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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 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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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 |
Börner, Heidi.E |
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Title |
Evaluating safe patient handling systems: Is there a better way? |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Patient safety; Evaluation research; Occupational health and safety |
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Abstract |
This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1224 |
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Author |
Woods, M. |
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Title |
Parental resistance. Mobile and transitory discourses: A discursive analysis of parental resistance towards medical treatment for a seriously ill child |
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Year |
2008 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Pages |
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Keywords |
Nurse-family relations; Parents and caregivers; Pacific peoples; Communication; Children; Chronically ill |
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Abstract |
This qualitative thesis uses discourse analysis to examine parental resistance towards medical treatment of critically ill children. It is an investigation of the 'mobile and transitory' discourses at play in instances of resistance between parents, physicians and nurses within health care institutions, and an examination of the consequences of resistance through providing alternative ways of perceiving and therefore understanding these disagreements. The philosophical perspectives, methodology and methods used in this thesis are underpinned by selected ideas taken from the works of Michel Foucault and Pierre Bourdieu and supported by relevant literature in the fields of media, law, children, parenting, caring, serious childhood illness, medicine and nursing. It is argued that from an examination of interview based texts, parental resistance is an omnipresent but transitory occurrence that affects many of the interactions between the parents of seriously ill children and clinical staff. It is maintained that within these interactions, the seeds of this resistance are sown in both critical decision making situations and in everyday occurrences between doctors, nurses and parents within healthcare institutions. Contributing factors to parental resistance include the use of power games by staff, the language of medicine, forms of symbolic violence, the presence or absence of trust between parents and medical staff, the effects of medical habitus, and challenges to the parental role and identity. Overall, it is proposed in this thesis that parents who resist treatment for their seriously ill child are not exceptions to the normative patient-physician relationship. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1140 |
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Author |
Sye, J. |
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Title |
A fine balance |
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Year |
2008 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Pages |
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Keywords |
Paediatric nursing; Community health nursing; Nurse-patient relations; Children; Patient rights |
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Abstract |
The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates. |
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Call Number |
NRSNZNO @ research @ 911 |
Serial |
895 |
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Author |
Water, T. |
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Title |
The meaning of being in dilemma in paediatric practice: A phenomenological study |
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Year |
2008 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Volume |
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Pages |
259 pp |
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Keywords |
Psychology; Paediatric nursing; Paedetric practice; Problem solving |
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Abstract |
This study explores the phenomenon of dilemma in paediatric practice. Using a hermeneutic phenomenological method informed by the writings of Heidegger [1889-1976] and Gadamer [1900-2002] this study provides an understanding of the meaning of 'being in dilemma' from the perspective of predominantly paediatric health care professionals but also families in New Zealand. Study participants include four families who had a child requiring health care and fifteen health care practitioners from the disciplines of medicine, nursing, physiotherapy, play specialist and occupational therapy who work with families and children requiring health care. Participants' narratives of their experiences of 'being in dilemma' were captured via audio taped interviewing. These stories uncover the everyday realities facing health professionals and families and provide an ontological understanding for the notion of dilemma. The findings of this study suggest that experience of dilemma for health professionals reveals a world that is uncertain and questionable where they are thrown into having to make uncomfortable choices and must live with the painful consequences of their actions. The consequences of being in such dilemma are having to find ways of living with the angst, or risk becoming too sensitive or desensitizing. For families the experience of dilemma reveals a similar phenomenon most evident in circumstances where they feel totalized by the impact of heath care encounters. This study has uncovered that the perspectives that health professionals and families bring to the experience of dilemma reveal different concerns and commitments and may be hidden from each other. This thesis proposes that health professionals and families need support in living with their own personal encounters of enduring experiences of dilemma. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1234 |
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Author |
Fleck, K. |
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Title |
Finding the shadows in the mirror of experience: An ontological study of the global-co-worker |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ScholarlyCommons@Victoria |
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Issue |
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Pages |
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Keywords |
Culture; Nursing philosophy |
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Abstract |
