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Author |
Kaviani, N.; Stillwell, Y. |
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Title |
An evaluative study of clinical preceptorship |
Type |
Journal Article |
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Year |
2000 |
Publication |
Nurse Education Today |
Abbreviated Journal |
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Volume |
20 |
Issue |
3 |
Pages |
218-226 |
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Keywords |
Preceptorship; Nursing; Education; Evaluation research |
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Abstract  |
A preceptorship programme of 100 hours duration was developed and delivered by a nurse education institute, in consultation with a health care organisation. The purpose of the study was to examine preceptors, preceptees, and nurse managers' preceptions of the preceptor role and factors which influenced the performance of preceptors. Using focus groups, participants were each asked to identify the outcomes of the programme in practice. Study findings highlighted the importance of formal preceptor preparation, personal and professional development of the preceptors, and the promotion of positive partnerships between nurse educators and nurse practitioners. The need for formal recognition of the preceptor role in practice, particularly in relation to the provision of adequate time and resources, emerged from the study. The research findings enabled the development of an evaluative model of preceptorship, which highlights the intrinsic and extrinsic factors impacting on the preceptor role |
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Call Number |
NRSNZNO @ research @ |
Serial |
654 |
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Author |
Litchfield, M.; Ross, J. |
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Title |
The role of rural nurses: National survey |
Type |
Report |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Online on the Ministry of Health's Centre for Rural Health pages |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Personnel; Nursing specialties; Primary health care |
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Abstract |
A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1175 |
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Author |
Jones, R.G. |
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Title |
Rongoa Maori and primary health care |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Held by NZNO Library |
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Abstract |
A thesis submitted in partial fulfilment of the requirements for the degree of Master of Public Health.
Rongoa Maori, in its wider sense, refers to the traditional medical system of the indigenous people of New Zealand. The aims of this thesis were to identify the major issues involved in incorporating traditional healing in this context and to look at how this might be achieved. |
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Call Number |
NZNO @ research @ WA 300 JON |
Serial |
1364 |
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Author |
Strochnetter, K.T. |
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Title |
Influences on nurses' pain management practices within institutions: A constructivist approach |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Interprofessional relations; Pain management; Nursing |
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Abstract |
Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient. |
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Call Number |
NRSNZNO @ research @ |
Serial |
909 |
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Author |
MacGeorge, Jane Mary |
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Title |
Non-invasive continuous positive airway pressure therapy in patients presenting with cardiogenic pulmonary odema |
Type |
Book Whole |
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Year |
2000 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
121 pp |
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Keywords |
Continuous Positive Airway Pressure; Respiratory Therapy; Heart diseases |
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Abstract |
Examines the value of early intervention of continuous positive airway pressure (CPAP) in the emergency setting, and the influence of experienced nurses on early initiation of CPAP. Investigates the difference that therapy made to mortality and morbidity for patients presenting with cardiogenic pulmonary odema (CPO) to a metropolitan emergency department. Performs a retrospective audit of 54 cases over the period of one year. |
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Call Number |
NZNO @ research @ |
Serial |
1428 |
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Author |
Williams, B.G. |
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Title |
The primacy of the nurse in New Zealand 1960s-1990s: Attitudes, beliefs and responses over time |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; History; Registered nurses |
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Abstract |
