Discuss three challenges facing nurses in the contemporary Australian health care system.



The government of Australia sets various national healths’ polices and subsidies schemes through the department of Health and Ageing financed by the state government as well as the private sector. Like any other countries in the world the growing pressure on health funding are also faced by Australia because of the increasing patient’s expectation and rapid technological changes. The state government of Australia facilitates various kinds of health services like acute and psychiatric hospital services (Department of foreign affairs and trade, Australian government 2008). The other services which are provided by the government are community and public health services, dental health, occupational health and various types of health inspection functions and disease control activities. Australian health care system achieved a good ranks internationally which is reflected by the continuous development in life expectancy and decreasing infant mortality (Bruce K Armstrong et al 2007). But the major challenge confronted by government of Australia is about the funds and systematic delivery of health care and the continuous rising burden of chronic diseases and the rising trend of unfashionable organization of health services (Bruce K Armstrong et al 2007).

Along with the challenges of the health care system in Australia the nurses are also facing a number of challenges among which the influencing factors are related to pay, workload, convenience and family responsibilities, job satisfaction and the status of psychological rewards. The major challenges which were faced by the nurses in the contemporary period are related to recruitment and retention, ethics and legal challenges and the cultural diversity which are the most common in Australian health care system (Jackson, D & Daly, J 2004). Beside the challenges of recruitment and retention the nurses of Australia has to face the legal challenge and the code of ethics. The legal challenge and the code of ethics were continuously confronted by the nurses of Australia (Australian Nursing and Midwifery Council, n.d). In addition to the legal challenge and the code of ethics the nurses have to also face the challenge of cultural diversity and they have to understand the implication of the cultural based knowledge and skills for developing the nursing care, sensitivity and awareness towards the cultural diversity.


 Recruitment and retention of nurses:

There are serious shortages of nurses in Australia.  It is found that  the current crisis in Australian health care is due to the shortage of nurses in regional level as well as global level(Duffield and O’Brien-Pallas 2003; Preston 2006). The shortages of nurses results in discrepancy in patient care and delivery in Australia. The decline of education of nurses and the decrease in nursing educated workforce is still not recognized properly and suitable policy is still awaited to face them.

The statistics shows that the largest numbers of health care professionals about 30% are being employed in the health care system (Megan-Jane Johnstone, n.d).The health care professionals work with various models of service consistently because of the development of  science and technology in the filed of health care, increased aging population, high level of consumer expectations and the chasing force to find efficiencies in an industry where the expenditure regularly increases(Megan-Jane Johnstone, n.d).

It has been seen that the challenge of recruitment and retention in the area of nursing is faced by the whole world and this crisis has been rising year by year which cause negative impact on health care system across the world including the Australian health care system (Megan-Jane Johnstone, n.d). In the current scenario  the deficiency of nurses in a Australia has awaken to give more attention on the future of nursing and how the shortage of nurses can be addressed in order to prevent the health care challenges which is faced by Australia and to protect the public welfare (John Daly 2007) So it is of immense importance to pay attention and has  to reexamine  the future of nursing by giving a particular emphasis and efforts on the recruitment and retention of future  nurses to fulfill the required health care sector demands of physical professional (Guidebook for Nurse Futurists)

By analyzing the needs of nurses in future, government and concerned health care authorities should implemented incentive oriented policies and strategies which can bring nurse back to the workforce and various scholarship schemes to attract the new comers for the nursing profession (Megan-Jane Johnstone, n.d). The current problem of nursing shortage is cause serious problem in health care sector. Due to the shortage of nurses insecurity is felt in the safety of patient care (Duffield and O’Brien-Pallas 2003).

It is found that shortages of nurses are most prevalent in rural and remote regions, especially in Indigenous communities, and in particular areas of care, such as mental health, aged care, and disability care (Armstronget al. 2007: 485-487). These shortages could be the consequences of different mechanism such as lack of nurse professionals, unable to retain them in their profession, job dissatisfaction, working part time, working through agencies and early retirement. Lacks of proper leadership are some factors which effect on the nurses retention (Donley 2005: 312-318).

Ethics and legal challenges:

The ethical and the legal challenges were faced by the nurses when they act as an advocate for the client. Nurses are frequently confronted with ethical and legal challenges related to care provided to clients ( The bindings to follow the ethical codes are legally binding in almost in all the states. The board of authorities who deals with this profession has given the full authority to rusticate the nurses if they found guilty in unprofessional conduct and violation of ethical codes (Roberson 2007:191-199). Nurses need to focus on ethical practices; the nurse practice act; and client rights which are guided through are needed to focus on ethical practices; the nurse practice act; and client rights which are guided through state and federal level. The nurse acts as an advocate to inform and support a person in such a way so that he can make the best decisions possible for himself. The distinctions made between the ethics and legal law, as ethics include the policies of a hospital, the opinion of the people, hospital etiquette, and following the orders of the supervisor and have the judgmental thinking of right or wrong in a given situation. The ability to justify the case can control risk failing to check the moral errors and the possible harms which can occur in the health care environment (Australian Nursing and Midwifery Council, n.d). 

