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Author |
O'Brien, A.J.; Kar, A. |
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Title |
The role of second health professionals under New Zealand mental health legislation |
Type |
Journal Article |
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Year |
2006 |
Publication  |
Journal of Psychiatric & Mental Health Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
3 |
Pages |
356-363 |
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Keywords |
Scope of practice; Psychiatric Nursing; Nurse-patient relations |
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Abstract |
The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for the second health professional role is suggested as a way of supporting clinical practice in this area. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1045 |
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Author |
O'Brien, A.J. |
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Title |
The therapeutic relationship: Historical development and contemporary significance |
Type |
Journal Article |
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Year |
2001 |
Publication |
Journal of Psychiatric & Mental Health Nursing |
Abbreviated Journal |
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Volume |
8 |
Issue |
2 |
Pages |
129-137 |
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Keywords |
Psychiatric Nursing; Nursing models; History of nursing; Nurse-patient relations |
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Abstract |
This article examines the therapeutic relationship, a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realised in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualisations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1088 |
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Author |
Murphy, R. |
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Title |
A day in the life of an acute hospital psychiatric nurse |
Type |
Journal Article |
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Year |
2005 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
11 |
Issue |
9 |
Pages |
24-25 |
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Keywords |
Nursing; Psychiatric Nursing; Interprofessional relations; Mental health; Multidisciplinary care teams |
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Abstract |
A nurse presents a personal account of a typical day at Middlemore Hospital's 50-bed acute inpatient mental health unit Tiaho Mai. The article covers aspects of shift handover, working with multidisciplinary teams, developing care plans, working with families, and responding to emergencies. |
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Call Number |
NRSNZNO @ research @ |
Serial |
957 |
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Author |
Surtees, R. |
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Title |
Developing a therapeutic alliance in an eating disorders unit |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
10 |
Pages |
14-16 |
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Keywords |
Nursing specialties; Multidisciplinary care teams; Psychiatric Nursing; Nurse-patient relations; Anorexia nervosa |
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Abstract |
The author presents the approach of a nursing team at Christchurch's Princess Margaret Hospital, in the regional specialist service for people with anorexia nervosa. This unit provides the only specialist inpatient unit in the country, consisting of a six or seven-bed facility that shares a unit with a mother and baby unit. A multidisciplinary team of psychiatric nurses, dietitians, occupational therapists, psychiatrists, psychologists and social workers all make significant contributions. The Christchurch unit uses a cognitive-behavioural therapy model (CBT) across the disciplines, a multidimensional approach incorporating psychotherapeutic, psychoeducational, biomedical and behaviourist paradigms. This occurs within a “lenient flexible approach”. Within the Unit, the eight nurses constitute what could be seen as an “intra”-disciplinary team within the wider “inter”-disciplinary or MDT team. They apply an evidence-based nursing approach with a commitment to partnership and advocacy with their patients. They use collaborative techniques for defining shared goals, and the careful management of the introduction of food. As one of the team members, the author envisages that the job of specialised nurses is to form a therapeutic alliance with patients, which takes account of the dynamic ways that patients may negotiate their own complex understandings of health, care, and recovery. |
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Call Number |
NRSNZNO @ research @ |
Serial |
982 |
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Author |
Neville, S.J.; Gilmour, J.A. |
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Title |
Differentiating between delirium and dementia |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
9 |
Pages |
22-25 |
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Keywords |
Dementia; Psychiatric Nursing; Clinical assessment; Older people |
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Abstract |
Accurate nursing assessment is a critical element in the identification of health problems and treatment strategies for older adults who have delirium and/or dementia. This practice update provides information on the differentiation between these two debilitating and adverse health events, along with some useful assessment frameworks and other resources. Comments from people with delirium and dementia are interspersed throughout the article to draw attention to the impact of these conditions on people's lives and well-being. The article includes the 'A presenting concern framework', useful mnemonic devices to help nurses assess an older person who may have delirium or dementia, and a list of online resources. |
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Call Number |
NRSNZNO @ research @ |
Serial |
983 |
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Author |
McKenna, B.; O'Brien, A.J.; Dal Din, A.; Them, K. |
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Title |
Responsible clinician role offers opportunities for nurses |
Type |
Journal Article |
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Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
11 |
Pages |
12-14 |
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Keywords |
Psychiatric Nursing; Advanced nursing practice; Law and legislation; Mental health |
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Abstract |
The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
992 |
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Author |
Smith, M.C. |
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Title |
Reviewing the role of a mental health nurse practitioner |
Type |
Journal Article |
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Year |
2008 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
14 |
Issue |
3 |
Pages |
20-22 |
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Keywords |
Psychiatric Nursing; Nurse practitioners; Evaluation research; Professional competence |
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Abstract |
The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role. |
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Call Number |
NRSNZNO @ research @ |
Serial |
993 |
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Author |
Crowe, M.; O'Malley, J.; Bigwood, S. |
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Title |
