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Bunn, S. (2007). An exploration of the transition of patients from intensive care to the ward environment: A ward nursing perspective. Ph.D. thesis, , .
Abstract: The transition of patients from intensive care to the ward environment is a regular occurrence in intensive care. Today patients are often transferred earlier and sicker due to the demands for intensive care beds. This results in patients with higher acuity being cared for in the wards. Here ward nurses have to meet the ongoing complex demands of caring for higher acuity patients, alongside managing high patient-to-nurse ratios, staffing concerns, and varying levels of experienced nurses. This research explored the experiences of ward nurses receiving patients transferred from intensive care. The aims were to identify any areas of concern, highlight specific problems that occur on transition and to address what information is pertinent to ward nurses when receiving patients from intensive care. A qualitative descriptive methodology using focus groups was utilised to gather information about these experiences. Three focus groups were held with ward nurses from various wards within the study setting hospital. All participants had considerable contact with intensive care and were familiar with the processes of transferring patients. Five themes emerged from the focus groups – Patients as intensive care staff say they are; Time to prepare the biggest thing; Documentation as a continuation of patient care; They forget what its like; and Families, a need to know about them. The theme Patients as intensive care staff say they are relates to reliable information sharing focused on the patient, their needs and condition. Participants expressed their concern that patients were not always in the condition that the intensive care staff stated they were on the referral. Having adequate time to prepare was considered important for the majority of ward nurses receiving patients from intensive care. Documentation was highlighted in the theme Documentation as a continuation of patient care particularly in relation to fluid balances and vital sign history. The theme They forget what its like suggests there is a perception that intensive care nurses have a lack of understanding of what the ward staff can actually manage. Decreased staffing levels during certain shift patterns and a lack of appropriately experienced staff on the wards is a common concern for ward nurses. Ward nurses also recognised that caring for families was part of their role. Patients and families may respond differently to the transfer process and their inclusion in transfer planning was seen as essential. Communication was a reoccurring element throughout all themes.The author concludes that communication is the paramount factor that impacts on a 'smooth transition' for ward nurses. A 'smooth transition' refers to the transfer of patients from intensive care to the next level of care. Subsequently, nurses' perceptions need to change, whereby transfer planning from ICU should be the focus rather than discharge planning. Transfer planning and education for all nursing staff is vital if the transfer process is to be improved. Consequently, transitional care within the context of ICU aims to ensure minimal disruption and optimal continuity of care for the patient. The knowledge gained from this research may provide better understanding of the multifaceted issues linked with transitional care that may be adapted for a wider range of patients in various clinical environments.
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Bigwood, S. (2007). Got to be a soldier: Mental health nurses experiences of physically restraining patients. Ph.D. thesis, , .
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Bridgen, A. F. (2007). A heuristic journey of discovery: Exploring the positive influence of the natural environment on the human spirit. Ph.D. thesis, , .
Abstract: The intention of this heuristic study was to explore and discover the essence of the positive influence of the natural environment on the human spirit. The study quest was identified as a central concern that evolved from the author's personal experience of spiritual awakening in the natural environment and an interest in the concept of connectedness in nursing care and practice. The study also focused on the self of the nurse and the qualities of holistic nursing care. Guided by heuristic methodology developed by Moustakas (1990) the thesis traces a journey of discovery. Using conversational interviews, six nurses were asked to describe their experiences of their spirit being positively influenced in the natural environment. These nurses were also asked if these beneficial experiences had any flow-on effect to their nursing practice. From these interviews various commonalities of experience were identified as well as some experiences unique to the individual participants. The participant knowing was articulated using Reed's (1992) dimensions of relatedness in spirituality as a framework. Reed describes these dimensions as being able to be experienced intrapersonally, interpersonally and transpersonally. A substantive body of nursing and non-nursing literature was explored to support the participant knowing and provide strength to the discussion. The study discovered that the human spirit is positively influenced in the natural environment. The three actions of personal healing and wellbeing in the natural environment, knowing self – knowing others and sustaining self in nursing practice were valued by the participants as contributing to the quality of their nursing care. In bringing together spirituality, the natural environment and nursing, holism was discovered to be the significant and connecting constituent. The study has some implications for the discipline of nursing that are also discussed by the author.
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Grainger, J. (2007). Mind shift: Creating change through narrative learning cycles: A qualitative interpretive study of clinical conversation as an appraisal process for sexual and reproductive health nurses. Ph.D. thesis, , .
