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Spence, D., & Fielding, S. (2002). Win-win-win: Collaboration advances critical care practice. Contemporary Nurse, 13(2/3), 223–228.
Abstract: This paper provides an overview of the structure and processes of an eighteen month, distance education course focused on developing advanced practice in the context of critical care nursing. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) was developed as a collaboration between Auckland University of Technology and two regional health providers. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This course is set against a background of increasing interest in education post registration. The acquisition of highly developed clinical capabilities requires a combination of nursing experience and education. This requires collaboration between clinicians and nurse educators, and approaches to address accessibility of relevant educational opportunities for nurses outside the country's main centres.
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Day, W. (2003). Women and cardiac rehabilitation: A review of the literature. Contemporary Nurse, 16(1-2), 92–101.
Abstract: This literature review explores some of the issues related to women's experience of cardiac rehabilitation and demonstrates that women's experience may be different to that of men. Much of the research related to coronary heart disease (CHD) has been performed using either exclusively male populations or such small numbers of women that the results from the women studied were unable to be analysed independently. The author advocates that nurses working within this area of practice require an understanding of women's experience of recovery from a heart attack in order to better meet their needs.
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Giddings, D. L. S., Roy, D. E., & Predeger, E. (2007). Women's experience of ageing with a chronic condition. Journal of Advanced Nursing, 58(6), 557–565.
Abstract: This paper is a report of a study to explore the experiences of 'almost old' women as they grow older while living with a chronic condition. Little is known about the contextual effects of ageing and how it shapes and is shaped by a woman's chronic illness experience. Seven women aged between 50 and 58 years participated in this interpretive descriptive study that explored the issues of ageing with a chronic condition. Three focus groups were held between March 2003 and March 2004. Transcriptions were analysed after each focus group. Participants were given the opportunity to respond to the findings as the analysis progressed. The experience of living with a chronic illness foreshadowed what was to come with ageing and embodied the ageing process: it was just part of their lives. Alongside this, the women now felt less out of place. Their peers were catching up and beginning to experience aspects of participants' everyday reality. The women, however, experienced double jeopardy because ageing amplified the ongoing vulnerabilities of living with a chronic condition. The authors conclude that nurses who recognise the resourcefulness and expertise of women who live with a chronic condition can effectively be co-strategists in helping them to age well.
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Greenwood, S., Wright, T., & Nielsen, H. (2006). Conversations in context: Cultural safety and reflexivity in child and family health nursing. Journal of Family Nursing, 12(2), 201–224.
Abstract: This article outlines some key aspects of the practice of a number of nurse educators and researchers, and their commitment to the needs of their specific region. The group has been based at the Waikato Institute of Technology (WINTEC) over the last decade and have worked collaboratively across primary health, cultural safety, and child and family health domains of the nursing curriculum. They share a common philosophy underpinned by notions of diversity and health equity. The philosophy informs their theoretical inquiry, practice and research interests, and pedagogical concerns. In this article, the nurse researchers begin by situating themselves within the region, its people, and influences before moving into a consideration of the wider political and policy environment. They then consider the destabilising effects of cultural safety education and the tension between biculturalism and multiculturalism in their context. Finally, they reflect on how these ideas inform their work with postgraduate child and family nurses.
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Strickland, A. (2006). Nurse-initiated retinoblastoma service in New Zealand. Insight: The Journal of the American Society of Ophthalmic Registered Nurses, 31(1), 8–10.
Abstract: This article describes the implementation of a nurse-led, dedicated support network and service for children with a diagnosis of retinoblastoma and their families. Nurses with an interest in retinoblastoma at an Auckland Ophthalmology Department realised that the service provided was not meeting the needs of patients and families, particularly since the numbers had increased over the past two years. This article outlines the development of a cost-effective approach that improved the service.
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Richardson, F. I., & Carryer, J. B. (2005). Teaching cultural safety in a New Zealand nursing education program. Journal of Nursing Education, 44(5), 201–208.
Abstract: This article describes the findings of a research study on the experience of teaching cultural safety. As a teacher of cultural safety, the first author was interested in exploring the experience of teaching the topic with other cultural safety teachers. A qualitative approach situated in a critical theory paradigm was used for the study. The study was informed by the ideas of Foucault and feminist theory. Fourteen women between ages 20 and 60 were interviewed about their experience of teaching cultural safety. Five women were Maori and 9 were Pakeha. Following data analysis, three major themes were identified: that the Treaty of Waitangi provides for an examination of power in cultural safety education; that the broad concept of difference influences the experience of teaching cultural safety; and that the experience of teaching cultural safety has personal, professional, and political dimensions. These dimensions were experienced differently by Maori and Pakeha teachers.
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Flynn, L., Carryer, J. B., & Budge, C. (2005). Organisational attributes valued by hospital, home care, and district nurses in the United States and New Zealand. Journal of Nursing Scholarship, 37(1), 67–72.
