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Author |
MacGeorge, J.M.; Nelson, K. |
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Title |
The experience of the nurse at triage influences the timing of CPAP intervention |
Type |
Journal Article |
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Year |
2003 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
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Volume |
11 |
Issue |
4 |
Pages |
234-238 |
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Keywords  |
Emergency nursing; Clinical decision making; Hospitals; Quality of health care |
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Abstract |
This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP. |
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Call Number |
NRSNZNO @ research @ |
Serial |
847 |
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Author |
Currie, J.; Edwards, L.; Colligan, M.; Crouch, R. |
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Title |
A time for international standards? Comparing the Emergency Nurse Practitioner role in the UK, Australia and New Zealand |
Type |
Journal Article |
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Year |
2007 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
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Volume |
15 |
Issue |
4 |
Pages |
210-216 |
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Keywords |
Emergency nursing; Cross-cultural comparison; Nursing; Education |
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Abstract |
The aim of this paper is to compare the Emergency Nurse Practitioner role in the UK, Australia and New Zealand. Whilst geographically distant, the role of the Emergency Nurse Practitioner within these three countries shares fundamental similarities, causing the researchers to question, is this a time to implement international standards for the role? The Emergency Nurse Practitioner role in all three countries is gradually establishing itself, yet there are shared concerns over how the role is regulated and deficits in standardisation of scope of practice and educational level. Together these issues generate confusion over what the role embodies. The authors suggest that one method of demystifying the Emergency Nurse Practitioner role would be to progress towards international standards for regulation, education and core components of practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
971 |
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Author |
Mortensen, A.; Young, N. |
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Title |
Caring for refugees in emergency departments in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
20 |
Issue |
2 |
Pages |
24-35 |
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Keywords |
Emergency nursing; Culture; Mental health; Health status |
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Abstract |
This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours. |
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Call Number |
NRSNZNO @ research @ 557 |
Serial |
543 |
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Author |
Holbrook, P. |
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Title |
Nurse initiated analgesia in an emergency department: Can nurses safely decrease door to analgesia times by providing analgesia before medical assessment? |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Drug administration; Nursing; Pain management |
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Abstract |
Pain management practices within emergency departments require a more patient focused approach due to extended waiting times for analgesia. This dissertation questions current methods of providing timely and appropriate delivery of analgesia. Nurses represent the biggest resource in emergency departments therefore are in a position to be able to access patients in a timely fashion. A review of the literature pertaining to nurse initiated analgesia protocols has been evaluated and information relating to efficiency and safety utilised to discuss the processes for planning and implementation of a similar protocol. The author finds that the literature provides no evidence that nurse initiated analgesic practices prior to medical assessment compromises patient safety or delays diagnosis. A discussion of the benefits to patients, nurses and the institution has been included to highlight the appropriateness of extending nursing roles. |
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Call Number |
NRSNZNO @ research @ |
Serial |
664 |
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Author |
Mitchell, M.H. |
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Title |
Clinical decision-making processes in emergency nursing |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Education; Clinical decision making |
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Abstract |
The aim of this research paper is to explore the processes of clinical decision-making in relation to emergency nurses and to examine the educational requirements for the development of clinical decision-making skills. Clinical decision-making is foundational to professional nursing practice. It is the expectation of the profession and the organisations in which nurses work that appropriate clinical decision-making will occur. Patients also rightly expect, when being cared for by nurses, that the clinical decisions pertaining to their care will be optimal. |
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Call Number |
NRSNZNO @ research @ 592 |
Serial |
578 |
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Author |
Ritchie, M.S. |
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Title |
Process evaluation of an emergency department family violence intervention programme |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Evaluation |
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Abstract |
Family violence is common and there are significant long-term negative health effects from victimisation. Health professionals are now recognised as key providers of family violence intervention. The Hawke's Bay District Health Board HBDHB) launched a Family Violence Intervention Programme in the emergency department in 2002, in accordance with national directives. The Family Violence Intervention Programme includes routine questioning for partner abuse within social history assessments for all women 16 years and over who seek healthcare services. Nurses assumed responsibility for implementing this programme into emergency department practice. Establishing partner abuse screening in practice requires an organisational and attitudinal change. Achieving and sustaining this change can be difficult. Evaluation was considered an essential aspect of the systems approach adopted within the HBDHB Family Violence Intervention Programme to support change. The aim of this study was to identify the enablers and barriers to routine questioning in the emergency department one year after the programme was launched and the strategies to address these barriers. The staff who have responsibility for routinely questioning women were considered well placed to provide this information. The methodology selected was evaluation research using semi-structured interviews. The design included member checking and triangulation of the findings. Eleven emergency department staff members participated in five (two group and three single) interviews. The interviews revealed that routine questioning for partner abuse is difficult in the emergency department setting. Barriers to questioning exist and enablers can eliminate or minimise these. Enablers such as policy and training support routine questioning. Barriers identified included the lack of privacy and time. Participants suggested strategies to overcome these. These barriers, enablers and solutions were either personal or organisational in origin and all had a common theme of safety. An outcome of the study was the development of a model of barriers and enablers to ensure safety when routinely questioning women for partner abuse. This evaluation has utility within the HBDHB as it informs programme progression. However, the evaluation has wider implications. The experiences of the emergency department staff led to the emergence of key themes that may inform the development of comparable programmes. Introducing routine questioning requires a practice change; a multifaceted approach focusing on safety can assist staff to achieve that change. |
