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Author |
Sheward, K.A. |
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Title  |
Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying |
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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 |
Palliative care; Hospitals; Communication; Nurse-patient relations |
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Abstract |
The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting. |
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Call Number |
NRSNZNO @ research @ |
Serial |
772 |
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Author |
Clayton, J.R. |
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Title |
Exploring transitions: Working in “the space between the no longer and the not yet” |
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Year |
2008 |
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 |
Communication; Nurse-patient relations; Case studies |
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Abstract |
This thesis uncovers a personal journey of reflective practice, focusing on the author's emerging role as a nurse facilitating transitions using a dialectical approach in the context of a private nursing practice. Transitions encompass: life changes, loss, and adjustment to changes in function. Dialectical nurse facilitation of transition (DNFT) is a way of exploring self in the transitional space between “the no longer and the not yet”. In this facilitated process people potentially discover paradoxes, tensions, and creative energy, as they search for a way forward. The research design details a dialectical heuristic quest through journaling and reflecting on practice supervision and peer review, over a two year period. Exemplars written after reflecting on case notes reveal the lived experiences of participants. These case reviews show the complexity of patterns for people undergoing transitions and nurse facilitation. A relational pattern for DNFT encompasses compassionate engagement, catalytic mirroring, and interconnectedness. An exploration of literature encompasses nursing theories, facilitation, dialogue, loss, grief, spirituality and transition. This thesis provides a basis for evaluative research on the effectiveness of DNFT in health care settings in the future. Discussions regarding the expansion of these reflective and praxis genres are included which may be of interest to nursing education and practice contexts. |
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Call Number |
NRSNZNO @ research @ 1203 |
Serial |
1188 |
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Author |
Wilson, D.; McBride-Henry, K.; Huntington, A.D. |
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Title |
Family violence: Walking the tight rope between maternal alienation and child safety |
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Journal Article |
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Year |
2005 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
18 |
Issue |
1-2 |
Pages |
85-96 |
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Keywords |
Nursing; Domestic violence; Nurse-patient relations; Children |
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Abstract |
This paper discusses the complexity of family violence for nurses negotiating the 'tight rope' between the prime concern for the safety of children and further contributing to maternal alienation, within a New Zealand context. The premise that restoration of the mother-child relationship is paramount for the long-term wellbeing of both the children and the mother provides the basis for discussing implications for nursing practice. Evidence shows that when mothers are supported and have the necessary resources there is a reduction in the violence and abuse she and her children experience; this occurs even in situations where the mother is the primary abuser of her children. The family-centred care philosophy, which is widely accepted as the best approach to nursing care for children and their families, creates tension for nurses caring for children who are the victims of abuse as this care generally occurs away from the context of the family. |
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Call Number |
NRSNZNO @ research @ |
Serial |
698 |
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Author |
Radka, I.M. |
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Title |
Handover and the consumer voice: The importance of knowing the whole, full story |
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Year |
2003 |
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 |
Communication; Patient satisfaction; Nurse-patient relations |
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Abstract |
In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare. |
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Call Number |
NRSNZNO @ research @ 883 |
Serial |
867 |
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Author |
Major, G.; Holmes, J. |
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Title |
How do nurses describe health care procedures? Analysing nurse-patient interaction in a hospital ward |
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Journal Article |
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Year |
2008 |
Publication |
Australian Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
25 |
Issue |
4 |
Pages |
58-70 |
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Keywords |
Communication; Nursing; Nurse-patient relations |
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Abstract |
This study examines the communication strategies used by nurses on the ward in one aspect of the job, namely the ways that they describe health procedures to patients. The data used in this project was collected by nurses on a busy hospital ward as part of Victoria University's Language in the Workplace Project. Three nurses carried minidisc recorders as they went about their normal working day, recording their conversations with patients, visitors, and other staff. The data was collected in a women's hospital ward. All patients, nurses, cleaners and ward clerks were female; two doctors were female and two were male. Twenty three instances where nurses described procedures to patients were identified in the data set. The analysis identified several typical components; indicated there was no fixed order of components; and demonstrated that all except the core component of describing the procedure were optional rather than obligatory elements. The researchers note this is qualitative and exploratory research. The findings demonstrate the benefit of discourse analysis within a sociolinguistic framework for the analysis of nurse-patient interaction. The results indicate that health discourse is not one-sided, nor is it as straightforward as many nursing textbooks suggest. |
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Call Number |
NRSNZNO @ research @ 975 |
Serial |
959 |
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Author |
Chadwick, A.; Hope, A. |
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Title |
In pursuit of the named nurse |
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Journal Article |
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Year |
2000 |
Publication |
Australasian Journal of Neuroscience |
Abbreviated Journal |
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Volume |
