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Author |
Taua, C. |
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Title |
Revisiting the past: A focused ethnography of contemporary dual diagnosis nursing practice |
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Year |
2005 |
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Abbreviated Journal |
Copy downloadable from the NZNO Library |
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Issue |
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Keywords |
Psychiatric Nursing |
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Abstract |
As has been the case internationally, deinstitutionalisation of dual diagnosis (intellectual disability and mental illness) services has also occurred in New Zealand. Inpatient services have been redefined to respond to the more acute focus that has arisen out of this deinstitutionalisation process and nurses are having to redefine their roles in response. This study was undertaken to explore and describe the culture of nursing practice in a dual diagnosis inpatient unit in one psychiatric hospital. A focused ethnographic approach was used to triangulate data gathered from fieldwork observations, review of documents and semi-structured interviews. Schein's (1985) levels of culture model, was used to identify and explore the artifacts, values and assumptions evident in this nursing practice. Analysis presents three key themes categorised as 'communication', 'assessment' and 'safety'. While these key themes are shown to be evident in the everyday practice of the nurses, how these relate to the notion of 'dual diagnosis nursing' is not clear. Therefore, the author describes the major finding of this study as revealing a nursing culture holding tight to traditional psychiatric and psychopaedic nursing practices and struggling to develop a distinctive culture in the absence of a defined dual diagnosis knowledge base. The author concludes that these findings suggest an urgent need to provide nurses with support in gaining contemporary knowledge regarding dual diagnosis nursing. Support for nurses in advancing these areas then impacts on support for the patients. It is suggested that additional research is undertaken to assess the learning needs of the nurses in order to develop clinical practice guidelines for this area. Further recommendations are made to address system issues which are contributing to the gap in knowledge. |
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Call Number |
NRSNZNO @ research @ |
Serial |
674 |
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Author |
Hames, P.V.M. |
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Title |
Patient advocacy: A concept analysis |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Pages |
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Keywords |
Patient rights; Nursing; Nurse-patient relations |
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Abstract |
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Call Number |
NRSNZNO @ research @ 689 |
Serial |
675 |
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Author |
Clark, P.N. |
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Title |
The potential for nurse-led clinics on oncology at Southland District Health Board |
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Year |
2006 |
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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Keywords |
Older people; Scope of practice; Nursing; Oncology; Cancer |
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Abstract |
The author points to a “waiting list crisis” occurring in ambulatory oncology services at Southland District Health Board (SDHB), and notes that the literature suggests this is occurring both nationally and globally. This is due to factors such as an increase in the number of people aged 65 years and over, many of whom will develop cancer. Furthermore new drug therapies and indications for treatment have led to increased numbers of patients referred for oncological assessment in the out-patient clinics. The author notes that, at SDHB, this delay for patients to be seen at a first specialist assessment appointment is causing concern for patients, managers and the medical and nursing staff involved. This dissertation analyses relevant literature in order to explore the nature and outcomes of nurse-led clinics. A range of studies indicate that effective care can be provided by nurses working in a variety of nurse-led clinics settings. These studies reveal ways in which a nurse-led clinic might be established and delivered in oncology services and, the author suggests, this will go some way to provide a solution for SDHB. These clinics would assess and monitor the follow-up of selected patients with stable disease and established care plans such as patients receiving adjuvant chemotherapy for bowel and breast cancer. This would allow medical oncologists to see more new patients at first assessment and the follow-up of complex cases, and could go some way in relieving the current waiting lists. The educational preparation and competency of nurses leading such a clinic are considered. |
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Call Number |
NRSNZNO @ research @ |
Serial |
677 |
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Author |
Dewes, C.A. |
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Title |
Perceptions and expectations of a kaiawhina role |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Keywords |
Maori; Students; Nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 692 |
Serial |
678 |
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Author |
McEldowney, R.A.; Richardson, F.; Turia, D.; Laracy, K.; Scott, W.; MacDonald, S. |
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Title |
Opening our eyes, shifting our thinking: The process of teaching and learning about reflection in cultural safety education and practice: An evaluation study |
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Report |
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Year |
2006 |
Publication |
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Abbreviated Journal |
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Pages |
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Keywords |
Cultural safety; Nursing; Culture |
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Abstract |
