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Author Bunn, S. url  openurl
  Title An exploration of the transition of patients from intensive care to the ward environment: A ward nursing perspective Type
  Year 2007 Publication Abbreviated Journal Victoria University of Wellington Library  
  Volume Issue (up) Pages  
  Keywords Clinical decision making; Nursing; Communication  
  Abstract The transition of patients from intensive care to the ward environment is a regular occurrence in intensive care. Today patients are often transferred earlier and sicker due to the demands for intensive care beds. This results in patients with higher acuity being cared for in the wards. Here ward nurses have to meet the ongoing complex demands of caring for higher acuity patients, alongside managing high patient-to-nurse ratios, staffing concerns, and varying levels of experienced nurses. This research explored the experiences of ward nurses receiving patients transferred from intensive care. The aims were to identify any areas of concern, highlight specific problems that occur on transition and to address what information is pertinent to ward nurses when receiving patients from intensive care. A qualitative descriptive methodology using focus groups was utilised to gather information about these experiences. Three focus groups were held with ward nurses from various wards within the study setting hospital. All participants had considerable contact with intensive care and were familiar with the processes of transferring patients. Five themes emerged from the focus groups – Patients as intensive care staff say they are; Time to prepare the biggest thing; Documentation as a continuation of patient care; They forget what its like; and Families, a need to know about them. The theme Patients as intensive care staff say they are relates to reliable information sharing focused on the patient, their needs and condition. Participants expressed their concern that patients were not always in the condition that the intensive care staff stated they were on the referral. Having adequate time to prepare was considered important for the majority of ward nurses receiving patients from intensive care. Documentation was highlighted in the theme Documentation as a continuation of patient care particularly in relation to fluid balances and vital sign history. The theme They forget what its like suggests there is a perception that intensive care nurses have a lack of understanding of what the ward staff can actually manage. Decreased staffing levels during certain shift patterns and a lack of appropriately experienced staff on the wards is a common concern for ward nurses. Ward nurses also recognised that caring for families was part of their role. Patients and families may respond differently to the transfer process and their inclusion in transfer planning was seen as essential. Communication was a reoccurring element throughout all themes.The author concludes that communication is the paramount factor that impacts on a 'smooth transition' for ward nurses. A 'smooth transition' refers to the transfer of patients from intensive care to the next level of care. Subsequently, nurses' perceptions need to change, whereby transfer planning from ICU should be the focus rather than discharge planning. Transfer planning and education for all nursing staff is vital if the transfer process is to be improved. Consequently, transitional care within the context of ICU aims to ensure minimal disruption and optimal continuity of care for the patient. The knowledge gained from this research may provide better understanding of the multifaceted issues linked with transitional care that may be adapted for a wider range of patients in various clinical environments.  
  Call Number NRSNZNO @ research @ 827 Serial 811  
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Author Radka, I.M. openurl 
  Title Handover and the consumer voice: The importance of knowing the whole, full story Type
  Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library  
  Volume Issue (up) Pages  
  Keywords Communication; Patient satisfaction; Nurse-patient relations  
  Abstract In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare.  
  Call Number NRSNZNO @ research @ 883 Serial 867  
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Author MacDonald, L.M. url  openurl
  Title Nurse talk: Features of effective verbal communication used by expert district nurses Type
  Year 2003 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Communication; Nurse-patient relations; District nursing  
  Abstract This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development.  
  Call Number NRSNZNO @ research @ 1180 Serial 1165  
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Author Davies, B. url  openurl
  Title Same person different nurse: A study of the relationship between nurse and patient based on the experience of shifting from secondary care to home-based nursing Type
  Year 2008 Publication Abbreviated Journal Research Archive at Wintec  
  Volume Issue (up) Pages  
  Keywords Nurse-patient relations; Communication; Hospitals; Home care  
  Abstract This study focuses on power themes in the nurse-patient relationship. The study is a critical reflection of the author's practice using a humanistic perspective from Hartrick Doane and Varcoe's (2005) model of relational family practice. It reviews the literature relating to power relationships in communication between nurses and patients and compares the ability to provide relational care in the home with hospital care. Practice examples demonstrate the shift in power relationships that the author had noticed since changing roles from hospital based to home care nursing. This is related to cultural, socio-environmental, historical and traditional influences on power in communication. The study is based on her reflection of the paradigm shift in her practice. Her practice moved from a problem solving approach to an empowerment, strengths based approach within partnership. The ethical challenges of discussing her practice in relation to clients has been managed by scrambling patient data so that it is not related to a single person and is focused on the author's nursing practice.  
