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Author |
Connor, M. |
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Title |
Sharing the burden of strife in chronic illness: A praxiological study of nursing practice in a community context |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
Chronically ill; Nursing; Nurse-patient relations; Nursing research; Methodology |
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Abstract |
This inquiry is an in-depth exploration of one middle aged woman's experience of strife in chronic illness and her nursing care involving four nurses (including the author) in a community context over a three-year period. The study is praxiological in that the understanding achieved is derived from practice within a 'research as praxis' methodology positioned in the disciplinary perspective of nursing as a practical human science. Five methodological premises inform the research processes: reflexivity, dialogue, moral comportment, re-presentation in narrative and critique. They emanate from an eclectic ontological praxiology based on the research framework constructed from Gadamerian philosophical hermeneutics, components of other philosophical praxiologies evolved from an exploration of the practical discourse in philosophy and my preferred health and nursing assumptions. The research processes include researcher journalling, a summary of Sarah's nursing record and dialogical meetings with Sarah and the nurse co-participants. Using the research material a narrative is then co-constructed. The narrative is structured around what Sarah viewed as the overall nursing contribution to her care; the 'sharing of her burden of illness'. This, she maintained, enabled her to live safely in the community. Finally there occurs a critique of the narrative within a discursive framework. Three themes, embedded in particular discourses, emerged from the narrative both in Sarah's and the nurses' experience; paradox, moral meaning and metaphor. Sarah's experience is interpreted as taking place in the 'in-between space' of the disease and health-illness discourses. Two main concepts which depict the tension experienced in this space are the 'the ontological assault of illness' and 'entrapment in the disease discourse'. The nurses, in this instance, 'pushed the boundaries' to create a space for the nursing as a caring practice discourse on the margins of nursing as a functional service discourse. The author notes that, within the nursing as a caring practice space, many 'fine lines' were walked with Sarah. Walking the 'fine line' of an 'intense relationship' was seen as advanced nursing practice. The research highlights important implications for a person and/or families who live with chronic illness and practice and educational issues for advanced nurse practitioners. Further, it promotes praxiological methodologies as advantageous for expanding nursing knowledge. |
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Call Number |
NRSNZNO @ research @ 495 |
Serial |
481 |
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Author |
Tipa, Zoe; Wilson, Denise; Neville, Stephen; Adams, Jeffery |
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Title |
Cultural Responsiveness and the Family Partnership Model |
Type |
Journal Article |
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Year |
2015 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
31 |
Issue |
2 |
Pages |
35-47 |
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Keywords |
Well-child care; Family partnership model; Child and family nursing; Maori; Biculturalism; Nurse-patient relationship |
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Abstract |
Investigates the bicultural nature of the Family Partnership Model for working with Maori whanau in the context of well-child care services. Reports a mixed-methods study in 2 phases: an online survey of 23 nurses trained in the Family Partnership Model and 23 not trained in the model; observation of nurses' practice and interviews with 10 matched nurse-Maori client pairs. Identifies 3 aspects of the findings: respectful relationships, allowing clients to lead, and lack of skills. |
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Call Number |
NZNO @ research @ |
Serial |
1501 |
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Author |
Fourie, W.; McDonald, S.; Connor, J.; Bartlett, S. |
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Title |
The role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality |
Type |
Journal Article |
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Year |
2005 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
Available online from Coda: An institutional repository for the ITP sector |
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Volume |
14 |
Issue |
2 |
Pages |
134-141 |
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Keywords |
Psychiatric Nursing; Nurse-patient relations; Organisational change |
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Abstract |
This study compared the perceptions that registered psychiatric nurses have of their roles with their actual practice. Following the closure of large scale psychiatric institutions in New Zealand, there was was an increased demand for limited beds in acute inpatient facilities for acutely mentally ill patients. This change in location and downsizing of acute inpatient beds challenged traditional roles of mental health nursing, resulting in confusion over what roles mental health nurses should now perform in the new context of care. This qualitative descriptive exploratory study observed nursing practice on three selected wards and used focus group interviews to establish from registered nurses what they perceived their roles to be. A key finding of this study was that many of the nursing roles related to delivering care from a crisis management perspective, which covers aspects such as assessment, stabilisation of symptoms and discharge planning. Participants also believed that the therapeutic relationship was a fundamental role in inpatient care. Nurses used any opportunity to make it a reality such as kitchen organisation, medications, or dealing with a challenging patient. This study highlighted the complexity of the roles that nurses performed and went some way to give voice to what at times seems an invisible practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
