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Author Bishop, D.; Ford-Bruins, I.
Title Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 3 Pages 203-212
Keywords Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models
Abstract (up) This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
Call Number NRSNZNO @ research @ 1082 Serial 1067
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Author Moko Business Associates,
Title Career pathways and core competencies in Maori mental health nursing Type Report
Year 2003 Publication Abbreviated Journal
Volume Trm/03/04 Issue Pages
Keywords Maori; Mental health; Nursing; Careers in nursing; psychiatric nursing
Abstract (up) This report reviews relevant literature pertaining to clinical career pathways and associated core competencies for nursing in New Zealand. The review identifies and analyses existing clinical career pathways for nurses and mental health workers in New Zealand, paying particular attention to the content, structure, strengths, criticisms and applicability to the development of a clinical career pathway for Maori registered nurses to work in Maori mental health (NGO organisations). This report is part of Te Rau Matatini's current work on the development of a career pathway for Maori registered nurses with mental health work experience to work in NGO, community settings. It is a preliminary report, based on existing literature. A subsequent report was planned detailing the career pathway developed by Te Rau Matatini, with strong guidance and input from Maori mental health nurses and the wider Maori mental health sector.
Call Number NRSNZNO @ research @ Serial 823
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Author Vermeulen, J.
Title “And there's the likes of me”: A phenomenological study of the experience of four women inpatients at a mental health unit Type
Year 2002 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Psychiatric Nursing; Patient satisfaction; Hospitals; Nurse-patient relations
Abstract (up) This research draws on the experiences of four women whilst they were inpatients at the Mental Health Unit in Southland. The Husserlian path of phenomenology was followed and in-depth interviewing used to collect data. Colaizzi's method of analysis enabled accurate interpretation of transcripts. The overall goal of this research was to provide health professionals with an opportunity to inform their practice, based on what consumers were saying about their experience of hospitalisation. Themes emerged through participants relating their experience by using comparisons with either their outside world or previous episodes of hospitalisation. Through analysis, two fundamental structures became evident within the findings. These were 'the environment as containment' and 'the road to recovery'. The author concludes that this study raises significant issues surrounding the experience of hospitalisation at the Mental Health Unit that have implications for future research and for future service delivery.
Call Number NRSNZNO @ research @ Serial 1246
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Author Dorofaeff, M.J.
Title Shared status and advocating practices: Nurses who work with clients who have a co-existing intellectual disability and mental health problem Type
Year 2007 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Mental health; Psychiatric Nursing
Abstract (up) This research is informed by the interpretive phenomenology of van Manen, and explores the lived experience of nursing from the perspective of nurses who provide care for people with a co-existing intellectual disability and mental health problem. Although nursing research is commonly informed by phenomenology, there is a dearth of literature of any description written from the perspective of nurses who provide care for people with intellectual disabilities and mental health problems. As a result of the closure of many large institutions in New Zealand there are not many nurses who work with people who have intellectual disabilities and co-existing mental health problems. The study participants were four nurses purposefully selected because they provided care for people with intellectual disabilities and mental health problems. Data was collected using semi-structured interviews, and the researcher identified and wrote about the recurring themes in the transcribed interview data, which best captured the lived experience of the participants. The themes were: criticism of services, holistic caring, working with the client, issues of status, need for specialist knowledge, enduring relationships, diagnostic issues, advocating, modelling good practice; and working alongside. After further analysis the themes were encompassed within the larger interrelated themes of “Status and positioning” and “Advocating practices”, and finally within a single theme of: “The status and positioning of the nurse and the client leads to advocating practices.” These themes were found to be consistent with the nursing literature and with the researcher's own lived experience as a nurse who works in a specialist mental health intellectual disability service. The findings of this research have implications for a number of groups in New Zealand. Among the author's conclusions are that input is required from the Nursing Council of New Zealand, the nursing profession, nurse educators and the government to raise the status of clients with co-existing intellectual disabilities and mental health problems and the nurses who work with this client group. In addition, the roles for nurses who work with this client group are emerging and are likely to be diverse and there is a need for further research to capture the different experiences of these nurses.
Call Number NRSNZNO @ research @ Serial 747
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Author Joyce, M.
Title The Strengths Perspective: Relevance and application to mental health nursing and crisis resolution work Type
Year 2004 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Psychiatric Nursing; Nursing models; Evidence-based medicine
Abstract (up) This research paper aims to explore the contribution of the Strengths Perspective to mental health nursing practice. The Strengths Perspective emerged from the area of social work and is primarily concerned with emphasising the strengths and resources of the person, as they define them. The premise is that if a person is able to identify and call on those strengths then he or she is able to improve the quality of their life. The paper outlines the historical, philosophical and moral foundations of the Strengths Perspective and discusses the humanistic approach to mental health nursing. The aim is to demonstrate that the Strengths Perspective and mental health nursing have a strong alignment, particularly with regard to a person-centred approach to care. The influence and constraints of the biomedical model on both mental health nursing and strengths based practice is a theme of the paper. The contention is that the biomedical or pathological approach to care can often disable, not enable consumers of health care, whereas an approach that centres on a person and their strengths is more likely to empower and liberate. The paper concludes with a discussion of themes that emerged from reflection on the literature and propositions are then made about how mental health nurses might orientate their thinking and practice to utilise the Strengths Perspective to augment their clinical work.
