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Author (up) Armstrong, S.E.
Title Exploring the nursing reality of the sole on-call primary health care rural nurse (PHCRN) interface with secondary care doctors Type
Year 2006 Publication Abbreviated Journal University of Otago Library
Volume Issue Pages
Keywords Rural nursing; Rural health services; Relationships
Abstract A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors as a component of rural nursing practice and representative of the primary-secondary care interface. Crucial to patient centred care, the premise was that the quality of this interface would be variable due to multiple influences such as: the historical nurse/doctor relationship that has perpetuated medical dominance and nursing subordination; current policy direction encouraging greater inter-professional collaboration; and changing role boundaries threatening traditional professional positioning. A total of 11 nurses representing 10 separate rural areas participated in semi-structured interviews. Rural nurses typically interact with secondary care doctors for acute clinical presentations with two tiers of interaction identified. The first tier was presented as a default to secondary care doctors for assistance with managing primary care level clinical presentations in the absence of access to a general practitioner or an appropriate Standing Order enabling appropriate management. The second tier presented itself as situations where, in the professional judgement of the nurse, the client status indicated a need for secondary level expertise and/or referral to secondary care. The needs of the rural nurse in these interactions were identified as access to expertise in diagnosis, therapy and management, authorisation to act when intervention would exceed the nurse's scope of practice; the need to refer clients to secondary care; and the need for reassurance, encompassing emotional and professional issues. The quality of the interactions was found to be variable but predominantly positive. Professional outcomes of positive interactions included professional acknowledgement, support and continuing professional development. For the patient, the outcomes included appropriate, timely, safe intervention and patient centred care. The infrequent but less than ideal interactions between the participants and secondary care doctors led to professional outcomes of intraprofessional discord, a sense of invisibility for the nurse, increased professional risk and professional dissatisfaction; and for the client an increased potential for deleterious outcome and suffering. Instead of the proposition of variability arising from interprofessional discord and the current policy direction, the data suggested that variability arose from three interlinking factors; appropriate or inappropriate utilisation of secondary care doctors; familiarity among individuals with professional roles and issues of rurality; and acceptance by the primary care doctor of the sole on-call primary health care rural nurse role and the responsibility to assist with the provision of primary health care. Recommendations for improving interactions at the interface include national, regional and individual professional actions.
Call Number NRSNZNO @ research @ Serial 493
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Author (up) Blanchard, D.L.
Title Developing the place and role of family within the culture of critical care nursing: An action research approach Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Relationships; Nurse-family relations; Intensive care nursing; Nursing research
Abstract This research examines how nurses negotiate the context of the Intensive Care Unit (ICU) while working with families. The action research described in this thesis developed through a series of meetings and conversations where the conversations supported the reflexive intent of the research. In commissioning the research, the design of the meetings and conversations were as a series of overlapping actions. Data collection and data analysis occurred in the action research by meetings, reflective conversations, ad libitum observations, and in a research journal. Conceptual maps explain the progress and findings of the research in this thesis while categories distilled from the conversations also support the findings in the research. The Family Action Research Group that was established within this project proposed a Family Assessment Form for the family to provide an assessment of themselves and the patient. Implementing this assessment tool demonstrated that clear information was needed for the family in the ICU. Findings in this research focus on developing action research and family care in ICU. Findings also focused on the role of the researcher being of and not being of the context where action research is undertaken. Recommendations include staff examining relationships for potential asymmetries and seeking ways to address these to support families and staff. Suggested strategies for developing action research in a clinical context include detailed planning, clear focusing, transparency of data, and working to explain change initiatives through the research are also included.
Call Number NRSNZNO @ research @ 494 Serial 480
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Author (up) Blockley, Colette; Alterio, Maxine
Title Patients' experiences of interpersonal relationships during first time acute hospitalisation Type Journal Article
Year 2008 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 24 Issue 2 (Jul) Pages p16-26.
Keywords Acute hospitalisation; Vulnerability; Support; Nurse-patient relationships
Abstract Examines the role of interpersonal relationships on patients' experiences during first time acute hospitalisation. Involving 12 first time acute medical and surgical admission patients, it was developed from a wider study exploring patients' overall experiences. Using a qualitative methodology with data collected by means of personal stories and semi-structured interviews findings suggest that patient vulnerability is reduced through supportive interpersonal relationships and that it is nurses who play a key role in developing and maintaining these relationships with patients.
Call Number NZNO @ research @ Serial 1432
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Author (up) Gallocher-Shearer, S.