  Call Number NRSNZNO @ research @ 1195 Serial 1180  
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Author Clayton, J.R. url  openurl
  Title Exploring transitions: Working in “the space between the no longer and the not yet” Type
  Year 2008 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Communication; Nurse-patient relations; Case studies  
  Abstract This thesis uncovers a personal journey of reflective practice, focusing on the author's emerging role as a nurse facilitating transitions using a dialectical approach in the context of a private nursing practice. Transitions encompass: life changes, loss, and adjustment to changes in function. Dialectical nurse facilitation of transition (DNFT) is a way of exploring self in the transitional space between “the no longer and the not yet”. In this facilitated process people potentially discover paradoxes, tensions, and creative energy, as they search for a way forward. The research design details a dialectical heuristic quest through journaling and reflecting on practice supervision and peer review, over a two year period. Exemplars written after reflecting on case notes reveal the lived experiences of participants. These case reviews show the complexity of patterns for people undergoing transitions and nurse facilitation. A relational pattern for DNFT encompasses compassionate engagement, catalytic mirroring, and interconnectedness. An exploration of literature encompasses nursing theories, facilitation, dialogue, loss, grief, spirituality and transition. This thesis provides a basis for evaluative research on the effectiveness of DNFT in health care settings in the future. Discussions regarding the expansion of these reflective and praxis genres are included which may be of interest to nursing education and practice contexts.  
  Call Number NRSNZNO @ research @ 1203 Serial 1188  
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Author Gare, L. url  openurl
  Title Patient experience of joint replacement education: A joint venture Type
  Year 2006 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Nurse-patient relations; Health education; Communication  
  Abstract The aim of this research was to explore patients' educational experiences and the usefulness and benefits of this health education in the rehabilitation period, when undertaking a total joint replacement. An exploratory, qualitative descriptive study method was used to describing patients' experiences of health education. Five participants, convenience sampled, were interviewed eight to twelve weeks post surgery following unilateral total joint replacement in a tertiary hospital. Participants valued the education they received pre operatively, which included written material, video and individual interaction with varied health professionals. Although this was provided in a timely manner, evidence showed limited post operative reinforcement and follow up of given education and preparation for discharge. Three 'partnership' themes were identified from data, Communicative, Subservient and Knowledge. 'Communicative Partnership' conceptualised the participants' experiences of the nurse-patient relationship, whilst 'Subservient Partnership' captured the participants' experiences of 'being' patients. 'Knowledge Partnership' combined the participants' ideas about knowledge and their retention of this knowledge to assist with their rehabilitation post surgery. The needs and experiences of patients after total joint replacement reflect on transitional change – changes in roles, behaviour, abilities and relationships. Educational contents need to reflect a realistic recovery process to assist with this transitional period, delivered by health care professionals in a manner best suited for patients.  
  Call Number NRSNZNO @ research @ 1235 Serial 1220  
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Author Macfarlane, K. openurl 
  Title Communicating changes in a patient's condition: A critical incident approach Type
  Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz  
  Volume Issue (up) Pages  
  Keywords Communication; Clinical assessment; Physicians; Nursing; Relationships  
  Abstract This study explores how registered nurses working within the acute surgical ward environment of a New Zealand hospital communicate changes in a patient's condition. The purpose of this research study was to examine the processes, communication techniques and behaviours that nurses use, in order to determine the critical requirements for registered nurses to effectively communicate changes in patients' conditions to doctors. The critical incident technique developed by Flanagan (1954) was adapted and used to explore incidents that occurred when six registered nurses working in acute surgical wards communicated a change in a patient's condition to a doctor. Communication is an integral part of everyday activity. This study has shown an assessment process occurs before communication can take place. A nurse's concern for a patient's condition initiates the assessment process. A judgement is formed from the nurse's concern that a patient's condition has changed. Judgements take into account multiple ways of knowing including pattern recognition, empirical knowing and intuition. Institutional protocols also affect judgements and the ability of a nurse to ensure support is received for the patient's well being. The communication process is initiated for two reasons, to support the patient, and to support the nurse in providing care for the patient. Significant in determining the need for support is the action required that might be outside the nurse's scope of practice. The response should address the nurse's concern and take into account the importance of the relationship, trust between all parties, respect of each other's positions and knowing team members and their capabilities. Understanding these aspects of the communication process should enhance nurses and doctors abilities to effectively communicate regarding a change in a patient's condition.  