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Call Number |
NRSNZNO @ research @ |
Serial |
851 |
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Author |
Baur, P. |
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Title |
Patients who present to the emergency department but do not wait: An exploratory study |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Hospitals |
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Abstract |
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Call Number |
NRSNZNO @ research @ |
Serial |
849 |
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Author |
Rudd, J. |
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Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
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Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Hospitals; Risk management; Patient safety |
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Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
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Author |
Davies, M. |
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Title |
Lived experiences of nurses as they engage in practice at an advanced level within emergency departments in New Zealand |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Nurse practitioners; Advanced nursing practice |
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Abstract |
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Call Number |
NRSNZNO @ research @ 682 |
Serial |
668 |
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Author |
Horner, C. |
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Title |
Maintaining rural nurses' competency in emergency situations |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Nurse practitioners; Rural nursing; Education |
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Abstract |
On call emergency health services are becoming routinely provided by some rural nurses, predominantly within the South Island. Rural nurses have been advancing their practice to accommodate the limited availability of general practitioners in rural communities. Although this is becoming routine practice, the author has been providing a service such as this for the past 12 years. This dissertation describes this practice in relationship to the present social-political context, advancing nurse competencies and her experience of rural nursing in a rural town within the South Island. Particular significance for the rural nurse is the required independent practice and overall responsibility when remote from traditional medical oversight. Providing on call emergency care with the possibility of a broad spectrum of emergency situations while maintaining competence for the unpredictable frequency (or lack of frequency) of the rural emergency is the focus of this dissertation. The professional and personal risks are high for rural nurses when placed in situations they are not prepared for or unable to remain competent to manage. Implications resulting from the critique of the health service literature on this subject are identified. Firstly, rural nurses need to be insightful of their own emergency on call expertise and limitations. Secondly, rural nurses require ongoing education and thirdly that appropriate education is available and accessible to rural nurses. Lastly, rural nurses require maintenance of competency so these emergency skills are not lost. This dissertation and the resulting recommendations embrace Nursing Council of New Zealand Nurse Practitioner Competencies. The resulting outcomes fulfilling the rural nurse's need for maintenance of competency for emergency on call care, the community's need for safe appropriate emergency care and national legislation requirements. |
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Call Number |
NRSNZNO @ research @ |
Serial |
666 |
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Author |
Richardson, S. |
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Title |
Incorporation of research into clinical practice: The development of a clinical nurse researcher position |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
1 |
Pages |
33-42 |
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Keywords |
Emergency nursing; Nursing research; Hospitals |
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Abstract |
The author backgrounds the development of the role of an innovative Nurse Researcher (Emergency Medicine) role at Christchurch Hospital. She describes the emergency department and the factors leading to the creation of the role. Specific nursing research projects are reviewed, and the nature of nursing in relation to research is discussed. The author argues that the nurse researcher is integral to the expansion of evidence-based nursing, and that the role of Clinical Nurse Researcher in the emergency department has resulted in a higher profile for research, and the gradual integration of research as a clinical skill with direct practical relevance. |
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Call Number |
NRSNZNO @ research @ |
Serial |
536 |
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Author |
Bennison, C. |
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Title |
Emergency nurses' perceptions of the impact of postgraduate education on their practice in New Zealand |
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Year |
2008 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Nursing; Education |
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Abstract |
ABSTRACT
BACKGROUND: Emergency nursing is a specialty concerned with the care of people of all ages, with either perceived or actual unwellness presenting to the emergency department(ED) for assessment, resuscitation, investigation, treatment and review of their illness or injury. Emergency nurses apply specialty knowledge and expertise in the provision, delivery and evaluation of emergency nursing care. Over recent decades social, political and professional changes have affected nursing care delivery and nursing education. In particular the 21st century has witnessed the development of state funded postgraduate nursing education programmes, developing nurses specialty or advanced nursing knowledge, quality patient/client care and nursing practice within the tertiary education system.