This study explores the phenomenon of a personal exploratory field visit to HIV programmes in Malawi and how that informs the author's future plans to work cross-culturally with HIV. He uses hermeneutic phenomenology with the guidance of Heidegger and Gadamer, and draw on Ackermann, Hill, Maluleke, Moltmann, and Thielicke for theological direction. This study analyses how personal formation takes place and how the meaning of that experience can inform future cross-cultural interaction. The data of this study is drawn from a range of people interviewing 'me'. This includes a pre and post interview in relation to the author's three week exploratory visit to Malawi, and recorded daily reflections during the visit. Upon return he was interviewed about the experience by ten people from the following areas: nursing, counselling, development, theology, business, medicine, clergy, an Expatriate Malawian, and a women working from a Maori paradigm. These interviews focused on the author's experience with questions framed from the interviewer's specialty area. The transcripts become further data for this study. The findings of this thesis suggest that people wishing to work cross-culturally need to understand their motivation for their work, and understand who they are before entering a foreign land. This transformative journey also needs to continue as part of the process of working with people because we can only be effective with change if we are listening and hearing the other's perspective. It is in being open to this difference between persons that we continue to find ourselves. While perhaps we have a tendency to want to make everybody like us, we can only grow into our full potential in relationship with truly different others. Tensions experienced demonstrate that there is a complex need to understand how the context controls how HIV is perceived. This requires uncovering some of the deeper issues of HIV and culture, and knowing how to conceptualise these in both positive and informative ways. This thesis asks four key questions for the global-co-worker to work through before embarking on cross-cultural mission: 1. How do you know you should go?; 2. How are you going to make a difference?; 3. Who are you going to be?; and 4. What will sustain your involvement? The author's own experience has drawn me into a deeper awareness of the need for a vital connectedness of faith, hope and love underpinning the everydayness of such an experience. |
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Call Number |
NRSNZNO @ research @ 1250 |
Serial |
1235 |
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Author |
Barrington, J. |
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Title |
Shapeshifting: Prostitution and the problem of harm: A discourse analysis of media reportage of prostitution law reform in New Zealand in 2003 |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ScholarlyCommons@AUT |
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Volume |
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Pages |
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Keywords |
Feminist critique; Psychiatric Nursing; Domestic violence |
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Abstract |
The purpose of this research is to examine the cultural context which makes violence and abuse against women and children possible. In 2003, the public debate on prostitution law reform promised to open a space in which discourses on sexuality and violence, practices usually private or hidden, would publicly emerge. Everyday discourses relating to prostitution law reform reported in the New Zealand Herald newspaper in the year 2003 were analysed using Foucauldian and feminist post-structural methodological approaches. Foucauldian discourse analysis emphasises the ways in which power is enmeshed in discourse, enabling power relations and hegemonic practices to be made visible. The research aims were to develop a complex, comprehensive analysis of the media discourses, to examine the construction of harm in the media debate, to examine the ways in which the cultural hegemony of dominant groups was secured and contested and to consider the role of mental health nurses as agents of emancipatory political change. Mental health promotion is mainly a socio-political practice and the findings suggest that mental health nurses could reconsider their professional role, to participate politically as social activists, challenging the social order thereby reducing the human suffering which interpersonal violence and abuse carries in its wake. |
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Call Number |
NRSNZNO @ research @ 1228 |
Serial |
1213 |
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Author |
Atkin, Rachel |
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Title |
Discourses of deficiency: An analysis of the critical care outreach literature |
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Year |
2008 |
Publication |
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Abbreviated Journal |
http://researcharchive.wintec.ac.nz/1/ |
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Abstract |
Critical care outreach is part of a new approach to manage all critically ill patients, regardless of where they are located in the hospital. It is the complete process of care that focuses on individual patients needs rather than on beds and buildings. There has been a proliferation of research literature since critical care outreach teams were introduced and subsequently required to provide robust evidence in the form of research to prove the effectiveness of their service. The research conducted by nurses has largely focused on phenomenological inquiry and has utilised methodologies such as questionnaires and interviews. |
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Call Number |
NZNO @ research @ |
Serial |
1376 |
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Author |
Davies, B. |
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Title |
Same person different nurse: A study of the relationship between nurse and patient based on the experience of shifting from secondary care to home-based nursing |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Research Archive at Wintec |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse-patient relations; Communication; Hospitals; Home care |
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Abstract |
This study focuses on power themes in the nurse-patient relationship. The study is a critical reflection of the author's practice using a humanistic perspective from Hartrick Doane and Varcoe's (2005) model of relational family practice. It reviews the literature relating to power relationships in communication between nurses and patients and compares the ability to provide relational care in the home with hospital care. Practice examples demonstrate the shift in power relationships that the author had noticed since changing roles from hospital based to home care nursing. This is related to cultural, socio-environmental, historical and traditional influences on power in communication. The study is based on her reflection of the paradigm shift in her practice. Her practice moved from a problem solving approach to an empowerment, strengths based approach within partnership. The ethical challenges of discussing her practice in relation to clients has been managed by scrambling patient data so that it is not related to a single person and is focused on the author's nursing practice. |
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Call Number |
NRSNZNO @ research @ 1195 |
Serial |
1180 |
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Author |
Tustin-Payne, W. |
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Title |
Self esteem, competence assessment and nurses ability to write reflectively: Is there any connection? |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Wintec Research Archive |
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Volume |
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Issue |
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Pages |
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Keywords |
Professional competence; Nursing; Psychology; Quality of health care; Feminist critique |
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Abstract |
The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection. |
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Call Number |
NRSNZNO @ research @ 1198 |
Serial |
1183 |
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Author |
Kidd, J.D. |
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Title |
Aroha mai: Nurses, nursing and mental illness |
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Year |
2008 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Nursing; Culture |
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Abstract |