  Call Number NRSNZNO @ research @ Serial 724  
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Author Evans, S. openurl 
  Title Silence kills: Communication around adverse events in ICU Type
  Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz  
  Volume Issue (up) Pages  
  Keywords Intensive care nursing; Communication; Interprofessional relations  
  Abstract The aim of this dissertation is to assess the preventability or reduction of adverse events in the intensive care unit (ICU) through a literature review. Research shows the ICU is at high risk for errors, nevertheless there is a huge gap between knowing something should be done and applying this knowledge to practice. That being the case, this dissertation identifies and discusses several proven and transferable quality improvement proposals. These include: instituting anonymous error reporting; documentation of a daily goal-of-care; a nurse as ICU team co-ordinator; conflict resolution processes and communication training for all ICU staff. NThe author concludes that nurse-doctor collaboration requires the support of medicine, with recognition of the unique contribution nurses make to patient safety.  
  Call Number NRSNZNO @ research @ Serial 741  
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Author Sheward, K.A. openurl 
  Title Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying Type
  Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library  
  Volume Issue (up) Pages  
  Keywords Palliative care; Hospitals; Communication; Nurse-patient relations  
  Abstract The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.  
  Call Number NRSNZNO @ research @ Serial 772  
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Author Woods, M. url  openurl
  Title Parental resistance. Mobile and transitory discourses: A discursive analysis of parental resistance towards medical treatment for a seriously ill child Type
  Year 2008 Publication Abbreviated Journal NZNO Library  
  Volume Issue (up) Pages  
  Keywords Nurse-family relations; Parents and caregivers; Pacific peoples; Communication; Children; Chronically ill  
  Abstract This qualitative thesis uses discourse analysis to examine parental resistance towards medical treatment of critically ill children. It is an investigation of the 'mobile and transitory' discourses at play in instances of resistance between parents, physicians and nurses within health care institutions, and an examination of the consequences of resistance through providing alternative ways of perceiving and therefore understanding these disagreements. The philosophical perspectives, methodology and methods used in this thesis are underpinned by selected ideas taken from the works of Michel Foucault and Pierre Bourdieu and supported by relevant literature in the fields of media, law, children, parenting, caring, serious childhood illness, medicine and nursing. It is argued that from an examination of interview based texts, parental resistance is an omnipresent but transitory occurrence that affects many of the interactions between the parents of seriously ill children and clinical staff. It is maintained that within these interactions, the seeds of this resistance are sown in both critical decision making situations and in everyday occurrences between doctors, nurses and parents within healthcare institutions. Contributing factors to parental resistance include the use of power games by staff, the language of medicine, forms of symbolic violence, the presence or absence of trust between parents and medical staff, the effects of medical habitus, and challenges to the parental role and identity. Overall, it is proposed in this thesis that parents who resist treatment for their seriously ill child are not exceptions to the normative patient-physician relationship.  
  Call Number NRSNZNO @ research @ Serial 1140  
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Author Walsh, C. url  openurl
  Title Personal and professional choices, tensions, and boundaries in the lives of lesbian psychiatric mental health nurses Type
  Year 2007 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Sexuality; Psychiatric Nursing; Nurse-patient relations; Communication  
  Abstract This study aimed to articulate how sexual identity impacts on the therapeutic relationship between the client and the lesbian nurse in psychiatric mental health nursing. There is little consideration given in the literature or in research as to how sexuality of the nurse impacts on nursing practice. Most attitudes held by the public and nursing staff are based on the assumption that everyone is heterosexual, including nurses. Fifteen lesbian psychiatric mental health nurses from throughout New Zealand volunteered for two interviews and shared their experiences of becoming and being a lesbian psychiatric mental health nurse. The stories they told give new insights into how these nurses negotiate and position their lesbian identity in the therapeutic relationship. To work therapeutically with people in mental distress the nurse uses personal information about themselves to gain rapport with the client through appropriate self-disclosure. Being real, honest and authentic are also key concepts in this relationship so the negotiation of reveal/conceal of the nurse's identity is central to ongoing therapeutic engagement. One of the most significant things arising from the research is that participants are able to maintain their honesty and authenticity in the therapeutic relationship whether they self-disclose their lesbian identity or not. This is because the experiences in their personal lives have influenced how the participants 'know themselves' and therefore guide how they 'use self' in their therapeutic nursing. The concept of a 'licensed narrative' has also been developed during this research reflecting the negotiated understandings between the researcher and the participants. Further, the use of NVivo a qualitative software package helps to track and make transparent the research processes. These two aspects make a unique contribution to the field of narrative inquiry.  