Exploring the past, and pulling ideas through to the present, to inform the future can make a valuable contribution to nurses and nursing in New Zealand. By gaining some understanding of the attitudes and beliefs nurses held, and how these influenced their responsiveness, we can learn what active responses might help inform our future. Nurses in New Zealand, as individuals and within the profession as a whole, reveal the primacy of the nurse – nurses who have made and can continue to make a difference to the health of the peoples of New Zealand. A hermeneutic process was used to interpret material, from international texts, national texts and public records over four decades, the 1960s to 1990s. This was supplemented and contrasted with material from twelve oral history participants. Analysis of the material led to the emergence of four themes: Nurses' decision-making: changes over time; An emerging understanding of autonomy and accountability; Nurses as a driving force; and Creating a nursing future. These four themes revealed an overall pattern of attitudes, beliefs and responses of the New Zealand registered nurse. The themes surfaced major revelations about the primacy of the nurse in New Zealand, nurses confident in their ability to take the opportunity, seize the moment, and effect change. The author suggests that the contribution this thesis makes to the discipline of nursing is an understanding of how the nurse actively constructs the scope of a professional response to the context. The author notes that the thesis demonstrates how nurses can learn from the past, that the attitudes and beliefs that underpin our active responses can either move us forward, or retard our progress. As nurses we can also learn that to move forward we need particular attitudes, beliefs and responses, that these are identifiable, and are key factors influencing our future, thus ensuring the continued primacy of the nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
905 |
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Author |
Casey, H. |
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Title |
Empowerment: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Policy; Leadership; Careers in nursing; Mental health; Psychiatric nursing |
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Abstract |
For nurses to have control over their practice they need to have input into policy development. Nurses having control over their practice has been linked to nursing empowerment. Therefore the question explored in this research project is: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area? The literature reviewed for this project includes empowerment, power, the history of nursing in relation to women's role in society, oppression and resistance, and literature on Critical Social Theory as the underlying theoretical and philosophical position which informs the research process. In order to answer the research question a single focus group was used to gather data from a group of registered nurses practising in mental health. Focus groups as a data collection method produce data and insights that would be less accessible without the interaction found in the group. The key themes to emerge from the data analysis were: power is an important component of empowerment and power relationships; and at a systems level, professional, organisational, and political influences impact on feelings of empowerment and/or disempowerment. These key themes are discussed in relation to the literature and the broader social and cultural context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations for nurse leaders who aim to provide an empowering environment for nurses practising in mental health. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1145 |
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Author |
Brinkman, A. |
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Title |
A study into the causes and effects of occupational stress in a regional women's health service |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Stress; Midwifery; Nursing |
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Abstract |
Hospital-based health systems have the potential to be high stress environments, as staff work towards meetings the many and varied demands of the patients and their families / whanau in a situation of limited resources and unpredictable workloads. Dealing with physical and emotional trauma, and the 'normal' exigencies of daily life in what may be a far from normal workplace may compound the stresses facing health workers. Nurses, who are often at the interface between patients and other health professionals, may be caught in a cross-fire of transferred stress while also coping with stressors associated with their jobs. As well as being likely to have a negative effect on their well-being and job satisfaction, any such compounding impact of stress and stressors could have adverse impacts on patients and their supporters. The primary focus of this study has been to identify stress levels among nurses in a woman's health service, and to establish the causes of elevated stress. All staff were surveyed (with a 68% response rate). Midwives made up the largest portion, followed by nurses, doctors, therapies, support and clerical groups. The Job Stress Survey (JSS) and the General Health Questionnaire – 12 (GHQ-12) were used to help detect emergent stressors, and stress effects that staff were experiencing at the time. Aggregate data was used, focusing on the six occupational groupings and the nine areas within the health service. Findings from the JSS confirm that the staff had experienced a number of stressors, while indications of deleterious mental health effects in some staff emerged from the GHQ-12 scores. Occupational stress is a subset of general stress, making it difficult to separate one from the other as spheres of our lives overlap and interact. The stressors that were identified should contribute to the discussions and policies that might abet the reduction of stress. On the other hand, it is not possible to attribute the effects describes by the GHQ-12 as being derived primarily from occupational stress. A stressed staff member, no matter what the source of their stress might be, still needs support in order to cope. The author notes that the negative outcomes of occupational stress manifests themselves in many ways such as; mistakes, absenteeism, horizontal violence, burnout and turnover. These all affect the quality of the patient care delivered, leading to decreased patient satisfaction and and need to be addressed for these reasons. |
