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Author Ross, Jean
Title (up) 'Place' Matters to Rural Nurses: A Study Located in the Rural Otago Region of New Zealand Type Book Whole
Year 2017 Publication Abbreviated Journal
Volume Issue Pages 346 p.
Keywords Rural nursing; Identity; Otago; Sense of place
Abstract Explores the social construction of the evolving professional identity, of rural nurses between the 1990z and early 2000s, a period of time was associated with two

significant national directives impacting on the professional practice of rural nurses and their contribution to the delivery of health care, from the rural Otago region of NZ. Engages with the concepts of place and governmentality. Demonstrates that rural nursing is a place–based practice governed both from within and beyond location, an analytical diagrammatic matrix.
Call Number NZNO @ research @ Serial 1555
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Author Litchfield, M.
Title (up) A framework of complementary models of nursing practice: A study of nursing roles and practice for a new era of healthcare provision in New Zealand Type Report
Year 2001 Publication Abbreviated Journal Online on the Ministry of Health's Centre for Rural Health pages
Volume Issue Pages
Keywords Nursing models; Rural nursing; Policy; Scope of practice
Abstract This is the second of a series of research projects undertaken to present the contemporary picture of the nurse workforce and their work in rural settings to inform policy for development of rural healthcare. The document presents the findings of telephone interviews with nurses in different work rural work settings around the country discussing their practice. The analysis identified a framework of four models of nursing practice: two traditional models defined by the institutions employing nurses, and two emerging models defined by the new positions requiring nurses to respond directly to health need.
Call Number NRSNZNO @ research @ Serial 1176
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Author Pepers, M.G.
Title (up) A grey zone: The experience of violence in remote nursing practice Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Workplace violence; Rural health services; Rural nursing
Abstract This dissertation explores the issues affecting the exposure of isolated rural nurses working in New Zealand to violence from members of the local community, including the visiting public. Discussion on the collaborative role with the New Zealand Police is thematic in the issues presented. Challenges presented include the unique community dynamics of the Stewart Island nursing practice on the Island, with scope of practice, isolation and practice issues included. Role definition, present-day health-care delivery, the potential for violence including causation and reporting are presented. Incident management and risk strategies, including de-escalation are rationalised and described. Evidence for the nurse-police inter-service relationship along with issues including confidentiality and legislation are reviewed. Recommendations and conclusion are provided. The thread and theme of the dissertation is to encourage discussion within nursing circles on the provision of satisfactory safety standards for nurses working in remote isolated parts of New Zealand.
Call Number NRSNZNO @ research @ Serial 688
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Author Boyd, M.E.
Title (up) 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 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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Author Yarker-Hitchcock, V.
Title (up) Clinical supervision in a home care context Type
Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue 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 (up) 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 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 Horner, C.
Title (up) Emergency health provision and maintaining competency Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 125-136) Abbreviated Journal Ministry of Health publications page
Volume Issue Pages
Keywords Rural nursing; Professional competence; Emergency nursing
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.
Call Number NRSNZNO @ research @ Serial 756
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Author Barber, M.
Title (up) Exploring the complex nature of rural nursing Type Journal Article
Year 2007 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 13 Issue 10 Pages 22-23
Keywords Rural nursing; Scope of practice; Community health nursing
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.
Call Number NRSNZNO @ research @ 1212 Serial 1197
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Author Armstrong, S.E.
Title (up) 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 Armstrong, S.E.
Title (up) 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 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 Hutton, Gemma
Title (up) How do rural nurse specialists in South Westland perceive their personal safety whilst working in isolation? Type Book Whole
Year 2018 Publication Abbreviated Journal
Volume Issue Pages 97 p.
Keywords Rural nursing; Personal safety; Rural conditions
Abstract Identifies how rural nurse specialists (RNS) working in South Westland (SW) perceiver their personal safety in a rural environment as compared with an urban one. Uses a focus group to explore RNS responses and to identify the following themes related to safety in isolated environments: community, pressure to perform, and luck versus planning for safety. Suggests recommendations for future practice.
Call Number NZNO @ research @ Serial 1665
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Author Connor, Margaret J; Nelson, Katherine M; Maisey, Jane
Title (up) Impact of innovation funding on a rural health nursing service : the Reporoa experience Type Journal Article
Year 2009 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 25 Issue 2 Pages 4-14
Keywords Primary health care; Rural nursing; Innovation; Advancing practice
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.
Call Number NZNO @ research @ Serial 1443
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Author Ross, J.
Title (up) International perspective: The development of the advanced role of rural nurses in New Zealand Type Journal Article
Year 1999 Publication Australian Journal of Rural Health Abbreviated Journal
Volume 7 Issue 4 Pages 253-257
Keywords Nursing; Education; Rural nursing; Advanced nursing practice
Abstract This paper offers an insight into the development of the advanced role of rural nursing practice in New Zealand. The concept of advanced nursing practice is discussed within the context of the interdisciplinary healthcare team. It is argued that as nurses take on advanced practice, it is essential they receive appropriate clinical and theoretical skills to ensure they are in a position to provide competent and clinically safe, effective health care in an ethical, efficient manner. A description of a survey, undertaken by the author, studying rural nurses' skills provides the recommendation for the development of an appropriate postgraduate course at Masters level, designed specifically for primary rural nurses for the advanced role.
Call Number NRSNZNO @ research @ Serial 953
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Author Campbell, K.
Title (up) 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
Year 2004 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Rural nursing; Terminal care; Palliative care; Home care; Nurse-family relations
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.
Call Number NRSNZNO @ research @ Serial 822
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Author Dillon, D.R.
Title (up) 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 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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