13 |
Issue |
4 |
Pages |
6-9 |
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Keywords |
Advanced nursing practice; Hospitals; Evaluation; Nurse-family relations; Nurse-patient relations |
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Abstract |
This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required. |
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Call Number |
NRSNZNO @ research @ |
Serial |
924 |
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Author |
Farrow, T.; McKenna, B.; O'Brien, A.J. |
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Title |
Initiating committal proceedings 'just in case' with voluntary patients: A critique of nursing practice |
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Journal Article |
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Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
18 |
Issue |
2 |
Pages |
15-23 |
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Keywords |
Patient rights; Law and legislation; Mental health; Nurse-patient relations |
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Abstract |
The authors report a clinical audit that, combined with anecdotal evidence, verifies the practice of putting section 8B medical certificates on the files of voluntary mental health patients at the time of admission. This is seen as a strategy to balance the requirement to support and promote the autonomy of voluntary patients with the need to protect those patients or other people. A conceptual analysis of these issues indicates that such a practice is both legally questionable and ethically inappropriate. The authors suggest an alternative framework for practice that is legally and ethically preferable for both nurses and patients. |
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Call Number |
NRSNZNO @ research @ |
Serial |
618 |
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Author |
Mitchell, D.F. |
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Title |
Is it possible to care for the “difficult” male? A study exploring the interface between gender issues, nursing practice and men's health |
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Year |
1999 |
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 |
Male; Nurse-patient relations; Gender |
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Abstract |
This thesis is about caring for males, especially those males who could be considered “difficult” to care for through their use of behaviours such as silence, anger or defensive humour. This thesis is positioned in the view that these behaviours are often expressions of distress, which typically distance males from those who attempt to care for them. The author suggests that the word “distress” more accurately reflects the theme of the thesis, and it is used throughout the work. This thesis explores the interface between gender issues, nursing practice and caring for males. It is informed by a review of relevant literature and data gathered from a focus group of nine registered nurses. The analysis is framed by questions that are developed from a series of reflections on my personal and professional life. Critical social theory, with its emphases on dominant dialogue, power and emancipation is used to inform and guide this analysis. What is most obvious is the contrast between themes arising from the literature and those arising from the focus group. It appears that the literature, in the main, is critical of males in regard to concepts of masculinity, issues related to gender, and men's health. Males are portrayed as arbitrators of their own misfortune, as deliberately choosing a lifestyle that reflects poorly on their health, their self-expression, and communication with others. Concepts such as power and control over others, both at a societal and individual level, often feature. Conversely, the literature is noticeably lacking in regard to information about the health related experiences of males and about caring for males. In contrast, the participants of the focus group frame their discussion in the positive. For example, they suggest that males are interested in their health but require an environment that supports this expression of interest. They support this by identifying a range of behaviours they believe are effective in caring for males. The participants also suggest that it is the registered nurse rather than the male who manages issues to do with power and control. The thesis concludes that creating and sustaining an environment supportive of, and sensitive to the needs of males, is an activity that requires considerable thought, skill and experience. These areas are not adequately addressed in academic dialogue, research activity, or in the education of registered nurses. The thesis suggests that this situation is inconsistent with an ethic of care and that nursing should make a priority of broadening its research and knowledge base to better understand and care for males. |
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Call Number |
NRSNZNO @ research @ 503 |
Serial |
489 |
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Author |
Polaschek, N. |
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Title |
Living on dialysis: Concerns of clients in a renal setting |
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Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
41 |
Issue |
1 |
Pages |
44-52 |
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Keywords |
Nurse-patient relations; Psychology; Attitude to health; Terminal care |
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Abstract |
This article reports a study that sought to understand the experience of a group of Caucasian men with end stage renal failure managing their own haemodialysis therapy in their homes. The study used a critical interpretive methodology. The renal setting was critically viewed as a specialised health care context constituted by several interrelated discourses. Although established by the dominant professional discourse, it also includes a number of others, in particular an obscure client discourse that is a response to the dominant discourse. Initially, participants' own interpretations of their individual experiences were outlined. These were then collectively reinterpreted by contextualising them in terms of the critical view of the renal setting, in order to discern their own views as renal clients that were obscured by the language and ideas of the dominant discourse with which they had been enculturated. From an analysis of the set of accounts derived from interviews with six participants, four concerns of the renal client discourse were identified. These concerns were: (1) suffering from continuing symptoms of end stage renal failure and dialysis; (2) limitations resulting from negotiating dialysis into their lifestyle; (3) ongoingness and uncertainty of life on dialysis; and (4) altered relationship between autonomy and dependence inherent in living on dialysis. One specific implication of this study is that the distinctive potential of the nursing role in renal settings lies beyond the performance of a range of technical tasks, in addressing the experience of people living on dialysis, described here as the concerns of the renal client discourse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1072 |
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Author |
Dickinson, A.R.; Dignam, D. |
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Title |
