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Tabakakis, C., McAllister, M., & Bradshaw, J. (2020). Burnout in New Zealand resgistered nurses: the role of workplace factors. Kai Tiaki Nursing Research, 11(1), 9–16.
Abstract: Investigates the impact of workplace factors on burnout in NZ RNs. Conducts a cross-sectional survey among 480 RNs in which burnout, practice environment and negative acts in the workplace were self-reported by means of the Copenhagen Burnout Inventory (CBI), the Practice Environment Scale (PES), and the Negative Acts Questionnaire (NAQ).
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Jamieson, I., & Harding, T. (2019). The perspectives of key stakeholders regarding New Zealand's first graduate-entry nursing programme. Kai Tiaki Nursing Research, 10(1), 8–14.
Abstract: Backgrounds the circumstances surrounding the establishment of NZ's first graduate-entry registered nursing programme in 2014 an the Christchurch Polytechnic Institute of Technology and the University of Canterbury. Undertakes a qualitative, descriptive case-study involving purposive sampling of stakeholders in the programme's establishment
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Hughes, M., Kirk, R., & Dixon, A. (2018). Direction and delegation for New Zealand nurses. Kai Tiaki Nursing Research, 9(1), 36–37.
Abstract: Investigates how enrolled nurses (EN) and registered nurses (RN) perceive their experiences of direction and delegation. Employs narrative enquiry to describe communication during direction and delegation interactions.
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North, N. (2007). International nurse migration: Impacts on New Zealand. Policy, Politics, & Nursing Practice, 8(3), 220–228.
Abstract: Nurse migration flows in and out of New Zealand are examined to determine impacts and regional contexts. A descriptive statistics method was used to analyse secondary data on nurses added to the register, New Zealand nurse qualifications verified by overseas authorities, nursing workforce data, and census data. It found that international movement of nurses was minimal during the 1990s, but from 2001 a sharp jump in the verification of locally registered nurses by overseas authorities coincided with an equivalent increase in international registered nurses added to the local nursing register. This pattern has been sustained to the present. Movement of local registered nurses to Australia is expedited by the Trans-Tasman Agreement, whereas entry of international registered nurses to New Zealand is facilitated by nursing being an identified “priority occupation”. The author concludes that future research needs to consider health system and nurse workforce contexts and take a regional perspective on migration patterns.
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Marshall, B., Craig, A., & Meyer, A. (2017). Registered nurses' attitudes towards, and experiences of, aggression and violence in the acute hospital setting. Kai Tiaki Nursing Research, 8(1), 31–36.
Abstract: Examines NZ registered nurses' experiences of aggression and violence and the impact of aggression management training (AMT) on their experiences. Collects data using an internet survey incorporating Collins' Attitudes Towards Aggressive Behaviours Questionnaire. Rates the effect of participation in AMT on exposure to aggression or violence and its impact on attitudes towards aggression and violence.
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Dredge, A. (1999). An insider's view of professional nursing and care management of the critically ill patient. Vision: A Journal of Nursing, 5(8), 13–16.
Abstract: This article explores the role of the registered nurse (RN) in the critical care environment. It presents the Intensive Care Unit (ICU) as a unique environment, with a specific relationship to technology, and a history that mirrors scientific development. It explores the tensions for a caring profession with a distinct culture practising in a highly medicalised, acute environment, and affirms the value of quality human care.
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Lilley, S. (2006). Experiences of mentoring in primary health care settings: Registered nurses' and students' perspectives. Ph.D. thesis, , .
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Mearns, G. (2005). Developing autonomous ownership: A grounded theory study of how registered nurses working in aged care are advancing their nursing practice. Ph.D. thesis, , .
Abstract: The introduction of nurse practitioner registration into New Zealand in 2001 was heralded as a move that would open up a wealth of opportunities for registered nurses to extend their practice into more independent roles and to provide a client-centred health service. It was also seen as a way to retain experienced registered nurses in the clinical practice area by providing a credible clinical career pathway. If nurse practitioner's are to meet these expectations, then, the author suggests, it is important to understand the processes that encourage or discourage nurses from advancing their practice. One of the early scopes of practice to be introduced was nurse practitioner with an endorsement in aged care scope of practice. Grounded theory was the method used to generate an explanation of how registered nurses working in aged care were preparing for the introduction of nurse practitioner roles. An analysis of early data highlighted codes around registered nurses in aged care extending and advancing their practice rather than preparing specifically for the nurse practitioner role. The research question for this study was: 'How are registered nurses in aged care advancing their nursing practice?' Semi-structured interviews were used to collect data from ten experienced registered nurses working in aged care clinical practice settings ranging from secondary hospital facilities, to community settings and residential care villages. Dimensional analysis of the data eventually generated three major conceptual categories: 'ownership of nursing', 'extending practice', and 'moving out of a comfort zone'. Of these, 'ownership of nursing' was identified as the core construct that linked the other categories together. The substantive theory that explains how registered nurses in aged care advance their clinical practice is 'developing autonomous ownership'. Nurses who develop autonomous ownership of nursing are more likely than other nurses to move out of a current comfort zone and advance their practice into more independent roles that suit their autonomous ownership of nursing. This study identified important contextual factors and conditions that support the development of an autonomous ownership of nursing and that subsequently facilitate advancing nursing practice. These include creating supportive environments, organisational commitment to advanced nursing practice roles, visible nursing leadership, congruence between organisational and nursing philosophies, interdisciplinary collaboration and participating in postgraduate education. The author suggests that the significance of this study is that it generated a theory about the processes that encourage or discourage nurses from preparing for, and progressing into, advanced nursing practice roles such as nurse practitioner.
