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Author |
Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J. |
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Title |
The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand |
Type |
Journal Article |
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Year  |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
4 |
Pages |
259-270 |
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Keywords |
Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research |
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Abstract |
This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1064 |
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Author |
Bishop, D.; Ford-Bruins, I. |
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Title |
Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
3 |
Pages |
203-212 |
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Keywords |
Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models |
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Abstract |
This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed. |
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Call Number |
NRSNZNO @ research @ 1082 |
Serial |
1067 |
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Author |
Crowe, M.; Carlyle, D. |
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Title |
Deconstructing risk assessment and management in mental health nursing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
43 |
Issue |
1 |
Pages |
19-27 |
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Keywords |
Psychiatric Nursing; Risk management; Policy; Culture |
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Abstract |
The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1069 |
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Author |
Palmer, S.G. |
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Title |
Application of the cognitive therapy model to initial crisis assessment |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
30-38 |
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Keywords |
Mental health; Clinical assessment; Psychiatric Nursing |
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Abstract |
This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment. |
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Call Number |
NRSNZNO @ research @ 1085 |
Serial |
1070 |
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Author |
Phillips, B.N. |
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Title |
Possibilities for mental health nursing practice-based research |
Type |
Report |
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Year |
2003 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing research; Psychiatric Nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1257 |
Serial |
1242 |
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Author |
Lyall, C. |
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Title |
Therapeutic relationships: What are inpatient registered nurses perceptions of the factors which influence therapeutic relationship development? |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Registered nurses; Nurse-patient relations; Mental health |
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Abstract |
The question explored in this research project is: What are inpatient registered nurses' perceptions of the factors which influence therapeutic relationship development? The literature reviewed for this project includes the history of interpersonal relationships in nursing; therapeutic relationships; what constitutes these relationships. Also discussed is literature about phenomenology as the underlying theoretical and philosophical position that informs the research method. To answer the research question a single focus group was used to gather data from a group of registered nurses practising in inpatient mental health units. Focus groups as a data collection method produce data and insights that would not be accessible without the group interaction. The key themes to emerge from the data analysis were; time, environment, knowing / self-awareness, compassion and power imbalance / empowerment. These key themes are discussed in relation to the literature and the wider context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations to nurses, nurse leaders and managers who aim to provide therapeutic mental health unit environments. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1245 |
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Author |
McKenna, B. |
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Title |
Risk assessment of violence to others: Time for action |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
18 |
Issue |
1 |
Pages |
36-43 |
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Keywords |
Mental health; Workplace violence; Risk management; Nursing; Nurse-patient relations; Psychiatric nursing |
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Abstract |
The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings. |
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Call Number |
NRSNZNO @ research @ |
Serial |
621 |
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Author |
Farrow, T.; McKenna, B.; O'Brien, A.J. |
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Title |
Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation |
Type |
Journal Article |
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Year |
2002 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
11 |
Issue |
3 |
Pages |
164-169 |
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Keywords |
Mental health; Law and legislation; Psychiatric Nursing; Scope of practice |
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Abstract |
A new approach to mental health legislation has seen the involvement of a range of health professionals in legislated mental health roles, including the power of registered nurses to detain patients in hospital under Section 111 of the New Zealand Mental Health (Compulsory Assessment and Treatment) Act (1992). Under this Section, a nurse who believes that a voluntary patient meets the legal criteria of the Act can independently detain the patient for a period of up to six hours, pending further assessment by a medical practitioner. However, anecdotal evidence and a clinical audit undertaken by the authors suggest some doctors 'prescribe' Section 111 at the time of admission. This practice instructs nurses to initiate Section 111 if particular voluntary patients choose to leave hospital. This study outlines practice issues resulting from 'prescribing' Section 111; provides a legal critique of medical practitioners' involvement in this practice; and makes recommendations for guidelines toward a more constructive use of Section 111. |
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Call Number |
NRSNZNO @ research @ |
Serial |
651 |
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Author |
Farrow, T. |
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Title |
Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments |
Type |
Journal Article |
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Year |
2002 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
11 |
Issue |
4 |
Pages |
214-219 |
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Keywords |
Interprofessional relations; Psychiatric Nursing; Community health nursing; Qualiltative research; Suicide |
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Abstract |
'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly. |
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Call Number |
NRSNZNO @ research @ |
Serial |
785 |
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Author |
Gillard, D. |
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Title |
When I am nursing |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing models; Mental health; Adolescents; Psychiatric nursing |
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Abstract |