Managing it: A mother's perspective of managing a pre-school child's acute asthma episode |
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Journal Article |
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Year |
2002 |
Publication |
Journal of Child Health Care |
Abbreviated Journal |
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Volume |
6 |
Issue |
1 |
Pages |
7-18 |
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Keywords |
Asthma; Parents and caregivers; Children; Nurse-patient relations |
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Abstract |
This exploratory descriptive study informed by grounded theory examines the experience of mothers in managing their pre-school child's acute asthma attack at home. The study reveals that mothers perceive that they are responsible for the management of their pre-school child during an acute asthma episode, a process they described as 'managing it'. This process involves mother in 'working on treatment', 'making the call', 'watching' and 'calming', while the husband/partner, family, friends and health professionals are 'supporting treatment'. This study suggests that nurses and doctors need to move away from the current paternalistic view of health care delivery in acute settings and embrace the concepts of support and partnership in the care of the pre-school child with asthma and their family. |
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Call Number |
NRSNZNO @ research @ 728 |
Serial |
714 |
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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 |
Polaschek, N. |
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Title |
Negotiated care: A model for nursing work in the renal setting |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
42 |
Issue |
4 |
Pages |
355-363 |
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Keywords |
Chronically ill; Nursing models; Nurse-patient relations; Communication |
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Abstract |
This article outlines a model for the nursing role in the chronic health care context of renal replacement therapy. Materials from several streams of literature are used to conceptualise the potential for nursing work in the renal setting as negotiated care. In order to present the role of the renal nurse in this way it is contextualised by viewing the renal setting as a specialised social context constituted by a dominant professional discourse and a contrasting client discourse. While performing specific therapeutic activities in accord with the dominant discourse, renal nurses can develop a relationship with the person living on dialysis, based on responsiveness to their subjective experience reflecting the renal client discourse. In contrast to the language of noncompliance prevalent in the renal setting, nurses can, through their relationship with renal clients, facilitate their attempts to negotiate the requirements of the therapeutic regime into their own personal life situation. Nurses can mediate between the dominant and client discourses for the person living on dialysis. Care describes the quality that nurses actively seek to create in their relationships with clients, through negotiation, in order to support them to live as fully as possible while using renal replacement therapy. The author concludes that within chronic health care contexts, shaped by the acute curative paradigm of biomedicine, the model of nursing work as negotiated care has the potential to humanise contemporary medical technologies by responding to clients' experiences of illness and therapy. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1186 |
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Author |
MacDonald, L.M. |
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Title |
Nurse talk: Features of effective verbal communication used by expert district nurses |
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Year |
2003 |
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 |
Communication; Nurse-patient relations; District nursing |
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Abstract |
This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development. |
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Call Number |
NRSNZNO @ research @ 1180 |
Serial |
1165 |
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Author |
Valette, D. |
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Title |
Nursing an adolescent in an adult inpatient mental health unit |
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Year |
2002 |
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 |
Psychiatric Nursing; Adolescents; Nurse-patient relations; Professional competence; Mental health |
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Abstract |
This research paper reports on an exploration of the key elements nurses need to be aware of to effectively nurse adolescents in an adult inpatient unit. It describes the developmental needs and significant influences that affect this age-group, that when incorporated into nursing care, nurses can gain a therapeutic relationship with the adolescent. By means of a literature review, sharing the author's experience in nursing adolescents, and through vignettes of practice, an illustration of some common situations that may occur during the adolescent's inpatient stay are described. These situations are explored and a perspective is offered on how nurses may be effective in their nursing of an adolescent patient from the point of admission through to discharge. More research is needed on adolescent mental health nursing, however the author anticipates that nurses will be able to use this report as a helpful resource in their current practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1148 |
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Author |
Phillips, B.N. |
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Title |
Nursing care and understanding the experiences of others: A Gadamerian perspective |
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Journal Article |
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Year |
2007 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
14 |
Issue |
1 |
Pages |
89-94 |
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Keywords |
Nursing philosophy; Nurse-patient relations |
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Abstract |
This article investigates the process where nurses attempt to understand the experience of patients. The author argues that this transcends particular models of ill-health. Gadamerian hermeneutics, which has been used in nursing research to articulate the process of understanding, is elaborated on. Gadamer's exposition of understanding shows that practitioners need to be aware that understanding of other people is developed through a fusion of one's own history, language and culture with that of the other person. This occurs through a hermeneutic question-answer dialogue in which practitioners put their ideas at risk of being modified or rejected in the process. Understanding then, is a perceptual and conceptual process. In this way, the experience of nurses seeking to understanding those they nurse increases self-awareness, as well as enhancing their ability to further understand others. |
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Call Number |
NRSNZNO @ research @ 797 |
Serial |
781 |
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