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Author (up) O'Brien, A.J.; Hughes, F.; Kidd, J.D.
Title Mental health nursing in New Zealand primary health care Type Journal Article
Year 2006 Publication Contemporary Nurse Abbreviated Journal
Volume 21 Issue 1 Pages 142-152
Keywords Mental health; Primary health care; Nursing specialties; Community health nursing
Abstract This article describes the move in mental health from institutional care to community arrangements. It draws on international literature and New Zealand health policy, which gives increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc and leave room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care.
Call Number NRSNZNO @ research @ 730 Serial 716
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Author (up) O'Shea, M.; Reddy, L.
Title Action change in New Zealand mental health nursing: One team's perspective Type Journal Article
Year 2007 Publication Practice Development in Health Care Abbreviated Journal
Volume 6 Issue 2 Pages 137-142
Keywords Experiential learning; Psychiatric Nursing; Communication; Community health nursing
Abstract This paper describes an attempt at effecting change with specific relevance to the discharge planning of clients from a New Zealand inpatient mental health unit to a community setting. It explores how a team of community mental health nurses, practising in an urban/rural area, used the concepts of practice development to endeavour to bring about change while still retaining a client-centred focus. It describes how, in their enthusiasm, they embarked on the road to practice change without undertaking some of the essential ground work, Although they did not achieve all they set out to achieve, much was learnt in the process. In this paper, the authors outline their key learning points concerning the importance of engagement, communication, consistency and cooperation to the process and outcomes of practice change.
Call Number NRSNZNO @ research @ 897 Serial 881
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Author (up) Pearce, K.
Title Orientation: Reading the nurses map; what new Plunket Nurses need in an orientation programme Type
Year 2003 Publication Abbreviated Journal Victoria University Library
Volume Issue Pages
Keywords Plunket; Training; New graduate nurses; Curriculum; Community health nursing
Abstract The Plunket orientation programme, first implemented in 1994, aims to prepare new Plunket Nurses for autonomous practice within the complexity of community based nursing. This study seeks to identify what new Plunket Nurses feel are their orientation needs. An evaluation research approach was used. An examination of the literature explored how orientation is conducted and the needs of nurses in orientation. Key aspects in relation to orientation were identified as including socialisation, job change, new graduates, preceptorship, orientation frameworks and retention. A focus group followed by a postal survey were utilised to collect data from new Plunket Nurses nationwide to ascertain what they thought their orientation needs were. Data analysis was completed using descriptive statistics and thematic analysis. The results of the study identified key orientation needs for new Plunket Nurses. These were an orientation programme, preceptorship, clinical skills teaching, time in own area and beginning autonomous practice, administration needs and support needs. The participants recommended quality preceptorship and early clinical teaching from the Clinical Educator. There was a general dissatisfaction with orientation as it stands in preparing them for their role as a Plunket Nurse. Recommendations to the Plunket Management Team were made based on the results of this study.
Call Number NRSNZNO @ research @ Serial 1240
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Author (up) Rickard, Debbie
Title Parents as experts: partnership in the care of the chronically ill children : Margaret May Blackwell Travel Study, Fellowship for Nurses of Young Children, 1999 Type Report
Year 1999 Publication Abbreviated Journal
Volume Issue Pages 65p.
Keywords Chronically ill children – home care; Child health services; Paediatric nursing; Community health nursing; Reports
Abstract Visits paediatric community nursing services in the UK and Australia to report on how specialist and children's community nurses work with parents to deliver health care to children with asthma, diabetes and other endocrine disorders, cystic fibrosis, eczema, cardiac diseases, and liver transplants. Part of the Margaret May Blackwell Scholarship Reports series.
Call Number NZNO @ research @ Serial 1414
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Author (up) Russell, D.