Abstract: This thesis explores the process of an annual appraisal strategy, 'clinical conversation', from the perspective of seven nurses who were assessed using this technique. The findings demonstrate that clinical conversation is a strategy which facilitates reflection, both as a solitary exercise and with others, to ensure that learning from experience is optimised. The research used a qualitative interpretive approach informed by the model of Grounded Theory espoused by Strauss and Corbin. All eight nurses who were assessed using the clinical conversation strategy were advanced practitioners working within the scope of sexual and reproductive health. Two of the actual appraisals were observed and seven of the nurses were interviewed within eight weeks of being assessed. The outcome of the clinical conversation was primarily one of learning; the acquisition of new insights into self as practitioner. The learning was facilitated through the process of narration; telling the story of clinical practice. Three distinct narrative cycles were identified, each an experiential learning episode. The experience of undertaking a variety of assessment activities created a narrative with self and triggered an internal reflective thinking process; the experience of working with a peer created an additional narrative, a mutual dialogue reflecting back on practice; the experience of sharing practice with an assessor created a further and final narrative, a learning conversation. Each narrative can be seen as a catalyst for change. Primarily, the nurses felt differently about themselves in practice, the way they saw themselves had shifted. Such a change can be described as an alteration in perspective. These alterations in perspective led all nurses to identify ways in which they would change their actual clinical practice. In this way the nurses attempted to align their espoused beliefs about practice with their actual practice. The author notes that the study shows that each nurse responded differently to each narrative learning cycle: for some the conversation with the assessor was more of a catalyst for change than for others. In this way clinical conversation may be flexible enough to respond to a variety of differing learning styles. Learning was person specific which is an imperative for the continued professional development of already highly skilled clinicians. The implication of the research is that whilst clinical conversation was designed as a tool for appraising clinical competence, its intrinsic value lies in supporting the professional development of nurses.
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O'Shea, M., & Reddy, L. (2007). Action change in New Zealand mental health nursing: One team's perspective. Practice Development in Health Care, 6(2), 137–142.
Abstract: This paper describes an attempt at effecting change with specific relevance to the discharge planning of clients from a New Zealand inpatient mental health unit to a community setting. It explores how a team of community mental health nurses, practising in an urban/rural area, used the concepts of practice development to endeavour to bring about change while still retaining a client-centred focus. It describes how, in their enthusiasm, they embarked on the road to practice change without undertaking some of the essential ground work, Although they did not achieve all they set out to achieve, much was learnt in the process. In this paper, the authors outline their key learning points concerning the importance of engagement, communication, consistency and cooperation to the process and outcomes of practice change.
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Gage, J., & Hornblow, A. R. (2007). Development of the New Zealand nursing workforce: Historical themes and current challenges. Nursing Inquiry, 14(4), 330–334.
Abstract: This article reviews the development of the New Zealand nursing workforce, which has been shaped by social, political, scientific and interprofessional forces. The unregulated, independent and often untrained nurses of the early colonial period were succeeded in the early 1900s by registered nurses, with hospital-based training, working in a subordinate role to medical practitioners. In the mid/late 1900s, greater specialisation within an expanding workforce, restructuring of nursing education, health sector reform, and changing social and political expectations again reshaped nursing practice. Nursing now has areas of increasing autonomy, expanding opportunities for postgraduate education and leadership roles, and a relationship with medicine, which is more collaborative than in the past. Three current challenges are identified for nursing in New Zealand's rapidly evolving health sector; development of a nursing-focused knowledge culture, strengthening of research capacity, and dissemination of new nursing knowledge.
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Wilkinson, A. (2007). New age informatics & the management of perioperative nursing documentation. Dissector, 35(1), 20–23.
Abstract: Investigates the requirements for documentation by nurses. Research by Millar & Araquiza (1999) suggests that nurses spend an estimated 30% of their time documenting patient care.
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Payne, D., & Goedeke, S. (2007). Holding together: Caring for clients undergoing assisted reproductive technologies. Journal of Advanced Nursing, 60(6), 645–653.
Abstract: This paper reports a study to investigate the roles and experiences of nurses caring for clients undergoing assisted reproductive technologies (ART). Nurses are in a potentially unique position in the assisted reproductive technology environment as they maintain a more constant contact with the client. A qualitative approach was taken and a convenience sample of 15 nurses from New Zealand was interviewed in 2005. Data were analysed using interpretive description. The overarching theme identified was that of the potential role of the nurse to 'hold together' multiple components of the assisted reproductive technology process: holding together clients' emotional and physical experiences of assisted reproductive technologies; holding together the roles of different specialist team members; and holding together personal own emotions. It encompasses practices such as information-giving, interpreting, supporting and advocating. The researchers note that recognition of and support for the complexity of the role of ART nurses may positively contribute to clients' experiences.
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Hughes, F., & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki: Nursing New Zealand, 13(4), 14–16.