Call Number NRSNZNO @ research @ Serial 1185
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Author Valette, D.
Title Nursing an adolescent in an adult inpatient mental health unit Type
Year 2002 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Psychiatric Nursing; Adolescents; Nurse-patient relations; Professional competence; Mental health
Abstract (up) This research paper reports on an exploration of the key elements nurses need to be aware of to effectively nurse adolescents in an adult inpatient unit. It describes the developmental needs and significant influences that affect this age-group, that when incorporated into nursing care, nurses can gain a therapeutic relationship with the adolescent. By means of a literature review, sharing the author's experience in nursing adolescents, and through vignettes of practice, an illustration of some common situations that may occur during the adolescent's inpatient stay are described. These situations are explored and a perspective is offered on how nurses may be effective in their nursing of an adolescent patient from the point of admission through to discharge. More research is needed on adolescent mental health nursing, however the author anticipates that nurses will be able to use this report as a helpful resource in their current practice.
Call Number NRSNZNO @ research @ Serial 1148
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Author Trimmer, W.C.
Title The way things are done around here: Perceptions of clinical leadership in mental health nursing Type
Year 2006 Publication Abbreviated Journal coda, An Institutional Repository for the New Zealand ITP Sector
Volume Issue Pages
Keywords Leadership; Psychiatric Nursing; Clinical supervision: Mental health
Abstract (up) This research project explored nurses' perceptions of clinical leadership in mental health nursing practice. Within New Zealand no research exists that evaluates the role and impact the clinical leadership has in mental health nursing practice. From personal experience and discussion with colleagues the author argues that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses. The prime objective of this study was to increase knowledge about clinical leadership in mental health nursing practice. This research used a quantitative descriptive methodology, utilising survey design. A questionnaire was used to rank the attributes of the person the respondents identified as a clinical leader. The data was collected from 30 registered nurses working in mental health settings within the central region of New Zealand. Findings indicate that there is room for improvement with regard to clinical leadership in mental health nursing practice. Clinical leadership is perceived to be more effective by nurses in their second year of practice and in community settings. A statistically significant difference was indicated between nurses in their second year of practice and nurses in their third year of practice in terms of their ranking of clinical leadership abilities. Overall the respondents perceived poor communication and poor attitude as the biggest barriers to effective leadership. Support and good role models were said to influence nursing practice positively and the skills that were identified as being helpful in assisting and retaining nurses were mentorship and good communication. The results of the study are discussed in relation to the literature on transformational leadership skills. Finally, the general limitations of the study are outlined and implications for future research are discussed.
Call Number NRSNZNO @ research @ Serial 1149
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Author Puckey, T.C.
Title Vicarious traumatization: Relevance and implications for psychiatric mental health nursing Type
Year 2001 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Occupational health and safety; Mental health; Psychiatric Nursing; Trauma; Nursing
Abstract (up) This research project is concerned with the risk of vicarious traumatisation for psychiatric mental health nurses. Vicarious traumatisation is an occupational hazard that is largely unrecognised and unaddressed in the profession. The paper explores the nature of vicarious traumatisation, and its contemporary conceptualisation in the literature on helping-induced trauma. Findings from the literature search and understanding of the construct of vicarious traumatisation are considered against the essence of psychiatric mental health nursing, the therapeutic relationship and use of self, and the nature of daily practice. After consideration of the potential risk of vicarious traumatisation for the profession it is argued that it is a real risk and is likely to impact on all areas of psychiatric mental health nursing practice. Support for the position that vicarious traumatisation is not well recognised and understood is offered. The paper concludes with recommendations that psychiatric mental health nurses and the profession take serious note of vicarious traumatisation as a risk, and there is an ethical imperative for psychiatric mental health nurses to take measures to inform themselves of and engage in processes of risk management for nurses and clients.
Call Number NRSNZNO @ research @ Serial 572
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Author Bresaz, D.M.
