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Author |
Dredge, A. |
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Title |
An insider's view of professional nursing and care management of the critically ill patient |
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Journal Article |
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Year |
1999 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
5 |
Issue |
8 |
Pages |
13-16 |
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Keywords |
Intensive care nursing; Interprofessional relations; Registered nurses |
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Abstract |
This article explores the role of the registered nurse (RN) in the critical care environment. It presents the Intensive Care Unit (ICU) as a unique environment, with a specific relationship to technology, and a history that mirrors scientific development. It explores the tensions for a caring profession with a distinct culture practising in a highly medicalised, acute environment, and affirms the value of quality human care. |
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Call Number |
NRSNZNO @ research @ 1302 |
Serial  |
1287 |
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Author |
Herd, C.M.F. |
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Title |
Is it a dangerous game? Registered nurses' experiences of working with care assistants in a public hospital setting |
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Year |
2001 |
Publication |
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Abbreviated Journal |
Massey University, Palmerston North, Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Registered nurses; Personnel; Interprofessional relations |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1274 |
Serial |
1259 |
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Author |
Ryder-Lewis, M. |
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Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
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Year |
2004 |
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 |
Intensive care nursing; Interprofessional relations |
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Abstract |
This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
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Author |
Litchfield, M. |
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Title |
Towards a people-pivotal paradigm for healthcare: Report of the Turangi primary health care nursing innovation 2003-2006 |
Type |
Manuscript |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Held by the Ministry of Health, publication pending |
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Volume |
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Issue |
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Pages |
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Keywords |
Evaluation; Community health nursing; Nursing models; Interprofessional relations |
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Abstract |
This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1178 |
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Author |
Thompson, L.E. |
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Title |
Profession and place: Contesting professional boundaries at the margins |
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Year |
2006 |
Publication |
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Abbreviated Journal |
UC Research Repository |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Primary health care; Identity; Interprofessional relations |
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Abstract |
Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural. |
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Call Number |
NRSNZNO @ research @ 1177 |
Serial |
1162 |
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Author |
Miles, M.A.P. |
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Title |
A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 |
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Year |
2005 |
Publication |
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Abbreviated Journal |
NZNO Library, University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Interprofessional relations; Policy |
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Abstract |
This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory. The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture. The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions. The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries. Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators. The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing's perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine. The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions. |
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Call Number |
NRSNZNO @ research @ 1146 |
Serial |
1131 |
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Author |
French, P. |
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Title |
Nursing registration: A time to celebrate? |
Type |
Journal Article |
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Year |
2001 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
7 |
Issue |
8 |
Pages |
17-19 |
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Keywords |
History of nursing; Interprofessional relations; Physicians; Nursing philosophy |
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Abstract |
This article examines the knowledge and power relationships between the medical profession and nurses during the first half of the twentieth century. It argues that the 1901 Nurses' Registration Act allowed doctors to exert control over the nursing profession and that the hierarchal structure of the profession contributes to the culture of control and surveillance. |
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Call Number |
NRSNZNO @ research @ 1029 |
Serial |
1013 |
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Author |
Evans, S. |
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Title |
Silence kills: Challenging unsafe practice |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
3 |
Pages |
16-19 |
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Keywords |
Medical errors; Organisational change; Organisational culture; Patient safety; Interprofessional relations |
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Abstract |
The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals. |
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Call Number |
NRSNZNO @ research @ |
Serial |
994 |
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Author |
Shaw, S. |
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Title |
Constructing media images of nursing: How does the media represent nurses when reporting on nurse prescribing? |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
1 |
Pages |
16-18 |
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Keywords |
Drug administration; Interprofessional relations; Professional competence; Nursing; Eucation; Quality of health care |
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Abstract |
