| Records |
| Author |
Sheward, K.A. |
Title  |
Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying |
Type |
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| Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Palliative care; Hospitals; Communication; Nurse-patient relations |
| 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. |
| Call Number |
NRSNZNO @ research @ |
Serial |
772 |
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| Author |
Woodbridge, M. |
| Title |
From child savers to child activists: A participatory action research project with community child health nurses |
Type |
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| Year |
2002 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Community health nursing; Paediatric nursing |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 1266 |
Serial |
1251 |
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| Author |
Wilson, L.J. |
| Title |
Futurist planning, not a shortage stopgap: Recruitment and retention of registered nurses in New Zealand |
Type |
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| Year |
2001 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Recruitment and retention; Registered nurses; Policy; Careers in nursing |
| Abstract |
This literature review critically examines contributing factors to the current nursing shortage in New Zealand, centering on recruitment and retention of registered nurses. There is a dramatic widening between the supply of registered nurses and the demand for their services. All regions in New Zealand are reporting difficulty in hiring experienced and specialty nurses, and recruiting time is lengthening. This report suggests that the shortage is closely linked to factors in the nursing care environment. As a result of multiple factors during the centralising, cost-containing, acuity-increasing decade of the 1990s, the care environment has driven practising nurses out of acute care settings and discouraged new students from entering the profession. The availability of numerous alternative career opportunities has heightened the effect. Continuing causes to the non-selection of nursing as a profession are the influences of wage compression and limited career progression over the lifetime of the nurse, and insufficient orientation and mentoring of new nurses. Recent changes in the health care system have gone unevaluated and without oversight by nursing regulatory agencies – a situation not in the best interests of patients or nurses. A number of both literature-supported and resourceful approaches, including recommendations towards addressing the nursing shortage are proposed in this review. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1258 |
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| Author |
Thompson, S.A. |
| Title |
Getting it right: An exploration of compulsive caregiving and helping profession syndrome |
Type |
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| Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Psychology; Nursing |
| Abstract |
This thesis is a theoretical exploration of the concepts of 'Compulsive caregiving' and 'helping profession syndrome' in relation to the choice of nursing as a career. These concepts are derived from Bowlby's attachment theory and psychodynamic psychotherapy. Both have evolved from psychoanalytic theory. The thesis explains Bowlby's development of compulsive caregiving in health professionals. The author notes that her life history and experience as a nurse educator and as a nurse practicing psychotherapy support this theoretical explanation. An argument is developed that the propensity towards compulsive caregiving is a strength in nurses. Nursing places high value on caring and many of the traits exhibited by compulsive caregivers are desirable in nurses. Nursing as a caring interpersonal process is explored with reference to the literature. However, nursing has been identified as a stressful occupation. Support strategies such as professional supervision and reflective practice are discussed. Thesis concludes with a suggestion for further research on compulsive caregiving and helping profession syndrome. |
| Call Number |
NRSNZNO @ research @ 813 |
Serial |
797 |
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| Author |
Radka, I.M. |
| Title |
Handover and the consumer voice: The importance of knowing the whole, full story |
Type |
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| Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
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Pages |
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| Keywords |
Communication; Patient satisfaction; Nurse-patient relations |
| 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. |
| Call Number |
NRSNZNO @ research @ 883 |
Serial |
867 |
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| Author |
Lauder, G.C. |
| Title |
Health in the workplace: An exploration of healthy options for an aged care setting |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Geriatric nursing; Health behaviour; Workplace |
| Abstract |
People working in aged care settings in New Zealand spend approximately 30% of their lives in their workplace. There is a challenge for workplaces to support people to maintain and improve their health status. This project investigated the question: How can workplaces support staff to maintain health in an aged care environment? The project concerned two considerations: primarily what people can do for themselves and how the organisation can assist their interest and maintain their investment in health based activities and secondly what workplaces can do to make the organisations more healthy. The philosophy and the realities of the workplace were reviewed and the project addressed the strategies that could be adopted by the workplace. The study identifies a series of practical activities and outcomes that aged care facilities can undertake for nurses/caregivers or other members of staff working in the workplace. The findings lead to recommendations about healthy outcomes and managing health and creating a positive climate for health within the workplace. |
| Call Number |
NRSNZNO @ research @ 605 |
Serial |
591 |
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| Author |
de Carlo Ahuarangi, K. |
| Title |
Hei watea taupuhipuhi: The space of symbiosis: A conceptual framework for nursing practice |
Type |
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| Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Maori; Teaching methods; Nursing; Transcultural nursing |
| Abstract |