Title Environmental influences on inpatient assaultive behaviour Type
Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Workplace violence; Mental health; Psychiatric Nursing; Methodology; Administration
Abstract (up) This retrospective quasi-experimental study reviewed assaults in two adult mental health inpatient rehabilitation units. The majority of clients in this area experience enduring mental health illnesses and have complex physical health issues. The service comprises of an intensive rehabilitation unit and a secure extended rehabilitation unit. Between May and August 2001 the service moved to purpose built facilities. The opportunity was taken to review clients' assaultive behaviour in the new environment and to compare the incidents with those in the old environment to see if there had been any significant changes. Data on assault incidents including time of assault, place of assault, who was involved and what preventative actions were suggested were collected from the Incident and Accident Hazard Reports (IAHR) dating from 1 April 2000 until 31 May 2002. Staff were expected to complete IAHR reports on all assault incidents. The research examined whether the change in environmental conditions impacted on clients' wellbeing in relation to assaultive behaviour. Trends within the IAHR reports were also examined in order to compare these to similar studies completed in other parts of the world. There were 141 IAHR reports of assault incidents. Fifty of these occurred in the pre move period, 38 in the transition phase and 53 in the post move. There was no significant difference in the rate of assaults in the pre-move to post move period. Completion of the IAHR forms was seen to be very problematic, especially in relation to legal status of perpetrators and documentation of prevention strategies. An urgent audit of existing practice is now required to establish if problems found with the quality and completion of the IAHR forms continues to be evident in the rehabilitation service and if present staff education is needed to improve the standard of documentation. Research is also needed to establish the extent to which staff implement strategies to prevent assaults, and to reduce recidivism.
Call Number NRSNZNO @ research @ Serial 858
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Author Prebble, K.
Title Ordinary men and uncommon women: A history of psychiatric nursing in New Zealand public mental hospitals, 1939-1972 Type
Year 2007 Publication Abbreviated Journal University of Auckland Library
Volume Issue Pages
Keywords Psychiatric Nursing; Mental health; History; Gender
Abstract (up) This social-cultural history explores the changing context, culture, and identity of psychiatric nurses working in New Zealand public mental hospitals between 1939 and 1972. Primary documentary sources and oral history interviews provided the data for analysis. The thesis is divided into two periods: 1939 to 1959 when asylum-type conditions shaped the culture of the institutional workforce, and 1960 to 1972 when mental health reform and nursing professionalisation challenged the isolation and distinct identity of mental hospital nurses. Between 1939 and 1959 the introduction of somatic treatments did not substantially change nursing practice in mental hospitals. Overcrowding, understaffing and poor resources necessitated the continuance of custodial care. The asylum-type institutions were dependent on a male attendant workforce to ensure the safety of disturbed male patients, and the maintenance of hospital farms, gardens, and buildings. Although female nurses provided all the care and domestic work on the female side, the belief that psychiatric nursing was physically demanding, potentially dangerous, and morally questionable, characterised the work as generally unsuitable for women. Introduction of psychiatric nursing registration which was a move toward professionalisation did little to change the dominance of a male, working-class culture. From 1960 to 1972 psychiatric nurses' identity was contested. New therapeutic roles created the possibility of the nurses becoming health professionals. Their economic security and occupational power, however, was tied to an identity as unionised, male workers. As psychiatric nurses were drawn closer to the female-dominated nursing profession through health service changes and nursing education reform, both men and women acted to protect both their working conditions and their patients' welfare. To achieve these ends, they employed working-class means of industrial action. By accepting the notion that psychiatric nurses' identity was socially constructed, this thesis provides an interpretation that goes beyond the assumption that nursing is a woman's profession. Instead, it presents psychiatric nursing as a changing phenomenon shaped by contested discourses of gender, class and professionalisation. Nursing in public mental hospitals attracted ordinary men and uncommon women whose collective identity was forged from the experience of working in a stigmatised role.
Call Number NRSNZNO @ research @ 763 Serial 749
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Author Walsh, C.
Title Personal and professional choices, tensions, and boundaries in the lives of lesbian psychiatric mental health nurses Type
Year 2007 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Sexuality; Psychiatric Nursing; Nurse-patient relations; Communication
Abstract (up) This study aimed to articulate how sexual identity impacts on the therapeutic relationship between the client and the lesbian nurse in psychiatric mental health nursing. There is little consideration given in the literature or in research as to how sexuality of the nurse impacts on nursing practice. Most attitudes held by the public and nursing staff are based on the assumption that everyone is heterosexual, including nurses. Fifteen lesbian psychiatric mental health nurses from throughout New Zealand volunteered for two interviews and shared their experiences of becoming and being a lesbian psychiatric mental health nurse. The stories they told give new insights into how these nurses negotiate and position their lesbian identity in the therapeutic relationship. To work therapeutically with people in mental distress the nurse uses personal information about themselves to gain rapport with the client through appropriate self-disclosure. Being real, honest and authentic are also key concepts in this relationship so the negotiation of reveal/conceal of the nurse's identity is central to ongoing therapeutic engagement. One of the most significant things arising from the research is that participants are able to maintain their honesty and authenticity in the therapeutic relationship whether they self-disclose their lesbian identity or not. This is because the experiences in their personal lives have influenced how the participants 'know themselves' and therefore guide how they 'use self' in their therapeutic nursing. The concept of a 'licensed narrative' has also been developed during this research reflecting the negotiated understandings between the researcher and the participants. Further, the use of NVivo a qualitative software package helps to track and make transparent the research processes. These two aspects make a unique contribution to the field of narrative inquiry.
