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Walker, J., & Bailey, S. (1999). The clinical performance of new degree graduates. Nursing Praxis in New Zealand, 14(2), 31–42.
Abstract: This study aimed to identify how graduates perceived their clinical performance during their first year of practice. A convenience sample of 30 graduates was surveyed after 3 months and 7 months in practice, using an adapted form of a questionnaire devised by Ryan and Hodson (1992). The results showed that over time, graduates generally required less direction in all areas of clinical competence. After 7 months in practice, the majority of the graduates rated their performance in nursing skills, communication skills, and professionalism at the expected level or above. However, some still required direction with using theory and research in practice, with meeting client's psychosocial needs and with teaching clients. In the leadership competency, after 7 months, most graduates saw themselves functioning at the expected level related to client care and needed less direction in unit management skills. However, many of the unit management skills were rated as 'not applicable' indicating that new graduates are not initially placed in a management role. Implications for nursing education and limitations of the research are discussed.
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McArthur, J., & Dickinson, A. R. (1999). Decision making the explicit evidence-based way: Comparing benefits, harms and costs. Nursing Praxis in New Zealand, 14(1), 33–42.
Abstract: This paper explores the relationship between evidence, decision tools, and the effectiveness of the nursing contribution to health services. It examines a continuum of decision-making within the international trend of the Effectiveness Movement, drawing on international literature and local experience. It draws on the concept of explicit evidence-based decision-making, the guideline development movement as exemplified through the New Zealand Guidelines Group, information technology in decision support, and the challenges of an evidential approach to nursing. This article is based on a paper given at 'The Pride and Passion of Professional Nursing Practice' College of Nurses' Aotearoa (NZ) Conference, Rotorua, 8-9 October 1998.
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Holloway, K. T. (1999). Developing an evidence base for teaching nursing practice skills in an undergraduate nursing program. Nursing Praxis in New Zealand, 14(1), 22–32.
Abstract: This research seeks to determine an evidence basis for selecting content for the clinical skills curriculum in an undergraduate programme. Thirty-three senior nurse clinicians from medical-surgical areas in 2 large hospitals offering student placements were asked to rate the frequency of performance of 77 skills for the beginning registered nurse. Those skills frequently used and rated over 65% were considers for inclusion in the undergraduate programme. Clinicians were asked to list the 10 most important skills and related level of competence expected from the newly-registered nurse.
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Richardson, S. (1999). Emergency departments and the inappropriate attender: Is it time for a reconceptualisation of the role of primary care in emergency facilities? Nursing Praxis in New Zealand, 14(2), 13–20.
Abstract: This paper reviews currently identified issues concerning emergency department attendance, and examines the core question of the role of primary care in the emergency department. Asks whether this is an appropriate use of emergency department resources, and if so, what the implications are for the role of the emergency nurse. Suggests the establishment of Minor Injury Units in New Zealand like those in the UK.
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Gallaher, L. (1999). Expert public health nursing practice: A complex tapestry. Nursing Praxis in New Zealand, 14(3), 16–27.
Abstract: The research outlined in this paper used Heideggerian phenomenology to examine the phenomenon of expert public health nursing practice within a New Zealand community health setting. Narrative interviews were conducted with eight identified expert practitioners who are currently practising in this speciality area. Data analysis led to the identification and description of themes which were supported by paradigm cases and exemplars. Four key themes were identified which describe the finely tuned recognition and assessment skills demonstrated by these nurses; their ability to form, sustain and close relationships with clients over time; the skilful coaching undertaken with clients; and the way in which they coped with the dark side of their work with integrity and courage.
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Neville, S. J., & Alpass, F. (1999). Factors influencing health and well-being in the older adult. Nursing Praxis in New Zealand, 14(3), 36–45.
Abstract: This article offers a literature review of selected factors influencing the health and well-being of older people, with a particular emphasis on the older male. Implications for nursing practice in New Zealand are discussed.
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Christensen, D. J. C. (1999). Integrating the terminology and titles of nursing practice roles: Quality, particularity and levelling. Nursing Praxis in New Zealand, 14(1), 4–11.
Abstract: The author reconsiders the meaning of expert, specialist and advanced practice. She proposes that they are distinctive and complementary aspects of every nursing role and suggests a set of attributes for each. Expertise is discussed in terms of the quality of performance, speciality in relation to particularity of performance, and advanced practice with regard to the level of performance.
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Jones, B. (1999). Neonatal nurse practitioners: A model for expanding the boundaries of nursing culture in New Zealand. Nursing Praxis in New Zealand, 14(3), 28–35.
Abstract: This article outlines the development of the neonatal nurse practitioner role in New Zealand as an example of one advanced practice nursing role. A model of how nursing culture changes to include roles that incorporate components that historically have been considered the domain of other health professionals is proposed. This article outlines some of the issues surrounding the neonatal nurse practitioner role, including the educational requirements for this role in New Zealand.
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Farrow, T., & O'Brien, A. J. (2005). Discourse analysis of newspaper coverage of the 2001/2002 Canterbury, New Zealand mental health nurses' strike. International Journal of Mental Health Nursing, 14(3), 187–195.
Abstract: This paper reports on research into print media representations of industrial disputes in Canterbury in 2001, when mental health nurses undertook a variety of strike actions after stalled negotiations with the local district health board. One response to these actions was the temporary reduction of many of the regions' mental health services. The researchers identified themes of juxtaposed but largely deprecatory images of both mental health nursing and of consumers of services. Some professional nursing voices were given print space during the strike; however, these were largely incorporated into existing discourses rather than offering a nursing viewpoint on the strike. The researchers suggest organisational efforts to focus on ways of ensuring that mental health nurses are seen as a legitimate authority by the media.
