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Watson, S. L. (2007). Attitudinal shifting: A grounded theory of health promotion in coronary care. Ph.D. thesis, , .
Abstract: Current New Zealand health policy encourages collaborative health promotion in all sectors of health service delivery. The integrated approach to the acute management of coronary heart disease in a coronary care unit, combining medical therapy and lifestyle change, supports clinical health promotion. The aim of this study was to use the grounded theory approach to discover the main concerns of nurses' promoting health in an acute coronary care setting and to explain the processes that nurses used to integrate health promotional activities into their practice. Seventeen registered nurses from three coronary care units within a large metropolitan city in New Zealand were interviewed. Data were constantly compared and analysed using Glaser's emergent approach to grounded theory.The main concern for nurses promoting health within coronary care was ritualistic practice. In this study, ritualistic practice concerns the medically-based protocols, routines, language and technology that drives nursing practice in coronary care. This concern was resolved via the socio-cultural process of attitudinal shifting that occurs over time involving three stages. The three conceptual categories, environmental pressures, practice reality and responsive action are the main components of the theory of attitudinal shifting. In environmental pressures, nurses experience a tension between specialist medically-dominated nursing practice and the generalist nursing role of promoting health. In practice reality, nurses become aware that the individual needs of patients are not being met. This causes role conflict until the nurse observes colleagues who role model possibilities for practice, working with patients to promote health. Responsive action sees the nurse engaging in self-development, also focusing on the nurse-patient relationship, thereby enabling active patient involvement in individual health-promoting decisions. The author suggests that the findings from this research have implications for nursing practice and education. With the increasing specialisation in nursing practice, these findings may be of interest to nurses working in delegated medical roles where the reality of everyday practice precludes nurses from undertaking their essential nursing role. Health care facilities also need to ensure that there are opportunities for the personal and professional development of nursing staff. The place of health promotion within nursing undergraduate curricula needs to be examined, as many nurses found that they were ill prepared for undertaking health promotional activities.
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Grainger, J. (2007). Mind shift: Creating change through narrative learning cycles: A qualitative interpretive study of clinical conversation as an appraisal process for sexual and reproductive health nurses. Ph.D. thesis, , .
Abstract: This thesis explores the process of an annual appraisal strategy, 'clinical conversation', from the perspective of seven nurses who were assessed using this technique. The findings demonstrate that clinical conversation is a strategy which facilitates reflection, both as a solitary exercise and with others, to ensure that learning from experience is optimised. The research used a qualitative interpretive approach informed by the model of Grounded Theory espoused by Strauss and Corbin. All eight nurses who were assessed using the clinical conversation strategy were advanced practitioners working within the scope of sexual and reproductive health. Two of the actual appraisals were observed and seven of the nurses were interviewed within eight weeks of being assessed. The outcome of the clinical conversation was primarily one of learning; the acquisition of new insights into self as practitioner. The learning was facilitated through the process of narration; telling the story of clinical practice. Three distinct narrative cycles were identified, each an experiential learning episode. The experience of undertaking a variety of assessment activities created a narrative with self and triggered an internal reflective thinking process; the experience of working with a peer created an additional narrative, a mutual dialogue reflecting back on practice; the experience of sharing practice with an assessor created a further and final narrative, a learning conversation. Each narrative can be seen as a catalyst for change. Primarily, the nurses felt differently about themselves in practice, the way they saw themselves had shifted. Such a change can be described as an alteration in perspective. These alterations in perspective led all nurses to identify ways in which they would change their actual clinical practice. In this way the nurses attempted to align their espoused beliefs about practice with their actual practice. The author notes that the study shows that each nurse responded differently to each narrative learning cycle: for some the conversation with the assessor was more of a catalyst for change than for others. In this way clinical conversation may be flexible enough to respond to a variety of differing learning styles. Learning was person specific which is an imperative for the continued professional development of already highly skilled clinicians. The implication of the research is that whilst clinical conversation was designed as a tool for appraising clinical competence, its intrinsic value lies in supporting the professional development of nurses.
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Hewson, J. (2004). Professional support for the nurse practitioner in New Zealand. Ph.D. thesis, , .
Abstract: The nurse practitioner role is an important addition to nursing workforce development in New Zealand. At present there are relatively few nurse practitioners, however the number of nurses seeking Nursing Council endorsement continues to grow. These nurses are in a unique situation as pioneers having achieved the highest level of autonomous advanced nursing practice. This position will bring with it many challenges for those nurses who are among the first in the profession. Traditionally, nurses have always had formal and informal methods of support such as preceptors, role models and the hierarchy of nursing to help and guide them in their work. This network has generally been comprised of nurses more senior and qualified than the nurse needing support. Yet the nurse practitioner, considered to be the leading clinical nurse in New Zealand, may have very limited resources available for the clinical support needed to sustain their professional practice while keeping them refreshed, curious, creative and committed. The intent of this dissertation is to provide a framework of supportive mechanisms on which the emerging nurse practitioner can draw in their new professional domain throughout their career. The author explores the meaning of support, why there is a need for support for the nurse practitioner, the various methods of support noted in current literature and how these various methods can enhance the nurse practitioner's professional growth and development, maintain clinical safety, and foster job satisfaction.