Abstract: The aim of this study was to determine whether hospital-based, home care, and district nurses identify a core set of organisational attributes in the nursing work environment that they value as important to the support of professional practice. Survey data, collected in 2002 2003 from 403 home care nurses in the United States and 320 district nurses in New Zealand, were pooled with an existing data set of 669 hospital-based nurses to conduct this descriptive, nonexperimental study. The importance of organisational attributes in the nursing work environment was measured using the Nursing Work Index-Revised (NWI-R). The authors found that at least 80% of hospital-based, home care, and district nurses either agreed or strongly agreed that 47 of the 49 items comprising the NWI-R represented organisational attributes they considered important to the support of their professional nursing practice. Mean importance scores among home care nurses, however, were significantly lower than were those of the other two groups. The authors conclude that the overall, hospital-based, home care, and district nurses had a high level of agreement regarding the importance of organisational traits to the support of their professional practice. The intensity of the attributes' importance was less among home care nurses. Further research is needed to determine whether this set of organisational traits, measured using the NWI-R, is associated with positive nurse and patient outcomes in home care and district nursing practice, as has been shown in acute care settings.
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Wepa, D. (2003). An exploration of the experiences of cultural safety educators in New Zealand: An action research approach. Journal of Transcultural Nursing, 14(4), 339–348.
Abstract: This research is a study of the experiences of four cultural safety educators in nursing education in Aotearoa, New Zealand. Action research methods assisted the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action, and reflecting. The findings of the research revealed that the participants not only coped with everyday stressors of teaching but were also required to formulate knowledge for cultural safety. For the Maori participants, their stress was confounded with recruiting and retaining Maori students and macro issues such as commitment to their iwi (tribe). Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that many issues were organisational in nature and out of their control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations include the following: support for cultural safety educators to have a dialogue on a regular basis, the introduction of nurse educator programmes, paid leave provisions for educators to conduct and publish research so that a body of knowledge can be developed, and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burnout.
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Ho, T., & Mok, J. (2003). Condensate clearance from CPAP circuit: An examination of two methods of draining condensate from the inspiratory tubing. Journal of Neonatal Nursing, 9(4), 117–120.
Abstract: Clinical studies on adult ventilated patients demonstrate that bacterial contamination of the condensate occurs in ventilator circuits. The purpose of this research is to find out if this is also true of the condensate in the Continuous Positive Airway Pressure (CPAP) circuit. It aims to determine whether there is bacterial contamination in the humidifier reservoir of the CPAP system when the condensate is drained back into the humidifier reservoir without disconnecting the circuit, or when the inspiratory tubing is disconnected to drain out the condensate.
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Bland, M. F. (2002). Patient observation in nursing home research: Who was that masked woman? [corrected] [published erratum appears in Contemporary Nurse 2002 Apr; 12(2): 135]. Contemporary Nurse, 12(1), 42–48.
Abstract: This article discusses the issues that one nurse researcher faced during participant observation in three New Zealand nursing homes. These include the complexity of the nurse researcher role, the blurring of role boundaries, and various ethical concerns that arose, including the difficulties of ensuring that all those who were involved in the study were kept informed as to the researcher's role and purpose. Strategies used to maintain ethical and role integrity are outlined, with further debate and discussion around fieldwork issues and experiences for nurse researchers called for.
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Chadwick, A., & Hope, A. (2000). In pursuit of the named nurse. Australasian Journal of Neuroscience, 13(4), 6–9.
Abstract: This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required.
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Evans, S. (2003). Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes. Pediatric Intensive Care Nursing, 4(2), 7.
Abstract: The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
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Koorey, R. (2008). Is there a place for clinical supervision in perioperative nursing? Dissector, 35(4), 15–17.
Abstract: This article explores the concept of clinical supervision and outlines a brief history of implications for nursing practice. Models of clinical supervision are outlined and examples of how they may be applicable to the clinical setting of perioperative nursing are provided.
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Gallagher, P. (2007). Preconceptions and learning to be a nurse. Nurse Education Today, 27(8), 878–884.
Abstract: This article discusses the important role that preconceptions play in the process by which students learn to be nurses. The importance of preconceptions emerged from the analysis of data in a grounded theory study that sought to gain a greater understanding of how undergraduate student nurses in New Zealand experienced and responded to differences they perceived between the theory and the practice of nursing. It became clear that the preconceptions each student nurse held about the nature of nurses and nursing care were the standards against which the worth of the formal, practical and personal theories to which students were exposed during their nursing degree was evaluated. It was clear that preconceptions functioned as the mediator between the intentions of nursing education and the learning that eventuated for each student from practicum experiences. The implications for nursing education, for which preconceptions are not generally highly valued as a basis for learning about professional nursing, are that the individual experience and personal characteristics of each student receive significant focus when a nursing programme is planned. This means that the orthodox principles that underpin the design of nursing curricula should be reviewed and an overtly constructivist perspective adopted for nursing education for which the prior experiences of the student are the starting point.
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Carryer, J. B., Gardner, G., Dunn, S., & Gardner, A. (2007). The core role of the nurse practitioner: Practice, professionalism and clinical leadership. Journal of Clinical Nursing, 16(10), 1818–1825.
Abstract: This article draws on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. A study jointly commissioned by both countries' Regulatory Boards developed information of the newly created nurse practitioner role, to develop shared competency and educational standards. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner programme curricula and interviews with 15 nurse practitioners from the two countries. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care.
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