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Author |
McLean, J.M. |
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Title |
Pushing the boundaries: Relationships with adolescents |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Issue |
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Keywords |
Psychiatric Nursing; Mental health; Adolescents; Nurse-patient relations |
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Abstract |
Therapeutic relationships are central to mental health nursing. The nurse's role in maintaining professional yet therapeutic boundaries within this relationship can be challenging. When therapeutic boundaries are breeched within the nurse adolescent relationship the adolescent's safety within this relationship is compromised. There is currently limited literature on how nurses are managing professional boundaries in relationships with adolescents in this setting. The adolescent's nature is to push boundaries; therefore the nurse needs to be acutely aware of this boundary pushing in everyday practice settings. For the safety of the adolescent and the nurse it is vital the nurse understands her role in managing the professional boundary. This thesis explores, through the use of narrative inquiry, four adolescent mental health nurses' experiences of assessing, understanding and maintaining therapeutic boundaries with adolescents in a mental health setting in New Zealand. The unique and specific implications for adolescent mental health nursing are discussed. Three key themes emerged from the analysis and findings: the importance of the nurse clarifying his/her role; the learning that occurs throughout the practice journey; and the role of the nurse in keeping the adolescent and the nurse safe. These findings highlight the importance of clinical supervision and open communication with senior nurses and mentors, which assist the nurse in monitoring practice. When nurses do not have sufficient knowledge of the fundamental principles of adolescent mental health nursing; such as knowledge and skills in both adolescent development and psychodynamic nursing, they are at risk of boundary crossings. Recommendations from this research include more emphasis on psychodynamic nursing principles in nursing education and nursing practice. There is a need for specialised education for nurses in child and adolescent mental health nursing. Nursing entry to practice programmes for new graduate nurses working in mental health, could assist in providing this. There is a call for further research into therapeutic relationships and professional boundaries in this complex nursing specialty. |
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Call Number |
NRSNZNO @ research @ 762 |
Serial  |
748 |
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Author |
Dorofaeff, M.J. |
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Title |
Shared status and advocating practices: Nurses who work with clients who have a co-existing intellectual disability and mental health problem |
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Year |
2007 |
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 |
Mental health; Psychiatric Nursing |
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Abstract |
This research is informed by the interpretive phenomenology of van Manen, and explores the lived experience of nursing from the perspective of nurses who provide care for people with a co-existing intellectual disability and mental health problem. Although nursing research is commonly informed by phenomenology, there is a dearth of literature of any description written from the perspective of nurses who provide care for people with intellectual disabilities and mental health problems. As a result of the closure of many large institutions in New Zealand there are not many nurses who work with people who have intellectual disabilities and co-existing mental health problems. The study participants were four nurses purposefully selected because they provided care for people with intellectual disabilities and mental health problems. Data was collected using semi-structured interviews, and the researcher identified and wrote about the recurring themes in the transcribed interview data, which best captured the lived experience of the participants. The themes were: criticism of services, holistic caring, working with the client, issues of status, need for specialist knowledge, enduring relationships, diagnostic issues, advocating, modelling good practice; and working alongside. After further analysis the themes were encompassed within the larger interrelated themes of “Status and positioning” and “Advocating practices”, and finally within a single theme of: “The status and positioning of the nurse and the client leads to advocating practices.” These themes were found to be consistent with the nursing literature and with the researcher's own lived experience as a nurse who works in a specialist mental health intellectual disability service. The findings of this research have implications for a number of groups in New Zealand. Among the author's conclusions are that input is required from the Nursing Council of New Zealand, the nursing profession, nurse educators and the government to raise the status of clients with co-existing intellectual disabilities and mental health problems and the nurses who work with this client group. In addition, the roles for nurses who work with this client group are emerging and are likely to be diverse and there is a need for further research to capture the different experiences of these nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
747 |
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Author |
Tuitea, I. |
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Title |
Solution focused nursing: An alternative model for assessing psychosis and mai aitu in mental health |
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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 |
Pacific peoples; Mental health; Psychiatric Nursing; Culture |
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Abstract |
