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Author Jacobs, S.; Boddy, J.M.
Title The genesis of advanced nursing practice in New Zealand: Policy, politics and education Type Journal Article
Year 2008 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 24 Issue 1 (Mar) Pages 11-22
Keywords Nurse practitioners; History of nursing; Policy; Scope of practice
Abstract This contemporary historical study examines the health sector environment of the 1990s and the turn of the 21st century, and assesses the policy initiatives undertaken to advance nursing in New Zealand during that period. The authors look at the conditions and forces that saw nursing achieve a new emphasis on advanced and expanded scope of nursing practice, less than a decade after the commencement of New Zealand's first pre-registration nursing degrees.
Call Number (up) NRSNZNO @ research @ Serial 452
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Author Bleach, A.
Title Nurses talk the walk: An exploration of nurses' perception of advanced nursing practice on acute mental health inpatient units in New Zealand Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Mental health; Nursing; Policy; Registered nurses; Advanced nursing practice; Psychiatric Nursing
Abstract The last twenty years, particularly the early 1990s, ushered in major mental health sector reforms inclusive of deinstitutionalisation policies and subsequent development of community services. Concurrent changes to student nurses' education left registered nurses as the workforce mainstay on inpatient units. However, the author suggests, an emerging global shortage of nurses and implementation of the Employment Contracts Act (1991) negatively impacted on recruitment and retention of registered nurses. Inpatient nurses either left nursing or moved to community positions for better money and increased job status. The author suggests that, as a consequence, the 'critical mass' of experienced and skilled nurses who traditionally provided nursing leadership disappeared resulting in compromised standards of care for patients. As the manager of an inpatient unit, the author proposed the establishment of advanced nursing practice roles as one initiative to provide nursing leadership in order to attract and retain nurses. This study explored five inpatient nurses' perceptions of advanced practice and whether these roles could assist to provide leadership and improve standards of care. The research was a qualitative exploratory descriptive study using a focus group interview as the data collection method. A thematic analysis of the group discussion transcription revealed three key themes: 1) the 'makeup' of advanced nursing practice, 2) moving forwards: establishing roles, 3) moving sideways: barriers to role development. The themes are critically discussed in relation to selected literature. The thesis includes recommendations that could be used by nurses responsible for planning and implementing advanced practice roles on inpatient units.
Call Number (up) NRSNZNO @ research @ Serial 663
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Author Jacobs, S.
Title Advanced nursing practice and the nurse practitioner: New Zealand nursing's professional project in the late 20th century Type
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Nurse practitioners; History; Policy; Leadership; Advanced nursing practice
Abstract This thesis examines the forces influencing the development of contemporary advanced nursing practice in New Zealand. It begins with an historical approach to explore the various meanings of advanced nursing practice from the late 1800s through the first years of the 21st century. Seven historical understandings of the meaning of 'advanced' nursing practice emerge. The author's analysis of the broad scope of New Zealand nursing history, including a case study of the development and implementation of the nurse practitioner, draws on theoretical perspectives from sociology, political science, and nursing. She develops a “framework of critical factors for nursing to take into account when considering how to ensure the profession is able to deliver on its great potential to improve the health of New Zealand communities”. Examining the work of a range of nursing leaders, past and present, and drawing on the work of political scientist, John Kingdon, the author describes the work of several nurses as “policy entrepreneurship.”
Call Number (up) NRSNZNO @ research @ Serial 671
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Author Maw, H.
Title The challenge of developing primary health care nurse practitioner roles in rural New Zealand Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 201-214) Abbreviated Journal Ministry of Health publications page
Volume Issue Pages
Keywords Nurse practitioners; Rural health services; Interprofessional relations; Policy
Abstract The author traces the development of the nurse practitioner role in New Zealand, which was finally introduced in 2001. It traces the key events, from early debates on the issue, the influence of the Centre for Rural Health, and a series of government investigations into nursing which noted the untapped potential of the nursing workforce and the lack of ongoing clinical career pathways. Barriers to rural nurses becoming endorsed as primary health care nurse practitioners are examined, and some of the solutions to this issue are explored. Relationships between nurse practitioners and the local general practitioners, and community resistance are areas that need management. Education is seen as a key response to many of these issues.
Call Number (up) NRSNZNO @ research @ Serial 762
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Author Watson, S.L.
Title Attitudinal shifting: A grounded theory of health promotion in coronary care Type
Year 2007 Publication Abbreviated Journal AUT University Library
Volume Issue Pages
Keywords Health promotion; Policy; Professional development; Cardiovascular diseases; Nursing; Nurse-patient relations; Education
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.