Te watea taupuhipuhi, the space of symbiosis is a framework for nursing practice. It examines the notion of the nursing presence as holding continuity and multiplicity of viewpoint in space of symbiosis. The author developed a teaching-learning situation as an introduction of key ideas in his work where the Maori word “ako” becomes the catalyst of a particular pedagogy that outlines the central notions of symbiosis. Thus, he notes, his work realises that symbiosis occurs not only on the clinical arena of nursing but in the teaching – learning environment as well, his own space of symbiosis. Four rites of passage coalesce a totality of experience within the space of symbiosis, revealing that the central role of the nursing presence is to surface meaning and sense for all of experience which can be fearful, mysterious, paradoxical and chaotic. These four rites of passage are described as the interpretive, integrative, transformations and transcendent. The twelve dynamics of nursing from the axle around which a praxis of nursing revolves. An analysis of those twelve dynamics in rite of passage is situated within narratives taken from the author's nursing practice. He also draws extensively from Maori ontology and autobiography in positioning his exposition within this local context. |
| Call Number |
NRSNZNO @ research @ |
Serial |
901 |
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| Author |
Gingell, M.E. |
| Title |
Home based treatment nursing in Aotearoa New Zealand: Factors influencing the successful delivery of care |
Type |
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| Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
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Pages |
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| Keywords |
Mental health; Home care; Psychiatric Nursing |
| Abstract |
Home Based Treatment in acute mental health care is a relatively new phenomenon in New Zealand, although it has been utilised successfully overseas for many years. This paper considers factors that are integral elements of its successful implementation, specifically considering the relationship of nursing care to crisis intervention methodology. It describes how Home Based Treatment fits with contemporary crisis services and how the adherence to crisis intervention models can enable nurses to create a clearly defined recovery perspective in their practice. The author notes that service users in New Zealand and overseas have openly voiced their concerns around the discrepancies between how services have traditionally been delivered and how they wish services to be. He suggests that, as an alternative to inpatient care, Home Based Treatment is an option that promotes recovery and self determination. It is also an arena in which nurses can deconstruct the traditional power relationships between themselves and clients to create a new and invigorating way of practicing. |
| Call Number |
NRSNZNO @ research @ |
Serial |
589 |
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| Author |
Coupe, D. |
| Title |
How accountable is accountable for mental health nurses? |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Accountability; Nursing; Mental health |
| Abstract |
Accountability has been described by nurses as an elusive concept or myth. The author suggests that this elusive concept or myth can partly be attributed to accountability becoming visible usually following a critical incident. The overall goal of this project is to provide nurses working within mental health with the incentive to raise their awareness and explore what their roles and responsibilities are within the accountability process in a more positive scenario. This research paper reports on an exploration of the key components of accountability within the New Zealand mental health environment. It describes significant influences that affect accountability. This is achieved by the means of a literature review, sharing of the author's experience of being involved in a national inquiry, and the adaptation of a who what and how framework, in conjunction with a diagram displaying accountability levels and lines for mental health nurses. The author points out that the domains of accountability for nurses will continue to evolve and expand but what remains important is that consumers have access to good quality mental health care. |
| Call Number |
NRSNZNO @ research @ 604 |
Serial |
590 |
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| Author |
Stuart, J. |
| Title |
How can nurses address generalist/specialist/nursing requirements of the urban/rural population of Southland |
Type |
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| Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Nursing specialties; Policy; Technology; Scope of practice; Community health nursing |
| Abstract |
This study, which is undertaken in the Southland area, explores the effect of the increasing specialisation of nursing services in what is a rural/urban environment. It is indicated in the literature that systemic changes in health, such as the health reforms, and the increase in the use of technology have meant that nurses are required to function in disease oriented roles rather than according to their more traditional generalist roots. A significant event, which also affected nursing scope of practice, was the transfer of nurse education to the tertiary education institutions environment from the hospitals in the mid 1970s. The traditional nursing hierarchy and its nurse leadership role disappeared and the adoption of specialist nurse titles increased, and identified with a disease or disorder, for example 'diabetes' nurse. The increase in specialist categories for patients contributed to the nurse shortage by reducing the available numbers of nurses in the generalist nursing pool. The nurses in this rural/urban environment require generalist nurse skills to deliver their nursing services because of the geographical vastness of the area being a barrier to specialist nurses. Workforce planning for nurses in the rural/urban then must focus on how to reshape the nursing scope of practice to utilise the existing resources. This study explores how key areas of health services could be enhanced by reclaiming the nurse role in its holistic approach, in mental health, public health, geriatric services and psychiatric services. |
| Call Number |
NRSNZNO @ research @ 885 |
Serial |
869 |
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| Author |
Strochnetter, K.T. |
| Title |
Influences on nurses' pain management practices within institutions: A constructivist approach |
Type |
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| Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Interprofessional relations; Pain management; Nursing |
| Abstract |
Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient. |
| Call Number |
NRSNZNO @ research @ |
Serial |
909 |
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| Author |
Campbell, K. |
| Title |