AIM: The aim of this study is to investigate emergency nurses? perceptions of the impact of postgraduate education on their practice in New Zealand (NZ).
METHODS: This study utilises critical social theory as the overarching framework, informed by the writing of Jürgen Habermas (b.1929- ). It is the three phases of
Habermas?s practical intent of critical social theory; namely enlightenment, empowerment and emancipation, that this study is concerned with. This descriptive research study employs both quantitative and qualitative methods and is therefore known as mixed-methods research. Data collection took place over 12 weeks, from August to November 2006, using a survey questionnaire obtained with permission from Ms Dianne Pelletier, Sydney, Australia. The sample included 105 emergency nurses from District Health Board (DHB) emergency departments in NZ, 10 respondents from this sample self-selected to be interviewed by telephone. Ethical approval for this study was obtained from the University of Otago Ethics Committee for research involving human participants. Data was analysed using the Statistical Package for Social Sciences (SPSS).
RESULTS: Two main themes arose from the thematic analysis; these being positive and negative, these themes were further divided into 10 sub-themes. The results indicate that postgraduate study (PGS) has increased nurses? perception of their knowledge; leadership and understanding on the quality of patient care delivered, increased their academic and research skills and increased their confidence/self-esteem and recognition by their colleagues and team. Therefore the majority of respondents perceive postgraduate education has been an instrument of liberation and a process of empowerment and emancipation. A smaller percentage of respondents perceived that PGS had no effect on various aspects of patient care and another significantly smaller percentage of respondents reported negative results from PGS. This research identified similarities between this study and that of Pelletier and colleagues? (2003; , 2005; , 1998a; , 1998b) Australian study.
CONCLUSION: This study adds to the existing literature on postgraduate studies undertaken by nurses. No known study has previously investigated solely emergency nurses?perceptions of the effects of PGS, either nationally or internationally. The results of this study offer enlightening information regarding emergency nurses? perceptions of their PGS within NZ and offers a platform from which other studies may be undertaken. It also has the potential to inform nurses contemplating PGS and educators facilitating these programmes,as well as provide implications for policy development by the Nursing Council of NZ, NZ Universities, DHBs and the Ministry of Health. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1291 |
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Author |
Little, S. |
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Title |
An exploration of vicarious traumatisation in emergency nurses |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Occupational health and safety; Nursing research; Stress |
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Abstract |
This thesis explores the theoretical notions of suffering and caring within the nurse patient relationship in the context of emergency nursing. It includes a small pilot study that aimed to assess the feasibliity of a major research project, by describing the impact of vicarious traumatisation in emergency nurses, specifically in relation to their self capacities. This pilot study utilised a descriptive, correlational design. Data was collected by using the Inner Experience Questionnaire (IEQ) a twenty four-item questionnaire developed by Dr Pearlman (1995), and a profile sheet which identified demographic details. Twenty-seven emergency nurses participated in this pilot study. The IEQ was assessed for internal reliability by applying the Cronbachs alpha and utilising a focus group to gain insight into the usability and relevance of the questions. The internal reliability of the IEQ suggests that it may be an appropriate tool to measure disruption of self capacities in the population of emergency nurses. Although the results are limited, and conclusions cannot be drawn, findings suggest a correlation between the variables of age, experience, nursing qualifications and a history of personal trauma and the IEQ. There is evidence that emergency nurses are affected psychologically when caring for the victims of trauma in emergency departments and the IEQ has the potential as a tool to be integrated into future emergency nursing studies. A multidimensional methodological approach is recommended to capture the many contours of the complex phenomena of vicarious traumatisation and the emergency nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1249 |
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Author |
Richardson, S. |
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Title |
Increasing patient numbers: The implications for New Zealand emergency departments |
Type |
Journal Article |
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Year |
1999 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
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Volume |
7 |
Issue |
3 |
Pages |
158-163 |
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Keywords |
Emergency nursing; Organisational change |
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Abstract |
This article examines influences that impact on the work of the Emergency Departments (EDs). EDs are noticing increased attendance of patients with minor or non-urgent conditions. This increase in patient volume, together with on-going fiscal constraints and restructuring, has placed an added strain on the functioning of EDs. New Zealand nurses need to question the role currently given to EDs and identify the issues surrounding the increased use of these departments for primary health care. |
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Call Number |
NRSNZNO @ research @ 1108 |
Serial |
1093 |
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Author |
Blair, K.M. |
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Title |
Recognising the sick patient: An emergency nurses view: A research paper |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Patient safety; Diagnosis; Training; Clinical decision making |
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Abstract |
This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration. |
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Call Number |
NRSNZNO @ research @ |
Serial |
467 |
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