Nursing mental health consumers in the community |
Type |
Journal Article |
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Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
8 |
Issue |
8 |
Pages |
14-15 |
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Keywords |
Community health nursing; Psychiatric Nursing |
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Abstract |
The purpose of this research was to describe the characteristics of community mental health nursing care in the community. Twenty six nurses were enrolled in a study consisting of semi-structured interviews about the nature of their care. Responses were analysed to identify categories of skills. These were characterised as: establishing connectedness; promoting individual and family resilience, promoting citizenship; and addressing structural issues. Responses from the nurses are used to illustrate these categories. |
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Call Number |
NRSNZNO @ research @ 1024 |
Serial |
1008 |
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Author |
Lewer, D. |
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Title |
Analysing the Mental Health Act |
Type |
Journal Article |
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Year |
1999 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
5 |
Issue |
8 |
Pages |
14-16 |
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Keywords |
Psychiatric Nursing; Mental health; Law and legislation; Ethics |
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Abstract |
Changes brought by the Mental Health Act (MHA) to clinical practice, and some of the problems it has created for nurses, are examined in this article. Compulsory assessment and treatment orders (CATO) and the role of Duly Authorised Officers (DAO), and moral dilemmas that can arise as a consequence of CATOs used by DAOs are examined. The requirement for DAOs to act as patient advocates and to safeguard cultural beliefs are highlighted. The MHA promotes self responsibility and a treatment philosophy rather than detention of the mentally ill. |
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Call Number |
NRSNZNO @ research @ 1039 |
Serial |
1023 |
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Author |
McKenna, B. |
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Title |
Bridging the theory-practice gap |
Type |
Journal Article |
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Year |
1999 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
5 |
Issue |
2 |
Pages |
14-16 |
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Keywords |
Psychiatric nursing; Nursing; Education; Teaching methods |
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Abstract |
The author presents a case study of a joint appointment between a nurse lecturer and a staff nurse in an acute forensic psychiatry unit. He explores the advantages, disadvantages and reasons for success in relation to the findings of a survey of the literature on joint appointments. This technique is seen as a means of narrowing the gap between theory and practice which resulted when nurse training was transferred from hospitals to polytechnics. He highlights the need to develop research methodology to clarify potential benefits of this approach. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1024 |
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Author |
McKenna, B.; Poole, S. |
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Title |
Debating forensic mental health nursing [corrected] |
Type |
Miscellaneous |
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Year |
2001 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
7 |
Issue |
6 |
Pages |
18-20 |
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Keywords |
Psychiatric Nursing; Law and legislation; Cross-cultural comparison; History of nursing |
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Abstract |
Forensic mental health nursing roles have developed along different lines in the United States and the United Kingdom. The authors suggest that New Zealand nurses consider the evolution of such roles here. |
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Call Number |
NRSNZNO @ research @ 1043 |
Serial |
1027 |
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Author |
Webby, A. |
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Title |
Developing safe nursing practice for Maori |
Type |
Journal Article |
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Year |
2001 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
7 |
Issue |
1 |
Pages |
16-17 |
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Keywords |
Maori; Psychiatric Nursing; Nursing models |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
1028 |
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Author |
Crowe, M.; Luty, S. |
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Title |
Recovery from depression: A discourse analysis of interpersonal psychotherapy |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
43-50 |
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Keywords |
Psychiatric Nursing; Mental health; Nurse-patient relations |
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Abstract |
This paper describes a discourse analysis of the process of interpersonal psychotherapy (IPT) in the recovery from depression. It demonstrates how IPT is an effective treatment strategy for mental health nurses to utilise in the treatment of depression. The discourse analysis highlights how the development of more meaningful subject positions enables one woman to recover from her depression. The process of recovery is underpinned by an understanding of women's depression as promoted by contemporary social and cultural expectations for detachment and reflexivity. This paper shows how IPT provides an opportunity for recovery from depression for one woman by facilitating a reconstruction of her subject positions in relation to others. The discourse analysis revealed that the therapist facilitated this through the use of a range of techniques: seeking information, exploring beliefs/values/assumptions, exploring communication patterns, exploring affective responses and exploring alternative subject positions. |
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Call Number |
NRSNZNO @ research @ 1070 |
Serial |
1055 |
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Author |
Crowe, M. |
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Title |
Reflexivity and detachment: A discursive approach to women's depression |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
9 |
Issue |
2 |
Pages |
126-132 |
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Keywords |
Gender; Mental health; Psychiatric Nursing; Culture |
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Abstract |
This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1077 |
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Author |
McKenna, B. |
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Title |
Risk assessment of violence to others: Time for action |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
18 |
Issue |
1 |
Pages |
36-43 |
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Keywords |
Mental health; Workplace violence; Risk management; Nursing; Nurse-patient relations; Psychiatric nursing |
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Abstract |
The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings. |
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Call Number |
NRSNZNO @ research @ |
Serial |
621 |
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