Title Exploring the archetypal dimension in nursing Type
Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Methodology; Relationships; Nursing; Psychology
Abstract This study explores the archetypal dimension of nursing reality in nurses' stories through a window of nurse-nurse relations. The thesis argues the existence of the unconscious psyche and its importance for nursing, and the study unfolds a methodology that attends to unconscious processes and is congruent with analytical psychology and its practice. It is a two strand inquiry informed by general hermeneutics and Jungian thought engaging a synthetic interpretive methodology using interweaving intellectual and imaginistic processes. In the first strand of the inquiry five female registered nurses share their individual stories which become the text for a nursing narrative that reveals the what-is of nursing reality in essences of Story and Kinship, and a Lifeworld undermined by high levels of Stress. In the second strand of the inquiry the researcher engages imaginistic process to access the archetypal dimension of the nursing narrative, resulting in a sub text from which archetypal images emerge to reveal the more-than of nursing reality. The emergent images are amplified to reveal their symbolic meanings, and their connection to the nursing narrative is explored. An interpretation that is consistent with analytical psychology is offered in a synthesis of the material arising from the nurses' stories and the imaginistic process. The author notes that this synthetic understanding is teleological in nature and directs attention to the need for nursing to grow a differentiated consciousness that is honouring of the feminine principle in the psyche in contradistinction from an overweaning masculine patriarchal consciousness that compromises the nursing endeavour.
Call Number NRSNZNO @ research @ 496 Serial 482
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Author (up) Haitana, Jevada; Bland, Marian
Title Building relationships : the key to preceptoring nursing students Type Journal Article
Year 2011 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 27 Issue 1 Pages 4-12
Keywords Preceptorship experience; Undergraduate nursing students; Relationships
Abstract Seeks to understand the experiences of being a preceptor of student nurses, and the factors that impact on the role. Undertakes a qualitative descriptive study in a small provincial hospital of 5 registered nurse preceptors, who complete semi-structured audio-taped interviews. Analyses the data using a step-by-step process.
Call Number NZNO @ research @ Serial 1460
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Author (up) Lally, Elsa
Title Symbiotic relationships in patients' engagements with practice nurses Type Book Whole
Year 2014 Publication Abbreviated Journal
Volume Issue Pages 262 p.
Keywords Practice nurses; Patients; Symbiotic relationships; Primary health care; Surveys
Abstract Records from patient perspectives the nature of the engagements patients have with practice nurses which influence patients' health and well-being. Posits this mutually-beneficial close association as a form of symbiosis. Surveys 15 patients from seven rural and urban general practices in NZ about aspects of the participants' relationships and engagements with nurses, analysing the results using Narrative Inquiry methodology.
Call Number NZNO @ research @ Serial 1699
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Author (up) Macfarlane, K.
Title Communicating changes in a patient's condition: A critical incident approach Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Communication; Clinical assessment; Physicians; Nursing; Relationships
Abstract This study explores how registered nurses working within the acute surgical ward environment of a New Zealand hospital communicate changes in a patient's condition. The purpose of this research study was to examine the processes, communication techniques and behaviours that nurses use, in order to determine the critical requirements for registered nurses to effectively communicate changes in patients' conditions to doctors. The critical incident technique developed by Flanagan (1954) was adapted and used to explore incidents that occurred when six registered nurses working in acute surgical wards communicated a change in a patient's condition to a doctor. Communication is an integral part of everyday activity. This study has shown an assessment process occurs before communication can take place. A nurse's concern for a patient's condition initiates the assessment process. A judgement is formed from the nurse's concern that a patient's condition has changed. Judgements take into account multiple ways of knowing including pattern recognition, empirical knowing and intuition. Institutional protocols also affect judgements and the ability of a nurse to ensure support is received for the patient's well being. The communication process is initiated for two reasons, to support the patient, and to support the nurse in providing care for the patient. Significant in determining the need for support is the action required that might be outside the nurse's scope of practice. The response should address the nurse's concern and take into account the importance of the relationship, trust between all parties, respect of each other's positions and knowing team members and their capabilities. Understanding these aspects of the communication process should enhance nurses and doctors abilities to effectively communicate regarding a change in a patient's condition.
Call Number NRSNZNO @ research @ Serial 724
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Author (up) McKelvie, R.
Title Partnership in paediatric nursing: A descriptive exploration of the concept and its practice Type
Year 2001 Publication Abbreviated Journal
Volume Issue Pages
Keywords Paediatric nursing; Parents and caregivers; Children; Relationships
Abstract A 50 point research project presented in partial fulfilment of the requirements for the degree of Master of Nursing at Massey University.
Call Number NRSNZNO @ research @ 484 Serial 471
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Author (up) O'Reilly, A.F.
