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Author |
Hoare, K.; Fairhurst-Winstanley, W.; Horsburgh, M.; McCormack, R. |
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Title |
Nurse employment in primary care: UK and New Zealand |
Type |
Journal Article |
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Year |
2008 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
35 |
Issue |
1 |
Pages |
4-10 |
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Keywords |
Primary health care; Scope of practice; Nursing models |
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Abstract |
The researchers evaluate and compare the organisation of general practice in the UK and New Zealand. A key aim of the Primary Health Care Strategy is a reduction in health inequalities. Locally, some nurse leaders suggest that changing nurse practice employment from general practitioners to Primary Health Organisations will achieve this aim. The authors take lessons from the UK and suggest that nurses organising themselves into peer groups, remuneration of general practices for the attainment of positive patient outcomes, and a statutory duty of clinical governance, all contributed to the development of practice nurses' roles and expansion of numbers of nurse practitioners in general practice. Nurses have become partners with general practitioners in general practice in the UK, which the authors suggest is a much preferable alternative for some than employment by a Primary Health Organisation. |
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Call Number  |
NRSNZNO @ research @ |
Serial |
453 |
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Author |
McKinlay, E.M. |
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Title |
Thinking beyond Care Plus: The work of primary health care nurses in chronic conditions programmes |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
34 |
Issue |
5 |
Pages |
322-327 |
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Keywords |
Primary health care; Nursing models; Chronic diseases |
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Abstract |
This paper focuses on the work of primary health care nurses on chronic conditions, through both formal chronic care management (CCM) programmes and informal work. The author overviews the key components of CCM and describes Care Plus, a funding stream accessed via PHOs. The author gives examples of nurse led clinics and programmes in the general practice environment, and outlines the structures and processes necessary. A table summarises nurse involvement in several PHOs throughout the country. The author finds that the role of PHC nurses within a framework of inter-disciplinary chronic condition care is diverse and increasing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
455 |
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Author |
Pullon, S.; McKinlay, E.M. |
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Title |
Interprofessional learning: The solution to collaborative practice in primary care |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
34 |
Issue |
6 |
Pages |
404-408 |
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Keywords |
Interprofessional relations; Education; Primary health care; Communication |
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Abstract |
In this paper the authors outline the basis of interprofessional education, which occurs when members of two or more professions are engaged in learning together. They describe its relationship to primary care clinical practice, where it can lead to collaborative problem-solving approaches, mutual decision making and interdisciplinary teamwork. A New Zealand model of postgraduate interprofessional education is presented. Barriers to the implementation of interprofessional education in New Zealand are identified along with possible solutions. |
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Call Number |
NRSNZNO @ research @ |
Serial |
458 |
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Author |
Findlay, W. |
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Title |
The effect of peer learning and review groups on practice nurses' clinical practice: A mixed method survey |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Nursing; Education; Clinical supervision |
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Abstract |
The aim of the study was to explore how practice nurses perceive engagement in Peer Learning and Review Groups impacts personally and professionally on their clinical practice. An anonymous self-administered postal questionnaire was completed by 55 practice nurses who attend Peer Learning and Review Groups in the South Island. A mixed method design was utilised to obtain both qualitative and quantitative data. Practice nurses considered group attendance was important for professional development with the majority perceiving that their attendance had a positive effect on their clinical practice. The nurses perceived clear linkages between the significant learning that occurred in the groups and changes in delivery of patient care. Additional benefits included improved collegial relationships, professional awareness and personal growth. The author concludes that, together, these findings underline the importance of Peer Learning and Review Groups as an effective tool for ongoing personal and professional development within nursing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
490 |
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Author |
Lesa, R. |
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Title |
Advanced physical assessment skills: Factors that influence registered nurses' use of skills in the clinical setting, on completion of an advanced health assessment course |
Type |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Primary health care; Nursing specialties; Education |
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Abstract |
Traditionally the use of advanced physical assessment skills when assessing a patient or client has been the domain of the medical profession. The last few decades has seen many changes in health provision that have influenced nursing practice, as a result of the social and economic trends impacting on New Zealand society. A notable change in nursing practice has been an increased emphasis on the use of advanced physical assessment skills by registered nurses, as an expected part of the registered nurse's health assessment. Nurses in the United States, and more recently Canada and Australia, readily include these skills as an expansion of their health assessment into their nursing practice. The purpose of this research is to investigate whether New Zealand registered nurses have done the same. The factors that influence the registered nurses' use of these skills are also explored. This descriptive design was chosen in order to focus on exploring and describing this phenomenon in a holistic fashion. Data collection involved one hour semi- structured interviews with seven participants who all completed the same postgraduate advanced health assessment educational course. Three themes were identified as influencing the use of advanced physical assessment skills; the registered nurse's work environment, the registered nurse's attributes and the registered nurse's original nursing education. The findings from this research have implications for nurses in practice and nurse educators, in both undergraduate and postgraduate education. |
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Call Number |
NRSNZNO @ research @ |
Serial |
498 |
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Author |
Dillon, D.R. |
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Title |
