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Harding, T. S. (2008). Men's clinical career pathways: Widening the understanding. Coda: An institutional repository for the New Zealand ITP sector, 22(3), 48–57.
Abstract: This article, drawn from a larger study, reports on the factors that have influenced the choice of a group of New Zealand male nurses' clinical career pathways. Using discourse analysis, interview data from 18 participants were analysed and related to existing literature on male nurses. The analysis revealed that the predominance of men in selected areas of nursing can be attributed to multiple factors including: socialisation pressures that are grounded on gender stereotyping, a desire for challenge, homosocial tendencies, and the belief that multiple work experience equips them to be better nurses. The results challenge essentialist readings of masculinity within the context of nursing and identifies challenges for nursing education and the profession to enable men to contribute more widely to nursing.
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Hardcastle, J. (2008). 'Back to the bedside': Graduate level education in critical care. Nurse Education in Practice, 8(1), 46–53.
Abstract: This paper explores the relationships within teaching, learning and practice development in critical care nursing and questions the popular assumption that 'post graduate (Master's level) education fits all'. The need for critical care nurses to apply advanced knowledge and technical skills to complex and dynamic practice situations necessitates the development of critical thinking and a problem-solving approach to clinical practice that can be fostered through education and experience. Discussion focuses on the successful development and implementation of graduate level education for critical care nurses in the South Island of New Zealand and how this development is challenging existing approaches to the provision and evaluation of formal critical care education in New Zealand.
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Howie, L. (2008). Contextualised nursing practice. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 33-49). [Dunedin]: Rural Health Opportunities.
Abstract: This is the first of three chapters that describe nursing practice. The author presents the Rural Framework Wheel to elaborate aspects of the rural context. The Framework comprises four systems which describe aspects of rurality; being are socio-cultural, occupational, ecological, and health. These systems each comprise of subsystems, which provide a detailed analysis of the way nursing practice is particular in diverse rural settings. The Framework is presented as a work in progress, and is grounded in international nursing literature. It highlights rural nursing as a unique and challenging field, with the dominant themes of partnership and nursing emerging as underpinning the practice when nurses live and work in small, sometimes isolated communities.
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Roulston, E. (2008). Storytelling: The story of my advancing rural nursing journey. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 57-65). [Dunedin]: Rural Health Opportunities.
Abstract: The author takes a storytelling approach to describe her advancing practice as a registered nurse in a rural context. She adapted a theoretical 'reflective learning through storytelling' framework, from McDrury and Alterio (2002). The framework includes the concepts of reflection, learning, knowledge and experience which is related to professional practice and one's self.
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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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Jamieson, I. (2008). The mobile operating theatre project. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp.81-97). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter firstly presents the development of a mobile operating theatre project, which was implemented in 2002 to provide rural day-stay surgery. Secondly, it discusses the process and findings of a research project undertaken with the purpose of evaluating a perioperative (theatre and recovery) reskilling programme offered to 42 rural nurses from nine secondary hospitals, conducted over nine months in 2001. The training was given to nurses prior to the introduction of a mobile operating theatre service, and was seen as a key part of the service contract.
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Pedersen, C. (2008). Nurse-led telephone triage service in a secondary rural hospital. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 99-110). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter describes the development of a nurse-led after-hours telephone triage service in a rural secondary hospital in the Hawke's Bay District Health Board area. This service was a response to the health restructuring in the 1990s, which had led to the shift of secondary services out of the rural areas, and workforce recruitment issues. Secondly, it discusses the process and findings of a research project undertaken to identify and describe telephone callers' reported outcomes after using the service. The study found a high level of satisfaction amongst callers and a high level of compliance to advice.
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Horner, C. (2008). Emergency health provision and maintaining competency. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 125-136). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter focuses on issues associated with rural nursing and the provision of emergency care for patient(s) located remotely from secondary hospital services. All emergencies have diverse characteristics, but the rural practitioner also contends with having sole practice, professional and geographical isolation, and the lack of regular experience. The chapter reviews the PRIME (Primary Response in Medical Emergency) recommendations and training, and looks in particular at the issues around the maintenance of competency for the rural nurse providing emergency on call health care that includes managing medical and accident emergencies in the absence of a medical practitioner.
