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Author |
Carryer, J.B.; Gardner, G.; Dunn, S.; Gardner, A. |
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Title |
The core role of the nurse practitioner: Practice, professionalism and clinical leadership |
Type |
Journal Article |
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Year |
2007 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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Volume |
16 |
Issue |
10 |
Pages  |
1818-1825 |
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Keywords |
Professional competence; Nurse practitioners; Evaluation research; Cross-cultural comparison |
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Abstract |
This article draws on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. A study jointly commissioned by both countries' Regulatory Boards developed information of the newly created nurse practitioner role, to develop shared competency and educational standards. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner programme curricula and interviews with 15 nurse practitioners from the two countries. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
932 |
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Author |
O'Brien, A.P.; O'Brien, A.J.; Hardy, D.J.; Morrison-Ngatai, E.; Gaskin, C.J.; Boddy, J.M.; McNulty, N.; Ryan, T.; Skews, G. |
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Title |
The New Zealand development and trial of mental health nursing clinical indicators: A bicultural study |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Nursing Studies |
Abbreviated Journal |
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Volume |
40 |
Issue |
8 |
Pages |
853-861 |
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Keywords |
Biculturalism; Psychiatric Nursing; Professional competence; Evaluation |
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Abstract |
This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5-89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
956 |
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Author |
O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J. |
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Title |
Clinical indicators as measures of mental health nursing standards of practice in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
2 |
Pages |
778-788 |
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Keywords |
Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth |
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Abstract |
This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1059 |
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Author |
Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J. |
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Title |
The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
4 |
Pages |
259-270 |
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Keywords |
Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research |
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Abstract |
This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1064 |
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Author |
Gardner, A.; Hase, S.; Gardner, G.; Dunn, S.; Carryer, J.B. |
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Title |
From competence to capability: A study of nurse practitioners in clinical practice |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
Author copy available 12 months after publication from QUT ePrints |
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Volume |
17 |
Issue |
2 |
Pages |
250-258 |
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Keywords |
Nurse practitioners; Professional competence; Advanced nursing practice; Evaluation |
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Abstract |
This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners. |
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Call Number |
NRSNZNO @ research @ 945 |
Serial |
929 |
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Author |
Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N. |
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Title |
Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
46 |
Issue |
1 |
Pages |
95-109 |
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Keywords |
Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori |
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Abstract |
The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1060 |
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Author |
Roud, D.; Giddings, D.L.S.; Koziol-McLain, J. |
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Title |
A longitudinal survey of nurses' self-reported performance during an entry-to-practice programme |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
2 |
Pages |
37-46 |
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Keywords |
New graduate nurses; Methodology; Professional competence; Training |
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Abstract |
The researchers conducted a study to compare self-reported changes in both frequency and quality of performance of nursing behaviours in a cohort of recently graduated nurses undertaking a one year entry to practice programme. Thirty-three nurses were surveyed, seven weeks after beginning the programme and again seven months later, using a modified version of Schwirian's (1978) Six-Dimension Scale of Nursing Performance (6-DSNP). Over the study period participants reported significant increases in frequency of performance for the domains of leadership, critical care, teaching/collaboration, and planning/evaluation. Significant increases in the quality of nurse behaviours in the domains of critical care, planning/evaluation and interpersonal relations/communication were also reported. The modified Schwirian 6-DSNP was found to be a useful instrument for measuring nurses' self reporting of performance during periods of transition. |
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Call Number |
NRSNZNO @ research @ 553 |
Serial |
539 |
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Author |
Kelly, Stephanie; Domdom, Joey; Murray, Jacqui; Ulloa, Maria |
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Title |
Weaving professional practice with interprofessional education for real praxis outcomes |
Type |
Journal Article |
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Year |
2020 |
Publication |
Whitireia Journal of Nursing, Health and Social Services |
Abbreviated Journal |
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Volume |
27 |
Issue |
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Pages |
33-37 |
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Keywords |
Inter-professional education; Professional competence |
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Abstract |
Suggests that health, social-service and education delivery are increasingly required to be inter-professional. Advises that such professionals use an integrative and inter-professional approach to navigate the complexities of their practice environments in order to improve outcomes for their service users. |
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Call Number |
NZNO @ research @ |
Serial |
1712 |
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Author |
Walker, J.; Bailey, S. |
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Title |
The clinical performance of new degree graduates |
Type |
Journal Article |
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Year |
1999 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
31-42 |
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Keywords |
New graduate nurses; Professional competence; Nursing; Education; Teaching methods |
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Abstract |