Intertwining the role of partner and caregiver: A phenomenological study of the experiences of four New Zealand rural women who have cared for their terminally ill partners |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Rural nursing; Terminal care; Palliative care; Home care; Nurse-family relations |
| Abstract |
The stories of the women who live and work in rural settings in New Zealand have begun to reveal unique contributions that they have made to their families and community. This research study evolved from a trend the researcher observed as a district nurse providing community palliative care in rural New Zealand; that the majority of carers of those who are terminally in home-settings are in fact women. This qualitative study aimed to explore through guided conversational interviews the experiences of four women who have cared for their terminally ill partners who have subsequently died. The study investigated if these women's experiences were comparable to that of other women in existing palliative care literature. This research project focused particularly on elucidating the women's experience of intertwining the role of partner and caregiver. Heidegger's hermeneutic philosophy informed the methodology because he focused on what it meant to 'be' rather than 'how we know what we know'. The project focused on the meanings the women made of this dual role in their lives. Women already in the role of partner were now faced with the added responsibility of caregiver to meet the complex needs of their loved one. Usually they had no training to prepare them for this experience. The study reveals ways in which the visiting palliative care nurse becomes very important to them. The women's own voices reveal the high level of respect for their partners and address the harsh realities, revealing poignant and striking concerns in their lives. These stories are shared with the intent of enriching nurses' and other health professionals' understanding of the women's experiences. The author notes that understanding these women's experience is not only a way of honouring these remarkable women but more widely it will inform and possibly transform practice through guideline and policy refinement. |
| Call Number |
NRSNZNO @ research @ |
Serial |
822 |
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| Author |
Rose, A. |
| Title |
Is case management an efficient and effective model of care for complex patients in an acute medical setting? |
Type |
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| Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
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Pages |
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| Keywords |
Clinical decision making; Culture; Nursing; Quality assurance |
| Abstract |
This thesis looks at the prospect of developing and implementing case management as a model of care for complex patients in an acute medical setting. An extensive literature review was conducted to explore the concept of case management and to identify the role of the case manager, including the qualities and qualifications required for the position. Clinical pathways are a tool used in case management so these are also included in the literature review. As the author had been involved in the development of the first clinical pathway for Hutt Valley Health, this is used as an example to clarify how case management and clinical pathways can be used in conjunction. A discussion chapter examines the advantages and disadvantages of case management which shows that it can be an effective and efficient model of care through the development of clinical pathways. The ethical implications of case management are also considered. The thesis concludes with recommendations for the continued development of case management as a model of care to improve the quality of care for both patients and the organisation. During the course of the thesis, other areas that are worth further investigation have also been identified, such as the relevance of case management to different cultures. The thesis suggests that a proposal for case management for complex patients in the acute care setting is developed along with a job description for the role of the case manager. |
| Call Number |
NRSNZNO @ research @ |
Serial |
908 |
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| Author |
Mitchell, D.F. |
| Title |
Is it possible to care for the “difficult” male? A study exploring the interface between gender issues, nursing practice and men's health |
Type |
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| Year |
1999 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Male; Nurse-patient relations; Gender |
| 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. |
| Call Number |
NRSNZNO @ research @ 503 |
Serial |
489 |
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| Author |
Kerr, R.C. |
| Title |
Is the graduate nurse work-ready for emergency nursing? |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Mentoring; Preceptorship; Training; Emergency nursing |
| Abstract |
In this research paper for a Master of Nursing (Clinical), the author suggests that graduate nurses can successfully adapt to emergency nursing when supported with intensive domain-specific transition programmes to complement the national nursing entry to practice (NETP) programme in New Zealand. This outcome conflicts with the present traditional emergency department recruitment strategy that nurses must have two years acute care experience. The graduate believes they are prepared for practice for any healthcare setting but do need time to resolve the rift between theory and practice. This research project confirms the perpetuation of experienced nurses' perceptions that graduates are not work-ready but are unrealistically expected to hit the floor running following ad hoc orientation ranging from three days to four weeks. By creating domain-specific programmes with a minimum twelve-week staged rotation orientation package, graduate nurses can be nurtured as emergency nurses. The influential role of the organisation and experienced nurses is vital to limit reality shock and complement NETP. Preceptorship and mentorship programmes promote the graduates' confidence in themselves to become competent team members. Limits to this research are the non-differentiation between nurses new to emergency nursing and the graduate nurse in the published studies. Assumptions have therefore been made regarding successful transition in regard to newly qualified registered nurses in the emergency department. Further study and evaluation applicable in the New Zealand context is also recommended by the author where anecdotally only a few emergency departments are involved in socialising graduate nurses into the workforce regardless of the urgent need for more first-year-of-practice clinical placements. |
| Call Number |
NRSNZNO @ research @ |
Serial |
494 |
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