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Woods, M. (1997). Maintaining the nursing ethic: a grounded theory of the moral practice of experienced nurses. Ph.D. thesis, , .
Abstract: This thesis presents a study of the every-day moral decision making of experienced nurses. Eight experienced registered nurses participated in the completed research that is based on data gathered through interviews, document audit and literature review. A grounded theory approach was used to analyse the extensive data gathered for the study. This methodology generated a theoretical description involving the antecedents, processes and consequences of nursing moral decision making.Nursing practice has moral content, if not an entirely moral purpose, and moral decision making is the central component of this practice, yet the ethical aspects of nursing practice remain a comparatively recent field of study. It is therefore essential to nurses and their patients that this process is adequately studied and theorised. To date, very few studies have been undertaken in this area in New Zealand. This study aims to at least partially redress this situation by offering insights through conceptualisation and theoretical description of nursing moral decision making.The findings of the study reveal that antecedents such as personal moral development, upbringing and social experiences, contribute to a 'nursing ethic' in the moral decision making of experienced nurses. Furthermore, the study shows that the context and individual and shared perceptions of moral events influence the degree of nursing involvement in ethical situations. Finally, the study maintains that an intrinsic and persistent nursing ethic guides ethical decision making in nursing. This ethic is an undeniable phenomenon of considerable significance to nursing practice and education
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Stevenson, A. F. (1997). Realities and rhetoric: general hospital nursing in New Zealand 1945 to 1960. Ph.D. thesis, , .
Abstract: Up until the 1980s most of the historical writing about nursing and nurses in this country has been told from the points of view of past nursing leaders. The realities of day-to-day nursing in New Zealand general hospitals were relatively unknown.This thesis examines the experience of general hospital nursing between 1945 and 1960. The recollections of thirty-four nurses who nursed during this period have provided the key sources from which the major themes of this study have emerged. These themes, of dirty work, authoritarian control and discipline, and learning nursing are discussed within the context of an expanding hospital system and a shortage of nurses.The study demonstrates the vast differences between the recollections of nurses of the experience of nursing and the rather high-flown rhetoric of the nursing leadership.Changes to the amount of cleaning, the ;level of discipline and control, and ways in which learning nursing was organised were small and gradual and occurred in the late 1950s.Overall, though, nursing in general hospitals by 1960 ws almost unchanged from the 1930s.An ethos of selfless service, opposition to unionism, and Christian altruism was till dominant amongst the nursing leadership. Nurses in training still worked a six day week, were expected to stay on duty until the work was done, and were supervised closely in, on and off duty time
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Giddings, D. L. S. (1997). In/visibility in nursing: stories from the margins (United States, New Zealand, Diversity). Ph.D. thesis, , .
Abstract: Using the life history approach this study investigates the consequences of difference within the context of nursing. Life story interviews were conducted with 26 women nurses of varying racial, cultural and sexual identity backgrounds in the USA and New Zealand.The questions framing the interviews focused on the women's experience of difference and fairness in their lives and specifically within nursing.The creation of life story 'snippets' in the first level of analysis reflected the unique aspects of each woman's story and became the first step in the process of creating a thematic analysis or meta-story. The meta-story that emerged from the juxtaposition of the women's stories was “not fitting in to nursing”.The findings of this study suggest that in spite of the change in location of nursing education and its recent attention to the implications of client diversity, the continued imposition of traditional definitions of 'the nurse' by nursing institutions, renders difference amongst nurses invisible. This limits the ability of nurses to be authentic in their practice and also limits the extent to which they can implement the new policies recognizing difference amongst their client populations
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Watson, P. B. (1997). Evaluation of a self management plan for chronic obstructive pulmonary disease (Vol. 10). Ph.D. thesis, , .
Abstract: We hypothesized that the use of an Action Plan might assist self management for patients with chronic obstructive pulmonary disease (COPD).A pilot process and randomized, controlled study were undertaken to evaluate an action plan that provided advice on management of usual care and exacerbations, together with a booklet on self management. Fifty six subjects with COPD recruited through general practitioners (GPs) completed the six month study, 27 in the control group and 29 in the intervention group. The control group received usual care from their GP and the intervention group received a booklet and Action Plan from their practice nurse plus a supply of prednisone and antibiotic from their GP.The two groups were demographically similar with a mean age of 68 yrs. The resources were well received by GPs, practice nurses and the intervention group subjects. After six months there were no differences in quality of life scores or pulmonary function. There were significant changes in self management behaviour in the intervention group compared to controls. In response to seterioting symptoms, 34 versus7% (p= 0.014) initiated prednisone treatment and 44 versus 7 % (p=0.002 initiated antibiotics.Subjects in the intervention group readily adopted self management skills but did not shpw any difference in quality of life or lung function parameters. A larger prospective controlled clinical trial of this approach is warranted
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