Keywords: Nurse practitioners; Mentoring; Professional development
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Laracy, K. (2003). Exploration of the self: The journey of one pakeha cultural safety nurse educator. Ph.D. thesis, , .
Abstract: Cultural safety is taught in all undergraduate nursing programmes in Aotearoa/New Zealand. There is a predominance of Pakeha nurse educators in teaching this content. There is little explanation of what being Pakeha entails. This perpetuates a silence and continues the dominant hegemonic position of Pakeha in Aotearoa/New Zealand. This study suggests that as Pakeha cultural safety nurse educators we examine our dominance and critique the delivery of cultural safety education. This autobiographical study undertakes to explore the Pakeha identity of a cultural safety nurse educator. The author discusses identity in the context of a globalised world, and challenges the idea of a definitive Pakeha identity. There are multiple descriptions of Pakeha, all underdeveloped and inadequate for the purposes of cultural safety education. In this study, the author uses the heuristic process of Moustakas (1990) and Maalouf's (2000) ideas of vertical and horizontal heritage to locate and present the essence of the self. In keeping with the purpose of cultural safety education, the author considers her ethnic cultural self as described by Bloch (1983) and explores Helms' (1990) theory of White racial identity development. This thesis describes the position of one Pakeha in the context of teaching cultural safety in an undergraduate nursing degree programme in Aotearoa/New Zealand. For Pakeha cultural safety nurse educators the author argues that exploration of one's heritages and location of a personal Pakeha identity is pivotal to progressing the enactment of cultural safety in Aotearoa /New Zealand.
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Harry, J. (2008). Professional development in nursing through the pages of Kai Tiaki: A comparative analysis – 1920 to 1930 and 2000 to 2006. Ph.D. thesis, , .
Abstract: Kai Tiaki, first published in New Zealand in 1908, provides a means of communication among New Zealand nurses. It is currently the journal of the New Zealand Nurses Organisation members and previously was aligned to the New Zealand Trained Nurses' Association in the 1920s. This dissertation examines what nurses write about professional development through the pages of Kai Tiaki. Two time periods are examined, 1920 to 1930 and 2000 to 2006.
Central to the discussion on professional development is post-registration education. Post-registration education in nursing commenced in New Zealand in 1928, and has progressed to the current day where nurses can engage in post-graduate nursing to master and doctoral level. Kai Tiaki provides a channel for nurses to discuss and debate their thoughts on post-registration and post-graduate education. Two key themes emerge from analysis. Firstly, the survival mode of nurses highlights oppression as a contributing factor to professional development. Secondly, examining the role of the New Zealand Trained Nurses Association (1920s) and the New Zealand Nurses Organisation (2000s) presents an understanding of the political nature of the journal itself and how this influences professional development. This dissertation provides critical reflection on professional development for nurses through the pages of Kai Tiaki and provides suggestions for future research. Keywords: Professional development; Nursing
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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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Dent, G. W. (2008). Mental health nurses' knowledge and views on talking therapies in clinical practice. Ph.D. thesis, , .
Abstract: Using a qualitative descriptive research design, this study explored nurses' knowledge and views on their talking therapy training and skills in practice. The study examined the use of talking therapies, or specialised interpersonal processes, embodied within the Te Ao Maramatanga: New Zealand College of Mental Health Nurses Inc (2004) Standards of Practice for Mental Health Nurses in New Zealand. A survey questionnaire was sent to 227 registered nurses from a district health hoard mental health service and a sample of eight nurses participated in a semi-structured interview. Content analysis based on the headings “knowledge views, skill acquisition and skill transfer” established the major themes from the data collection processes. The findings confirmed that nurses believe their knowledge and skills in evidence-based talking therapies to be vitally important in mental health nursing practice. Nurses identified that talking therapy training courses needed to be clinically relevant and that some learning strategies were advantageous. The identification of some knowledge gaps for, nurses with limited post graduate experience, and for nurses who currently work in inpatient areas suggests that further consideration must be given to ensure that a cohesive, sustainable approach is ensured for progression of workforce development projects relevant to training in talking therapies for mental health nurses in New Zealand.
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Kennedy, W. (2008). How do Registered Nurses utilise self assessment and performance appraisal to inform their professional practice? Ph.D. thesis, , .
Abstract: This thesis describes an exploratory study of registered nurses within a local district health board which pursued 'if' and 'how' professional practice frameworks assisted nurses in their individual professional practice. Self assessment and performance appraisal are identified as critical elements of professional development by the Nursing Council of New Zealand, and this became the focus of the author's research. A qualitative descriptive framework was utilised to explore the research question, where experiences of registered nurses employed within inpatient adult medical and surgical settings were collected through questionnaire. Analysis of the data was through general inductive thematic approach. Eight themes arose, of which, two have sub-themes. The first four themes relate to self assessment and performance appraisal and the second four themes relate to professional practice. The findings from the participant's perspective provide an understanding of how participants' utilised self assessment and performance appraisal to inform their professional practice. There are significant implications for professional practice within the findings of this study, which are presented along with recommendations for future practice, and future avenues for research.