Title Changing public health nursing practice Type Journal Article
Year 1999 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 5 Issue 11 Pages 18-19
Keywords Public health; Community health nursing; Nursing models; Teamwork
Abstract A new approach to public health nursing in the Otago region is described, which comprises of 3 distinct groups of nurses working in early childhood centres, primary schools and high schools. A family nursing assessment approach is used. The philosophical underpinnings of this approach are examined, which seeks to empower patients and engage them in their health care. Two public health nurses are interviewed about the new partnership model of nursing.
Call Number NRSNZNO @ research @ 1041 Serial 1025
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Author (up) Sheridan, N.F.
Title Mapping a new future: Primary health care nursing in New Zealand Type
Year 2005 Publication Abbreviated Journal University of Auckland Library
Volume Issue Pages
Keywords Primary health care; Chronic diseases; Community health nursing; Nursing models
Abstract The aim of the study was to determine the practice of nurses employed in integrated care projects in New Zealand from late 1999 to early 2001. Integrated care was a major health reform strategy that emphasised primary health care as a means to improve service provision between the health sectors. An investigation of nurses' practice sought to determine the extent to which primary health care principles had been adopted in practice, as a comprehensive primary health care approach has been advocated globally in the management of chronic conditions; the leading cause of disability throughout the world and the most expensive problems faced by health care systems. The philosophical basis of the research was postpositivism. The study employed a quantitative non-experimental survey design because it allowed numeric descriptions of the characteristics of integrated care projects to be gained for the purpose of identifying nurses' practice. The unit of inquiry was the integrated care project, and 80 comprised the study population. Data were obtained on projects from expert informants (n=27) by telephone survey using a structured interview questionnaire developed by the researcher. Data obtained from interviews were statistically analysed in two stages. First, data were produced to comprehensively describe the characteristics of integrated care projects and nurses practice. The 'Public health interventions model' was used as a framework to analyses the interventions (activities) and levels of population-based practice of nurses. Following this, the social values embedded in nurses' practice were determined using 'Beattie's model of health promotion' as a framework for analysis. A strong association was found between nurses' practice in projects and strategies used in integrated care, such as information sharing, guideline development and promotion, and case management, and projects with an ethnic focus, low income focus, chronic condition focus, and well-health focus. Whilst nurses undertook interventions most frequently at the individual practice level they were also strongly associated with the small proportion of interventions that were undertaken at the community level. The majority of interventions by nurses reflected the health promotion value of health persuasion, indicating a paternalist and individual-oriented philosophy. Nurses were engaged in two interventions that indicated a collective-oriented philosophy – coalition building and community development, the latter reflecting health promotion values of negotiation, partnership and empowerment. The study demonstrated that nurses' practice in projects was predominantly centred on individual-focused population-based practice suggesting the need for a framework to assist nurses to transition their practice to include more activity at the community and systems levels. Without a reorientation of practice, nurses will remain limited in their ability to achieve health gains for populations. In response to this conclusion, and drawing on research results and reviewed literature, a new model, The 'Primary Health Care interventions model' was constructed. Recommendations include advocacy for the acceptance of the model by the health funder, professional nursing bodies, health organisations, educational institutions, nurses, communities, and individuals.
Call Number NRSNZNO @ research @ 679 Serial 665
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Author (up) Southgate, D.
Title Advocating practice: The role of the community oncology nurse Type
Year 2002 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Community health nursing; Cancer; Nurse-patient relations; Oncology
Abstract The primary aim of this research was to advocate for, and make known, the role of the community oncology nurse, and to bring alive the hidden issues of nursing people in the community who have active cancer treatment. This study is also about the author's journey from novice to expert in developing the role as a community oncology nurse. The research also aimed to identify and understand practice that community oncology nurses do and often take for granted. To capture the essence of this study the method of reflective topical autobiography was utilised, which gave the opportunity to gather advanced nursing inquiry, and generate new nursing knowledge. To obtain insight into the highs and lows in everyday interaction with patients, reflective practice stories are presented. The thesis generated by this research is that care required by cancer patients at home goes beyond the scope of traditional community health. It requires nurses to be competent in technological skills as well as bringing in-depth expertise to the practical and human needs of people experiencing cancer. The role involves holistic, family-centered care; anticipating patient and family needs; educating; managing symptoms; advocating; confronting ethical issues; coordinating complex care; and monitoring progress.