Call Number (up) NRSNZNO @ research @ Serial 807
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Author Bailey, A.M.
Title The New Zealand practice nurse in the primary health environment of the 21st century Type
Year 2004 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Policy; Practice nurses; Primary health care
Abstract This paper is a culmination of the author's inquiry, reflection and critical thinking on the transitional phase that practice nursing is currently undergoing as part of the New Zealand Primary Health Strategy. The paper utilises both reflection-in-action and reflection-on-action as well as reflection-before-action, as a process. The author's starting point for this inquiry was attending the New Zealand Nurses Organisation Primary Health Conference in Wellington and reading a report from the Expert Advisory Group on Primary Health Care Nursing. Knowing that practice nurses are the majority of nurses working in primary health, she was concerned that changes to primary health were being driven with little reference or participation by them. The paper explores how practice nursing evolved in New Zealand and the developments that have occurred in the 30 plus years since its inception. It describes the role and current work of practice nursing in general practice, and highlights the constraints that have held back development and continue to do so. The 2002 New Zealand Primary Health Strategy is shown to provide an opportunity for development and enhancement, if some of the constraints are removed. As part of looking to the future the possibilities for practice nurses to lead the way in primary health development are explored.
Call Number (up) NRSNZNO @ research @ Serial 831
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Author Holloway, K. T.
Title The future for nursing education: UKCC review has relevance for New Zealand Type Journal Article
Year 2000 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 16 Issue 2 Pages 17-24
Keywords Nursing; Education; Recruitment and retention; Clinical assessment; Policy
Abstract The author reviews the report 'Fitness for Practice' by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) noting many areas of relevance for New Zealand educators in outlining possible strategies for nursing education. Discussion of some of the recommendations is put in the context of a strategic review of undergraduate nursing education recently commissioned by the Nursing Council of New Zealand. Issues such as recruitment and access to education; retention; clinical assessment and placements; clinical skill acquisition and partnership are valid concerns for educators here also. Internationally, the author suggests, the commonalties in issues of concern lend validity to the concept of the global village and the necessity for a global perspective in health care workforce planning, including educational preparation.
Call Number (up) NRSNZNO @ research @ Serial 848
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Author Hamer, H.P.; Finlayson, M.; Thom, K.; Hughes, F.; Tomkins, S.
Title Mental health nursing and its future: A discussion framework: Report from the Expert Reference Group to the Deputy Director-General Dr Janice Wilson Type Report
Year 2006 Publication Abbreviated Journal
Volume Issue Pages
Keywords Mental health; Psychiatric Nursing; Policy; Leadership; Nurse practitioners; Nursing; Education; Careers in nursing
Abstract This project was initiated by the Ministry of Health to ensure a nationally coordinated approach to mental health nursing. The purpose of the project is to provide a national strategic framework for mental health nursing that will strengthen both nursing leadership and practice within the multi-disciplinary clinical environment. The framework reviews a range of key workforce issues identified by the Ministry of Health and provides strategies to move mental health nursing forward. The framework integrates directions from government mental health strategies, policies and directions, national and international literature as well as professional nursing requirements which aim to create a sustainable mental health nursing workforce using evidence based practice. The framework considers a range of key workforce issues identified by the Ministry of Health including: nursing leadership, nurse practitioners, standards, skill mix, clinical career pathways, professional supervision, education, research and recruitment and retention.
Call Number (up) NRSNZNO @ research @ Serial 865
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Author Honeyfield, Margy
Title The necessity of effective nursing leadership for the retention of professional hospital nurses Type
Year 2008 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages 64
Keywords Recruitment and retention; Leadership; Nursing; Policy
Abstract The author notes that it is widely accepted that there is a global shortage of nurses, and there are many studies in the health workforce literature about the negative aspects of nurse work environments, nursing workloads, decreased job satisfaction of nurses and the impact these have on patient health outcomes. In the past five years there has also been international and New Zealand-specific research into the effects of health restructuring on nursing leadership, retention of nurses, and on patient care. Much of this research has shown that countries with very different health care systems have similar problems, not only with retention of qualified nursing staff due to high levels of job dissatisfaction, but also with work design and the provision of good quality patient care in hospitals. This dissertation explores the many detrimental effects on nurses and nursing leadership, of extensive, and continuing, public health restructuring in New Zealand. The context of this dissertation is New Zealand public hospitals, with references pertaining to medical and surgical areas of nursing practice. Health reforms have negatively impacted on patient care delivery systems, patient health outcomes, and retention of educated nurses in the workforce. In order to resolve these issues, coordinated efforts are required in New Zealand district health boards to develop and sustain effective nursing leaders, who will promote and assist in the development of strong, healthy organisational cultures to retain and support professional nurses and the ways in which they wish to practise.
