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Author  |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Interprofessional relations; Rural nursing; Primary health care |
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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. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them. |
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Call Number |
NRSNZNO @ research @ 780 |
Serial |
764 |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse (PHCRN) interface with secondary care doctors |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Rural health services; Relationships |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
493 |
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Author |
Barber, M. |
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Title |
Nursing and living in rural New Zealand communities: An interpretive descriptive study |
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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 |
Rural nursing; Rural health services; Recruitment and retention |
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Abstract |
This study used an interpretive descriptive method to gain insight into and explore key issues for rural nurses working and living in the same community. Four Rural Nurse Specialists were recruited as participants. The nurses had lived and nursed in the same rural community for a minimum of 12 months. Participants were interviewed face to face and their transcribed interviews underwent thematic analysis. The meta-theme was: the distinctive nature of rural nursing. The themes identified were: interwoven professional and personal roles; complex role of rural nurses and relationships with the community. A conceptual model was developed to capture the relationship between the meta-theme and the themes. A definition for rural nursing was developed from the findings. This research identified some points of difference in this group of rural nurses from the available rural nursing literature. It also provides a better understanding of the supports Rural Nurse Specialists need to be successful in their roles, particularly around the recruitment and retention of the rural nursing workforce. |
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Call Number |
NRSNZNO @ research @ |
Serial |
820 |
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Author |
Barber, M. |
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Title |
Exploring the complex nature of rural nursing |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
10 |
Pages |
22-23 |
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Keywords |
Rural nursing; Scope of practice; Community health nursing |
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Abstract |
This article reports the results of a research study undertaken to examine how nurses manage their professional and personal selves while working in small rural communities. The participants were a small group of rural nurses on the West Coast. The rationale for the study was the long-term sustainability and viability of the service to this remote area. The research showed that the rural nurse specialists' role is a complex and challenging one, performed within the communities in which nurses live. |
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Call Number |
NRSNZNO @ research @ 1212 |
Serial |
1197 |
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Author |
Beasley, Catherine; Dixon, Robyn |
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Title |
Phase II cardiac rehabilitation in rural Northland |
Type |
Journal Article |
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Year |
2013 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
29 |
Issue |
2 |
Pages |
4-14 |
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Keywords |
Cardiac rehabilitation; Rural nursing |
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Abstract |
Reports a descriptive, exploratory, qualitative study of the perceptions and experiences of nurses who delivered cardiac rehabilitation in a rural health-care setting in Northland. Gathers data from two focus groups of 12 nurses in which five themes relating to cardiac rehabilitation are identified using a general inductive approach. |
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Call Number |
NZNO @ research @ |
Serial |
1482 |
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Author |
Boyd, M.E. |
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Title |
Advancing nursing knowledge: The experience of a nurse working with dying people in a highly remote rural area |
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 |
Terminal care; Rural nursing; Rural health services |
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Abstract |
By describing and gaining insight into one rural nurse's experience working with dying people in a highly, remote rural area, this project seeks to advance nursing practice. Key findings indicate that, through community partnership and teamwork, nurses can act to assist rural people by: increasing public awareness of health resources; exposing barriers to access; and identifying different health service needs. The author makes a case that some rural nurses may feel insufficiently prepared for rural nursing. To understand death and dying, key ideas from Kuebler-Ross's (1969) framework for dying are examined: denial, fear of dying, spirituality, hope, depression and how to die well. Nurses require a blend of end-of-life and rural nursing postgraduate education and skills, to manage well. Key findings imply that dying people can be helped by: improving function and independence to promote autonomy; encouraging faith, hope, and love within the person's personal concept of spirituality; listening to dying people, to oneself, to one's own reactions, and knowing oneself. Parse's theory (1981) indicates nurses can help rural dying people by the following key factors: encouraging the person to live life to the full while dying; accepting humans cannot be separated from their perspectives, circumstances or environments; focusing on quality of life from the person's perspective: encouraging the person to live life fully while dying; and offering new possibilities. The author goes on to say that Parse's human-universe-health process aids nurses to live their beliefs indicating Parse's theory could guide and advance nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
573 |
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Author |
Campbell, K. |
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Title |
Intertwining the role of partner and caregiver: A phenomenological study of the experiences of four New Zealand rural women who have cared for their terminally ill partners |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Terminal care; Palliative care; Home care; Nurse-family relations |
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Abstract |
The stories of the women who live and work in rural settings in New Zealand have begun to reveal unique contributions that they have made to their families and community. This research study evolved from a trend the researcher observed as a district nurse providing community palliative care in rural New Zealand; that the majority of carers of those who are terminally in home-settings are in fact women. This qualitative study aimed to explore through guided conversational interviews the experiences of four women who have cared for their terminally ill partners who have subsequently died. The study investigated if these women's experiences were comparable to that of other women in existing palliative care literature. This research project focused particularly on elucidating the women's experience of intertwining the role of partner and caregiver. Heidegger's hermeneutic philosophy informed the methodology because he focused on what it meant to 'be' rather than 'how we know what we know'. The project focused on the meanings the women made of this dual role in their lives. Women already in the role of partner were now faced with the added responsibility of caregiver to meet the complex needs of their loved one. Usually they had no training to prepare them for this experience. The study reveals ways in which the visiting palliative care nurse becomes very important to them. The women's own voices reveal the high level of respect for their partners and address the harsh realities, revealing poignant and striking concerns in their lives. These stories are shared with the intent of enriching nurses' and other health professionals' understanding of the women's experiences. The author notes that understanding these women's experience is not only a way of honouring these remarkable women but more widely it will inform and possibly transform practice through guideline and policy refinement. |