The purpose of the research was an evaluation of practice exemplars as a reflective process in teaching and learning about cultural safety. Six Maori, two Pacific and five Pakeha students, ranging in age from 30 to 40, took part in the research. The research findings revealed five sub themes: personal safety, power/ powerlessness, reflection, teaching and learning and cultural safety. The presentation, while acknowledging that cultural safety shared some commonalities with culture care theory, highlighted differences between the two. These included that cultural safety was explicit in identifying the inherent power of the nurse in health care relationships; related to the experience of the recipient of nursing care, and extended beyond cultural awareness and sensitivity; provided consumers of nursing services with the power to comment on practices; and contributed to the achievement of positive outcomes and experiences for them. It outlined the characteristics of a culturally safe nurse as a nurse who had undertaken a process of reflection on her/his own cultural identity and who recognised the impact their personal culture had on client care. |
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Call Number |
NRSNZNO @ research @ 693 |
Serial |
679 |
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Author |
Cook, D. |
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Title |
Open visiting: Does this benefit adult patients in intensive care units? |
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Year |
2006 |
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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Pages |
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Keywords |
Hospitals; Intensive care nursing |
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Abstract |
As the healthcare system moves toward a consumer-driven paradigm, visiting hours for family and significant others of the intensive care unit patient have become a topic of interest and discussion. Research since the 1970s has generated controversy and speculation over the ideal visiting practices in the adult intensive care unit. The aim of this dissertation was to examine the benefits for the patient, family members and nurses of appropriate visiting practices within intensive care areas in order to establish if open visiting is the best regime for patients in the adult intensive care unit (ICU). This dissertation explores visiting practices in adult critical care unit settings. Specifically, the benefits of visiting for patients, and the factors that may impede or facilitate visiting practices within the ICU were critically discussed. These factors included the benefits and disadvantages of open visiting, and the nurse as an influential factor in visiting. These areas linked together to form the basis for consideration of visiting in the ICU. Review of existing literature pertaining to visiting in the ICU indicated that patients wanted open visiting hours yet also indicated that they would like some visiting restrictions. Nurses appeared to value family input into care and were aware of patient and family needs, even though they may restrict visiting to suit their own work practices. Family members can provide the patient with psychological support, provide important historical data, assist the nurse with selected aspects of physical care, and actively encourage the patient's efforts to recover. The outcome of this exploration is the recommendation of an open visiting policy tailored to individual patients, as, the author suggests, this would foster nursing practice and ultimately benefit patients and their families. |
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Call Number |
NRSNZNO @ research @ |
Serial |
680 |
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Author |
Paterson, J.E. |
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Title |
Nurses' clinical decision-making: The journey to advancing practice |
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Year |
2006 |
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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Pages |
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Keywords |
Clinical decision making; Mentoring; Nursing; Nurse practitioners |
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Abstract |
This dissertation reports on a scholarly journey to better understand the processes of clinical decision-making by nurses. It begins by identifying the various terms used to describe a clinical decision, its components and the contexts within which clinical decisions are made. Two philosophies of decision-making are summarised. Some insight into the history of the phenomenological and the rationalist theories of decision-making is offered. The author notes that it became evident that both of these theories are applicable to all nurses and their clinical decision making competencies. Four studies that were undertaken to analyse the decision-making methods of nurse practitioners are critiqued. Of the studies two are British, one is American and one is Australian. The author has summarised the combined findings that identified that the nurses were using a blend of decision-making processes that involved rational decision making as well as the use of intuition. The studies identified that sound clinical decision-making is determined by appropriate educational and clinical preparation and supported by a formal mentoring process and the use of critical reflective practice. In conclusion, the author reflects on her knowledge of decision making prior to embarking on the dissertation and states her intent to facilitate and support advanced decision-making by her colleagues. She goes on to say that uppermost is the need for an institutional and managerial environment that encourages advanced and independent decision-making by nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
681 |
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Author |
Elliott, M.M. |
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Title |
Model of care development: Moving between liaison and complex care coordination in the community health setting |
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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 |
Community health nursing; Nursing models |
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Abstract |
Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services. |
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Call Number |
