Mackay, B. (2002). Leadership development: Supporting nursing in a changing primary health care environment. Nursing Praxis in New Zealand, 18(2), 24–32.
Abstract: The author argues that the involvement of nurses in the decision-making of health organisations is essential to maximise the contribution of nurses and promote positive outcomes for patients. She suggests that development of leadership skills will make nurses aware of power structures in the health system and allow them to become interdependent health professionals in primary health organisations (PHO). The particular competencies discussed are those proposed by Van Maurik (1997), namely ability to understand and manage organisational politics, work facilitatively with people and circumstances, and build a feeling of purpose.
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Jacobs, S. (2005). Advanced nursing practice and the nurse practitioner: New Zealand nursing's professional project in the late 20th century. Ph.D. thesis, , .
Abstract: This thesis examines the forces influencing the development of contemporary advanced nursing practice in New Zealand. It begins with an historical approach to explore the various meanings of advanced nursing practice from the late 1800s through the first years of the 21st century. Seven historical understandings of the meaning of 'advanced' nursing practice emerge. The author's analysis of the broad scope of New Zealand nursing history, including a case study of the development and implementation of the nurse practitioner, draws on theoretical perspectives from sociology, political science, and nursing. She develops a “framework of critical factors for nursing to take into account when considering how to ensure the profession is able to deliver on its great potential to improve the health of New Zealand communities”. Examining the work of a range of nursing leaders, past and present, and drawing on the work of political scientist, John Kingdon, the author describes the work of several nurses as “policy entrepreneurship.”
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Hamer, H. P., Finlayson, M., Thom, K., Hughes, F., & Tomkins, S. (2006). Mental health nursing and its future: A discussion framework: Report from the Expert Reference Group to the Deputy Director-General Dr Janice Wilson. Wellington: Ministry of Health.
Abstract: This project was initiated by the Ministry of Health to ensure a nationally coordinated approach to mental health nursing. The purpose of the project is to provide a national strategic framework for mental health nursing that will strengthen both nursing leadership and practice within the multi-disciplinary clinical environment. The framework reviews a range of key workforce issues identified by the Ministry of Health and provides strategies to move mental health nursing forward. The framework integrates directions from government mental health strategies, policies and directions, national and international literature as well as professional nursing requirements which aim to create a sustainable mental health nursing workforce using evidence based practice. The framework considers a range of key workforce issues identified by the Ministry of Health including: nursing leadership, nurse practitioners, standards, skill mix, clinical career pathways, professional supervision, education, research and recruitment and retention.
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Honeyfield, M. (2008). The necessity of effective nursing leadership for the retention of professional hospital nurses. Master's thesis, , .
Abstract: The author notes that it is widely accepted that there is a global shortage of nurses, and there are many studies in the health workforce literature about the negative aspects of nurse work environments, nursing workloads, decreased job satisfaction of nurses and the impact these have on patient health outcomes. In the past five years there has also been international and New Zealand-specific research into the effects of health restructuring on nursing leadership, retention of nurses, and on patient care. Much of this research has shown that countries with very different health care systems have similar problems, not only with retention of qualified nursing staff due to high levels of job dissatisfaction, but also with work design and the provision of good quality patient care in hospitals. This dissertation explores the many detrimental effects on nurses and nursing leadership, of extensive, and continuing, public health restructuring in New Zealand. The context of this dissertation is New Zealand public hospitals, with references pertaining to medical and surgical areas of nursing practice. Health reforms have negatively impacted on patient care delivery systems, patient health outcomes, and retention of educated nurses in the workforce. In order to resolve these issues, coordinated efforts are required in New Zealand district health boards to develop and sustain effective nursing leaders, who will promote and assist in the development of strong, healthy organisational cultures to retain and support professional nurses and the ways in which they wish to practise.
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Dennis, J. (2005). How will transformative primary health care nursing leadership facilitate better health outcomes for Southlanders? Ph.D. thesis, , .
Abstract: Changes within the New Zealand health system have led to an emphasis on primary health care. The New Zealand government and the Southland District Health Board have identified that nurses can make significant contribution to improving the primary health outcomes for New Zealanders. However, within Southland there exist barriers to nurses influencing health outcomes. A Southland draft Primary Health Care Nursing Strategic Plan 2005 recommended that the employment of a primary health care nursing leader would reduce these barriers and lead to a comprehensive primary health care nursing service. This dissertation argues, using literature, that the employment of a transformative nursing leader, using a facilitative style, would implement changes that would develop a community responsive nursing service, establish a primary health care educational structure and ensure quality nursing care. Successful implementation would occur as the leader facilitates experiential learning within groups and with individuals to review current experiences and implement transformative primary health care nursing changes that improves health for all. The dissertation introduces the background to the changing primary health care environment in New Zealand and to the Southland current situation in chapter one. Chapter two describes the unique features of transformative leadership style and how it is applies to nursing and specifically to Southland's changing primary health care environment. The chapter specifically emphasises the role of and the art of facilitation which is a critical transformative leadership process. Chapter three describes the process of the experiential learning cycle, which the author argues will improve health outcomes, when used by the transformative leader to enable nurses to learn from their experiences and make nursing changes that improve health care. Chapter four addresses the dissertation question by describing how transformative leadership will facilitate the experiential learning process to Southlanders and improve health outcomes, reduce inequalities and increase accessibility through a comprehensive primary health care nursing service.