Over the last century the nursing profession has drawn from numerous theories and disciplines to construct its own theoretical foundations. While this diversity and flexibility may be one of the nursing profession's strengths it may have contributed to nurses' difficulty in explaining the complexities of their every day clinical work. This is a particular challenge for the domain of mental health nursing. This dissertation discusses how nursing models that have credibility at a clinical level can contribute to informing and advancing nursing practice. Models can achieve this by assisting nurses to conceptualise and articulate what it is they do that makes a difference to patient outcomes. Through this process nurses can maintain a distinct professional identity and establish themselves as effective members of multidisciplinary health team. Specifically, the application and limitations of Godkin's (2001) proposed model of a 'healing presence' to the author's own practice in a one-to-one nurse-adolescent client relationship in the mental health nursing is examined. It is claimed that a 'healing presence' provides a meaningful way to understanding the author's own practice. The proposed model of a 'healing presence' embraces the diversity of her background, and allows the author to maintain a nursing identity by providing a nursing framework to critique her practice, furthering her understanding of what it is that 'expert' nurses do and how this impacts on patient outcomes. Also suggested is that a 'healing presence' can contribute to the author's own and other nurses advanced nursing practice by making nursing visible to the multidisciplinary health team and to articulate “what it is that I do 'when I am nursing'”. Through presenting this dissertation, the author wishes to inspire other nurses to examine and understand their own practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
914 |
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Author |
Crowe, M.; O'Malley, J.; Bigwood, S. |
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Title |
Nursing mental health consumers in the community |
Type |
Journal Article |
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Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
8 |
Issue |
8 |
Pages |
14-15 |
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Keywords |
Community health nursing; Psychiatric Nursing |
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Abstract |
The purpose of this research was to describe the characteristics of community mental health nursing care in the community. Twenty six nurses were enrolled in a study consisting of semi-structured interviews about the nature of their care. Responses were analysed to identify categories of skills. These were characterised as: establishing connectedness; promoting individual and family resilience, promoting citizenship; and addressing structural issues. Responses from the nurses are used to illustrate these categories. |
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Call Number |
NRSNZNO @ research @ 1024 |
Serial |
1008 |
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Author |
Muir-Cochrane, E.; Holmes, C.; Walton, J.A. |
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Title |
Law and policy in relation to the use of seclusion in psychiatric hospitals in Australia and New Zealand |
Type |
Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
13 |
Issue |
2/3 |
Pages |
136-145 |
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Keywords |
Psychiatric Nursing; Law and legislation; Policy; Patient rights; Cross-cultural comparison |
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Abstract |
This paper discusses legal issues associated with the seclusion of acutely disturbed patients in psychiatric hospitals in Australia and New Zealand. There continues to be great variation in opinion and operational definition as to whether seclusion is a medical treatment, nursing intervention and management tool, or merely a form of situational restraint. Reflecting this lack of clarity, mental health acts and policies concerning the regulation and practice of seclusion lack consistency and focus across geographical boundaries and jurisdictions. Australian and New Zealand legislation and institutional policy is discussed in order to shed light on the contemporary issues highlighted by this controversial nursing practice. The authors note that mental health professionals must continue to review the practice of seclusion and to actively promote the use of acceptable alternatives. In addition nurses and other mental health professionals have a responsibility to understand current legislation and policy frameworks and to influence change where this is necessary to ensure the best practice possible in their clinical area. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1074 |
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Author |
Crowe, M. |
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Title |
Reflexivity and detachment: A discursive approach to women's depression |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
9 |
Issue |
2 |
Pages |
126-132 |
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Keywords |
Gender; Mental health; Psychiatric Nursing; Culture |
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Abstract |
This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1077 |
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Author |
Matheson, S. |
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Title |
Psychiatric/mental health nursing: Positioning undergraduate education |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; History of nursing; Nursing; Education |
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Abstract |
In this paper, the critique of the mental health component of comprehensive nursing education and the questions that it raises are explored from historical, structural and ideological perspectives. In order to locate the past and highlight its significance to where psychiatric/mental health nurses find themselves today some of the history of the asylum system and the development of psychiatric nursing in New Zealand within these structures are presented. Ideological changes to the way mental health was thought about, and responded to, have had considerable impact on where psychiatric nurses practiced, how they practised and what they were named. This created the need for a different kind of nurse and has led to changes in the education of nurses. The structural influences on the training and education of nurses are identified through relevant reports and their recommendations and significance in relation to psychiatric/mental health nursing are examined. Issues deriving from the critique of undergraduate psychiatric/mental health nursing education highlight the urgent nature of the crisis and draw out the multiple and competing discourses that inform the education of nurses. In acknowledging that the crisis can be viewed from multiple perspectives the need for responses from multiple levels involving the Nursing Council of New Zealand, the Ministry of Health, the Mental Health Commission and nurses in education and practice are recommended. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1146 |
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Author |
Valette, D. |
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Title |
Nursing an adolescent in an adult inpatient mental health unit |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Adolescents; Nurse-patient relations; Professional competence; Mental health |
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Abstract |
This research paper reports on an exploration of the key elements nurses need to be aware of to effectively nurse adolescents in an adult inpatient unit. It describes the developmental needs and significant influences that affect this age-group, that when incorporated into nursing care, nurses can gain a therapeutic relationship with the adolescent. By means of a literature review, sharing the author's experience in nursing adolescents, and through vignettes of practice, an illustration of some common situations that may occur during the adolescent's inpatient stay are described. These situations are explored and a perspective is offered on how nurses may be effective in their nursing of an adolescent patient from the point of admission through to discharge. More research is needed on adolescent mental health nursing, however the author anticipates that nurses will be able to use this report as a helpful resource in their current practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1148 |
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