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Call Number |
NRSNZNO @ research @ |
Serial |
822 |
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Author |
Chick, D.N.P. |
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Title |
Rural district nurses as rehabilitationists |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1259 |
Serial |
1244 |
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Author |
Connor, Margaret J; Nelson, Katherine M; Maisey, Jane |
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Title |
Impact of innovation funding on a rural health nursing service : the Reporoa experience |
Type |
Journal Article |
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Year |
2009 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
25 |
Issue |
2 |
Pages |
4-14 |
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Keywords |
Primary health care; Rural nursing; Innovation; Advancing practice |
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Abstract |
Examines the impact of innovation funding through the MOH primary health-care nursing innovation funding scheme on Health Reporoa Inc, which offers a first-contact rural nursing service to the village of Reporoa and surrounding districts. Looks at funding impact during the project period of 2003-2006, and in the two years that followed. |
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Call Number |
NZNO @ research @ |
Serial |
1443 |
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Author |
Dillon, D.R. |
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Title |
Rural contexts: Islands |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 19-30) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Identity; Advanced nursing practice; Professional competence |
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Abstract |
This chapter explores the concept of islands particularly in relation to rurality, individual and community identities, and nursing. The author argues that all New Zealanders are islanders, and considers the implications of this on personal and community values, when they are shaped by geographic isolation and structural separateness. She explores commonalities between islanders and rural peoples in areas such as identity, isolation, and health, and outlines the impacts this has on rural nursing practice and competencies. A case study of a nurse on Stewart Island is briefly discussed. |
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Call Number |
NRSNZNO @ research @ 765 |
Serial |
461 |
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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 |
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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 |
Fitzwater, A. |
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Title |
The impact of tourism on rural nursing practice |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 137-43) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Tourism; Advanced nursing practice; Occupational health and safety |
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Abstract |
This chapter reviews some effects of the growth of tourism, including adventure tourism and the numbers of tourists over 50, on rural nursing practice. Tourism contributes to socio-cultural change within a community, and health resources that previously met the needs of the local community may not meet the expectations of growing numbers of tourists. The transient visitor includes both the tourist and the seasonal worker, and has become a feature of rural nursing. Major effects on rural nurses include the increased volume of work, the advanced scope of practice required to meet more complex needs of visitors, and challenges to personal and professional safety. |
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Call Number |
NRSNZNO @ research @ 773 |
Serial |
757 |
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Author |
Fitzwater, A. |
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Title |
The impact of tourism on a rural nursing practice |
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 |
Rural health services; Rural nursing; Tourism |
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Abstract |
Rural nursing in the remote context of South Westland is shaped by factors common to rural nursing practice world-wide including geographical and professional isolation, living and working in a small community, providing health care to rural people and the broad, generalist and advanced scope of nursing practice. Tourism is a major industry in the townships in the proximity of the two accessible glaciers in South Westland. The practice of the nurses in these areas is significantly affected by tourists seeking health care and by providing a health service for the large number of migrant seasonal workers who service the tourist industry. Tourists seek health care from the nurses across the full spectrum of health problems and their expectations of the health care required may exceed the service that can be provided. The nurses are challenged to advance their practice to find the personal and professional resources to provide a safe service. This includes the challenge of cultural safety and personal safety. The tourist industry brings significant numbers of young people as seasonal/temporary workers to the glacier areas. This imposes a youth culture onto the existing rural culture. Nursing practice has expanded to include the specialist practice of youth health care that includes the problems of alcohol and drug misuse, sexual and reproductive health, and youth mental health. This work is drawn from the experience of the nurses working in the glacier communities. The impact of the tourism industry on their rural nursing practice includes the increasing volume of work that challenges the viability of the service, the advanced scope of practice required to meet the health needs of tourists and the seasonal tourist industry workers, and challenges to personal and professional safety. |
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Call Number |
NRSNZNO @ research @ |
Serial |
659 |
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Author |
Gubb, Alicia |
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Title |
Rural nurse practitioner role to improve outcomes for Thames-Coromandel community |
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Book Whole |
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Year |
2020 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
115 p. |
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Keywords |
Nurse practitioners; Rural nursing; Transitional care; Thames Coromandel |
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Abstract |
Maintains that the Nurse Practitioner (NP) role has the potential to achieve more equitable outcomes for rural populations, particularly for older adults in their transition from hospital to the rural setting. Examines how NPs can reduce readmissions, from a thematic analysis of the literature using a realist synthesis approach, focusing on the Thames Coromandel rural community. Derives three themes from the analysis: self-efficacy, holistic care, and care grounded in nursing philosophy. |
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Call Number |
NZNO @ research @ |
Serial |
1750 |
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Author |
Horner, C. |
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Title |
Emergency health provision and maintaining competency |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 125-136) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Professional competence; Emergency nursing |
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Abstract |
This chapter focuses on issues associated with rural nursing and the provision of emergency care for patient(s) located remotely from secondary hospital services. All emergencies have diverse characteristics, but the rural practitioner also contends with having sole practice, professional and geographical isolation, and the lack of regular experience. The chapter reviews the PRIME (Primary Response in Medical Emergency) recommendations and training, and looks in particular at the issues around the maintenance of competency for the rural nurse providing emergency on call health care that includes managing medical and accident emergencies in the absence of a medical practitioner. |
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Call Number |
NRSNZNO @ research @ |
Serial |
756 |
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