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Older nurses face the challenges of tertiary study: a group of RGONs, most in their fifties, went back to school for a year. Here three share their journey to comprehensive registration.

EARLY LAST year, a group of five RGONs began our journey towards comprehensive nursing registration. A Nursing Council ruling that RGONs could no longer work in mental health was the impetus for us to do masters-level study to become comprehensive nurses so we could work in mental health.

We joined a group of new graduate nurses in the entry to mental health nursing programme at Auckland University's School of Nursing. Students are employed in Auckland District Health Board (DHB) mental health services. The programme is comprised of a clinically-focused course with preceptor support, and a theoretical course on concepts related to clinical practice. Students graduate with the Post Graduate Certificate in Health Sciences (Mental Health Nursing). Clinical placements and group supervision are aimed at supporting nurses new to mental health to develop reflective and interpersonal skills.

We had many years' experience in general nursing, including surgery, recovery, diabetes education, the prison service and nursing management. Two of us had met before the course on bureau work in mental health. At the time we did not realise we were working outside our scope of practice. There was an acute shortage of mental health nurses and the then director of mental health nursing for the DHB, Kate Prebble, negotiated with the Nursing Council for RGONs to do a year's post-graduate study to enable them to work in mental health. Four of us were invited to apply for the course and the fifth, Julie, answered an advertisement aimed at interested RGONs. She was in the last group of hospital-trained nurses in Auckland and was "the baby" of our group. The rest of us were seasoned veterans in our fifties, with grown families and several grandchildren.

Our further education differed greatly. Our trepidation on that first day was great. The general consensus was "What have we let ourselves in for?" It was heartening to discover our new graduate colleagues felt the same way. If we thought doing assignments and fulfilling clinical requirements was it, we were sadly mistaken. At the end of the year we had to sit a special state exam set by Nursing Council. The thought of the exam loomed over us all year. It caused apprehension and enormous pressure to perform well. We were the first group of RGONs to take this path and needed to prove it was a feasible way for RGONs to gain comprehensive registration.

The majority of our study was self-motivated. The nursing school was willing for us to participate in undergraduate mental health lectures, but our ability to do so was limited by shift work, clinical placements and full-time work. The university's online learning system enabled tests based on a mental health nursing text book. In hindsight, the exam was commonsense. The accumulation of past nursing experiences and a year of specialisation in mental health meant we all passed with flying colours. Research was a different matter and initially seemed incomprehensible. Some of us were computer illiterate, and what now seems simple, then held unknown terrors, eg accessing the internet. But as we were older and bolder, we were not afraid to seek support in our quest to achieve our goal.

The task ahead seemed enormous. We had been told our assignments were to be at masters-level but most of us had not written anything at undergraduate level. We had no idea of what was expected in our assignments. How to acquire references, let alone the APA referencing system were mysteries. We were given some basic assignment guidelines, which were helpful. But the presentation of assignments, justifying our discoveries and arguments, seemed overwhelming. The task of getting ourselves on track academically fell to our able, erudite and supportive lecturer Tony O'Brien, whose critiques of our efforts proved an effective learning tool. The university's student-learning centre was available to assist us, but it was the old problem of shift work and lack of time.

Clinical placements

We rotated through four clinical placements including acute, older people, community, child and family, and residential rehabilitation. We had to work under the supervision of a registered psychiatric or comprehensive nurse. Each rotation was for three months. We worked full-time, with a day off a fortnight to attend lectures. Achieving clinical competencies was a requirement of the specialty practice paper.

As with any group, our placement experiences differed. We felt well accepted by the mental health nurses, who respected our previous experience as general nurses. As a group of general nurses we all observed that, on occasions, patients' physical needs were overlooked. This mirrored the mental health needs of patients in "general" nursing situations, described in an article in Kai Tiaki Nursing New Zealand. (1)

Everywhere we worked there was a wealth of information we could access and staff supported us in our quest for knowledge.

We faced similar issues as the others on the programme. Many of the new graduates were women who had just finished three years' study and were now studying for another year plus working full-time and caring for a family. Together we faced our daunting task. We discovered our similarities over numerous cups of coffee, lunches in cafes and during supervision. We also shared clinical placements with the new graduates and gained mutual support from our combined strengths.

Our lectures were comprehensive, covering a diverse range of topics from the therapeutic use of self to ethical and legal issues. He came to a greater understanding of the world of those who used mental health services. We gained a passion for the difficulties and injustices they faced.

It was a worthwhile year--challenging, exciting and successful, proving that old RGONs can learn new tricks! We gained valuable insights into mental health services and know we have something to contribute. We now have comprehensive registration and a new richness and depth to our nursing practice. We are grateful to all who supported us on our journey.


1) Stabb, B. (2001-2002) Healing the heart and the spirit. Kai Tiaki Nursing New Zealand; 7:11,18-19.

--Marilynn Bruton, RGON, RCpN, PG Cert Health Sciences, works as a staff nurse in the Mason Clinic in Auckland.

--Lynette Harrison, RGON, RCpN, PG Cert Health Sciences, works as a staff nurse in the Auckland Hospital's acute mental health unit, Te Whetu Tawera.

--Julie Pleasants, RGON, RCpN, PG Cert Health Sciences, works as a staff nurse in the Buchanan Clinic in Auckland.
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Title Annotation:education
Author:Pleasants, Julie
Publication:Kai Tiaki: Nursing New Zealand
Date:Sep 1, 2003
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