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Phillips, B. N. (2007). Nursing care and understanding the experiences of others: A Gadamerian perspective. Nursing Inquiry, 14(1), 89–94.
Abstract: This article investigates the process where nurses attempt to understand the experience of patients. The author argues that this transcends particular models of ill-health. Gadamerian hermeneutics, which has been used in nursing research to articulate the process of understanding, is elaborated on. Gadamer's exposition of understanding shows that practitioners need to be aware that understanding of other people is developed through a fusion of one's own history, language and culture with that of the other person. This occurs through a hermeneutic question-answer dialogue in which practitioners put their ideas at risk of being modified or rejected in the process. Understanding then, is a perceptual and conceptual process. In this way, the experience of nurses seeking to understanding those they nurse increases self-awareness, as well as enhancing their ability to further understand others.
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Walsh, K., Moss, C., Lawless, J., McKelvie, R., & Duncan, L. (2008). Puzzling practice: A strategy for working with clinical practice issues. International Journal of Law and Psychiatry, 14(2), 94–100.
Abstract: The authors share the evolution of innovative ways to explore, 'unpack' and re-frame clinical issues that exist in everyday practice. The elements of these processes, which they call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which they draw on and use in their practice development work and in research practice. This paper pays attention to a particular form of puzzling practice that they found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle; exploring the heart of out practice; formulating the puzzle question; visualising the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.
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Fourie, W., McDonald, S., Connor, J., & Bartlett, S. (2005). The role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality. Available online from Coda: An institutional repository for the ITP sector, 14(2), 134–141.
Abstract: This study compared the perceptions that registered psychiatric nurses have of their roles with their actual practice. Following the closure of large scale psychiatric institutions in New Zealand, there was was an increased demand for limited beds in acute inpatient facilities for acutely mentally ill patients. This change in location and downsizing of acute inpatient beds challenged traditional roles of mental health nursing, resulting in confusion over what roles mental health nurses should now perform in the new context of care. This qualitative descriptive exploratory study observed nursing practice on three selected wards and used focus group interviews to establish from registered nurses what they perceived their roles to be. A key finding of this study was that many of the nursing roles related to delivering care from a crisis management perspective, which covers aspects such as assessment, stabilisation of symptoms and discharge planning. Participants also believed that the therapeutic relationship was a fundamental role in inpatient care. Nurses used any opportunity to make it a reality such as kitchen organisation, medications, or dealing with a challenging patient. This study highlighted the complexity of the roles that nurses performed and went some way to give voice to what at times seems an invisible practice.
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Smythe, E. (2003). Uncovering the meaning of 'being safe' in practice. Contemporary Nurse, 14(2), 196–204.
Abstract: This paper moves away from the prevalent discourse of competence to consider the meaning of the experience of 'being safe' within the context of childbirth. It offers findings from a doctoral study, informed by the philosophies of Heidegger and Gadamer. Following ethical approval, the data was collected in New Zealand by tape-recorded interviews of 5 midwives, 4 obstetricians, 1 general practitioner and 10 women. The method was informed by van Manen. The findings reveal that in seeking the meaning of being safe one needs to be aware that the unsafety may already be present in the situation. Practitioners may be able to do little to rectify the unsafeness. There is, however, a spirit of safe practice, explicated in this paper, that is likely to make practice as safe as it can possibly be. Wise practitioners are ever mindful that a situation may be or become unsafe, and are always aware of their own limitations.
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Wepa, D. (2003). An exploration of the experiences of cultural safety educators in New Zealand: An action research approach. Journal of Transcultural Nursing, 14(4), 339–348.
Abstract: This research is a study of the experiences of four cultural safety educators in nursing education in Aotearoa, New Zealand. Action research methods assisted the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action, and reflecting. The findings of the research revealed that the participants not only coped with everyday stressors of teaching but were also required to formulate knowledge for cultural safety. For the Maori participants, their stress was confounded with recruiting and retaining Maori students and macro issues such as commitment to their iwi (tribe). Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that many issues were organisational in nature and out of their control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations include the following: support for cultural safety educators to have a dialogue on a regular basis, the introduction of nurse educator programmes, paid leave provisions for educators to conduct and publish research so that a body of knowledge can be developed, and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burnout.
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Gage, J., & Hornblow, A. R. (2007). Development of the New Zealand nursing workforce: Historical themes and current challenges. Nursing Inquiry, 14(4), 330–334.
Abstract: This article reviews the development of the New Zealand nursing workforce, which has been shaped by social, political, scientific and interprofessional forces. The unregulated, independent and often untrained nurses of the early colonial period were succeeded in the early 1900s by registered nurses, with hospital-based training, working in a subordinate role to medical practitioners. In the mid/late 1900s, greater specialisation within an expanding workforce, restructuring of nursing education, health sector reform, and changing social and political expectations again reshaped nursing practice. Nursing now has areas of increasing autonomy, expanding opportunities for postgraduate education and leadership roles, and a relationship with medicine, which is more collaborative than in the past. Three current challenges are identified for nursing in New Zealand's rapidly evolving health sector; development of a nursing-focused knowledge culture, strengthening of research capacity, and dissemination of new nursing knowledge.
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