Call Number NRSNZNO @ research @ Serial 1163
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Author (up) Stuart, J.
Title How can nurses address generalist/specialist/nursing requirements of the urban/rural population of Southland Type
Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing specialties; Policy; Technology; Scope of practice; Community health nursing
Abstract This study, which is undertaken in the Southland area, explores the effect of the increasing specialisation of nursing services in what is a rural/urban environment. It is indicated in the literature that systemic changes in health, such as the health reforms, and the increase in the use of technology have meant that nurses are required to function in disease oriented roles rather than according to their more traditional generalist roots. A significant event, which also affected nursing scope of practice, was the transfer of nurse education to the tertiary education institutions environment from the hospitals in the mid 1970s. The traditional nursing hierarchy and its nurse leadership role disappeared and the adoption of specialist nurse titles increased, and identified with a disease or disorder, for example 'diabetes' nurse. The increase in specialist categories for patients contributed to the nurse shortage by reducing the available numbers of nurses in the generalist nursing pool. The nurses in this rural/urban environment require generalist nurse skills to deliver their nursing services because of the geographical vastness of the area being a barrier to specialist nurses. Workforce planning for nurses in the rural/urban then must focus on how to reshape the nursing scope of practice to utilise the existing resources. This study explores how key areas of health services could be enhanced by reclaiming the nurse role in its holistic approach, in mental health, public health, geriatric services and psychiatric services.
Call Number NRSNZNO @ research @ 885 Serial 869
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Author (up) Sye, J.
Title A fine balance Type
Year 2008 Publication Abbreviated Journal AUT University Library
Volume Issue Pages
Keywords Paediatric nursing; Community health nursing; Nurse-patient relations; Children; Patient rights
Abstract The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates.
Call Number NRSNZNO @ research @ 911 Serial 895
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Author (up) Thompson, R.
Title Red Band nursing: From swannies to stethoscopes Type
Year 2004 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Rural nursing; Community health nursing; Public health
Abstract The author notes that many registered nurses undertake a role in the community which may or may not be recognised for what it really is – one of these roles may be that of the unpaid health care provider. The nurse may be called on by family, friends, neighbours, or the wider community to provide a voluntary health service at any time of the day or night according to the need of the person wanting the information or assistance. This is the story of one such nurse. Four themes have been uncovered from a nursing practice that has spanned three decades of providing an on-call basic first aid service to a community of about two hundred households in a rural community. These experiences are used to shape the stories within the story of this voluntary role, and provide a framework to discuss the implications for the future of voluntary practice.The themes are: Maintaining personal and professional boundaries; Maintaining values and a high standard of care; Commitment to ongoing education; Accepting accountability for one's actions. The confidence and competence that such practice demands is explained from a personal perspective, along with an attempt to answer a question that is often asked – “Who will or indeed does anyone want to replace me when I retire or shift away from the district?” This question is addressed in the context that this story is written, the changes that the healthcare system is experiencing at present, and the impact that these changes may have for the future.
Call Number NRSNZNO @ research @ Serial 607
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Author (up) Trout, F.
Title Health needs assessment within the ecology of caring Type
Year 1999 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Community health nursing
Abstract
Call Number NRSNZNO @ research @ 1137 Serial 1122
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Author (up) Voice, D.M.