Call Number (up) NRSNZNO @ research @ Serial 868
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Author Hughes, F.
Title Reconnecting with policy: Requirements for survival as a mental health nurse Type Journal Article
Year 2006 Publication Journal of Psychosocial Nursing & Mental Health Services Abbreviated Journal
Volume 44 Issue 8 Pages 30-39
Keywords Policy; Mental health; Nursing specialties
Abstract This article discusses the disconnection between mental health nurses and policy, and the importance of reconnecting such relationships. It is suggested this will benefit consumers, provide influence in health care policies and, ultimately, contribute to strategies to improve the health of our nation. In this article, the author draws on her own experiences and applies these to a discussion of how mental health nurses can influence and strengthen their relationships with nursing policy.
Call Number (up) NRSNZNO @ research @ Serial 938
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Author Stone, P.W.; Tourangeau, A.E.; Duffield, C.M.; Hughes, F.; Jones, C.A.; O'Brien-Pallas, L.; Shamian, J.
Title Evidence of nurse working conditions: A global perspective Type Journal Article
Year 2003 Publication Policy, Politics, & Nursing Practice Abbreviated Journal
Volume 4 Issue 2 Pages 120-130
Keywords Nursing; Recruitment and retention; Policy; Cross-cultural comparison; Nursing research
Abstract The purpose of this article is to review evidence about nurse workload, staffing, skill mix, turnover, and organisational characteristics' effect on outcomes; discuss methodological considerations in this research; discuss research initiatives currently under way; review policy initiatives in different countries; and make recommendations where more research is needed. Overall, an understanding of the relationships among nurse staffing and organisational climate to patient safety and health outcomes is beginning to emerge in the literature. Little is known about nursing turnover and more evidence is needed with consistent definitions and control of underlying patient characteristics. Research and policy initiatives in Australia, Canada, New Zealand, and the United States are summarised.
Call Number (up) NRSNZNO @ research @ Serial 951
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Author Woods, M.
Title Dissecting a brave new nursing world Type Journal Article
Year 2002 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 8 Issue 10 Pages 20-22, 36
Keywords Nursing; Education; Nursing Council of New Zealand; Policy
Abstract This article critiques the 'Strategic Review of Undergraduate Education' commissioned by the Nursing Council. The premise of the review is examined, along with the foundations of nursing practice and the role of nursing education.
Call Number (up) NRSNZNO @ research @ Serial 1003
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Author Crowe, M.; Carlyle, D.
Title Deconstructing risk assessment and management in mental health nursing Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 43 Issue 1 Pages 19-27
Keywords Psychiatric Nursing; Risk management; Policy; Culture
Abstract The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
Call Number (up) NRSNZNO @ research @ Serial 1069
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Author Muir-Cochrane, E.; Holmes, C.; Walton, J.A.
Title Law and policy in relation to the use of seclusion in psychiatric hospitals in Australia and New Zealand Type Journal Article
Year 2002 Publication Contemporary Nurse Abbreviated Journal
Volume 13 Issue 2/3 Pages 136-145
Keywords Psychiatric Nursing; Law and legislation; Policy; Patient rights; Cross-cultural comparison
Abstract This paper discusses legal issues associated with the seclusion of acutely disturbed patients in psychiatric hospitals in Australia and New Zealand. There continues to be great variation in opinion and operational definition as to whether seclusion is a medical treatment, nursing intervention and management tool, or merely a form of situational restraint. Reflecting this lack of clarity, mental health acts and policies concerning the regulation and practice of seclusion lack consistency and focus across geographical boundaries and jurisdictions. Australian and New Zealand legislation and institutional policy is discussed in order to shed light on the contemporary issues highlighted by this controversial nursing practice. The authors note that mental health professionals must continue to review the practice of seclusion and to actively promote the use of acceptable alternatives. In addition nurses and other mental health professionals have a responsibility to understand current legislation and policy frameworks and to influence change where this is necessary to ensure the best practice possible in their clinical area.
Call Number (up) NRSNZNO @ research @ Serial 1074
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Author Mackay, B.
Title An analysis of innovative roles in primary health care nursing Type
Year 2004 Publication Abbreviated Journal Northland Polytechnic Library
Volume Issue Pages
Keywords Nurse practitioners; Primary health care; Maori; Policy; Careers in nursing
Abstract An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process.
Call Number (up) NRSNZNO @ research @ Serial 1124
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