Islands, islandness and nursing: Advanced nursing practice in rural remote and small island areas |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Primary health care |
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Abstract |
This dissertation focuses on the concepts of island, island-ness, and isolation. It aims to further advance the national and international literature relating to the health beliefs of island people as linked to the provision of primary health care services within New Zealand. New Zealand is an island nation made up of two main islands and numerous outlying islands, relatively isolated from the rest of the world by water. This geography means going anywhere from New Zealand involves traveling either “over” or “on” the sea. All people of New Zealand since the first inhabitants, whether residents or visitors, have arrived to New Zealand either by sea or more recently by plane. The population of New Zealand is 25% rural, with most of these rural dwellers residing in the South Island, and several of the smaller off shore Islands. This builds a sense of culture of the people, or tangata whanua (the people of the land), for whom there are degrees of island-ness, and the characteristics of this can be seen amongst the people of New Zealand. A further challenge which is discussed comes in the form of the “island penalty” which encompasses high transport costs, long distances to travel to main centres, lack of specialists and trained health workers, effects of migration and tourism, and communication difficulties. The more isolated people are, the tougher the challenges become. Most rural island populations are served by lay care workers, volunteers, and rural and remote nurses. Nurses are often the main health care providers to small island populations, and they demonstrate advanced nursing practice which is acknowledged internationally as meeting Nurse Practitioner competencies. As a group these nurses possess knowledge of the extrinsic and intrinsic factors involved in the health needs and health determinants of these island communities. Researching these advanced nursing roles adds to the body of knowledge around isolated and island communities. The author suggests that studying the concepts of islands, islandness, and isolation in relation to health beliefs will bring more understanding of services for the advanced rural nurse to consider in developing appropriate, accessible, affordable and adaptable Primary Health Care which is fair and equitable. |
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Call Number |
NRSNZNO @ research @ |
Serial |
507 |
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Author |
Horsburgh, M.; Goodyear-Smith, F.; Yallop, J.; O'Connor, S. |
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Title |
Implementation of a nursing initiative in primary care: A case report, cardiovascular disease risk reduction |
Type |
Journal Article |
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Year |
2008 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
35 |
Issue |
3 |
Pages |
183-186 |
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Keywords |
Multidisciplinary care teams; Cardiovascular diseases; Case studies; Primary health care |
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Abstract |
The aim was to report on implementation of a nursing initiative of cardiovascular disease (CVD) screening risk assessment at the Mornington Health Centre, Dunedin, with initial outcomes after six months. The practice aim was 80% of their eligible population assessed within three to four years, particularly targeting high-risk groups. The audit indicates that in their first six months, Mornington Health Centre had screened 42% of their eligible patients. This is described as very successful progress towards their goal of 80%. A number of key organisational factors are identified that are likely to have contributed to the development and success of the nurse CVD risk assessment programme at Mornington Health Centre. The authors suggest that this case study demonstrates how organisational change, where the practice nurse role in the multidisciplinary team is clear, can facilitate a practice to meet a population-based goal. |
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Call Number |
NRSNZNO @ research @ |
Serial |
514 |
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Author |
Alcorn, G. |
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Title |
The youth health specialty in New Zealand: Collaborative practice and future development |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
34 |
Issue |
3 |
Pages |
162-167 |
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Keywords |
Adolescents; Community health nursing; Primary health care; Nurse practitioners; School nursing |
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Abstract |
This paper details the workforce capacity of youth health nursing and medical staffing required for community-based and school-based youth health services. The author shows how youth health services seek to complement the care delivered by Primary Health Organisations (PHOs) and other allied health care services in the community. She outlines the development and operation at VIBE, a community-based youth health service in the Hutt Valley with school-based youth health services delivered at four low deciles secondary schools. She explains that developing workforce capacity for youth health services is a primary health care priority and an important means to address inequalities and to improve the health services of young people. |
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Call Number |
NRSNZNO @ research @ |
Serial |
518 |
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Author |
Murrell-McMillan, K.A. |
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Title |
Why nurses in New Zealand stay working in rural areas |
Type |
Journal Article |
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Year |
2006 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
33 |
Issue |
3 |
Pages |
173-175 |
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Keywords |
Rural nursing; Recruitment and retention; Job satisfaction; Teamwork; Primary health care |
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Abstract |
The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues. |
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Call Number |
NRSNZNO @ research @ |
Serial |
530 |
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Author |
Clendon, J.; Krothe, J. |
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Title |
The nurse-managed clinic: An evaluative study |
Type |
Journal Article |
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Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
20 |
Issue |
2 |
Pages |
15-23 |
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Keywords |
Evaluation research; Nurse managers; Primary health care; Cross-cultural comparison |
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Abstract |
Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic. |
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Call Number |
NRSNZNO @ research @ |
Serial |
547 |
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Author |
Mackay, B. |
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Title |
General practitioners' perceptions of the nurse practitioner role: An exploratory study |
Type |
Journal Article |
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Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
116 |
Issue |
1170 |
Pages |
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Keywords |
Nurse practitioners; Physicians; Interprofessional relations; Primary health care |
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Abstract |