This research presents a discourse analysis of articles published in the New Zealand Herald between October 1999 and September 2005. The terms “nurse prescribing” and “prescribing fights” identified seven articles published which referred specifically to this issue. They were predominantly editorial comments and statements attributed to senior doctors. Examples of comments from these articles are presented and discussed in this article, and three inter-related themes are identified – competence, responsibility and competition. Discussion on competence centred on education, skill and experience level of nurses, as described by editorial comment and senior doctors. Positive international research and experience of nurse prescribing did not feature. A number of comments in the articles analysed could be seen to represent concerns about competition between medicine and nursing. One interpretation of the comments contained in these articles is to see medical practitioner groups defending their status and desire to define and control nursing practice. The media has the power to select the information conveyed and, in these instances, appears to have demonstrated a bias towards the medical community's perspective. |
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Call Number |
NRSNZNO @ research @ |
Serial |
979 |
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Author |
Murphy, R. |
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Title |
A day in the life of an acute hospital psychiatric nurse |
Type |
Journal Article |
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Year |
2005 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
11 |
Issue |
9 |
Pages |
24-25 |
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Keywords |
Nursing; Psychiatric Nursing; Interprofessional relations; Mental health; Multidisciplinary care teams |
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Abstract |
A nurse presents a personal account of a typical day at Middlemore Hospital's 50-bed acute inpatient mental health unit Tiaho Mai. The article covers aspects of shift handover, working with multidisciplinary teams, developing care plans, working with families, and responding to emergencies. |
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Call Number |
NRSNZNO @ research @ |
Serial |
957 |
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Author |
Horsburgh, M.; Perkins, R.; Coyle, B.; Degeling, P. |
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Title |
The professional subcultures of students entering medicine, nursing and pharmacy programmes |
Type |
Journal Article |
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Year |
2006 |
Publication |
Journal of Interprofessional Care |
Abbreviated Journal |
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Volume |
20 |
Issue |
4 |
Pages |
425-431 |
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Keywords |
Interprofessional relations; Attitude of health personnel; Nurse managers; Nursing; Education; Organisational culture |
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Abstract |
This study sought to determine the attitudes, beliefs and values towards clinical work organisation of students entering undergraduate medicine, nursing and pharmacy programmes in order to frame questions for a wider study. University of Auckland students entering medicine, nursing and pharmacy programmes completed a questionnaire based on that used by Degeling et al. in studies of the professional subcultures working in the health system in Australia, New Zealand, England and elsewhere. Findings indicate that before students commence their education and training medical, nursing and pharmacy students as groups or sub-cultures differ in how they believe clinical work should be organised. Medical students believe that clinical work should be the responsibility of individuals in contrast to nursing students who have a collective view and believe that work should be systemised. Pharmacy students are at a mid-point in this continuum. There are many challenges for undergraduate programmes preparing graduates for modern healthcare practice where the emphasis is on systemised work and team based approaches. These include issues of professional socialisation which begins before students enter programmes, selection of students, attitudinal shifts and interprofessional education. |
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Call Number |
NRSNZNO @ research @ |
Serial |
937 |
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Author |
Gage, J.; Hornblow, A.R. |
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Title |
Development of the New Zealand nursing workforce: Historical themes and current challenges |
Type |
Journal Article |
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Year |
2007 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
14 |
Issue |
4 |
Pages |
330-334 |
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Keywords |
History of nursing; Nursing research; Personnel; Interprofessional relations |
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Abstract |
This article reviews the development of the New Zealand nursing workforce, which has been shaped by social, political, scientific and interprofessional forces. The unregulated, independent and often untrained nurses of the early colonial period were succeeded in the early 1900s by registered nurses, with hospital-based training, working in a subordinate role to medical practitioners. In the mid/late 1900s, greater specialisation within an expanding workforce, restructuring of nursing education, health sector reform, and changing social and political expectations again reshaped nursing practice. Nursing now has areas of increasing autonomy, expanding opportunities for postgraduate education and leadership roles, and a relationship with medicine, which is more collaborative than in the past. Three current challenges are identified for nursing in New Zealand's rapidly evolving health sector; development of a nursing-focused knowledge culture, strengthening of research capacity, and dissemination of new nursing knowledge. |
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Call Number |
NRSNZNO @ research @ 946 |
Serial |
930 |
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Author |
Strochnetter, K.T. |
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Title |
Influences on nurses' pain management practices within institutions: A constructivist approach |
Type |
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Year |
2000 |
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 |
Interprofessional relations; Pain management; Nursing |
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Abstract |
Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient. |
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Call Number |
NRSNZNO @ research @ |
Serial |
909 |
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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 |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Interprofessional relations; Rural nursing; Primary health care |
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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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Call Number |
NRSNZNO @ research @ 780 |
Serial |
764 |
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