The objective of this paper is to establish if there is any documented research and literature evidence that describe what the presenting clinical symptoms of Mai Aitu is, and also to explore an alternative frame-work to assess Pacific Islanders who present to mental health in crisis. As a community mental health nurse in the Crisis Assessment and Treatment Team (CATT), the author reports being confronted almost every day with an increasing number of Pacific Islanders presenting in crisis with symptoms consistent with the well documented signs of psychosis. For instance, symptoms like hallucinations, delusion and paranoid ideation which are also well known for describing schizophrenia. Her concern is that mental health nurses may be compromising their practice, the safety of the Pacific Island population and possibly the credibility of the profession with what appears like a lack of knowledge and awareness regarding the clinical symptoms of some Pacific Island mental illness. In Tonga it is called Avea Avanga, in Fiji it is referred to as Lialia, in Samoa it is known as Mai Aitu. The author notes that the issue becomes apparent when Samoan clients present in crisis with what appears to be psychosis but the fanau believe their love one is not mentally unwell, that he or she is simply suffering a traditional Samoan illness. Therefore they insist he or she be treated at home, instead of through admission to the psychiatric hospital, and also that they be seen by a Samoan healer instead of a psychiatrist. |
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Call Number |
NRSNZNO @ research @ 753 |
Serial |
739 |
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Author |
Shanks, A. |
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Title |
Stories within stories: What are client stories and how do community mental health nurses work with them? |
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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 |
Mental health; Psychiatric Nursing; Nurse-patient relations |
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Abstract |
There is limited nursing research as to how mental health nurses work with client stories. Furthermore mental health nurses have not been asked how they would define a client story within their practice. Client's stories allow promotion of the storyteller's experience leading to increased self awareness by supporting growth, and personal development of the individual through exploration of their experience. While listening and working with these stories, mental health nurses are able to interpret, reframe and validate the experiences and meanings disclosed over time. Three community mental health nurses were interviewed about how they identified client stories within their clinical practice. They explained how they created an environment for stories to be told, and worked to enhance meanings, and view alternative possibilities by 'carrying' the story until the client was ready to explore it. By working and understanding stories, mental health nurses were able to work collaboratively with the client to provide humanistic care. Themes of therapeutic relationship, purposeful use of self, and narrative as therapy were identified within the nurse's stories, providing an understanding of how mental health nurses practice. This study was framed by narrative inquiry and influenced by Riessman and Polkinghorne. Core stories are presented from the analysis of the nurses stories about how they defined 'story' and worked with the client stories. |
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Call Number |
NRSNZNO @ research @ |
Serial |
738 |
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Author |
Kempthorne, A. |
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Title |
Why do nurse graduates choose to work in the area of mental health? |
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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 |
Careers in nursing; Psychiatric Nursing; Mental health |
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Abstract |
The low numbers of nurses attracted to work in mental health is a concern particularly with the increased demand for mental health services. Strategies are required to increase recruitment to this less popular area of nursing to ensure that a high quality of care is provided for people suffering from mental illness. The World Health Organisation is aware that this area of health has been neglected and that it is time to promote mental health. This study aimed to examine the influences involved in nurses choosing to work in this area. A descriptive survey using a questionnaire was given to seven groups of new graduates enrolled in the New Graduate Mental Health Nursing programme through five educational institutes. At the time of writing there were no published studies around this topic in New Zealand. This study will attempt to inform nurses, the Nursing Council of New Zealand, tertiary institutions and the government of New Zealand that there is evidence of a need to develop and change practices to address the predicted workforce decline. |
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Call Number |
NRSNZNO @ research @ |
Serial |
733 |
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Author |
Walsh, K.; McAllister, M.; Morgan, A.; Thornhill, J. |
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Title |
Motivating change: Using motivational interviewing in practice development |
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Journal Article |
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Year |
2004 |
Publication |
Practice Development in Health Care |
Abbreviated Journal |
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Volume |
3 |
Issue |
2 |
Pages |
92-100 |
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Keywords |
Psychiatric Nursing; Hospitals; Motivation; Older people |
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Abstract |
The present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self-efficacy and managing resistance to change. |
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Call Number |
NRSNZNO @ research @ |
Serial |
718 |
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Author |
Goulding, M.T. |
