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Author |
Green, M. |
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Title |
Psychiatric consultation liaison nurse: A model for practice |
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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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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 |
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 |
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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 |
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 |
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 |
Type |
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 |
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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Volume |
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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 |
Walsh, K.; McAllister, M.; Morgan, A.; Thornhill, J. |
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Title |
Motivating change: Using motivational interviewing in practice development |
Type |
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 |
Shanks, A. |
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Title |
Stories within stories: What are client stories and how do community mental health nurses work with them? |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
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 |
Farrow, T. |
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Title |
Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments |
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 |
4 |
Pages |
214-219 |
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Keywords |
Interprofessional relations; Psychiatric Nursing; Community health nursing; Qualiltative research; Suicide |
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Abstract |
'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly. |
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Call Number |
NRSNZNO @ research @ |
Serial |
785 |
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Author |
Morrison-Ngatai, E. |
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Title |
Mai i muri ka haere whakahaere: Maori woman in mental health nursing |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Maori; Female; Psychiatric Nursing |
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Abstract |
Contents: Chapter 1 Kupu whakataki – introduction; Chapter 2 Raranga mohiotanga – literature review; Chapter 3 To te wahine mana tuku iho – theoretical framework; Chapter 4 Tahuri ki te rangahau – research methodology; Chapter 5 Whakaaturanga whakaoho – beginnings; Chapter 6 Kia pakari – positioning and contesting; Chapter 7 E ara ki runga wahine toa – standing and enduring; Chapter 8 Kua takoto te whariki. |
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Call Number |
NRSNZNO @ research @ |
Serial |
828 |
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Author |
Crowe, M. |
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Title |
Psychiatric diagnosis: Some implications for mental health nursing care |
Type |
Journal Article |
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Year |
2006 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
53 |
Issue |
1 |
Pages |
125-131 |
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Keywords |
Psychiatric Nursing; Diagnosis; Culture; Gender; Socioeconomic factors; Nursing models |
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Abstract |
This article explores some of the functions of psychiatric diagnosis and the implications this has for mental health nursing care. It critiques the psychiatric diagnosis as a categorisation process that maintains oppressive power relations within society, by establishing and enforcing normality through gender, culture and class biases. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is used to illustrate some of the inherent biases in the diagnostic process. The author argues that mental health nursing practice needs to demonstrate an awareness of the power relations inherent in any diagnostic process and make attempts to redress these at both the individual and sociopolitical levels. To create a true patient-centred partnership in mental health nursing, the nursing focus should be on the patient's experience rather than the psychiatric diagnosis with which the experience is attributed. NB this is a reprint of article first published in Journal of Advanced Nursing, 2000 Mar; 31(3), 583-9. |
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Call Number |
NRSNZNO @ research @ |
Serial |
837 |
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Author |
Clayton, J.R. |
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Title |
The recovery of hope: A personal journey through paradigms toward emancipatory practice |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Mental health; Teaching methods; Nursing philosophy |
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Abstract |
This study traces the author's transition from being a mental health nurse to becoming a facilitator of an education programme, the Health and Wellbeing course, for those in recovery from mental illnesses. Within this transition, she describes a journey from disease-focused paradigms toward emancipatory paradigms, evidenced by her application of the recovery approach to her teaching. The 'recovery approach' proposed by the Mental Health Commission in November 1998, and other models of health, are explored using the methodology of descriptive/interpretive philosophical inquiry, autobiographical narrative and a dialectical research design. The author draws from the philosophies of phenomenology and existentialism to present excerpts from her journals, exemplars, poetry and artwork which illuminate epiphanies occurring as she integrates health paradigms in the design of the Health and Wellbeing course. Within this process the recovery approach is revealed as being consistent with the teaching principles of the Health and Wellbeing course. The author goes on to say that the dialectical research design reveals paradoxes and transformations in nursing, medical, psychological, and humanistic paradigms within the New Zealand socio-political context from the 1970s to 2003. The way these are integrated into her practice as an educator, becomes evident in the dialectical research cycles of being, thinking, developing a project, the encounter of teaching, making sense and communication. These cycles reveal her being in the roles of nurse and educator and the thinking through of paradigms that lead to the design and philosophy of a Health and Wellbeing course, the encounter of teaching, and the communication of insights gained. The author's main objective is to show the importance of nurses and educators developing a reflective consciousness when working with sufferers of mental illness. This reflective consciousness involves three levels: The primary level, or raw experience; the social level, or our socio-political contexts and social values, and, the realised level, insights gained about knowledge and experience. |