This study aimed to identify how graduates perceived their clinical performance during their first year of practice. A convenience sample of 30 graduates was surveyed after 3 months and 7 months in practice, using an adapted form of a questionnaire devised by Ryan and Hodson (1992). The results showed that over time, graduates generally required less direction in all areas of clinical competence. After 7 months in practice, the majority of the graduates rated their performance in nursing skills, communication skills, and professionalism at the expected level or above. However, some still required direction with using theory and research in practice, with meeting client's psychosocial needs and with teaching clients. In the leadership competency, after 7 months, most graduates saw themselves functioning at the expected level related to client care and needed less direction in unit management skills. However, many of the unit management skills were rated as 'not applicable' indicating that new graduates are not initially placed in a management role. Implications for nursing education and limitations of the research are discussed. |
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Call Number |
NRSNZNO @ research @ |
Serial |
638 |
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Author |
Fourie, W.; Oliver, J.D. |
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Title |
Defining currency of practice for nurse educators |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
18 |
Issue |
3 |
Pages |
30-39 |
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Keywords |
Quality assurance; Professional competence; Education |
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Abstract |
Recent Nursing Council of New Zealand guidelines for competence-based practising certificates and the fact that all nurse educators must have a current practising certificate prompted the Nursing Schools within the Tertiary Accord of New Zealand (TANZ) to explore issues surrounding current competency in practice and how this can be maintained by nurse educators. The authors note that discussions related to competence-based practising certificates generally refer to competence only in terms of direct patient care. They set out to clarify the issue with specific reference to nurse educators who, by the nature of their scope of practice, often do not carry a patient caseload. They review the literature relating to currency of practice and draw on the findings of a survey of TANZ Nursing Schools and provide a position on how currency of practice applies to nurses working in an educational setting. They present strategies to maintain clinical, teaching and scholarly currency and make some suggestions for providing evidence that currency of practice is maintained. |
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Call Number |
NRSNZNO @ research @ |
Serial |
614 |
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Author |
Noble-Adams, R. |
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Title |
'Exemplary' nurses: An exploration of the phenomenon |
Type |
Journal Article |
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Year |
2001 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
17 |
Issue |
1 |
Pages |
24-33 |
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Keywords |
Nurse-patient relations; Nursing; Professional competence |
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Abstract |
This paper examines the phenomenon of exemplary nursing. It includes a literature review to identify the characteristics of good nurses. These include particular personality traits, altruism, caring, expert practice, vocation, commitment and attitude. Aspects of the nurse-patient relationship with such nurses is described. |
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Call Number |
NRSNZNO @ research @ 640 |
Serial |
626 |
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Author |
Floyd, S.; Meyer, A. |
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Title |
Intramuscular injections: What's best practice? |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
6 |
Pages |
20-22 |
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Keywords |
Professional competence; Registered nurses; Quality of health care; Evidence-based medicine |
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Abstract |
The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent. |
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Call Number |
NRSNZNO @ research @ |
Serial |
986 |
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Author |
Smith, M.C. |
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Title |
Reviewing the role of a mental health nurse practitioner |
Type |
Journal Article |
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Year |
2008 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
14 |
Issue |
3 |
Pages |
20-22 |
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Keywords |
Psychiatric Nursing; Nurse practitioners; Evaluation research; Professional competence |
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Abstract |
The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role. |
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Call Number |
NRSNZNO @ research @ |
Serial |
993 |
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Author |
Ross, J. |
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Title |
Perspectives on developing the advanced role of rural nursing in New Zealand |
Type |
Journal Article |
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Year |
2001 |
Publication |
Health Manager |
Abbreviated Journal |
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Volume |
8 |
Issue |
1 |
Pages |
19-21 |
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Keywords |
Rural nursing; Advanced nursing practice; School nursing; Professional competence |
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Abstract |
The author traces the development of rural nursing, which began as an assistant role for general practitioners, to the present role which incorporates advanced nursing practice. She reports the results of two surveys of nurses' roles and skills, from 1996 and 1999-2000. Specific rural competencies are identified, in managing isolation, professionalism in a small community, nurse/patient relationships in a small community, and independence. |
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Call Number |
NRSNZNO @ research @ 1313 |
Serial |
1297 |
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Author |
Shaw, S. |
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Title |
Constructing media images of nursing: How does the media represent nurses when reporting on nurse prescribing? |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
1 |
Pages |
16-18 |
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Keywords |
Drug administration; Interprofessional relations; Professional competence; Nursing; Eucation; Quality of health care |
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Abstract |
This research presents a discourse analysis of articles published in the New Zealand Herald between October 1999 and September 2005. The terms “nurse prescribing” and “prescribing fights” identified seven articles published which referred specifically to this issue. They were predominantly editorial comments and statements attributed to senior doctors. Examples of comments from these articles are presented and discussed in this article, and three inter-related themes are identified – competence, responsibility and competition. Discussion on competence centred on education, skill and experience level of nurses, as described by editorial comment and senior doctors. Positive international research and experience of nurse prescribing did not feature. A number of comments in the articles analysed could be seen to represent concerns about competition between medicine and nursing. One interpretation of the comments contained in these articles is to see medical practitioner groups defending their status and desire to define and control nursing practice. The media has the power to select the information conveyed and, in these instances, appears to have demonstrated a bias towards the medical community's perspective. |
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Call Number |
NRSNZNO @ research @ |
Serial |
979 |
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