This study explores perceptions of general practitioners in the Northland District Health Board (NDHB) regarding the nurse practitioner role, identifying their knowledge of and perceived problems with that role, and their experience of nurses in advanced practice. A purposive sample of all 108 general practitioners in NDHB was undertaken, with a response rate of 46.3%. General practitioners favourably viewed nurse practitioner functions traditionally associated with nursing, such as health teaching, home visiting, obtaining health histories, and taking part in evaluation of care, but less favourably viewed those functions associated with medicine, such as prescribing, ordering laboratory tests, and physical assessment. While expecting few problems with patient acceptance, the general practitioners felt that funding and doctors' acceptance would be problematic. Most general practitioners indicated they had knowledge of the nurse practitioner role and had experienced working with a nurse in advanced practice, but some uncertainty and lack of knowledge about the nurse practitioner role was evident. The author recommends more education and discussion with Northland general practitioners to ensure they are fully informed about the nurse practitioner role and its potential positioning in primary healthcare, to reduce uncertainty, minimise role confusion and promote collaboration between general practitioners and nurse practitioners. |
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Call Number |
NRSNZNO @ research @ |
Serial |
557 |
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Author |
Ross, J. |
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Title |
Role identification: An impediment to effective core primary health care teamwork |
Type |
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Year |
2001 |
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 |
Multidisciplinary care teams; Teamwork; Primary health care |
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Abstract |
This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners and the understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future. |
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Call Number |
NRSNZNO @ research @ |
Serial |
571 |
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Author |
Maw, H. |
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Title |
The challenge of developing primary health care nurse practitioner roles in rural New Zealand |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Rural health services; Primary health care |
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Abstract |
When the New Zealand Nursing Council introduced the nurse practitioner as a new level of nurse in 2001, the opportunity arose for the introduction of primary health care nurse practitioners into the rural practice arena in this country. This dissertation explores the influences on the development of rural nursing in the last decade in New Zealand including the role of the Centre for Rural Health in advancing rural nursing education, as well as the impact the shortage of health professionals in rural New Zealand has had on the development of the rural primary health care nurse practitioner concept. For pioneering primary health care nurse practitioner roles to be successfully implemented in rural communities in New Zealand, several challenges need to be faced; the creation of roles and employment opportunities, community acceptance of the role, medical and nursing acceptance of the role and the establishment of independent nurse prescribing within the constraints imposed by current legislation. The dissertation explores the current literature in an attempt to offer solutions to the identified challenges. With the creation of primary health care nurse practitioner roles and the establishment and acceptance of these roles in rural communities, a new mode of health service delivery in rural New Zealand will begin. |
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Call Number |
NRSNZNO @ research @ |
Serial |
576 |
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Author |
Magrath, K.L. |
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Title |
From chrysalis to butterfly: Transition experiences of new graduates in primary health care nursing practice in New Zealand |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; New graduate nurses; Mentoring |
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Abstract |
Primary health care is a dynamic and ever-changing area of practice which has undergone many changes in the last ten years. Traditionally, primary health care was not a routine choice for new graduate nurses as they were encouraged to work in a hospital setting before seeking a position in the community. Bachelor of Nursing programmes emphasise primary health care practice and increasingly nurses and their employers are moving away from the traditional belief of 'doing your time in the hospital' before contemplating the move to primary health care. Currently in New Zealand increasing numbers of graduates from Bachelor of Nursing programmes want to begin their working life as registered nurses in this area. A constructivist approach was taken to explore the experience of five nurses who entered primary health care practice as new graduates. Participants were interviewed using a semi-structured format. They constructed their experience as role transition and identified a number of significant factors which had impacted on their practice. These factors included both the personal and practice challenges they experienced and the strategies they used to address them. Further research findings were a transition time of one year, the importance of both formal and informal support, planned orientation and opportunities for reflection. A number of mediating factors including new graduate programmes, peer support and mentorship were also discussed. Key implications for practice, education, employers and future research regarding transition to primary health care for new graduates are discussed. This research emphasised the importance of appropriate resources and support for new graduates from Bachelor of Nursing programmes. These factors are suggested as integral to the development of new graduates' practice in primary health care and reduction of the challenges inherent in this transition. |
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Call Number |
NRSNZNO @ research @ |
Serial |
587 |
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Author |
Mackay, B. |
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Title |
Leadership development: Supporting nursing in a changing primary health care environment |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
18 |
Issue |
2 |
Pages |
24-32 |
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Keywords |
Leadership; Professional development; Primary health care; Nursing |
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Abstract |
The author argues that the involvement of nurses in the decision-making of health organisations is essential to maximise the contribution of nurses and promote positive outcomes for patients. She suggests that development of leadership skills will make nurses aware of power structures in the health system and allow them to become interdependent health professionals in primary health organisations (PHO). The particular competencies discussed are those proposed by Van Maurik (1997), namely ability to understand and manage organisational politics, work facilitatively with people and circumstances, and build a feeling of purpose. |
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Call Number |
NRSNZNO @ research @ |
Serial |
619 |
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