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Fitzwater, A. (2008). The impact of tourism on rural nursing practice. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 137-43). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter reviews some effects of the growth of tourism, including adventure tourism and the numbers of tourists over 50, on rural nursing practice. Tourism contributes to socio-cultural change within a community, and health resources that previously met the needs of the local community may not meet the expectations of growing numbers of tourists. The transient visitor includes both the tourist and the seasonal worker, and has become a feature of rural nursing. Major effects on rural nurses include the increased volume of work, the advanced scope of practice required to meet more complex needs of visitors, and challenges to personal and professional safety.
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Hale, R. (2008). Older patient perceptions of transitional care. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 147-152). [Dunedin]: Rural Health Opportunities.
Abstract: The author describes transitional care as undertaken within the Waikato District Health Board health care environment. Transitional care supports people moving between acute health care (inpatient) and primary health care (home). It is a rehabilitative model based in smaller, predominantly rural communities to enable the older person to actively work towards recovery of functional ability within their own environment. Research indicates this rehabilitation model is applicable to the rural situation and satisfaction levels of the patients and caregivers tends to be positive.
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Campbell, K. (2008). Experiences of rural women who have cared for their terminally ill partners. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 166-178). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter firstly offers background information in relation to palliative care and the role of women as providers of care in the home setting. Secondly, it discusses a study that evolved from a trend the author observed as a district nurse providing community palliative care in rural New Zealand and from New Zealand literature; that the majority of carers of the terminally ill in home-settings are women. The aim of this research study was to offer insights into the requirements of caring for a dying person at home and provide information to assist nurses working in the community and other women who take on the caregiver's role.
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Robertson, A. M. (2008). Rural women and maternity services. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 179-97). [Dunedin]: Rural Health Opportunities.
Abstract: The author discusses the roles that nurses undertake in response to rural communities' health needs, focusing on the provision of maternity service. The author reviews structural changes such as the 1990 Amendment to the Nurses Act 1977 which, the author suggests, introduced a climate of professional rivalry, changes in funding that cut back general practitioners in the field, and the development of Lead Maternity Carers. Despite controversial developments, New Zealand maternity services have evolved to include a unique and internationally respected model of midwifery care. However, the author highlights several areas that limit the positive contribution of rural nurses and midwives. These include workforce recruitment and retention, equity of access, and issues around maintaining competency and education.
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Higgins, A. (2008). Collaboration to improve health provision: Advancing nursing practice and interdisciplinary relationships. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 215-223). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter introduces national policies and strategies that promote interdisciplinary collaboration as a means of providing better access to health care for all communities. It identifies a role for advancing nursing practice as part of a collaborative approach to healthcare in rural areas. An increasing focus on collaboration as a concept within health practice during the last 10 years has become evident in policy documents from the Report of the Ministerial Taskforce on Nursing (Ministry of Health, 1998) to the Working Party for After Hours Primary Health Care (Ministry of Health, 2005). The emphasis would seem to be in response to political pressure to address health inequalities and an apparent assumption that interprofessional collaboration results in improved communication, fewer gaps in provision of care and more effective use of the limited health funds.
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Armstrong, S. E. (2008). Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46). [Dunedin]: Rural Health Opportunities.
Abstract: A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them.
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Wilson, D., & Neville, S. J. (2008). Nursing their way not our way: Working with vulnerable and marginalised populations. Contemporary Nurse, 27(2), 165–176.
Abstract: This paper uses the findings of two studies to explore the nature of nurses' practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. The first study was with the elderly with delirium and used a critical gerontological methodology informed by postmodernism and Foucault's understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory informed by a Maori-centred methodology. The findings show that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to people's lives outside of the health care environment is ignored. Consequently, the foundations of nursing practice, that of holism, is found to be merely a rhetorical construct.
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