This research takes an autoethnographical approach to exploring the connections between being a nurse, doing nursing work, and experiencing a mental illness. Data is comprised of autoethnographical stories from 18 nurses. Drawing on Lyotard's (1988) postmodern philosophy of 'regimes of phrases' and 'genres of discourse,' the nurses' stories yielded three motifs: Nursing, Tangata Whaiora (people seeking wellness) and Bullying. Interpretation of the motifs was undertaken by identifying and exploring connected or dissenting aspects within and between the motifs. |
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Call Number |
NRSNZNO @ research @ 478 |
Serial |
465 |
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Author |
Harding, T.S. |
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Title |
Men's clinical career pathways: Widening the understanding |
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Journal Article |
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Year |
2008 |
Publication |
Klinisk sygepleje |
Abbreviated Journal |
Coda: An institutional repository for the New Zealand ITP sector |
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Volume |
22 |
Issue |
3 |
Pages |
48-57 |
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Keywords |
Male nurses; Gender; Careers in nursing |
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Abstract |
This article, drawn from a larger study, reports on the factors that have influenced the choice of a group of New Zealand male nurses' clinical career pathways. Using discourse analysis, interview data from 18 participants were analysed and related to existing literature on male nurses. The analysis revealed that the predominance of men in selected areas of nursing can be attributed to multiple factors including: socialisation pressures that are grounded on gender stereotyping, a desire for challenge, homosocial tendencies, and the belief that multiple work experience equips them to be better nurses. The results challenge essentialist readings of masculinity within the context of nursing and identifies challenges for nursing education and the profession to enable men to contribute more widely to nursing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
646 |
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Author |
Atherfold, C. |
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Title |
Will someone walk with me? A case study exploration of graduate nurses' perceptions of the preceptored experience |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Unitec New Zealand Library |
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Pages |
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Keywords |
Preceptorship; New graduate nurses |
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Abstract |
The transition from student to registered nurse is a challenging and often stressful time in a nurse's career. This thesis is a case study research project that explores the graduate nurses' perceptions of preceptorship as a strategy to support this transition at Lakes District Health Board (DHB). As a provider of graduate nurse programmes since 1995, Lakes DHB has provided preceptorship for the nurse in the initial period of clinical practice. Annual evaluation by questionnaire identified that this has been applied in a range of ways in different clinical settings with varying degrees of effectiveness. Further inquiry into graduate nurses' perceptions of the preceptored experience during the first twelve weeks of practice within Lakes DHB forms the basis of this research project. The intention is to utilise this insight to further inform the development of preceptor education programmes and application of the preceptor role in the practice setting. Using the case study research method, data has been collected from fourteen participants using semi-structured interviews, focus groups and secondary data from the previous year's questionnaire undertaken by preceptors and graduate nurses. Thematic analysis of the data has resulted in two categories, each with three associated themes. The first category relates to functional factors in the way the preceptorship role is applied. This explores the role of the Clinical Nurse Educator (CNE), organisation within the unit and the teaching of clinical skills. The second category relates to psychosocial considerations and includes the graduate's sense of being scared and advocacy of the preceptor, socialisation and team support, and the preceptor's own experience as a registered nurse. Recommendations from the research include the allocation of a dedicated preceptor selected with consideration for relational ability; complementary rostering and workload allocation to ensure that the preceptor and graduate nurse work together; early notification when preceptor arrangements break down; implementation of a clinical coaching plan; and strengthening the CNE's role as a leader facilitating and supporting preceptorship in the units. Opportunities for further research that arise from the study include the perceptions of the preceptors and the nursing leadership in clinical areas. Structuring the application of preceptorship, to ensure that all of these aspects are woven throughout the graduate nurse's transition results in Korowai Aroha, a cloak of covering for a supported transition that facilitates the development of practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
866 |
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Author |
Howie, L. |
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Title |
Rural society and culture |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 3-18 ) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Culture |
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Abstract |
The author takes a multidisciplinary approach to examine how the location and concept rural is defined and provides a critique of the disparate definitions available. Definitions encompass different disciplines such as sociology and anthropology, and there are national distinctions based on historical factors. The chapter also investigates the way researchers speak about rural people, particularly as the human aspect of health is a primary concern to nursing. The focus is on the socio-cultural, occupational, ecological, and health aspects of rurality. The Rural Framework Wheel is introduced, which is a method to categorise rural contextual definitions. Rurality is presented as a variable and evolving concept that provides particular challenges to nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
460 |
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Author |
Horner, C. |
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Title |
Emergency health provision and maintaining competency |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 125-136) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Professional competence; Emergency nursing |
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Abstract |
This chapter focuses on issues associated with rural nursing and the provision of emergency care for patient(s) located remotely from secondary hospital services. All emergencies have diverse characteristics, but the rural practitioner also contends with having sole practice, professional and geographical isolation, and the lack of regular experience. The chapter reviews the PRIME (Primary Response in Medical Emergency) recommendations and training, and looks in particular at the issues around the maintenance of competency for the rural nurse providing emergency on call health care that includes managing medical and accident emergencies in the absence of a medical practitioner. |
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Call Number |
NRSNZNO @ research @ |
Serial |
756 |
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