For the proper functioning of the health care sector code of ethics for the practicing nurses in has been implemented which is relevant and necessary for all nurses at every levels and in various areas of the practice which include management, clinical education and research domains. The cares provided by the Nurses to the client are frequently confronted with ethical and legal challenges. The main aim of the code of ethics for Nurses in Australia is to identify and analyze the fundamental and ethical standard which helps in committed nursing profession. It also provide nurses the stand  point through which it reflect the conduct and attitude of themselves and others take justified decision by practicing  peoples human rights and required values which is expected to uphold by the nurses(Australian Nursing and Midwifery Council). Nurses may find themselves in direct conflict when they are acting as an advocate for their client in terms of their right.

Cultural diversity:

The self assessment of culture which enables the nurses to develop an awareness of own cultural values, practices, attitudes and beliefs. The foundation of creating congruent nursing care depends upon the self assessment of culture. The congruent care plan can be based on cross cultural communication as it is identified as one of the most important landmarks in cultural assessment. So, it is necessary to analyze the various ways in which people from different cultural backgrounds communicate with one another. (Omeri, A., & Raymond, L. 2009). Cultural understanding and appreciation does not mean giving up one’s own culture and belief, it just help us to make better relation with other certain cultures (Multicultural Communities Council of SA Inc, 2005). The major challenges which were faced by the nurses among the culturally diverse people in oral and verbal communication. To overcome this problem the nurses should be prepared to convey their message nonverbally by using the various techniques like through gestures, body movement and face expression, varied voice tone etc. Further non verbal communications pattern varies widely across the different cultures. So it is necessary that nurses must have sense of humor and aware to convey cultural differences by the use of silence, face expressions including the eye contact, touch, spacing and distance (Omeri, A., & Raymond, L; 2009). The non verbal attitude and behavior are culturally significant and if any one fell to follow the cultural code it may cause a serious violation of law. Violating the law and norms and unable to relate the appropriate male- female relationships among different culture may risk the nurses therapeutic relationship with the clients and their families (Omeri, A., & Raymond, L; 2009). They have to know about the codes of ethical and professional nursing practice to bring unity, fairness for everyone and respect for the other person. Nurses have to learn the various beliefs and the values of the different cultural group during the care of patient (Omeri, A., & Raymond, L. 2009).


The health care system of Australia ranks well internationally however it is not free from challenges. In the contemporary Australian health care system nurses has gone through several challenges and their problems are not formally recognized or strategically addressed (Jackson, D & Daly, J 2004).

The availability and stability of quality nursing services depends on the appropriate recruitment and retention of nurses, for that suitable measures should be undertaken to face the challenges so that in future the goal for the realization of a preferred healthier future for all can be achieved(Megan-Jane Johnstone, n.d). Nurses should undertake the responsibility to follow the guidelines for providing quality and safe care to the patients by following the ethical principles. Cultural diversity is the major challenge faced by the nurses; however nurses should develop awareness in them to face the challenging diverse culture and aims to deliver the nursing care to the diverse people in culturally meaningful and safe way (Omeri, A., & Raymond, L; 2009).


Armstrong, BK, Gillespie, JA, Leeder, SR, Rubin, GL & Russell, LM 2007, ‘Challenges in health and health care for Australia’, The Medical Journal of Australia, vol. 187, no. 9, November, pp. 485-487, Available from: (Accessed on 28 September 2011)

Australian Nursing and Midwifery Council, Royal College of Nursing, Australia (n.d), Code of Ethics for Nurses in Australia. Available from: (Accessed on 29 September 2011).

Bruce K Armstrong, James A Gillespie, Stephen R Leeder, George L Rubin and Lesley M Russell(2007) Challenges in health and health care for Australia, The medical journal of Australia. Available from: (Accessed on September 30 2011)

Department of foreign affairs and trade, Australian government (2008), Health care in Australia, Available from: (Accessed 12 October 2011)

Donley, R 2005, ‘Challenges for nursing in the 21st century’, Nursing Economics,

vol. 23, no. 6, November-December, pp. 312-318.

Ethical and Legal Issues In Acting as a Client Advocate (n.d), Available from: (Accessed on 29 September 2011).

Jackson, D & Daly, J 2004, ‘Current Challenges and Issues Facing Nursing in Australia’, Nursing Science Quarterly, vol. 17, no. 4, October, pp. 352-355. (Accessed on 29 September 2011).

John Daly (2007) Report on Nurse Workforce Futures, Council of Deans of Nursing and Midwifery (Australia and New Zealand)

Megan-Jane Johnstone (n.d), Nurse Recruitment and Retention: Imperatives of imagining the future and taking a proactive stance. Available from:  (Accessed on 30 September 2011)

Multicultural Communities Council of SA Inc 2005, Working Cross Culturally: A Guide, WCC, Adelaide, pp. 6-89, (Accessed 29 September 2011).

Omeri, A., & Raymond, L.(2009). Diversity in the context of multicultural Australia: Implications for nursing practice, Australia.

Roberson, AJ 2007, ‘Adolescent Informed Consent: Ethics, Law, and Theory to Guide Policy and Nursing Research’, Journal of Nursing Law, vol. 11, no. 4, pp. 191-196, (Accessed on 29 September 2011).


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