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Bleach, A. (2005). Nurses talk the walk: An exploration of nurses' perception of advanced nursing practice on acute mental health inpatient units in New Zealand. Ph.D. thesis, , .
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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Dal Din, A. (2006). Accepting the challenge: Registered nurses' experiences of undertaking the statutory role of Responsible Clinician in New Zealand. Ph.D. thesis, , .
Abstract: This aim of this thesis was to explore and describe registered nurses' experiences of undertaking the statutory role of Responsible Clinician under the Mental Health (Compulsory Assessment and Treatment) Act 1992. The role of Responsible Clinician has been available to nurses since 1992 yet to date there has been little research into nurses' experiences of undertaking this role. An exploratory descriptive approach was therefore used in this study. A convenience sample of four nurses who had been undertaking the role of Responsible Clinician was recruited. Their experiences were elicited through in-depth interviews. Analysis of the interview material revealed the themes of legitimacy, relationships, expanding practice, responsibility and accountability, approaches to care, nurses' responsiveness to the role and support of the role. The author points to this research being important to nurses who are working in the psychiatric mental health area so that they can understand the role more fully. In this way, more nurses may choose to undertake the role of Responsible Clinician.
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Thompson, R. (2008). On call but not rostered. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 67-78). [Dunedin]: Rural Health Opportunities.
Abstract: In this chapter the author uses storytelling to explore the legal and ethical issues she experiences as a rural volunteer registered nurse. She describes the relationship between the nurse and community embodied in areas such as the public perception of nurses, and discusses aspects of her practice in the light of the particular legal and ethical context of rural areas.
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McKenzie-Green, B. (2003). Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study. Ph.D. thesis, , .
Abstract: Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities.
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Williams, B. G. (2000). The primacy of the nurse in New Zealand 1960s-1990s: Attitudes, beliefs and responses over time. Ph.D. thesis, , .
Abstract: Exploring the past, and pulling ideas through to the present, to inform the future can make a valuable contribution to nurses and nursing in New Zealand. By gaining some understanding of the attitudes and beliefs nurses held, and how these influenced their responsiveness, we can learn what active responses might help inform our future. Nurses in New Zealand, as individuals and within the profession as a whole, reveal the primacy of the nurse – nurses who have made and can continue to make a difference to the health of the peoples of New Zealand. A hermeneutic process was used to interpret material, from international texts, national texts and public records over four decades, the 1960s to 1990s. This was supplemented and contrasted with material from twelve oral history participants. Analysis of the material led to the emergence of four themes: Nurses' decision-making: changes over time; An emerging understanding of autonomy and accountability; Nurses as a driving force; and Creating a nursing future. These four themes revealed an overall pattern of attitudes, beliefs and responses of the New Zealand registered nurse. The themes surfaced major revelations about the primacy of the nurse in New Zealand, nurses confident in their ability to take the opportunity, seize the moment, and effect change. The author suggests that the contribution this thesis makes to the discipline of nursing is an understanding of how the nurse actively constructs the scope of a professional response to the context. The author notes that the thesis demonstrates how nurses can learn from the past, that the attitudes and beliefs that underpin our active responses can either move us forward, or retard our progress. As nurses we can also learn that to move forward we need particular attitudes, beliefs and responses, that these are identifiable, and are key factors influencing our future, thus ensuring the continued primacy of the nurse.
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Wassner, A. (1999). Labour of love: Childbirth at Dunedin Hospital, 1862-1972. Dunedin: A Wassner.
Abstract: This book covers obstetrical care from a nursing perspective at the Dunedin Hospital's Maternity Units. The researcher found little information on the two lying-in (maternity) wards of the first two Dunedin Hospitals. The book presents historical records outlining obstetric nursing procedures and maternity culture at the Dunedin Hospitals, The Benevolent Institution, The Batchelor Maternity Hospital, and Queen Mary Hospital. It covers cultural, social and legislative changes over the period, and examines conditions and pay for nursing staff across this time. A chapter on the evolution of baby care looks at changes in acceptable practices around nursery care, breast and bottle feeding, and medical procedures. The book has an extensive list of appendices, including staff lists, training notes for staff, duty lists, and interviews with staff and patients.
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Roberts, F. (1999). The people the programme & the place: Nurses' perceptions of the Lakeland Health Professional Development Programme. Ph.D. thesis, , .
Abstract: This thesis concerns the Professional Development Programme at Lakeland Health. In New Zealand, such programmes were introduced as a mechanism to openly recognise the clinical expertise of nurses. Clinical Career Pathways were introduced to nursing in North America in the 1970's at a time of nursing shortage. Prior to their inception, nurses wishing to develop their careers had to move to administration, management or education. The programmes recognised and rewarded expertise in practice. A qualitative, descriptive approach (using focus groups) was used with Registered Nurses to gather their perceptions of what helps nurses enroll in the Professional Development Programme. The ideas and insights of nine Registered Nurses were clustered around three main categories: The People (fear; being struck; motivation; feedback; peer support; ways of learning); the Programme (relevance; flexibility; Bachelor's Degrees; implementation; supporting information; fairness); the Place (time; regular and accessible; support from nurse leaders; management). These perceptions are discussed in more detail in the context of nursing at Lakeland Health and of Clinical Career Pathways in New Zealand. The findings are helpful for the evaluation and future development of the Professional Development at Lakeland Health. The research contributes to our understanding of what helps nurses enroll in a Clinical Career Pathway, and emphasises the importance of the People, the Programme and the Place.
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