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Author Dillon, D.R.
Title Rural contexts: Islands Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 19-30) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Rural nursing; Identity; Advanced nursing practice; Professional competence
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.
Call Number NRSNZNO @ research @ 765 Serial 461
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Author Yarker-Hitchcock, V.
Title Clinical supervision in a home care context Type
Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue (up) Pages
Keywords Clinical supervision; Home care; Rural nursing; Rural health services
Abstract Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in relation to its effect on clinical practice. It is not clear whether supervision actually produces a change in clinician behaviour, or whether it produces benefits in terms of client outcomes. This thesis evaluates the impact of clinical supervision on five co-ordinators in a rural home care setting. It looks at the impact clinical supervision has on their practice and professional growth. The nurses all belong to one organisation, Access Homehealth Ltd. The study builds on the findings of a clinical supervision pilot, which was trialed within the organisation in 2002. The pilot examined which model of supervision was most beneficial for Access Homehealth staff. Clinical Supervision is defined as a designated interaction between two or more practitioners within a supportive environment, that enhances reflective practice and professionalism, which in turn contributes to improved practice and client outcomes. The methodology of this research was qualitative evaluation. The themes which emerged related to personal support, managing stress and alleviating feelings of isolation, reflection, enhancing practice, improved communication skills and the concept of clinical supervision as a safety net. Participants also revealed that one-on-one supervision appeared more helpful than group supervision, and that phone supervision facilitated in-depth dialogue. These findings are important, as they demonstrate it is feasible to simultaneously offer a number of formats of clinical supervision within one organisation, allowing for the organisation to provide what works best for different workers. They also show that clinical supervision is a valuable and useful support tool for home care co-ordinators in order to facilitate empowerment, reflection and growth in practice. Further research is needed to provide evidence of the benefits of supervision on improving client outcomes.
Call Number NRSNZNO @ research @ 593 Serial 579
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Author Howie, L.
Title Contextualised nursing practice Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 33-49) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Rural nursing; Nursing models; Nursing research
Abstract This is the first of three chapters that describe nursing practice. The author presents the Rural Framework Wheel to elaborate aspects of the rural context. The Framework comprises four systems which describe aspects of rurality; being are socio-cultural, occupational, ecological, and health. These systems each comprise of subsystems, which provide a detailed analysis of the way nursing practice is particular in diverse rural settings. The Framework is presented as a work in progress, and is grounded in international nursing literature. It highlights rural nursing as a unique and challenging field, with the dominant themes of partnership and nursing emerging as underpinning the practice when nurses live and work in small, sometimes isolated communities.
Call Number NRSNZNO @ research @ 766 Serial 750
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Author Thompson, R.
Title On call but not rostered Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 67-78) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Rural nursing; Ethics; Registered nurses
Abstract In this chapter the author uses storytelling to explore the legal and ethical issues she experiences as a rural volunteer registered nurse. She describes the relationship between the nurse and community embodied in areas such as the public perception of nurses, and discusses aspects of her practice in the light of the particular legal and ethical context of rural areas.
Call Number NRSNZNO @ research @ 768 Serial 752
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Author Jamieson, I.
Title The mobile operating theatre project Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp.81-97) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Rural nursing; Surgery; Training; Evaluation
Abstract This chapter firstly presents the development of a mobile operating theatre project, which was implemented in 2002 to provide rural day-stay surgery. Secondly, it discusses the process and findings of a research project undertaken with the purpose of evaluating a perioperative (theatre and recovery) reskilling programme offered to 42 rural nurses from nine secondary hospitals, conducted over nine months in 2001. The training was given to nurses prior to the introduction of a mobile operating theatre service, and was seen as a key part of the service contract.
Call Number NRSNZNO @ research @ 769 Serial 753
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Author Pedersen, C.
Title Nurse-led telephone triage service in a secondary rural hospital Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 99-110) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Rural nursing; Telenursing; Evaluation
Abstract This chapter describes the development of a nurse-led after-hours telephone triage service in a rural secondary hospital in the Hawke's Bay District Health Board area. This service was a response to the health restructuring in the 1990s, which had led to the shift of secondary services out of the rural areas, and workforce recruitment issues. Secondly, it discusses the process and findings of a research project undertaken to identify and describe telephone callers' reported outcomes after using the service. The study found a high level of satisfaction amongst callers and a high level of compliance to advice.
Call Number NRSNZNO @ research @ 770 Serial 754
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Author Fitzwater, A.
Title The impact of tourism on rural nursing practice Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 137-43) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Rural nursing; Tourism; Advanced nursing practice; Occupational health and safety
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.
Call Number NRSNZNO @ research @ 773 Serial 757
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Author Armstrong, S.E.
Title Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Interprofessional relations; Rural nursing; Primary health care
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.
Call Number NRSNZNO @ research @ 780 Serial 764
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Author Chick, D.N.P.
Title Rural district nurses as rehabilitationists Type
Year 2003 Publication Abbreviated Journal University of Otago Library
Volume Issue (up) Pages
Keywords Rural nursing
Abstract
Call Number NRSNZNO @ research @ 1259 Serial 1244
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Author Howie, L.
Title Rural society and culture Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 3-18 ) Abbreviated Journal Ministry of Health publications page
Volume Issue (up) Pages
Keywords Rural nursing; Culture
Abstract The author takes a multidisciplinary approach to examine how the location and concept rural is defined and provides a critique of the disparate definitions available. Definitions encompass different disciplines such as sociology and anthropology, and there are national distinctions based on historical factors. The chapter also investigates the way researchers speak about rural people, particularly as the human aspect of health is a primary concern to nursing. The focus is on the socio-cultural, occupational, ecological, and health aspects of rurality. The Rural Framework Wheel is introduced, which is a method to categorise rural contextual definitions. Rurality is presented as a variable and evolving concept that provides particular challenges to nursing practice.
Call Number NRSNZNO @ research @ Serial 460
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Author Lindley, G.
Title Using frameworks to critically analyse the advancement of rural practice: One nurse's experience Type
Year 2007 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Rural nursing; Nursing models
Abstract The process of describing her scope of practice led the author to become interested in just how she has advanced her practice and the journey that unfolded. The author was introduced to a number of models or frameworks and these frameworks have been critiqued within this dissertation.
Call Number NRSNZNO @ research @ Serial 483
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Author 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 (up) 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 Dillon, D.R.
Title Islands, islandness and nursing: Advanced nursing practice in rural remote and small island areas Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Rural nursing; Primary health care
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.
Call Number NRSNZNO @ research @ Serial 507
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Author Robertson, A.M.
Title Meeting the maternity needs of rural women: Negotiating the reality of remote rural nursing and midwifery practice Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Rural nursing; Midwifery
Abstract Recent changes to the way that health services are provided and issues related to the rural health workforce are creating an international crisis in the availability of rural maternity care. International trends show a workforce decline in rural general practitioner obstetric specialists and rural midwives, as well as a decline in rural births. The aim of this study is to highlight the maternity needs of rural New Zealand women. Further, it discusses how the changes to maternity services in New Zealand, over the last sixteen years, have impacted on the rural nurse and midwife role and therefore on service provision. This information is intended to identify issues that could be used as the basis for development of a uniquely rural model of maternity care.
Call Number NRSNZNO @ research @ Serial 510
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Author Boyd, M.E.
Title Advancing nursing knowledge: The experience of a nurse working with dying people in a highly remote rural area Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Terminal care; Rural nursing; Rural health services
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.
Call Number NRSNZNO @ research @ Serial 573
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