Keywords: Professional development; Registered nurses
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McLoughlin, N. (2007). Dying to know: Advancing palliative care nursing competence with education in elderly health settings. Ph.D. thesis, , .
Abstract: This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities.
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Brinkman, A., Wilson-Salt, R., & Walker, L. (2008). Education survey report: Implications for practice. Wellington: New Zealand Nurses Organisation.
Abstract: Professional development is an ongoing requirement of nurses as a result of the Health Practitioners Competence Assurance Act. The Act?s principal purpose is to protect the health and safety of the public by ensuring health practitioners are fit and competent to practise. This survey was designed to explore the avenues nurses have taken, and would prefer to take, for their professional development. The questionnaire was sent to a random sample of the New Zealand Nurses Organisation's registered and enrolled nurse members. Nurses overwhelmingly favoured professional development in the workplace. More than half the respondents reported a conflict with other time commitments, while a number of respondents wrote of their desire for work-life balance. The cost of fees, ability to take time off work, and time and travelling distance were all hurdles to professional development. Nurses cited information technology, conflict resolution, managing challenging behaviour, and dealing with rostered & rotating shifts as aspects of their current work for which their nursing education (pre and post) had not adequately prepared them. Nurses also indicated that their pre-registration education in health systems and political processes was inadequate for their current work. As nurses aged, their interest in professional development increased, though many still preferred workplace options. The authors conclude that, in order for professional development opportunities to be accessible and relevant, resources and time must be made available. This is vital to achieve ongoing education of nurses and improved patient outcomes. Management support, combined with effective assessment of learning needs guiding professional development opportunities, are fundamental to ensuring nurse competence.
Keywords: Professional development; Professional Competence; Nursing
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Miller, J. S. (2013). Workplace learning: exploring the context and culture in New Zealand. Master's thesis, University of Otago, .
Abstract: Explores the rationale underpinning the development of education programmes within urban district hospitals throughout the country, and ascertains how these workplaces develop education programmes, given that the majority of nurses in New Zealand have identified that they prefer to participate in workplace-based professional development. Cites a clear requirement to foster learning during a nurse's development post-registration, while considering how prepared nurse educators were to fulfil their roles as lifelong learning facilitators and mentors. Utilises the perspective of nurse educators employed in District Health Boards (DHBs) geographically isolated from universities providing post-registration learning.
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Houston, G. (2018). The impacts for the registered nurses of the New Entry to Specialty Practice Mental Health and Addiction Nursing Programme, of the programme, on their personal and professional development. Master's thesis, University of Canterbury, Christchurch.
Abstract: Explores the impact on nurses three to six years after completion of the New Entry to Specialty Practice (NESP) Programme. Thematically analyses in-depth, semi-structured interviews to identify the aspects of personal and professional development affected by the programme, using a qualitative descriptive approach. Focuses on four key themes: well set up; thinking differently; inter-connectedness; and reciprocation.
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Hawes, P. C. (2016). What educational and other experiences assist recently qualified nurses to understand and deal with clinical risk and patient safety? Master's thesis, Victoria University of Wellington, Wellington.
Abstract: Interviews 9 nurses in their first year of clinical practice to investigate how newly-qualified nurses recognise and develop those skills relating to clinical risk and patient safety. Identifies workplace culture, clinical role models, exposure to the clinical environment, experiential learning, narrative sharing, debriefing and simulation as contributing to learning and understanding clinical risk and safe patient care. Considers strategies to facilitate professional development.
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Quiding, J. (2021). Improving assessment inter-rater reliability of a nursing ePortfolio: An Integrative Review. Master's thesis, Auckland University of Technology, Auckland.
Abstract: Analyses 13 articles using an integrative review methodology framework and thematic analysis to support the data analysis process, seeking to clarify the inter-rater reliability of nursing ePortfolio assessment. Identifies two themes emerging from the data: the subjective nature of the assessor, and external factors due to the nature of nursing portfolio requirements. Considers how to minimise assessment variability due to subjective factors.
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Perkins, Z. (2020). The experiences of nurse managers navigating between two conceptual models of leadership in Aotearoa New Zealand. Master's thesis, Massey University, Wellington.
Abstract: Confronts the inherent conflict for nurse managers (NM) in the dual nature of their leadership role, the Professional Practice Model (PPM) and the Generic Management Model (GMM). Examines the challenges for NMs in trying to balance the conflicting requirements of their roles. Surveys five NMs about their main challenges: role confusion, expectations, support, and professional development. Contributes to the ongoing evolution of the NM role.
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