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Call Number |
NRSNZNO @ research @ |
Serial |
900 |
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Author |
Harker, D.Y. |
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Title |
Nurses as patients: The stories of two woman nurse educators as recipients of nursing care |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Education; Preceptorship; Feminist critique |
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Abstract |
In this research two nurse-patients have engaged in a conversation about their experience of 'being nursed'. The project sets out to address the following questions: How might our experiences as nurses who have been hospitalised be drawn upon to influence positive changes in nursing practice? What effect might our experiences of hospitalisation have on us as nurses and on our nursing practice? The study utilises narrative as inquiry and the method of story telling and auto/biography to tell the stories of Maria (a pseudonym) and the researcher herself. This interpretive research has been informed by the feminist process and sits within a postmodern framework. Maria's stories were audio taped and transcribed before being prepared for analysis using 'core story creation', and the process of 'emplotment' (Emden, 1998b). The author's reflective topical autobiographical narrative was constructed through the processes described by Johnstone (1999). Three distinct qualities emerged from both experiences. The first, 'knowing as nurse-patient' contains the three sub-themes of 'having knowledge', 'expectations of being nursed', and 'knowledge gained'. The second distinct quality 'being nursed' contains the two sub-themes of 'feeling safe and cared for' and 'presencing'; and the third, 'not being nursed', contains the four sub themes 'feeling vulnerable', 'invisibility of nurses', 'getting out' and 'feeling let down'. The sub-theme 'getting out' includes three additional sub themes of 'wanting to get out and not wanting to be there', 'leaving and the need for closure' and 'not wanting to go back'. The author notes that nursing does make a difference to patient care. However, for patients to receive therapeutic care, new graduate nurses must be preceptored/mentored by experienced nurses in supportive programmes. Suggestions for further research have been identified. |
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Call Number |
NRSNZNO @ research @ |
Serial |
907 |
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Author |
Robertson, G. |
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Title |
Disquiet in the development of clinical supervision for professional development in nursing practice: A literature review |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Clinical supervision; Professional development; Nursing |
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Abstract |
Nursing literature reflects that nurses have been exploring and experiencing the process of clinical supervision for well over a decade. Nurses in the United States, United Kingdom, Scandinavia, and Australasia have written much over the past fifteen years. However, the author notes that nurses grapple with what clinical supervision is within nursing development and disquiet continues to emerge in the literature. This literature review expands on themes that surround this disquiet. These centre on continued confusion and lack of clear definition; whether psychotherapy is implemented under the guise of clinical supervision, who uses it, and the dearth of empirical evaluation of its effectiveness. The lack of significant empirical evidence of its ability to assist practitioners to deliver improved patient/client care continues despite claims of improved professional and personal development, therapeutic relationship, and occupational stress management. These claims come from both supervisees and supervisors. The manner in which clinical supervision is portrayed in nursing in that it is frequently referred to as a support system, rather than one of learning a complex set of communication skills is also highlighted. The continued debate on what model(s) best suit nurses, or whether line management should provide clinical supervision as a means to ensure quality standards and control over nursing practice and optimal patient care is discussed. Whether nursing should stop borrowing from other fields and develop their own model(s) is also raised. Two emerging stances focus on a process that is practice-based as identified by senior staff and management, or one that continues along the lines of what psychotherapy has developed with practitioner-identified developmental needs. These issues raise many questions for further development in nursing, one being are nurses developed enough in their self-awareness to understand what they are to adopt into their practice? Authentic voices from those nurses experienced in the practice of providing and receiving clinical supervision, are shaping therapeutic practice for nurses in the future, and continue to sharpen the debate. Some reference to unpublished data and local practice in the Wellington area have been included as a stimulus for further incorporation of clinical supervision in local practice development. |
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Call Number |
NRSNZNO @ research @ |
Serial |
794 |
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Author |
Love, E. |
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Title |