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Title |
The influence of work-related stress on nurses' smoking: A comparison of perceived stress levels in smokers and non-smokers in a sample of mental health nurses |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Smoking; Psychiatric Nursing; Stress; Mental health |
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Abstract |
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Call Number |
NRSNZNO @ research @ 701 |
Serial |
687 |
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Author |
Martin, H.E. |
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Title |
Marking space: A literary psychogeography of the practice of a nurse artist |
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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 |
Psychiatric Nursing; Mental health; Nurse-patient relations |
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Abstract |
The author suggests that the thesis as a production of disciplined work presented in a creative style is congruent with performance and presentation best practice in community arts. As a practising nurse artist the author describes creating spaces of alternate ordering within the mental health field environment. “I also inhabit the marginal space of the artist working in hospital environments. This Other Place neither condones nor denies the existence of the mental health field environment as it is revealed. Yet, it seeks to find an alternative to the power and subjectivity of the [social] control of people with an experience of mental illness that inhabit this place both voluntarily and involuntarily. I have used a variety of texts to explore the experience and concept of Otherness. The poems are intended to take you, as a reader where you could not perhaps emotionally and physically go, or might have never envisaged going. They also allow me as the author to more fully describe the Otherness of place that is neither the consumer story nor the nurse's notation, but somewhere alternately ordered to these two spaces. Drawing on the heuristic research approaches of Moustakas and literary psychogeography , particularly the work of Guy Debord, this thesis creates the space to explore the possibilities of resistance and change and the emergence of the identity of the nurse artist within the mental health field environment”. |
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Call Number |
NRSNZNO @ research @ |
Serial |
685 |
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Author |
Taua, C. |
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Title |
Revisiting the past: A focused ethnography of contemporary dual diagnosis nursing practice |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Copy downloadable from the NZNO Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing |
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Abstract |
As has been the case internationally, deinstitutionalisation of dual diagnosis (intellectual disability and mental illness) services has also occurred in New Zealand. Inpatient services have been redefined to respond to the more acute focus that has arisen out of this deinstitutionalisation process and nurses are having to redefine their roles in response. This study was undertaken to explore and describe the culture of nursing practice in a dual diagnosis inpatient unit in one psychiatric hospital. A focused ethnographic approach was used to triangulate data gathered from fieldwork observations, review of documents and semi-structured interviews. Schein's (1985) levels of culture model, was used to identify and explore the artifacts, values and assumptions evident in this nursing practice. Analysis presents three key themes categorised as 'communication', 'assessment' and 'safety'. While these key themes are shown to be evident in the everyday practice of the nurses, how these relate to the notion of 'dual diagnosis nursing' is not clear. Therefore, the author describes the major finding of this study as revealing a nursing culture holding tight to traditional psychiatric and psychopaedic nursing practices and struggling to develop a distinctive culture in the absence of a defined dual diagnosis knowledge base. The author concludes that these findings suggest an urgent need to provide nurses with support in gaining contemporary knowledge regarding dual diagnosis nursing. Support for nurses in advancing these areas then impacts on support for the patients. It is suggested that additional research is undertaken to assess the learning needs of the nurses in order to develop clinical practice guidelines for this area. Further recommendations are made to address system issues which are contributing to the gap in knowledge. |
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Call Number |
NRSNZNO @ research @ |
Serial |
674 |
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Author |
Bleach, A. |
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Title |
Nurses talk the walk: An exploration of nurses' perception of advanced nursing practice on acute mental health inpatient units in New Zealand |
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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 |
Mental health; Nursing; Policy; Registered nurses; Advanced nursing practice; Psychiatric Nursing |
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Abstract |