Title Everyday district nurses' experiences revealed through distillation: Palliative care in the community Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords District nursing; Palliative care; Community health nursing; Nursing
Abstract This modified action research inquiry focused on the everyday, palliative care practice experiences of a group of district nurses. The intent was to develop an understanding of common issues of concern for this group of district nurses when providing palliative home care in a specific community context and to implement practical, achievable strategies in response to these local issues. Five district nurses identified four broad areas for action through four praxis group meetings and comprising one full cycle. These four areas have been named as methods of enhancing support for people and families, possibilities for creatively managing workloads, mechanisms to enrich working partnership with other palliative care providers and possible vehicles for supporting nurses' self care. Implementation of action from this action research project focused on enhancing care and outcomes for people and family served by this group of district nurses in their local community. This study illuminates everyday essences of the district nurse role and the elements articulated by this group in supporting their practice in one New Zealand community. This study also reveals some of the tensions and messiness when employing an action research methodology with nurses in the workplace. The author notes that this research focused on a little known area (palliative care delivered by district nurses in New Zealand) in a local community (a culturally vibrant and ethnically diverse yet with poor health and socioeconomic statistics). She goes on to say that it has resonance with other nurses, particularly those working in community settings who may experience similar issues and concerns. This research also offers important insights for nurses working in any practice setting.
Call Number NRSNZNO @ research @ 520 Serial 506
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Author (up) Weidenbohm, K.
Title Pioneering rural nursing practice: An impact evaluation of a preventive home visiting service for older people Type
Year 2006 Publication Abbreviated Journal University of Auckland Library
Volume Issue Pages
Keywords Community health nursing; Rural health services; Older people; Home care; Preventive health services
Abstract
Call Number NRSNZNO @ research @ 579 Serial 565
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Author (up) Wilson, B.
Title Maintaining equilibrium: The community mental health nurse and job satisfaction Type
Year 2005 Publication Abbreviated Journal University of Otago Library
Volume Issue Pages
Keywords Community health nursing; Mental health; Job satisfaction; Stress
Abstract
Call Number NRSNZNO @ research @ 681 Serial 667
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Author (up) Wilson, H.V.
Title Surveillance or support: Divergent discourses in Plunket nursing practice Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Public health; Children; Community health nursing; Plunket
Abstract Plunket nurses are New Zealand child health nurses who work in the community with the families of new babies and preschool children. Their work is called child health surveillance and this is considered to involve routine and unproblematic practices which are generally carried out in homes and clinics in the context of a relationship with the child's mother (Ministry of Health 1996; Royal New Zealand Plunket Society 1997). However, evidence in the literature that surveillance can have implications for power relations throws doubts on official claims that the relationship between the mother and nurse operates as a partnership (Trout and Polaschek 1996). The purpose of this thesis was to explore the way in which surveillance is constituted within the discourses of Plunket nurses and to examine these discourses for any implications of unequal power relations. Foucauldian discourse theory and poststructuralism, which informed this thesis, provided the opportunity to challenge assumptions about power and knowledge in the child health context. Analysis of the discourses generated by interviews with five Plunket nurses revealed that, contrary to the claims in the official literature, the relationship between the Plunket nurse and the mother is not that of an equal partnership but is constituted in various and unexpected ways. It was through the nurses' discourses of surveillance that the power relations underpinning this relationship were surfaced. While these discourses suggested that many mothers who use the nursing service are actively involved on their own terms, there are a number of women for whom the surveillance activities of the nurse have been shown to be particularly intrusive (Mayall 1986; Clinton 1988; Bloor and McIntosh 1990; Knott and Latter 1999). It may be primarily this unwelcome surveillance which accounts for the considerable number of women who, the statistics show, cease using Plunket services particularly in the early months. It is perhaps for this reason that the nurses in this study locate themselves as being caught between divergent discourses of support and surveillance. Findings indicate that the resolution of this dilemma by abandoning surveillance practices might improve maternal satisfaction with the Plunket nursing service. The author concludes that a child health service responsive to mothers' stated needs rather than institutional requirements or the nurse's own agenda could lead to a more open and equal relationship between mother and nurse. This relationship would be likely to benefit mothers and babies and, at the same time, enhance both nursing practice and nurses' satisfaction with their work.
Call Number NRSNZNO @ research @ Serial 899
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