Title Relinquishing personhood in dementia: Discordant discourses: A nurse's inquiry Type
Year 2002 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Dementia; Nursing; Nurse-patient relations; Relationships
Abstract This thesis traces the journey of the author's inquiry into family members' experience of the relinquishment of the personhood of a loved one with a dementia; a journey in which she reports that her own prior understandings were significantly challenged. The study was prompted by her experience of working in the area of dementia care and hearing, in the course of the working day, comments such as 'there's nobody there' made in relation to someone suffering from severe dementia. Such comments appear to imply that the person of the dementia sufferer in some way is no longer present. They are comments which relate to the very nature of personhood. The study takes impetus from the fact that the ways in which nurses view the personhood of dementia sufferers has significant consequences for the ways in which they respond to dementia sufferers and their families. This thesis, which retells the stories of four family members who each have a loved one with a dementia illness, reveals that rather than there being a unified concept of personhood in dementia, and in spite of the fact that particular understandings of dementia and personhood dominate our cultural conversations, in their day to day lives these four family members managed and made sense of their experience through particular and different ways of looking at the impact dementia has on the personhood of dementia sufferers. Not all did, in fact, relinquish the personhood of their family member. In their lived lives, the four research participants had recourse, each in different ways, to multiple discourses of personhood. For some, in addition to loss, there was also unexpected gain. This finding necessitated and shaped further inquiry into discourse and the role of discourse in shaping, constraining and opening up possibilities for meaning, and into the two substantive areas of dementia and personhood. Nurses work closely alongside the family of dementia sufferers who are daily faced with the challenge of managing and making meaning of that situation. It is critically important that they are able to recognise, validate and support the variety of needs that family members have. Nurses, whose education is traditionally based on a biomedical framework, are nevertheless often required to mediate between different understandings. Not only do they need currency of knowledge in the rapidly changing biomedical field of dementia, but they need also an understanding of the role and the power of discursive constructions of both dementia and personhood. Such understanding will provide insight into alternate ways of understanding these concepts. However, although such understanding is critical for nurses working in this area, the author suggests that nursing literature has not brought these discussions to the fore.
Call Number NRSNZNO @ research @ 792 Serial 776
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Author (up) Skerman, N.; Manhire, K.; Thompson, S.; Abel, S.
Title Extended Plunket Service for vulnerable teenage mothers : well-child nurses' perspectives Type Journal Article
Year 2015 Publication Kai Tiaki Nursing Research Abbreviated Journal
Volume 6 Issue 1 Pages 36-40
Keywords Teenage Mothers; Well-Child Nurses; Nurse-Client Relationships; Social Issues; Postnatal Health Services; Surveys
Abstract Reports nurses' perspectives on their role in the extended Well Child/Tamariki Ora service to teenage mothers which has been delivered by the Royal NZ Plunket Society since 2011 to adolescent mothers in Hawke's Bay. Focuses on what nurses consider necessary for this client population and the challenges nurses face. Evaluates the service at two intervals : first when the babies were six months old, and second when they were three years. Conducts interviews to identify the factors essential to successful service delivery : trusting nurse/client relationships, strong inter-agency relationships, team-work and support.
Call Number NZNO @ research @ Serial 1410
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Author (up) Whitehead, N.; Parsons, J.; Dixon, R.
Title Quality and staffing : is there a relationship in residential aged care? Type Journal Article
Year 2015 Publication Kai Tiaki Nursing Research Abbreviated Journal
Volume 6 Issue 1 Pages 28-35
Keywords Residential Aged Care; Nursing Homes; Staffing; Relationships
Abstract Explores whether there is a relationship between staffing and quality indicators in residential care of older people, in both rest homes and continuing-care hospitals. Conducts a longitudinal survey of 18 residential-care rest homes and 16 continuing-care hospitals in the greater Auckland region to explore the relationship between direct-care staffing levels, skill mix and quality indicators. Collects data over a 6-month period on type of staffing, including registered nurses, enrolled nurses, and support workers; quality indicators, including falls, new fractures, pressure ulcers, weight loss, urinary tract infections (UTI), poly-pharmacy or multiple medications, presence of indwelling catheters and use of daily restraints. Uses logistic analysis to analyse the inverse relationship between staffing levels and adverse events, and whether there is an association between staff type and the incidence of the five quality indicators.
Call Number NZNO @ research @ Serial 1409
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Author (up) Yarwood, Judy
Title Nurses' view of family nursing in community contexts: an exploratory study Type Journal Article
Year 2008 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 24 Issue 2 (Jul) Pages 41-51
Keywords Family; Family nursing; Community Nurses; Relationships
Abstract Explores, through the use of focus groups, ways in which community based nurses interact with family as a whole. Identifies Public health, Practice, District, Well child health and rural nurses as all having an integral role in building relationships with family to ensure child and family health. Suggests the findings point to a need for the establishment of a recognised family/family health nursing role.
Call Number NZNO @ research @ Serial 1433
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