NRSNZNO @ research @ |
Serial |
684 |
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Author |
Martin, H.E. |
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Title |
Marking space: A literary psychogeography of the practice of a nurse artist |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Mental health; Nurse-patient relations |
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Abstract |
The author suggests that the thesis as a production of disciplined work presented in a creative style is congruent with performance and presentation best practice in community arts. As a practising nurse artist the author describes creating spaces of alternate ordering within the mental health field environment. “I also inhabit the marginal space of the artist working in hospital environments. This Other Place neither condones nor denies the existence of the mental health field environment as it is revealed. Yet, it seeks to find an alternative to the power and subjectivity of the [social] control of people with an experience of mental illness that inhabit this place both voluntarily and involuntarily. I have used a variety of texts to explore the experience and concept of Otherness. The poems are intended to take you, as a reader where you could not perhaps emotionally and physically go, or might have never envisaged going. They also allow me as the author to more fully describe the Otherness of place that is neither the consumer story nor the nurse's notation, but somewhere alternately ordered to these two spaces. Drawing on the heuristic research approaches of Moustakas and literary psychogeography , particularly the work of Guy Debord, this thesis creates the space to explore the possibilities of resistance and change and the emergence of the identity of the nurse artist within the mental health field environment”. |
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Call Number |
NRSNZNO @ research @ |
Serial |
685 |
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Author |
Mulcahy, D.M. |
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Title |
Journeys cross divides: Nurses and midwives' experiences of choosing a path following separation of the professions |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Pages |
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Keywords |
Midwifery; Nursing; Policy; Careers in nursing |
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Abstract |
In 2003 the Health Practitioners Competence Assurance Act was introduced and established separate regulatory authorities for nursing and midwifery. This study is designed to explore the experiences of dually registered practitioners affected by this divide, as now there are two separate and possible paths, and two corresponding sets of competencies to fulfil. The design for this qualitative descriptive study utilised the written and oral narratives of three practitioners affected by this professional regulation and demonstrated its impact on their career development. Individual storytelling, as narrative, provided a theoretical lens aiding insight into their experience and pattern of decision making. In addition, symbolic consideration of the study data was provided by collective storytelling via the perennial myth of the hero journey. Shifting professional ground following the Health Practitioners Competence Act 2003 generated a focus for the inquiry into practitioners' modes of adjustment. For the practitioners in the study, transition between the occupational roles of nursing and midwifery comprised the possible career trajectories. A status passage, as the process of change from one social status to another, is described and includes the transitional experience of anticipation, expectation, contrast, and change. The author suggests that the findings from this research provide illumination of the nuances of professional decision making as a lived experience, and highlight how these practitioners dealt with shifting meaning, values, awareness, choices, and relationships. Aspects of group agency and identity, change management, and professional role transition were revealed. Life pattern, revealed through narrative, was an important research construct for exposing the ways in which the participants negotiated change, and displayed the function of their thinking and reasoning through dilemmas. Perception of individual and group identity revealed attitudes of esteem to the dominant discourse, and exposed dynamic tension between work patterns and life stage. Renegotiating arrangements of personal and professional commitment resulted from this dynamic interplay, and the relationship to stress and burnout was explored. |
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Call Number |
NRSNZNO @ research @ 700 |
Serial |
686 |
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Author |
Goulding, M.T. |
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Title |
The influence of work-related stress on nurses' smoking: A comparison of perceived stress levels in smokers and non-smokers in a sample of mental health nurses |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Pages |
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Keywords |
Smoking; Psychiatric Nursing; Stress; Mental health |
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Abstract |
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Call Number |
NRSNZNO @ research @ 701 |
Serial |
687 |
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Author |
Pepers, M.G. |
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Title |
A grey zone: The experience of violence in remote nursing practice |
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Year |
2006 |
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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Pages |
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Keywords |
Workplace violence; Rural health services; Rural nursing |
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Abstract |