875 |
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Author |
Davies, B. |
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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 |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Research Archive at Wintec |
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Pages |
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Keywords |
Nurse-patient relations; Communication; Hospitals; Home care |
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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. |
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Call Number |
NRSNZNO @ research @ 1195 |
Serial |
1180 |
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Author |
Southgate, D. |
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Title |
Advocating practice: The role of the community oncology nurse |
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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 |
Community health nursing; Cancer; Nurse-patient relations; Oncology |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1163 |
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Author |
Cleaver, H. |
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Title |
Reflections on knowing, not knowing and being in palliative care nursing |
Type |
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Year |
2005 |
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 |
Palliative care; Nursing; Terminal care; Nurse-family relations; Nurse-patient relations |
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Abstract |
The author notes that responses to questions from dying people and their families are as individual as each nurse, patient, family member, or situation. This is well recognised and an unspoken truth in palliative care practice. This paper explores the subjective nature of knowledge in palliative care generated through capturing moments of practice and subsequent reflections. This demonstrates how the author uses her model of care to open a space that enables the person and their family to find meaning from their experience and articulate what they need at the time. The author identifies her interest in the paradoxical reality of knowing and not knowing and describes how that paradox contributes to her role in supporting individuals' needs within their realities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
511 |
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Author |
Mitchell, D.F. |
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Title |
Is it possible to care for the “difficult” male? A study exploring the interface between gender issues, nursing practice and men's health |
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Year |
1999 |
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 |
Male; Nurse-patient relations; Gender |
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Abstract |
This thesis is about caring for males, especially those males who could be considered “difficult” to care for through their use of behaviours such as silence, anger or defensive humour. This thesis is positioned in the view that these behaviours are often expressions of distress, which typically distance males from those who attempt to care for them. The author suggests that the word “distress” more accurately reflects the theme of the thesis, and it is used throughout the work. This thesis explores the interface between gender issues, nursing practice and caring for males. It is informed by a review of relevant literature and data gathered from a focus group of nine registered nurses. The analysis is framed by questions that are developed from a series of reflections on my personal and professional life. Critical social theory, with its emphases on dominant dialogue, power and emancipation is used to inform and guide this analysis. What is most obvious is the contrast between themes arising from the literature and those arising from the focus group. It appears that the literature, in the main, is critical of males in regard to concepts of masculinity, issues related to gender, and men's health. Males are portrayed as arbitrators of their own misfortune, as deliberately choosing a lifestyle that reflects poorly on their health, their self-expression, and communication with others. Concepts such as power and control over others, both at a societal and individual level, often feature. Conversely, the literature is noticeably lacking in regard to information about the health related experiences of males and about caring for males. In contrast, the participants of the focus group frame their discussion in the positive. For example, they suggest that males are interested in their health but require an environment that supports this expression of interest. They support this by identifying a range of behaviours they believe are effective in caring for males. The participants also suggest that it is the registered nurse rather than the male who manages issues to do with power and control. The thesis concludes that creating and sustaining an environment supportive of, and sensitive to the needs of males, is an activity that requires considerable thought, skill and experience. These areas are not adequately addressed in academic dialogue, research activity, or in the education of registered nurses. The thesis suggests that this situation is inconsistent with an ethic of care and that nursing should make a priority of broadening its research and knowledge base to better understand and care for males. |
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Call Number |
NRSNZNO @ research @ 503 |
Serial |
489 |
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Author |
Watson, S.L. |
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Title |
Attitudinal shifting: A grounded theory of health promotion in coronary care |
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Year |
2007 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Health promotion; Policy; Professional development; Cardiovascular diseases; Nursing; Nurse-patient relations; Education |
