Gallaher, L. (1999). Expert public health nursing practice: A complex tapestry. Nursing Praxis in New Zealand, 14(3), 16–27.
Abstract: The research outlined in this paper used Heideggerian phenomenology to examine the phenomenon of expert public health nursing practice within a New Zealand community health setting. Narrative interviews were conducted with eight identified expert practitioners who are currently practising in this speciality area. Data analysis led to the identification and description of themes which were supported by paradigm cases and exemplars. Four key themes were identified which describe the finely tuned recognition and assessment skills demonstrated by these nurses; their ability to form, sustain and close relationships with clients over time; the skilful coaching undertaken with clients; and the way in which they coped with the dark side of their work with integrity and courage.
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O'Brien, A. J., Hughes, F., & Kidd, J. D. (2006). Mental health nursing in New Zealand primary health care. Contemporary Nurse, 21(1), 142–152.
Abstract: This article describes the move in mental health from institutional care to community arrangements. It draws on international literature and New Zealand health policy, which gives increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc and leave room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care.
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O'Shea, M., & Reddy, L. (2007). Action change in New Zealand mental health nursing: One team's perspective. Practice Development in Health Care, 6(2), 137–142.
Abstract: This paper describes an attempt at effecting change with specific relevance to the discharge planning of clients from a New Zealand inpatient mental health unit to a community setting. It explores how a team of community mental health nurses, practising in an urban/rural area, used the concepts of practice development to endeavour to bring about change while still retaining a client-centred focus. It describes how, in their enthusiasm, they embarked on the road to practice change without undertaking some of the essential ground work, Although they did not achieve all they set out to achieve, much was learnt in the process. In this paper, the authors outline their key learning points concerning the importance of engagement, communication, consistency and cooperation to the process and outcomes of practice change.
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Connor, M. (2004). Courage and complexity in chronic illness: Reflective practice in nursing. Wellington: Daphne Brasell & Whitireia Publishing.
Abstract: This book presents the reflective account of an actual nursing practice situation (a woman living with chronic asthma).The author provides a descriptive narrative and then delves deeper into the narrative to obtain greater understanding of what she calls “strife” in chronic illness and the best nursing practice to assist its resolution.
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Crowe, M., O'Malley, J., & Bigwood, S. (2002). Nursing mental health consumers in the community. Kai Tiaki: Nursing New Zealand, 8(8), 14–15.
Abstract: The purpose of this research was to describe the characteristics of community mental health nursing care in the community. Twenty six nurses were enrolled in a study consisting of semi-structured interviews about the nature of their care. Responses were analysed to identify categories of skills. These were characterised as: establishing connectedness; promoting individual and family resilience, promoting citizenship; and addressing structural issues. Responses from the nurses are used to illustrate these categories.
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Russell, D. (1999). Changing public health nursing practice. Kai Tiaki: Nursing New Zealand, 5(11), 18–19.
Abstract: A new approach to public health nursing in the Otago region is described, which comprises of 3 distinct groups of nurses working in early childhood centres, primary schools and high schools. A family nursing assessment approach is used. The philosophical underpinnings of this approach are examined, which seeks to empower patients and engage them in their health care. Two public health nurses are interviewed about the new partnership model of nursing.
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Barber, M. (2007). Exploring the complex nature of rural nursing. Kai Tiaki: Nursing New Zealand, 13(10), 22–23.
Abstract: This article reports the results of a research study undertaken to examine how nurses manage their professional and personal selves while working in small rural communities. The participants were a small group of rural nurses on the West Coast. The rationale for the study was the long-term sustainability and viability of the service to this remote area. The research showed that the rural nurse specialists' role is a complex and challenging one, performed within the communities in which nurses live.
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Horsburgh, M., Smith, V. A., & Kivell, D. (2002). South Auckland community paediatric nursing service: A framework for evaluation. Nursing Praxis in New Zealand, 18(3), 40–49.
Abstract: This paper describes the Kidz First paediatric community homecare nursing team in South Auckland. While the service was not initially planned as an integrated approach to child health, its evolution reflects the move to more community based care delivery and the expansion of nurse-led initiatives in New Zealand. The components of a community paediatric home nursing team as described by Eaton (2000) are used to provide the framework with which to describe the service. A focus group held with the Kidz First paediatric community homecare nurses has enabled definition of the key nursing components provided to children and their families living in South Auckland.
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Farrow, T. (2003). 'No suicide contracts' in community crisis situations: A conceptual analysis. Journal of Psychiatric & Mental Health Nursing, 10(2), 199–202.
Abstract: 'No suicide contracts' take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable for the person concerned. They are commonly used in community crisis situations with suicidal people in New Zealand. This article describes and analyses the use of 'no suicide contracts' in these settings. It is argued that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation.
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Farrow, T. (2002). Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments. International Journal of Mental Health Nursing, 11(4), 214–219.
Abstract: 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
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McKey, A., & Huntington, A. D. (2004). Obesity in pre-school children: Issues and challenges for community based child health nurses. Contemporary Nurse, 18(1-2), 145–151.
Abstract: In this paper, literature related to childhood obesity in New Zealand and internationally is explored to identify current issues, and the implications for nurses in community based child health practice are discussed. Themes that emerged from the literature relate to the measurement of obesity, links between childhood and adult obesity and issues for families. Studies that investigated maternal perceptions of childhood obesity found that mothers identified their child as being overweight or obese only when it imposed limitations on physical activity or when the children were teased rather than by referring to individual growth graphs. The implications for nursing in the area of child health practice are discussed. Understanding of the complex and emotive issues surrounding childhood obesity is required when devising health promotion strategies.
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Clendon, J., & White, G. E. (2001). The feasibility of a nurse practitioner-led primary health care clinic in a school setting: A community needs analysis. Journal of Advanced Nursing, 34(2), 171–178.
Abstract: The aim of this study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a New Zealand primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses were the most appropriate nurses to lead such a clinic. Utilising a community needs analysis method, data were collected from demographic data, 17 key informant interviews and two focus group interviews. Analysis was exploratory and descriptive. Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the public health nurse was less than anticipated and that community expectations were such that for a public health nurse to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. The authors conclude that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required.
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Challis-Morrison, S. (2006). Caring for a community wanderer. Kai Tiaki: Nursing New Zealand, 12(11), 20–22.
Abstract: A community based registered nurse from Waikato District Health Board's Older Persons Assessment Team (OPAT) presents her experiences of working with older people with dementia. She uses a case study approach to highlight the issue of wandering, behaviour which can be difficult to modify and can cause carer distress. She outlines a team approach to the condition which requires good communication and co-ordination. Key aspects of management included a risk assessment plan, support for caregivers, and encouraging activity.
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Francis, L. (2007). Polio is history – isn't it. Whitireia Nursing Journal, 14, 24–31.
Abstract: Using the stories of four polio survivors who have since contracted post polio syndrome (PPS), this article discusses the theories regarding the cause of PPS as well as the varying symptoms and problems for those living with the disease.
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Crowe, M., O'Malley, J., & Gordon, S. (2001). Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand. Journal of Advanced Nursing, 35(1), 88–96.
Abstract: The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services.
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