Call Number NRSNZNO @ research @ Serial 1164
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Author Fourie, W.; McDonald, S.; Connor, J.; Bartlett, S.
Title The role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality Type Journal Article
Year 2005 Publication International Journal of Mental Health Nursing Abbreviated Journal Available online from Coda: An institutional repository for the ITP sector
Volume 14 Issue 2 Pages 134-141
Keywords Psychiatric Nursing; Nurse-patient relations; Organisational change
Abstract (up) This study compared the perceptions that registered psychiatric nurses have of their roles with their actual practice. Following the closure of large scale psychiatric institutions in New Zealand, there was was an increased demand for limited beds in acute inpatient facilities for acutely mentally ill patients. This change in location and downsizing of acute inpatient beds challenged traditional roles of mental health nursing, resulting in confusion over what roles mental health nurses should now perform in the new context of care. This qualitative descriptive exploratory study observed nursing practice on three selected wards and used focus group interviews to establish from registered nurses what they perceived their roles to be. A key finding of this study was that many of the nursing roles related to delivering care from a crisis management perspective, which covers aspects such as assessment, stabilisation of symptoms and discharge planning. Participants also believed that the therapeutic relationship was a fundamental role in inpatient care. Nurses used any opportunity to make it a reality such as kitchen organisation, medications, or dealing with a challenging patient. This study highlighted the complexity of the roles that nurses performed and went some way to give voice to what at times seems an invisible practice.
Call Number NRSNZNO @ research @ Serial 875
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Author Phillips, B.N.
Title An interpretation of four men's experiences of suicidality Type
Year 2004 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Mental health; Psychiatric Nursing; Gender; Qualiltative research
Abstract (up) This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of the author's own particular horizon of meaning as researcher and mental health nurse. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, he explores the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. Recovering was a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change.
Call Number NRSNZNO @ research @ 1214 Serial 1199
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Author Apelu, J.
Title Pacific community mental health nurses' experiences of working for a district health board in New Zealand Type
Year 2008 Publication Abbreviated Journal ResearchArchive@Victoria http://hdl.handle.net/10063/684
Volume Issue Pages
Keywords Psychiatric Nursing; Pacific peoples; Community health nursing; District Health Boards; Culture
Abstract (up) This study explored the perspectives of Pacific nurses on what it is like for them to work in a Pacific community mental health (PCMH) service within a district health board. Five Pacific Island nurses who worked in the three Pacific community mental health services based in the Auckland region participated in the project. The study employed narrative inquiry to gather data through focused storytelling method. The results of the study have indicated that PCMH nursing is a unique nursing field as well as highlighting significant practice issues for nurses. Complex service infrastructure and language have been found to be the major contributing practice constraints. The findings suggest the need for district health board authorities, Pacific mental health service management, professional nursing education and development programs to consider addressing these practice issues to prevent further increase in the problem of PCMH nurses shortage and enhance recruitment and retention of these nurses.
Call Number NRSNZNO @ research @ Serial 1153
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Author Cook, N.; Phillips, B.N.; Sadler, D.
Title The Tidal Model as experienced by patients and nurses in a regional forensic unit Type Journal Article
Year 2005 Publication Journal of Psychiatric & Mental Health Nursing Abbreviated Journal
Volume 15 Issue 5 Pages 536-540
Keywords Psychiatric Nursing; Nursing models; Evaluation; Nurse-patient relations
Abstract (up) This study looks at the effect of implementing the Tidal Model at Rangipapa, a regional secure mental health forensic unit. A phenomenological study was undertaken to obtain reflective description of the nursing care experience from the perspective's of four registered nurses and four “special patients”. Five major themes were identified that appeared to capture the experiences of the participants. The themes show changes to the unit's unique culture and values following implementation of the model. These changes engendered a sense of hope, where nurses felt they were making a difference and patients were able to communicate in their own words their feelings of hope and optimism. Levelling was experienced as an effect emerging from individual and group processes whereby a shift in power enhanced a sense of self and connectedness in their relationships. These interpersonal transactions were noted by the special patients as being positive for their recovery. This enabled effective nurse-patient collaboration expressed simply as working together. The participants reported a feeling of humanity, so that there was a human face to a potentially objectifying forensic setting. Implications arising from this study are that the use of the model enables a synergistic interpersonal process wherein nurses are professionally satisfied and patients are validated in their experience supporting their recovery.
Call Number NRSNZNO @ research @ Serial 941
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