The last twenty years, particularly the early 1990s, ushered in major mental health sector reforms inclusive of deinstitutionalisation policies and subsequent development of community services. Concurrent changes to student nurses' education left registered nurses as the workforce mainstay on inpatient units. However, the author suggests, an emerging global shortage of nurses and implementation of the Employment Contracts Act (1991) negatively impacted on recruitment and retention of registered nurses. Inpatient nurses either left nursing or moved to community positions for better money and increased job status. The author suggests that, as a consequence, the 'critical mass' of experienced and skilled nurses who traditionally provided nursing leadership disappeared resulting in compromised standards of care for patients. As the manager of an inpatient unit, the author proposed the establishment of advanced nursing practice roles as one initiative to provide nursing leadership in order to attract and retain nurses. This study explored five inpatient nurses' perceptions of advanced practice and whether these roles could assist to provide leadership and improve standards of care. The research was a qualitative exploratory descriptive study using a focus group interview as the data collection method. A thematic analysis of the group discussion transcription revealed three key themes: 1) the 'makeup' of advanced nursing practice, 2) moving forwards: establishing roles, 3) moving sideways: barriers to role development. The themes are critically discussed in relation to selected literature. The thesis includes recommendations that could be used by nurses responsible for planning and implementing advanced practice roles on inpatient units. |
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Call Number |
NRSNZNO @ research @ |
Serial |
663 |
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Author |
Cowan, L.M.; Deering, D.; Crowe, M.; Sellman, D.; Futterman-Collier, A.; Adamson, S. |
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Title |
Alcohol and drug treatment for women: Clinicians' beliefs and practice |
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Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
48-55 |
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Keywords |
Psychiatric Nursing; Substance abuse; Gender; Attitude of health personnel; Alcoholism; Drug abuse |
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Abstract |
The present paper reports on the results of a telephone survey of 217 alcohol and drug treatment clinicians on their beliefs and practice, in relation to service provision for women. Nurses comprised the second largest professional group surveyed. Seventy-eight percent of clinicians believed that women's treatment needs differed from men's and 74% reported a range of approaches and interventions, such as assisting with parenting issues and referral to women-only programmes. Several differences emerged in relation to approaches and interventions used, depending on clinician gender, work setting and proportion of women on clinicians' caseload. Implications for mental health nursing include the need to more systematically incorporate gender-based treatment needs into practice and undergraduate and postgraduate education and training programmes. |
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Call Number |
NRSNZNO @ research @ |
Serial |
652 |
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Author |
Farrow, T.; McKenna, B.; O'Brien, A.J. |
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Title |
Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation |
Type |
Journal Article |
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Year |
2002 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
11 |
Issue |
3 |
Pages |
164-169 |
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Keywords |
Mental health; Law and legislation; Psychiatric Nursing; Scope of practice |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
651 |
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Author |
McKenna, B.; Poole, S.; Smith, N.A.; Coverdale, J.; Gale, C. |
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Title |
A survey of threats and violent behaviour by patients against registered nurses in their first year of practice |
Type |
Miscellaneous |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
56-63 |
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Keywords |
New graduate nurses; Workplace violence; Occupational health and safety; Training; Mental health; Psychiatric nursing |
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Abstract |
For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes. |
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Call Number |
NRSNZNO @ research @ |
Serial |
649 |
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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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Author |
Green, M. |
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Title |
Psychiatric consultation liaison nurse: A model for practice |
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 |
Nursing models; Psychiatric Nursing |
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Abstract |
Psychiatric consultation liaison (PCL) nursing is an evolving specialist area of mental health nursing in the USA, UK, Australia and New Zealand. The aim of this dissertation is to explore models of PCL nursing practice in order to develop and discuss a PCL nursing model applicable to the New Zealand context. The role of the PCL nurse was of particular interest to the author as a new practitioner in this specialist area. While there have been PCL nurses in practice for over 50 years, the literature does not offer much clarity about models of PCL nursing. From a review of the literature, four themes were recurrent in the work of PCL nurses. These themes represent four functions which are vital to the role of the PCL nurse: partnership, expertise of the PCL nurse, therapeutic relationship and organisational consultation. The needs of the patient are the core of this model and the primary objective is to improve the quality of care of patients in the general hospital with co-existing physical and psychological problems. It is imperative that PCL nurses evaluate their practice and embark on research to investigate clinical outcomes, cost effectiveness and the impact of PCL nurse practice on patients and staff. This PCL nursing model provides a beginning for this process. It also clarifies and articulates the role of the PCL nurse which enables the service to be promoted to colleagues. This PCL nursing model represents a critique of the author's understanding of the role of the PCL nurse. As expertise develops, the model will continue to be tested and refined. |
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Call Number |
NRSNZNO @ research @ |
Serial |
608 |
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