health issues experienced by Indigenous children, including poor nutrition, oral and ear health, and infections. The chapter provides concrete ways in which nurses and midwives can care for Indigenous children and also discusses examples of community programs working to reduce the rate of accidents and self-harm in Indigenous children.