Abstract: The authors review the contemporary notion of obesity and suggest that the nursing approach, with an emphasis on treatment, are shaped by a culture located within “western” views of ideal body shape. The biomedical framework regards obesity as disease and obese people as the cause of their own health problems. The authors note varying cultural interpretations of obesity, and suggest that by viewing obesity as a disease, the cultural, social or economic determinants of obesity are not acknowledged. Nursing needs to broaden the concept of the categories of difference to respond in a culturally safe way to obesity. Cultural safety asks that nurses care for people “regardful” of difference. This means nurses must reflect on the care given, so that the biomedical model is not just replicated. Nurse-led clinics offer an opportunity for practices based on nursing values of care and cultural safety. Such clinics are based on nursing's social model of health, rather than a biomedical, disease-focused model.
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Dellagiacoma, T. (2007). Contracting as a career option for nurses. Kai Tiaki: Nursing New Zealand, 13(1), 20–22.
Abstract: A nurse presents research and her own experiences of contracting. Contracting, as defined in this article, refers to a nurse not employed permanently on a wage. It covers agency nursing, short and long fixed-term contracts and secondments. The author identifies the need to continue to develop professionally, which is now a mandatory requirement under the Health Practitioners Competence Assurance (HPCA) Act. Contractors have little, if any financial support to develop professionally, and time taken to do courses is not paid. Taking study leave within a contract may also not be an option. Options for managing professional development in these conditions are offered, including goal setting, investing in education or training, and considering some longer contracts. Practical financial advice and examples are given, including managing accounts and consideration of employment law. The author recommends that skilled nurses looking for interesting ways to develop their careers and to branch out in an entrepreneurial way should seriously consider taking up contract work.
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Litchfield, M. (2007). The innovation effort: ?Are you in or are you out??.
Abstract: A graphic presentation in PDF format (April 2007) of the findings and policy implications of the developmental evaluation research programme for the Turangi Primary Health Care Nursing Innovation.
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Houliston, S. (2007). Flight nurse perceptions of factors inflencing clinical decision making in their practice environment. Master's thesis, , .
Abstract: Flight nurse perceptions of factors inflencing clinical decision making in their practice environment: a thesis presented in partial fulfilment of the requirements for the Degree of Master of Nursing at the Eastern Institute of Technology, Taradale, New Zealand
The research project sought to describe the flight nurses perceptions about the factors that influence clinical decision making in their flight nursing practice, using a descriptive survey methodology. Themes emerged as factors which participants perceived influenced clinical decision making in their flight nursing role and in the aeromedical role. These themes included pre-flight preparation, patient status, experience and education of the nurse, and the challenges associated with the physical and atmospheric environments.
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Howie, J. (2007). Choosing the place of birth : how primigravida women experiencing a low-risk pregnancy choose the place in which they plan to give birth in New Zealand. Master's thesis, , .
Abstract: A thesis submitted to the Otago Polytechnic Dunedin, in partial fulfilment of the degree of Master of Midwifery.
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Alleyne, D. (2007). The context of nursing in New Zealand prisons from historical and contemporary perspectives. Master's thesis, , .
Abstract: This dissertation by Deborah Alleyne explores the current context of nursing in New Zealand prisons through rediscovering the history of its introduction and development, and review of relevant literature. Prison nursing is recognised as a unique branch of the wider nursing profession by virtue of the environment in which nurses work and the population for whom they provide care. Four key themes are identified from the literature review: custody versus caring; nurses' relationship with custody staff; nurses' relationship with prisoners; isolation.
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Barber, M. (2007). Nursing and living in rural New Zealand communities: an interpretive descriptive study. Master's thesis, , .
Abstract: A thesis submitted in partial fulfilment of the requirements of the degree of Master of Nursing at Otago Polytechnic, Dunedin, New Zealand. June 2007
This study used an interpretive descriptive method to gain insight into and
explore key issues for rural nurses working and living in the same
community. Four Rural Nurse Specialists were recruited as participants. The
nurses had lived and nursed in the same rural community for a minimum of
12 months. Participants were interviewed face to face and their transcribed
interviews underwent thematic analysis.
The meta-theme was: the distinctive nature of rural nursing. The themes
identified were: interwoven professional and personal roles; complex role of
rural nurses and relationships with the community. A conceptual model was
developed to capture the relationship between the meta-theme and the
themes. A definition for rural nursing was developed from the findings.
This research identified some points of difference in this group of rural
nurses from the available rural nursing literature. It also provides a better
understanding of the supports Rural Nurse Specialists need to be successful
in their roles, particularly around the recruitment and retention of the rural
nursing workforce.
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