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Mockett, L., Horsfall, J., & O'Callaghan, W. (2006). Education leadership in the clinical health care setting: A framework for nursing education development. Nurse Education in Practice, 6(6), 404–410.
Abstract: This paper describes how a new framework for clinical nursing education was introduced at Counties Manukau District Health Board. The project was initiated in response to the significant legislative and post registration nursing education changes within New Zealand. The journey of change has been a significant undertaking, and has required clear management, strong leadership, perseverance and understanding of the organisation's culture. The approach taken to managing the change had four stages, and reflects various change management models. The first stage, the identification process, identified the impetus for change. Creating the vision is the second stage and identified what the change would look like within the organisation. To ensure success and to guide the process of change a realistic and sustainable vision was developed. Implementing the vision was the third stage, and discusses the communication and pilot phase of implementing the nursing education framework. Stage four, embedding the vision, explores the process and experiences of changing an education culture and embedding the vision into an organisation. The paper concludes by discussing the importance of implementing robust, consistent, strategic and collaborative processes that reflect and evaluate best educational nursing practice.
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Casey, H. (2000). Empowerment: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area. Ph.D. thesis, , .
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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Trimmer, W. C. (2006). The way things are done around here: Perceptions of clinical leadership in mental health nursing. Ph.D. thesis, , .
Abstract: 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.
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Litchfield, M., & Laws, M. (1999). Achieving family health and cost-containment outcomes: Innovation in the New Zealand Health Sector Reforms. In Cohen,E. & De Back,V. (Eds.), The outcomes mandate: New roles, rules and relationships. Case management in health care today (pp. 306-316). St Louis: Mosby.
Abstract: The chapter presents the research findings of the 1992-1993 Wellington Nurse Case Management Scheme Project as a distinct model of nurse case management, which introduced a role and form of practice of a family nurse and a diagram of the service delivery structure required for support and relevant for the New Zealand health system reforms.
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Clunie, S. (2006). The current trend and importance of postgraduate education for nurses. coda, An Institutional Repository for the New Zealand ITP Sector, 10, 18–23.
Abstract: The purpose of this essay is to examine why postgraduate education has become so important, to examine some of the issues around mandatory continuing education and the practical effect of this on a nursing career. Four strategies from the Ministry of Health, designed to facilitate changing nurse education, are discussed. The importance of Professional Development Recognition programmes is discussed along with the need for strong nursing leadership.
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Wilson, M. (2001). Organisational psychopaths and our health culture. Kai Tiaki: Nursing New Zealand, 7(3), 27–29.
Abstract: The author discusses recent research on organisational psychopaths, and suggests it offers an explanation for the state of the health system since managerialism was ushered in through health reforms. She identifies personality traits of organisational psychopaths and of aberrant self-promoters. The author gives her experience of changes to the structure of nursing at a North Island metropolitan public hospital over an 8-year period.
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Mackay, B. (2007). Leadership strategies for role development in primary health care nursing. coda, An Institutional Repository for the New Zealand ITP Sector, 11, 31–39.
Abstract: This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support.
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Trimmer, W. C. (2006). The way things are done around here: Perceptions of clinical leadership in mental health nursing. Whitireia Nursing Journal, 13, 68–69.
Abstract: Based on the author's thesis, this research project explored nurses' perceptions of clinical leadership 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.
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Buisman, B. (2006). Nursing 2020: How will 'Magnet' hospitals fit in? Nursing Journal Northland Polytechnic, 10, 33–41.
Abstract: Nursing shortages, technology, advances in genetics and the knowledge explosion are trends that have an influence on the nursing profession in the future. This article will examine these trends and give an overview of what it may be like to nurse in an acute-care hospital in the year 2020. The impact of leadership, management and political influences will also be discussed. The American concept of 'Magnet' hospitals will be described as one possible solution to the issues that affect the nursing profession in New Zealand.
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Turner, C. L. E. A process evaluation of a shared leadership model in an intensive care unit. Ph.D. thesis, , .
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