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Call Number |
NRSNZNO @ research @ |
Serial |
854 |
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Author |
Bresaz, D.M. |
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Title |
Environmental influences on inpatient assaultive behaviour |
Type |
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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 |
Workplace violence; Mental health; Psychiatric Nursing; Methodology; Administration |
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Abstract |
This retrospective quasi-experimental study reviewed assaults in two adult mental health inpatient rehabilitation units. The majority of clients in this area experience enduring mental health illnesses and have complex physical health issues. The service comprises of an intensive rehabilitation unit and a secure extended rehabilitation unit. Between May and August 2001 the service moved to purpose built facilities. The opportunity was taken to review clients' assaultive behaviour in the new environment and to compare the incidents with those in the old environment to see if there had been any significant changes. Data on assault incidents including time of assault, place of assault, who was involved and what preventative actions were suggested were collected from the Incident and Accident Hazard Reports (IAHR) dating from 1 April 2000 until 31 May 2002. Staff were expected to complete IAHR reports on all assault incidents. The research examined whether the change in environmental conditions impacted on clients' wellbeing in relation to assaultive behaviour. Trends within the IAHR reports were also examined in order to compare these to similar studies completed in other parts of the world. There were 141 IAHR reports of assault incidents. Fifty of these occurred in the pre move period, 38 in the transition phase and 53 in the post move. There was no significant difference in the rate of assaults in the pre-move to post move period. Completion of the IAHR forms was seen to be very problematic, especially in relation to legal status of perpetrators and documentation of prevention strategies. An urgent audit of existing practice is now required to establish if problems found with the quality and completion of the IAHR forms continues to be evident in the rehabilitation service and if present staff education is needed to improve the standard of documentation. Research is also needed to establish the extent to which staff implement strategies to prevent assaults, and to reduce recidivism. |
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Call Number |
NRSNZNO @ research @ |
Serial |
858 |
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Author |
Gillard, D. |
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Title |
When I am nursing |
Type |
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Year |
2002 |
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; Mental health; Adolescents; Psychiatric nursing |
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Abstract |
Over the last century the nursing profession has drawn from numerous theories and disciplines to construct its own theoretical foundations. While this diversity and flexibility may be one of the nursing profession's strengths it may have contributed to nurses' difficulty in explaining the complexities of their every day clinical work. This is a particular challenge for the domain of mental health nursing. This dissertation discusses how nursing models that have credibility at a clinical level can contribute to informing and advancing nursing practice. Models can achieve this by assisting nurses to conceptualise and articulate what it is they do that makes a difference to patient outcomes. Through this process nurses can maintain a distinct professional identity and establish themselves as effective members of multidisciplinary health team. Specifically, the application and limitations of Godkin's (2001) proposed model of a 'healing presence' to the author's own practice in a one-to-one nurse-adolescent client relationship in the mental health nursing is examined. It is claimed that a 'healing presence' provides a meaningful way to understanding the author's own practice. The proposed model of a 'healing presence' embraces the diversity of her background, and allows the author to maintain a nursing identity by providing a nursing framework to critique her practice, furthering her understanding of what it is that 'expert' nurses do and how this impacts on patient outcomes. Also suggested is that a 'healing presence' can contribute to the author's own and other nurses advanced nursing practice by making nursing visible to the multidisciplinary health team and to articulate “what it is that I do 'when I am nursing'”. Through presenting this dissertation, the author wishes to inspire other nurses to examine and understand their own practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
914 |
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Author |
Cook, N.; Phillips, B.N.; Sadler, D. |
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Title |
The Tidal Model as experienced by patients and nurses in a regional forensic unit |
Type |
Journal Article |
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Year |
2005 |
Publication |
Journal of Psychiatric & Mental Health Nursing |
Abbreviated Journal |
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Volume |
15 |
Issue |
5 |
Pages |
536-540 |
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Keywords |
Psychiatric Nursing; Nursing models; Evaluation; Nurse-patient relations |
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Abstract |
This study looks at the effect of implementing the Tidal Model at Rangipapa, a regional secure mental health forensic unit. A phenomenological study was undertaken to obtain reflective description of the nursing care experience from the perspective's of four registered nurses and four “special patients”. Five major themes were identified that appeared to capture the experiences of the participants. The themes show changes to the unit's unique culture and values following implementation of the model. These changes engendered a sense of hope, where nurses felt they were making a difference and patients were able to communicate in their own words their feelings of hope and optimism. Levelling was experienced as an effect emerging from individual and group processes whereby a shift in power enhanced a sense of self and connectedness in their relationships. These interpersonal transactions were noted by the special patients as being positive for their recovery. This enabled effective nurse-patient collaboration expressed simply as working together. The participants reported a feeling of humanity, so that there was a human face to a potentially objectifying forensic setting. Implications arising from this study are that the use of the model enables a synergistic interpersonal process wherein nurses are professionally satisfied and patients are validated in their experience supporting their recovery. |
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Call Number |
NRSNZNO @ research @ |
Serial |
941 |
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