  Call Number NRSNZNO @ research @ Serial 1164  
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Author Lally, E.J. url  openurl
  Title An exploration of language and nursing practice to improve communication in the context of ear syringing Type
  Year 2002 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Communication; Practice nurses; Economics  
  Abstract This action research inquiry explores communication and nursing practice in an effort to improve practice and enhance patient care. Action research is a critical reflective process that involves spirals or cycles of planning, acting, reflecting/evaluating and replanning the next cycle. Using ear syringing as a procedure, in the general practice setting and at two separate surgeries, the author and another practice nurse co-researched this study during working hours. Twelve people consented to participate in the research that involved the audiotaping of each ear syringing interaction. Following each transcription of the recording, the researchers read their own and then each other's transcripts, and listened to the recordings. They discussed and reflected on their findings and planned the next cycle. Throughout the process, the researchers found a number of areas of practice to change or enhance. Changes included the use of technical language such as “contraindications” and “auditory meatus”, the side effects of syringing, improvements in communicating situations where ear syringing is not recommended and the options available, and post procedure information. These changes became a significant challenge, for example when both researchers forgot the changes, thus repeating previous errors and omissions. This factor highlighted the need to practise any changes prior to interactions, and to have a cue card on hand to facilitate recollection and to cement improvements into practice. Although time constraints limited this inquiry to three cycles, at the final meeting the researchers agreed to continue the reflective process they had begun to explore their practice.  
  Call Number NRSNZNO @ research @ Serial 1189  
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Author Brunton, Margaret; Cook, Catherine; Walker, Leonie; Clendon, Jill openurl 
  Title Where are we?: workplace communication between RNs in culturally-diverse healthcare organisations; Analysis of a 2-phase, mixed-method study: a report prepared for the New Zealand Nursing Education and Research Foundation Type Report
  Year 2017 Publication Abbreviated Journal  
  Volume Issue (up) Pages 82 p.  
  Keywords Communication in nursing; Registered nurses; Surveys  
  Abstract Examines cultural influences on perceptions and practices of cross-cultural communication among registered nursing staff from diverse ethnicities in NZ. Employs an exploratory approach to obtain qualitative feedback by means of semi-structured interviews with 36 Internationally Qualified Nurses (IQN) and 17 NZ Registered Nurses (NZRN). Uses data from the interviews to construct a questionnaire survey to seek responses from a random national sample of RNs.  
  Call Number NZNO @ research @ Serial 1543  
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Author Jarden, Amanda J url  openurl
  Title Before-school check nurses' experiences of motivational interviewing during the weight-related referral process : an interpretive phenomenological study Type Book Whole
  Year 2018 Publication Abbreviated Journal  
  Volume Issue (up) Pages 240 p.  
  Keywords School nurses; Childhood obesity; Before School Check programme; Motivational interviewing; Communication; Surveys  
  Abstract Investigates nurses' experiences of weight-related conversations with whanau, and their level of understanding and application of motivational interviewing, during the Before-School Check programme to identify 95% of high-weight children. Uses a questionnaire focussed on competencies in conjunction with recorded interviews concentrated on process-oriented accounts of the referral process.  
  Call Number NZNO @ research @ Serial 1645  
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Author Ferguson, Katelyn Maye url  openurl
  Title The appropriation of cultural safety: A mixed methods analysis Type Book Whole
  Year 2021 Publication Abbreviated Journal  
  Volume Issue (up) Pages 250 p.  
  Keywords Cultural safety; Nursing practice; Cross-cultural communication; Maori health care; Internationally Qualified Nurses (IQN)  
  Abstract Argues that the concept of cultural safety (CS) has been appropriated from an indigenous-led bicutural context to an inclusive cross-cultural framework for working with diverse patient populations. Investigates nurses' understanding of the 'Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice' published in 2011 by the Nursing Council of NZ. Conducts a mixed-methods survey using both closed and open-ended questions to gauge nurses' confidence in applying the guidelines and their view of their relevance. Describes differences between NZ Registered Nurses (RN) and Internationally Qualified Nurses (IQN) in their understanding of CS. Argues that the CS model should be by Maori, for Maori.  
  Call Number NZNO @ research @ Serial 1763  
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