This dissertation explores the issues affecting the exposure of isolated rural nurses working in New Zealand to violence from members of the local community, including the visiting public. Discussion on the collaborative role with the New Zealand Police is thematic in the issues presented. Challenges presented include the unique community dynamics of the Stewart Island nursing practice on the Island, with scope of practice, isolation and practice issues included. Role definition, present-day health-care delivery, the potential for violence including causation and reporting are presented. Incident management and risk strategies, including de-escalation are rationalised and described. Evidence for the nurse-police inter-service relationship along with issues including confidentiality and legislation are reviewed. Recommendations and conclusion are provided. The thread and theme of the dissertation is to encourage discussion within nursing circles on the provision of satisfactory safety standards for nurses working in remote isolated parts of New Zealand. |
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Call Number |
NRSNZNO @ research @ |
Serial |
688 |
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Author |
Watkins, B.E. |
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Title |
Making meaning of a personal experience of discrimination in relation to a disability: An exploration of the literature |
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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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Pages |
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Keywords |
People with disabilities; Nursing |
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Abstract |
This paper explores the reaction of the author's colleagues when she returned to work disabled after recovering from an injury. In order to understand the new experience of disability and discrimination and to help answer what changed the behaviour of colleagues, the author considered evidence from the published literature. After considering many different models of disability, the social model of disability helped clarify and frame her own experience. Reflecting on this literature and personal experience, she suggests that there is acknowledgement that society's attitudes are changing slowly through governmental action and the activism of the disabled. However, she goes on to say, it is only through progressing education, experiencing disability, and continuing emancipatory research that progress will be made to release people with disabilities from their bonds of prejudice and oppression. |
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Call Number |
NRSNZNO @ research @ 734 |
Serial |
720 |
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Author |
Scott, W. |
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Title |
Listen to the beat of my heart: The lived experience of panic attack in undergraduate nursing students: An interpretive inquiry |
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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 |
Psychology; Students; Nursing; Midwifery |
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Abstract |
This interpretive inquiry explores the lived experience of 3 undergraduate nursing students and one midwifery student who have panic attacks. The aim of the research is to give voice to these students and to raise awareness among nurse educators about the impact that panic attacks may have for them. The research question asks, “what is the lived experience of panic attack in undergraduate nursing students?” A semi structured interview was conducted with each student in order to gain significant data. The research identified four key themes implicit to the lived experience of panic attack analysis: Listen to the beat of my heart (embodiedness), fearfulness, shamefulness, and holding one's own (coping). The findings suggest that the lived experience of panic attack is embedded in the lifeworld of lived body, lived time, lived relation, and lived space. Panic attack affects students physically and emotionally and interpersonally. The significant finding is that nurse educators need be aware of the coping or non-coping strategies used by students and, most importantly, recognise the impact that panic attacks have on their study. |
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Call Number |
NRSNZNO @ research @ 735 |
Serial |
721 |
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Author |
Macfarlane, K. |
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Title |
Communicating changes in a patient's condition: A critical incident approach |
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Year |
2006 |
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 |
Communication; Clinical assessment; Physicians; Nursing; Relationships |
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Abstract |
This study explores how registered nurses working within the acute surgical ward environment of a New Zealand hospital communicate changes in a patient's condition. The purpose of this research study was to examine the processes, communication techniques and behaviours that nurses use, in order to determine the critical requirements for registered nurses to effectively communicate changes in patients' conditions to doctors. The critical incident technique developed by Flanagan (1954) was adapted and used to explore incidents that occurred when six registered nurses working in acute surgical wards communicated a change in a patient's condition to a doctor. Communication is an integral part of everyday activity. This study has shown an assessment process occurs before communication can take place. A nurse's concern for a patient's condition initiates the assessment process. A judgement is formed from the nurse's concern that a patient's condition has changed. Judgements take into account multiple ways of knowing including pattern recognition, empirical knowing and intuition. Institutional protocols also affect judgements and the ability of a nurse to ensure support is received for the patient's well being. The communication process is initiated for two reasons, to support the patient, and to support the nurse in providing care for the patient. Significant in determining the need for support is the action required that might be outside the nurse's scope of practice. The response should address the nurse's concern and take into account the importance of the relationship, trust between all parties, respect of each other's positions and knowing team members and their capabilities. Understanding these aspects of the communication process should enhance nurses and doctors abilities to effectively communicate regarding a change in a patient's condition. |
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Call Number |
NRSNZNO @ research @ |
Serial |
724 |
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