Towards the best of both worlds: Developing a partnership between education and practice to improve clinical practicum experience and learning outcomes for undergraduate nursing students |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Education; Teaching methods |
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Abstract |
One proposed method for addressing concerns about a `theory-practice gap' in nurse education and perceived clinical shortcomings in beginning practitioners, is improved collaboration between education and practice. This paper is about a New Zealand nursing initiative to promote optimal learning outcomes for nursing students through supported hospital clinical experiences. It is implemented through a contractual partnership between Lakeland Health Limited in Rotorua, and Waiariki Institute of Technology. An associated “Clinical Nurse Educator Programme”, developed by lecturers at Waiariki's nursing school, prepares hospital nurses to be Clinical Nurse Educators. These “C.N.Es” replace and enhance the clinical role formerly provided by nursing lecturers, and short term contracted nurses. The programme is entering its fourth year with positive evaluations, and has extended into another hospital. Literature suggests that although educators are important, students may consider hospital nurses much more significant for their clinical learning and developing confidence 'in the real world'. These nurses are on hand, and generally have clinical credibility not afforded to academic staff. However, ward nurses, like contracted nurse teachers, have reported not having enough curriculum knowledge, nor teaching skills to optimise student learning. This C.N.E programme addresses these shortcomings through its selection of experienced nurses in current practice, and 50 hours of theoretical and practical course content, to prepare them for the role. This paper provides a clinical and personal perspective of the C.N.E programme, its beginnings, how it works locally, and process for its ongoing development. Not only does this programme provide a bridge between theory and practice for students during their clinical practicum placements, but communication, consultation and collaboration between education, practice and the workplace have also improved. Nurses in both sectors are confident that through the developing partnerships, students and future practice will benefit from the aim to provide students with 'the best of both worlds'. |
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Call Number |
NRSNZNO @ research @ |
Serial |
897 |
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Author |
Wilson, H.V. |
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Title |
Surveillance or support: Divergent discourses in Plunket nursing practice |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Public health; Children; Community health nursing; Plunket |
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Abstract |
Plunket nurses are New Zealand child health nurses who work in the community with the families of new babies and preschool children. Their work is called child health surveillance and this is considered to involve routine and unproblematic practices which are generally carried out in homes and clinics in the context of a relationship with the child's mother (Ministry of Health 1996; Royal New Zealand Plunket Society 1997). However, evidence in the literature that surveillance can have implications for power relations throws doubts on official claims that the relationship between the mother and nurse operates as a partnership (Trout and Polaschek 1996). The purpose of this thesis was to explore the way in which surveillance is constituted within the discourses of Plunket nurses and to examine these discourses for any implications of unequal power relations. Foucauldian discourse theory and poststructuralism, which informed this thesis, provided the opportunity to challenge assumptions about power and knowledge in the child health context. Analysis of the discourses generated by interviews with five Plunket nurses revealed that, contrary to the claims in the official literature, the relationship between the Plunket nurse and the mother is not that of an equal partnership but is constituted in various and unexpected ways. It was through the nurses' discourses of surveillance that the power relations underpinning this relationship were surfaced. While these discourses suggested that many mothers who use the nursing service are actively involved on their own terms, there are a number of women for whom the surveillance activities of the nurse have been shown to be particularly intrusive (Mayall 1986; Clinton 1988; Bloor and McIntosh 1990; Knott and Latter 1999). It may be primarily this unwelcome surveillance which accounts for the considerable number of women who, the statistics show, cease using Plunket services particularly in the early months. It is perhaps for this reason that the nurses in this study locate themselves as being caught between divergent discourses of support and surveillance. Findings indicate that the resolution of this dilemma by abandoning surveillance practices might improve maternal satisfaction with the Plunket nursing service. The author concludes that a child health service responsive to mothers' stated needs rather than institutional requirements or the nurse's own agenda could lead to a more open and equal relationship between mother and nurse. This relationship would be likely to benefit mothers and babies and, at the same time, enhance both nursing practice and nurses' satisfaction with their work. |
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Call Number |
NRSNZNO @ research @ |
Serial |
899 |
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Author |
McArtney, M. |
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Title |
