Muir-Cochrane, E., Holmes, C., & Walton, J. A. (2002). Law and policy in relation to the use of seclusion in psychiatric hospitals in Australia and New Zealand. Contemporary Nurse, 13(2/3), 136–145.
Abstract: This paper discusses legal issues associated with the seclusion of acutely disturbed patients in psychiatric hospitals in Australia and New Zealand. There continues to be great variation in opinion and operational definition as to whether seclusion is a medical treatment, nursing intervention and management tool, or merely a form of situational restraint. Reflecting this lack of clarity, mental health acts and policies concerning the regulation and practice of seclusion lack consistency and focus across geographical boundaries and jurisdictions. Australian and New Zealand legislation and institutional policy is discussed in order to shed light on the contemporary issues highlighted by this controversial nursing practice. The authors note that mental health professionals must continue to review the practice of seclusion and to actively promote the use of acceptable alternatives. In addition nurses and other mental health professionals have a responsibility to understand current legislation and policy frameworks and to influence change where this is necessary to ensure the best practice possible in their clinical area.
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Nicol, M. J., Manoharan, H., Marfell-Jones, M., Meha-Hoerara, K., Milne, R., O'Connell, M., et al. (2002). Issues in adolescent health: A challenge for nursing. Contemporary Nurse, 12(2), 155–163.
Abstract: This review provides an overview of the health issues for adolescents, and the implications for nursing practice, particularly around health promotion. It looks at the social context of adolescents including peer pressure, along with health issues such as suicide, mental health, sexual health, and smoking.
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Carter, H., McKinlay, E. M., Scott, I., Wise, D., & MacLeod, R. (2002). Impact of a hospital palliative care service: Perspective of the hospital staff. JBI Reports, 18(3), 160–167.
Abstract: The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service.
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Farrow, T., McKenna, B., & O'Brien, A. J. (2002). Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation. International Journal of Mental Health Nursing, 11(3), 164–169.
Abstract: A new approach to mental health legislation has seen the involvement of a range of health professionals in legislated mental health roles, including the power of registered nurses to detain patients in hospital under Section 111 of the New Zealand Mental Health (Compulsory Assessment and Treatment) Act (1992). Under this Section, a nurse who believes that a voluntary patient meets the legal criteria of the Act can independently detain the patient for a period of up to six hours, pending further assessment by a medical practitioner. However, anecdotal evidence and a clinical audit undertaken by the authors suggest some doctors 'prescribe' Section 111 at the time of admission. This practice instructs nurses to initiate Section 111 if particular voluntary patients choose to leave hospital. This study outlines practice issues resulting from 'prescribing' Section 111; provides a legal critique of medical practitioners' involvement in this practice; and makes recommendations for guidelines toward a more constructive use of Section 111.
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Gohns, A. (2002). Management of opioid substitution treatment in the primary health care setting: A national training course for service providers. Full text online from the Royal New Zealand College of General Practitioners' website, 29(3), 172–175.
Abstract: The aim of this research was to describe a national opioid treatment training programme that was introduced into primary health care, and evaluate its effectiveness following its first year of operation. The programme was introduced as a strategy to recruit, train and support a primary health care workforce in the provision of methadone treatment. For the evaluation a written questionnaire was sent to the general practitioner, practice nurse and pharmacist participants of training programmes held throughout New Zealand in 2000. One hundred and forty-five (98%) participants reported that the overall quality of the course was good or better, and that relevant issues were, in general, covered. However a recurring theme related to difficulties in designing a course relevant to the three different professional groups, with some material not equally applicable to all. Another prominent theme pertained to the issue of funding. general practitioners lamented the failure to address the issue of transferring patients from a free specialist clinic to their practice for care. The evaluation of this pilot programme indicates that this training in methadone maintenance treatment was well-received by primary health care providers. However, the author notes that there is no benchmark with which to compare it.
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McLeland, A., & Williams, A. (2002). An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries. Contemporary Nurse, 12(2), 185–193.
Abstract: The purpose of this qualitative study was to analyse the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalisation; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalisation. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability.
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Holdaway, M. A. (2002). A Maori model of primary health care nursing. Doctoral thesis, Massey University, Palmerston North.
Abstract: Identifies how traditional nursing practice in Maori communities may be enhanced. Highlights the need for nursing to broaden concepts of health, community, and public health nursing, to focus on issues of capacity-building, community needs, and a broader understanding of the social, political, cultural, and economic contexts of the communities primary health-care nurses serve. Explores how health is experienced by Maori women during in-depth interviews using critical ethnographic method, underpinned by a Maori-centred approach. Articulates a model of health that is a dynamic process based on the restoration and maintenance of cultural integrity, derived from the principle of self-determination.
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Farrow, T. (2002). Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments. International Journal of Mental Health Nursing, 11(4), 214–219.
Abstract: 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
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Kirkham, S., Smye, V., Tang, S., Anderson, J., Blue, C., Browne, A., et al. (2002). Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research. Research in Nursing & Health, 25(3), 222–232.
Abstract: The authors trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalisation and help-seeking experiences of diverse ethnocultural populations.
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Spence, D., & Fielding, S. (2002). Win-win-win: Collaboration advances critical care practice. Contemporary Nurse, 13(2/3), 223–228.
Abstract: This paper provides an overview of the structure and processes of an eighteen month, distance education course focused on developing advanced practice in the context of critical care nursing. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) was developed as a collaboration between Auckland University of Technology and two regional health providers. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This course is set against a background of increasing interest in education post registration. The acquisition of highly developed clinical capabilities requires a combination of nursing experience and education. This requires collaboration between clinicians and nurse educators, and approaches to address accessibility of relevant educational opportunities for nurses outside the country's main centres.
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Bickley, J. (2002). A study of medical, nursing, and institutional not-for-resuscitation (NFR) discourses. Ph.D. thesis, , .
Abstract: This study investigates the way that medical, nursing and institutional discourses construct knowledge in the specific context of Not-for-resuscitation (NFR)in a New Zealand general hospital where NFR guidelines are available in the wards and from the regional ethics committee. The thesis argues that there are ranges of techniques that staff use to construct NFR knowledge, enacted through various forms of speech and silence, which result in orderly and disorderly experiences for patients nearing death. The study was conducted through a critical analysis of the talk of health professionals and the Chairperson of the Regional Ethics Committee.
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Nicol, M. J. (2002). The teaching of genetics in New Zealand undergraduate nursing programmes. Nurse Education Today, 22(5), 401–408.
Abstract: This paper reports the results of a survey to determine how much genetics is taught in the bioscience component of the three-year Bachelor of Nursing degree offered by 16 tertiary education institutes in New Zealand. A questionnaire was mailed to the bioscience lecturers seeking information on the bioscience and genetics content of current programmes. They were also asked to indicate their perception of the impact and relevance of new genetic knowledge on health care and nursing education. Results indicated that on average 250-350 hours are devoted to the teaching of biosciences. Less than 10 hours are devoted to genetics at 66% of institutes, one institute did not teach any aspect of genetics. None of the institutes taught more than 20 hours of genetics in the programme, although 47% of lecturers said they would like to teach more genetics if there were more time available in the curriculum. Lecturers teaching bioscience to Bachelor of Nursing students are aware of the importance of genetics in health care and to nursing in particular, and the majority are of the opinion that more genetics should be included in undergraduate programmes, however 'curriculum crowding' is a problem.
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