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Abstract |
Current New Zealand health policy encourages collaborative health promotion in all sectors of health service delivery. The integrated approach to the acute management of coronary heart disease in a coronary care unit, combining medical therapy and lifestyle change, supports clinical health promotion. The aim of this study was to use the grounded theory approach to discover the main concerns of nurses' promoting health in an acute coronary care setting and to explain the processes that nurses used to integrate health promotional activities into their practice. Seventeen registered nurses from three coronary care units within a large metropolitan city in New Zealand were interviewed. Data were constantly compared and analysed using Glaser's emergent approach to grounded theory.The main concern for nurses promoting health within coronary care was ritualistic practice. In this study, ritualistic practice concerns the medically-based protocols, routines, language and technology that drives nursing practice in coronary care. This concern was resolved via the socio-cultural process of attitudinal shifting that occurs over time involving three stages. The three conceptual categories, environmental pressures, practice reality and responsive action are the main components of the theory of attitudinal shifting. In environmental pressures, nurses experience a tension between specialist medically-dominated nursing practice and the generalist nursing role of promoting health. In practice reality, nurses become aware that the individual needs of patients are not being met. This causes role conflict until the nurse observes colleagues who role model possibilities for practice, working with patients to promote health. Responsive action sees the nurse engaging in self-development, also focusing on the nurse-patient relationship, thereby enabling active patient involvement in individual health-promoting decisions. The author suggests that the findings from this research have implications for nursing practice and education. With the increasing specialisation in nursing practice, these findings may be of interest to nurses working in delegated medical roles where the reality of everyday practice precludes nurses from undertaking their essential nursing role. Health care facilities also need to ensure that there are opportunities for the personal and professional development of nursing staff. The place of health promotion within nursing undergraduate curricula needs to be examined, as many nurses found that they were ill prepared for undertaking health promotional activities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
807 |
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Author |
Sye, J. |
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Title |
A fine balance |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Paediatric nursing; Community health nursing; Nurse-patient relations; Children; Patient rights |
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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. |
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Call Number |
NRSNZNO @ research @ 911 |
Serial |
895 |
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Author |
McKenzie-Green, B. |
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Title |
Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study |
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Year |
2003 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Older people; Registered nurses; Nurse-patient relations |
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Abstract |
Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities. |
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Call Number |
NRSNZNO @ research @ 912 |
Serial |
896 |
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Author |
Hall, J. |
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Title |
Building trust to work with a grounded theory study of paediatric acute care nurses work |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Auckland University of Technology Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse-family relations; Nurse-patient relations; Children; Paediatric nursing; Intensive care nursing |
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Abstract |
Grounded theory methodology has guided the grounded theory methods used to explore the acute care paediatric nurses' perspective of what they do when a child has had a severe accident. The research was initiated from the experience of nursing children in the context of a rehabilitation centre and wondering how acute care nurses promoted a child's recovery after a severe unintentional injury. Many avenues were used to search international and New Zealand literature but the scarcity of literature related to what acute care paediatric nurses do was evident. Nursing children in the acute care ward after a severe accident is complex. It encompasses nursing the family when they are experiencing a crisis. It is critical that the acute care nurse monitors and ensures the child's physiological needs are met, and the nurse “works with” the child to maintain and advance medical stability. Nursing interactions are an important part of “working with”, communication is the essence of nursing. This research has focussed on the nurses' social processes whilst caring for the physical needs of the child and interacting with the family and multidisciplinary team when appropriate. An effective working-relationship with a nurse and family is founded on trust. Grounded theory methods supported the process of exploring the social processes of “building trust” whilst “working with” families in a vulnerable position. Nurses rely on rapport to be invited into a family's space to “work with” and support the re-establishment of the parenting role. The “stepping in and out” of an effective working-relationship with a family is reliant on trust. Nurses build trust by spending time to “be with”, using chat to get to know each other, involving and supporting the family to parent a “different” child and reassuring and giving realistic hope to help the child and parents cope with their changed future. A substantive theory of the concept of “building trust to work with” has been developed using grounded theory methods. The theory has been conceptualised using the perspective of seven registered nurses working in paediatric acute care wards that admit children who have had a severe traumatic accident. |
