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Turner, R. S. (2007). Preceptorship in nursing: Preceptors' and preceptees' experiences of working in partnership. Ph.D. thesis, , .
Abstract: This research is about preceptorship in nursing. There is considerable emphasis placed on health care organisations to support newly appointed graduate nurses, and preceptorship is a recommended model. Despite this emphasis, the author suggests that little is known about how preceptorship partnerships work in practice. The primary focus of this exploratory descriptive qualitative study was to explore the perspectives that preceptors and preceptees, who had worked in partnership, had about how they established and sustained their respective roles. Three sets of registered nurses who had recently completed a preceptorship experience were interviewed about their partnership. Content and thematic analysis of this descriptive data revealed four main themes. The preceptorship relationship grows out of respect for each another and develops as a result of honest and open communication. Preceptees who have an initial positive experience into their new work area settle quickly and efficiently into their new role. Preceptees appreciate preceptors who are welcoming, supportive and willing to undertake the role, while preceptors are happy to undertake the role if the graduate displays an interest in learning and are willing to be guided. The preceptee learns what it means to be a registered nurse in the particular working context, while the preceptor learns how to support learning processes and evidence-based practices. The author goes on to say that further exploration and investigation of these themes and of the relationships that evolve during preceptorship partnerships is needed. By understanding these findings, organisations can prepare both the preceptor and preceptee as they begin to undertake their role to ensure future partnerships will be successful.
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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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Spence, D., & Wood, E. E. (2007). Registered nurse participation in performance appraisal interviews. Journal of Professional Nursing, 23(1), 55–59.
Abstract: This article presents the findings of an interpretive study that explored and documented the meaning and impact of nurse participation in performance appraisal interviews. Data gleaned from nine New Zealand registered nurses employed by a single district health board provide evidence that nurses are often disappointed by the process of performance appraisal. Although they believe in the potential value of performance appraisal interviews, they seldom experience the feedback, direction, and encouragement necessary for an effective appraisal process. It is suggested that changes to the current professional development program and its accompanying performance appraisal will require skilled commitment on the part of nurses, managers, and the employing organisation to improve and develop the assessment and promotion of nursing practice.
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Dellagiacoma, T. (2007). Contracting as a career option for nurses. Kai Tiaki: Nursing New Zealand, 13(1), 20–22.
Abstract: A nurse presents research and her own experiences of contracting. Contracting, as defined in this article, refers to a nurse not employed permanently on a wage. It covers agency nursing, short and long fixed-term contracts and secondments. The author identifies the need to continue to develop professionally, which is now a mandatory requirement under the Health Practitioners Competence Assurance (HPCA) Act. Contractors have little, if any financial support to develop professionally, and time taken to do courses is not paid. Taking study leave within a contract may also not be an option. Options for managing professional development in these conditions are offered, including goal setting, investing in education or training, and considering some longer contracts. Practical financial advice and examples are given, including managing accounts and consideration of employment law. The author recommends that skilled nurses looking for interesting ways to develop their careers and to branch out in an entrepreneurial way should seriously consider taking up contract work.
Keywords: Professional development; Nursing; Work
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Mackay, B. (2007). Leadership strategies for role development in primary health care nursing. coda, An Institutional Repository for the New Zealand ITP Sector, 11, 31–39.
Abstract: This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support.
Keywords: Primary health care; Leadership; Professional development
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Naidu, A. (2007). Is scholarship an integral component of advanced nursing practice? Whitireia Nursing Journal, 14, 50–53.
Abstract: This article defines scholarship and how it links to nursing. It explores how nurses perceive scholarship and how it can enhance their practice. While agreeing that scholarship plays a vital role in the image of nursing as a professional practice, the article's main focus is on scholarship as an integral component of advanced nursing practice.
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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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Kennedy, W. (2007). Professional supervision to enhance nursing practice. Available online from Eastern Institute of Technology, 14(2), 3–6.
Abstract: This article examines the concept of clinical supervision as “professional supervision”. Professional supervision contains many elements, is structured and not without effort. Fundamentally it is about being safe and professional. 'Reflective learning' and 'Live/tutorial' models are reviewed in different contexts for assisting nurses work through everyday issues, conflicts and problems of their role. The author concludes that regardless of which model is used there are benefits for safety and professionalism.
Keywords: Professional development; Clinical supervision; Nursing; Education
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Minto, R. (2006). The future of practice nursing. New Zealand Family Physician, 33(3), 169–172.
Abstract: The author describes and discusses the main barriers to practice nurses achieving their potential as a profession. She identifies key obstacles as the funding model, GP attitudes and the current employment model. Shared governance, the development of a patient-centred services, and new employment models are proposed as the basis of a new model of primary care delivery.
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Clunie, S. (2006). The current trend and importance of postgraduate education for nurses. coda, An Institutional Repository for the New Zealand ITP Sector, 10, 18–23.
Abstract: The purpose of this essay is to examine why postgraduate education has become so important, to examine some of the issues around mandatory continuing education and the practical effect of this on a nursing career. Four strategies from the Ministry of Health, designed to facilitate changing nurse education, are discussed. The importance of Professional Development Recognition programmes is discussed along with the need for strong nursing leadership.
Keywords: Nursing; Education; Professional development; Leadership; Policy
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Dobbs, L. (2006). Can evidence improve nursing practice? coda, An Institutional Repository for the New Zealand ITP Sector, 10, 27–32.
Abstract: Evidenced Based Practice is aimed at providing safe, effective and cost-appropriate health care. The utilisation of EBP in nursing has proved to be valuable not only for patients and nurses, but also for other health professionals and the wider community. However, despite the recognised benefits of EBP, a significant gap between theory and practice exists. This paper explores some of the issues behind not implementing EBP, such as comfort with traditional practices, lack of engagement with EBP, and time constraints.
Keywords: Evidence-based medicine; Nursing; Professional development
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Phillips, B. N. (2005). A survey of mental health nurses' opinion of barriers and supports for research. Nursing Praxis in New Zealand, 21(1), 24–32.
Abstract: This paper reports the findings of a preliminary survey of two district health boards, which shows that high workloads and lack of relief staffing appear as the greatest hurdles to mental health nurses participating in practice-based nursing research. A further constraint on their participation is lack of research expertise and experience. Consultative discussions with senior mental health nurses support these conclusions. In this paper, mentoring and flexible research designs are promoted as possible ways of overcoming these barriers.
Keywords: Professional development; Mental health; Nursing research
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Holloway, K. T., & Pearson, J. R. (2005). Trailblazers: Primary health care programme evaluation. (Vol. Paper presented June 2004 at Royal New Zealand Plu).
Abstract: This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful.
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Spence, D. (2004). Advanced nursing practice through postgraduate education, part one. Nursing Praxis in New Zealand, 20(2), 46–55.
Abstract: In New Zealand the clinically focused postgraduate papers and programmes, available through universities and polytechnics, are evaluated from an educational perspective but little evaluation of the implications for practice has been undertaken. This paper is Part One of a report on a study that sought to illuminate the impact of clinically focused postgraduate education on advancing nursing practice. Hermeneutic methodology provided a framework for analysing both the perspectives of nurses who had undergone such education and those who had directly employed and worked alongside these nurses. Emerging themes are described here. In a second article the findings will be discussed in relation to literature. Constraining factors will be identified and strategies designed to maximise the benefits of education for advancing nursing practice will be recommended.
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