Nursing development units: Between a rock and a hard place |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Professional development; Nursing |
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Abstract |
Practice development, situated at the nurse-patient interface, is a crucial aspect of professional development as a whole. The Nursing Development Unit (NDU) is one model of structured clinical practice development. NDU have their origin in a desire to provide the best possible care for patient through the support and development of autonomous therapeutic nurses. All possible sources of NDU-related literature from 1983-1999 were reviewed to determine the effectiveness of the NDU model. The purpose of the research was to establish the role of the parent organisation in supporting the ongoing viability of NDU; to describe the key processes and activities of NDU that are instrumental in the development of nursing practice; to clarify the role of the NDU in contributing to improved patient outcome; and finally to identify the critical indicator of successful NDUs for their application in the New Zealand context. The study found that British nursing journals have played a large part in promoting the NDU model. The pioneering units were given positive coverage and this has by and large continued. Accreditation systems have been important in maintaining standards and providing a generic framework for implementation. The trend is now towards internal funding from the parent organisation. The review identified a number of key features for the successful establishment of NDUs. NDUs appear to have under emphasised the development of socio-political acumen in the nursing staff. However, the NDU does offer a model for the development of confident, assertive, autonomous professionals. The NDU model values nursing as professional practice. The author concludes that the NDU model has stood the test of time, and demonstrated the ability to be at the vanguard of contemporary practice development. The model is flexible and its potential is maximised when it is tailored to meet the need of the parent organisation. The model has been successfully established in Australia, and has the potential to be adapted and refined for the New Zealand context. |
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Call Number |
NRSNZNO @ research @ |
Serial |
561 |
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Author |
Teekman, B.; Stillwell, Y. |
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Title |
Exploring reflective thinking in nursing practice |
Type |
Journal Article |
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Year |
2000 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
31 |
Issue |
5 |
Pages |
1125-1135 |
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Keywords |
Nursing; Problem solving; Experiential learning |
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Abstract |
Sense-Making, a qualitative research method, was used to obtain and analyse data from interviews with 10 registered nurses, in order to study reflective thinking in actual nursing practice. Ten non-routine nursing situations were analysed for the presence of reflective thinking. Reflective thinking was extensively manifest, especially in moments of doubt and perplexity, and consisted of such cognitive activities as comparing and contrasting phenomena, recognising patterns, categorising perceptions, framing, and self-questioning in order to create meaning and understanding. Self-questioning was identified as a significant process within reflective thinking. By exploring and analysing the type of questions respondents were asking themselves, the study uncovered three hierarchical levels of reflective thinking, focussed on action, evaluation and critical enquiry. The findings of this study resulted in the development of a model of reflective thinking, which is discussed in terms of the implications for learning in nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
655 |
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Author |
de Carlo Ahuarangi, K. |
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Title |
Hei watea taupuhipuhi: The space of symbiosis: A conceptual framework for nursing practice |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Maori; Teaching methods; Nursing; Transcultural nursing |
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Abstract |
Te watea taupuhipuhi, the space of symbiosis is a framework for nursing practice. It examines the notion of the nursing presence as holding continuity and multiplicity of viewpoint in space of symbiosis. The author developed a teaching-learning situation as an introduction of key ideas in his work where the Maori word “ako” becomes the catalyst of a particular pedagogy that outlines the central notions of symbiosis. Thus, he notes, his work realises that symbiosis occurs not only on the clinical arena of nursing but in the teaching – learning environment as well, his own space of symbiosis. Four rites of passage coalesce a totality of experience within the space of symbiosis, revealing that the central role of the nursing presence is to surface meaning and sense for all of experience which can be fearful, mysterious, paradoxical and chaotic. These four rites of passage are described as the interpretive, integrative, transformations and transcendent. The twelve dynamics of nursing from the axle around which a praxis of nursing revolves. An analysis of those twelve dynamics in rite of passage is situated within narratives taken from the author's nursing practice. He also draws extensively from Maori ontology and autobiography in positioning his exposition within this local context. |
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Call Number |
NRSNZNO @ research @ |
Serial |
901 |
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