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Call Number |
NRSNZNO @ research @ |
Serial |
597 |
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Author |
Wilson, S.C. |
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Title |
A qualitative exploration of emotional competence and its relevance to nursing relationships |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Massey Research Online |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse-patient relations; Nursing; Education; Students; Professional competence |
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Abstract |
This qualitative research project explored the experiences of nurse educators who sought to assess aspects, which could be related to facilitation of emotional competence, in nursing students. Focus groups were conducted in three different educational institutions, offering a Bachelor of nursing degree. Each of the participants had a teaching and assessment role within the school of nursing. The contributions of the nurse educators and their interactions were audio taped, transcribed and then later, analysed using thematic and focus group analysis practices. From the analysis of the experiences of the nurse educators, four predominant themes arose which capture the areas of importance to the participants. Student nurses can develop emotional competence by critically reflecting during classroom and clinical experiences. Continuous consideration must be made within each practicing area of nursing, of the environmental and relational challenges which inhibit or facilitate nurse's ability to practice with emotional competence. Educators and practicing nurses, who work alongside students, must uphold the expectation that emotional competence is a requisite ability and provide opportunities to foster emotional growth and skills to resolve conflict within the culture of nursing. A common view shared by the educators was that the profession of nursing needs to have a clear understanding of what constitutes emotional competence. Strategies to realistically incorporate emotional competence into the educational curriculum and competency based assessment opportunities within nursing education are required. Suggestions are presented from which undergraduate nursing education can facilitate development of emotional competence with those students working toward becoming a registered nurse. Emotional competence is suggested as an essential learning outcome in the movement toward transformative nursing education and a collaborative nursing profession. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1144 |
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Author |
Clayton, J.R. |
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Title |
Exploring transitions: Working in “the space between the no longer and the not yet” |
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Year |
2008 |
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 |
Communication; Nurse-patient relations; Case studies |
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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. |
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Call Number |
NRSNZNO @ research @ 1203 |
Serial |
1188 |
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Author |
MacDonald, L.M. |
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Title |
Nurse talk: Features of effective verbal communication used by expert district nurses |
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Year |
2003 |
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 |
Communication; Nurse-patient relations; District nursing |
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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. |
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Call Number |
NRSNZNO @ research @ 1180 |
Serial |
1165 |
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Author |
Cavanagh, C. |
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Title |
Dignity and palliative care: A search to discover the true meaning of the concept of “dying with dignity” |
Type |
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Year |
2004 |
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 |
Palliative care; Nursing; Case studies; Nurse-patient relations; Terminal care |
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Abstract |
This paper presents an exploration of a foundational goal of palliative care nursing which is to help patients die with dignity. The paper presents this practice exploration as a journey to gain understanding of the concept of dignity; the author notes that it does not avoid the difficulties encountered in practice situations because dying with dignity is unique and curiously also invisible and different for everyone. Much of human life is conducted through stories and much of nursing involves telling and listening to stories. Many of our social institutions are comprised almost entirely of opportunities for telling and retelling stories. Nurses are constantly listening to patients telling them what is going on in their lives and because of this the stories related here are written bold and raw. The three stories explore and reveal in-depth details of nursing practice that evolved and changed after reflection. The paper also reveals and explores the untold and often painful stories that challenge nurses' capacity to offer dignified care. To deepen the exploration towards discovering ways to articulate the complexity of dignity, the author reflected on the nature of the practice changes documented in the stories and then used a range of diverse literature and her love of the paintings and philosophy of a New Zealander, Ralph Hotere, to support her ideas that dignity is indeed a complex phenomenon. |
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Call Number |
NRSNZNO @ research @ |
Serial |
595 |
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