Paterson, M. (2000). Dealing with life and death decisions. Kai Tiaki: Nursing New Zealand, 6(7), 14–16.
Abstract: This article examines the implications for nurses of not-for-resuscitation orders and orders to withdraw treatment. The rights of patients and correct procedure in the case of not-for-resuscitation or do-not-resuscitate orders are considered, as well as the ethical dilemma facing nurses in cases of the withdrawal of treatment. Guidelines are offered to assist nurses in reaching an ethical decision to withdraw treatment. Euthanasia is defined and case law decisions on not-for-resuscitation and treatment withdrawal are cited.
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Bradshaw, W. (2007). Helping clients move towards health change. Kai Tiaki: Nursing New Zealand, 13(7), 16–18.
Abstract: The author reflects on his use of the American psychotherapist James Prochaska's stages of change theory. This model deals with individuals and how they move towards change, through stages of pre-contemplation to maintenance of changed behaviours. He presents examples of his use of the model with clients, when dealing with issues of smoking cessation and weight loss. He analyses his practice and interactions with clients, and affirms that stages of change model can be a useful tool to bring about change within clients. He suggests it gives clients the opportunity to contemplate change and gives nurses working in health promotion the opportunity to be part of the change process.
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Lowe, L. (2002). Linking housing and health status. Kai Tiaki: Nursing New Zealand, 8(9), 26–27.
Abstract: The author examines the impact of poor housing on health, and looks at how the situation can be improved. Ways that nurses can work towards improving housing standards and thus health are discussed.
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French, P. (2001). Nursing registration: A time to celebrate? Kai Tiaki: Nursing New Zealand, 7(8), 17–19.
Abstract: This article examines the knowledge and power relationships between the medical profession and nurses during the first half of the twentieth century. It argues that the 1901 Nurses' Registration Act allowed doctors to exert control over the nursing profession and that the hierarchal structure of the profession contributes to the culture of control and surveillance.
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Warren, B. L. (2007). Using paracetamol before immunisation: Does it work? Kai Tiaki: Nursing New Zealand, 13(5), 24–26.
Abstract: The author presents a review of evidence on the prophylactic use of paracetamol prior to infant and child immunisation. The research was prompted when the Otago District Health Board was planning its Meningococcal B strategy. The evidence suggests that it was appropriate when the whole cell pertussis vaccine was used, but it was not recommended since the introduction of better vaccines such as acellular pertussis with fewer antigens and fewer side effects. Paracetamol may still be given orally to treat pain and fever that occasionally follows vaccination. Paracetamol pharmacology is presented, along with alternatives to paracetamol.
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Macfie, B. (2006). Assessing health needs and identifying risk factors. Kai Tiaki: Nursing New Zealand, 12(6), 16–18.
Abstract: In 2004, Plunket nurses from eight areas around New Zealand participated in collecting data for a research project on health needs assessment practices. This project aimed to examine risk factors identified by Plunket nurses, what areas of health need considered to be priorities; grading of health needs; and how closely the results of health need assessment aligned with the individual clients' deprivation score. The researchers examine the assessment of health needs against the use of the Deprivation Index, which indicates a specific population in a specific area, as a funding model. This study appeared to show there are two distinct groups of clients assessed as high needs: those with risk factors such as family violence and severe parental mental illness, and who may live in an area of 1-7 deprivation; and those with multiple risk factors which include poverty, low education, and/or reluctance to access services and support, and who usually live in dep 8-10 areas. This research supports the anecdotal evidence that significant health needs exist outside the lower deprivation areas.
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Richardson, S. (2005). Coping with outbreaks of the norovirus. Kai Tiaki: Nursing New Zealand, 11(7).
Abstract: The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages.
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Prentice, D., & Hathaway, M. (2001). Responding to a death from meningococcal disease: A case study. Kai Tiaki: Nursing New Zealand, 7(5), 16–18.
Abstract: The public health nurses present a case study on adapting meningococcal disease public health protocols to work with the situation of a Cook Island family following the death of a member from meningococcal disease. They discuss the meningococcal disease epidemic in New Zealand and outline the signs and symptoms of the disease.
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Evans-Murray, A. (2004). Meeting the needs of grieving relatives. Kai Tiaki: Nursing New Zealand, 10(9), 18–20.
Abstract: This article examines the role of nurses working in intensive care units who may need to work with families as they face the death of a loved one. How the nurse communicates with relatives during these crucial hours prior to the death can have profound implications on their grief recovery. Universal needs for families in this situation have been identified in the literature, and include: hope; knowing that staff care about their loved one; and having honest information about their loved one's condition. A case study is used to illustrate key skills and techniques nurses can employ to help meet these universal needs. In the first stage of grief the bereaved is in shock and may feel a sense of numbness and denial. The bereaved may feel confused and will have difficulty concentrating and remembering instructions, and they may express strong emotions. Studies on families' needs show that honest answers to questions and information about their loved one are extremely important. It is often very difficult for the nurse to give honest information when the prognosis is poor. Good communication skills and techniques are discussed, in which hope is not offered at the expense of truthfulness, and the nurse facilitates the process of saying goodbye and expressing emotions. Practical techniques, such as including the family in basic care such as foot massaging and simple hygiene routines, may also be used to move the family from being bystanders to the impending death, to comforters.
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Wright, R. (2001). Linking theory with practice. Kai Tiaki: Nursing New Zealand, 7(2), 14–15.
Abstract: This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family.
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Powell, J. (2002). Caring for patients after an ICU admission. Kai Tiaki: Nursing New Zealand, 8(7), 24–25.
Abstract: The author presents research on nursing strategies that reduce the psychological effects of critical illness and prevent the intensive care unit (ICU) atmosphere from adversely affecting the nurse-patient relationship. Post-traumatic stress disorder and other phobic anxiety syndromes are noted as a risk among former ICU patients. Four interventions to put in place for discharge are presented: patient-centred nursing, communication, multidisciplinary care, and patient/family education.
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Ho, T. (2000). Ethical dilemmas in neonatal care. Kai Tiaki: Nursing New Zealand, 6(7), 17–19.
Abstract: The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment.
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Webby, A. (2008). Should non-Maori research and write about Maori? Kai Tiaki: Nursing New Zealand, 14(5), 20–21.
Abstract: The author examines the complexities surrounding non-Maori nurse researchers working on Maori issues. She suggests that as long as respect and observation of Maori processes is shown, and work is undertaken collaboratively with Maori, then such a role is appropriate.
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Webby, A. (2001). Developing safe nursing practice for Maori. Kai Tiaki: Nursing New Zealand, 7(1), 16–17.
Abstract: A safe mental health nursing practice for Maori is defined as one that includes Maori ways of knowing. The author also notes that Maori mental health nurses must be given the ability to create their own practice to best meet their clients' needs.
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Evans, S. (2007). Silence kills: Challenging unsafe practice. Kai Tiaki: Nursing New Zealand, 13(3), 16–19.
Abstract: The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals.
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