Studying at the Key Centre for Women's Health in Society
Student profiles
Nurse Practitioners value in women's health study
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Studying at the Key Centre for Women's Health in Society can lead health professionals into some highly innovative positions. For Alison Bean-Hodges, doing the Master's in Women's Health, has allowed her to become one of only two Women's Health Nurse Practitioners in Victoria. |
Alison, who is the manager of the Royal Women's Hospital Gynaecology Assessment Clinic has recently been endorsed as a Nurse Practitioner by the Nurses Board of Victoria (NBV) after seven years of study and peer evaluation. Others are following suite. Her colleague Cathy Watson is also a women's health nurse practitioner and two others, Karin Butler and Catie Bortolot are also nurse practitioner candidates and Key Centre Master's students. All work within the Gynaecology Assessment Clinic at the Women's, an innovative service working in close collaboration with the specialist medical services.
To qualify to become a nurse practitioner, a nurse has to have worked at an advanced level for at least five years, and been in a leadership role. The NBV requires candidates to do a master's degree, and further education in pharmacology. Rigorous peer evaluation from medical colleagues is also part of the endorsement process.
“You have to be able to demonstrate that you practice effectively, safely and that there are improved outcomes for women,” she says.
Alison did the Key Centre postgraduate diploma in women's health in 1995 and after this went into a community position at Inner South Community Health where she established a women's health clinic and outreach midwifery services.
‘I could not have done that without the Grad Dip, it was really vital to my role.” Following her stint in the community she joined the Women's Well Woman's Clinic at the Royal Women's and did further study in family planning.
In 1998 Alison decided to take the plunge and become a nurse practitioner and this meant shopping around for a Master's course.
Alison specifically chose the Key Centre course over a nursing Masters, because of its multidisciplinary focus. “I wanted a Masters that was relevant to my area of practice. Doing it at the Key Centre was terrific for me, and the fact that it was multidisciplinary - both the teachers and participants – was important to me. Getting the perspective of international students was really valuable too.”
Alison was able to do different units in other parts of the university to suit her clinical needs – such as a subject the Melbourne Sexual Health Centre.
Two study highlights for Alison include learning about how to critically evaluate health research and being introduced to psychological practice in women health.
There are 14 nurse practitioners in Victoria in a range of specialist areas. The Women's Health Nurse Practitioner role provides gynaecological assessment for symptomatic women presenting to the outpatients service at the Women's Hospital. The practitioners have a limited formulary which includes the capacity to prescribe antibiotics for sexually transmissible infections and oral contraception. They can also order investigations and manage an episode of care, for example, the treatment of a woman with chlamydia. Nurse practitioners also refer to specialists. “It's very much a collaborative role,” explains Alison.
Nurse practitioners are also aware of their professional limitations, they can for example, assess a woman with chronic pelvic pain, but the identification of a pelvic mass would immediate require referral to a medical colleague.
When Alison was finally endorsed in August this year, she was hugely relieved. Reaching the milestone has been a challenging and at times gruelling experience, she admits. “If you focus on the knocks and slights you may get, its easy to get burnt out. You have to focus on the big picture and pace yourself.”
She urges others considering this career option not to be put off and to keep up the enthusiasm by identifying mentors – clinical and others.
Radio teases out tricky taboo subjects
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ENCOURAGING INTIMATE TALK about sex on the radio is an unorthodox way to reach research subjects. However for Botswanan PhD student Josephine Nkosana it was the best option for eliciting information on a taboo topic –older men having sex with young girls. |
Josephine has recently finished her PhD at the Key Centre on intergenerational sexual relationships in urban Botswana – research with important public health implications given that the country has high STI rates and one of the highest HIV rates in the world. For every one adolescent boy, there are four adolescent girls infected with HIV in Botswana and there is a 20% prevalence rate among 15-19 year olds.
Disturbed by the devastating impact of HIV on young people, Josephine was motivated to do research that would help educate young people in her country. “I am someone who is interested in young people, as a mother, a health professional and a teacher,” she says.
“Studies conducted in sub Saharan Africa on intergenerational sexual relations revealed that there was a significant relationship between unsafe sex behaviours, increased risk of HIV infection and intergenerational sex,” says Josephine.
The research was conducted in three stages; a quantitative survey with 600 school girls, in-depth interviews and radio talkback with men and women. It found that 39% of girls had been approached to have sex with older men – most of those declined but one quarter did have sex and 30% of these (16) said no condom was used to prevent STI or HIV. Most of the female respondents did not see intergenerational sexual relationships in a positive light. But the men saw them as normal and pleasurable.
There were also socio economic reasons behind the intergenerational sex with 85 % of girls saying that men more than 10 years older were providing gifts and money. “Material gain seems to be the main motivation why girls have sexual relationships with older men,” says Josephine.
The decision to use radio to get the views of men was not taken lightly. “Radio talkback was considered to be the only viable alternative of reaching men who could talk freely through an anonymous medium. There were two sessions organised and 38 men and 18 women called from across the country,” said Josephine. The information from this part of the study confirmed that intergenerational sex was ‘transactional’. “Men were not willing to use condoms after they have given their young partners some valuable gifts and services,” said Josephine.
After four years in Australia, Josephine has returned to Botswana with her family to spread the word about her findings and publish the results. Her studies were supervised by Professor Doreen Rosenthal.
Her thesis is available to download from the University of Melbourne e-prints repository