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Author (up) Bishop, D.; Ford-Bruins, I.
Title Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 3 Pages 203-212
Keywords Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models
Abstract This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
Call Number NRSNZNO @ research @ 1082 Serial 1067
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Author (up) Cowan, L.M.; Deering, D.; Crowe, M.; Sellman, D.; Futterman-Collier, A.; Adamson, S.
Title Alcohol and drug treatment for women: Clinicians' beliefs and practice Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 1 Pages 48-55
Keywords Psychiatric Nursing; Substance abuse; Gender; Attitude of health personnel; Alcoholism; Drug abuse
Abstract The present paper reports on the results of a telephone survey of 217 alcohol and drug treatment clinicians on their beliefs and practice, in relation to service provision for women. Nurses comprised the second largest professional group surveyed. Seventy-eight percent of clinicians believed that women's treatment needs differed from men's and 74% reported a range of approaches and interventions, such as assisting with parenting issues and referral to women-only programmes. Several differences emerged in relation to approaches and interventions used, depending on clinician gender, work setting and proportion of women on clinicians' caseload. Implications for mental health nursing include the need to more systematically incorporate gender-based treatment needs into practice and undergraduate and postgraduate education and training programmes.
Call Number NRSNZNO @ research @ Serial 652
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Author (up) Crowe, M.; Ward, N.; Dunnachie, B.; Roberts, M.H.
Title Characteristics of adolescent depression Type Journal Article
Year 2006 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 15 Issue 1 Pages 10-18
Keywords Psychiatric Nursing; Mental health; Adolescents
Abstract This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.
Call Number NRSNZNO @ research @ 1065 Serial 1050
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Author (up) Farrow, T.
Title Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments Type Journal Article
Year 2002 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 11 Issue 4 Pages 214-219
Keywords Interprofessional relations; Psychiatric Nursing; Community health nursing; Qualiltative research; Suicide
Abstract 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
Call Number NRSNZNO @ research @ Serial 785
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Author (up) Farrow, T.; McKenna, B.; O'Brien, A.J.
Title Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation Type Journal Article
Year 2002 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 11 Issue 3 Pages 164-169
Keywords Mental health; Law and legislation; Psychiatric Nursing; Scope of practice
Abstract A new approach to mental health legislation has seen the involvement of a range of health professionals in legislated mental health roles, including the power of registered nurses to detain patients in hospital under Section 111 of the New Zealand Mental Health (Compulsory Assessment and Treatment) Act (1992). Under this Section, a nurse who believes that a voluntary patient meets the legal criteria of the Act can independently detain the patient for a period of up to six hours, pending further assessment by a medical practitioner. However, anecdotal evidence and a clinical audit undertaken by the authors suggest some doctors 'prescribe' Section 111 at the time of admission. This practice instructs nurses to initiate Section 111 if particular voluntary patients choose to leave hospital. This study outlines practice issues resulting from 'prescribing' Section 111; provides a legal critique of medical practitioners' involvement in this practice; and makes recommendations for guidelines toward a more constructive use of Section 111.
Call Number NRSNZNO @ research @ Serial 651
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Author (up) Farrow, T.; O'Brien, A.J.
Title Discourse analysis of newspaper coverage of the 2001/2002 Canterbury, New Zealand mental health nurses' strike Type Journal Article
Year 2005 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 14 Issue 3 Pages 187-195
Keywords Mental health; Nursing specialties; Industrial relations
Abstract This paper reports on research into print media representations of industrial disputes in Canterbury in 2001, when mental health nurses undertook a variety of strike actions after stalled negotiations with the local district health board. One response to these actions was the temporary reduction of many of the regions' mental health services. The researchers identified themes of juxtaposed but largely deprecatory images of both mental health nursing and of consumers of services. Some professional nursing voices were given print space during the strike; however, these were largely incorporated into existing discourses rather than offering a nursing viewpoint on the strike. The researchers suggest organisational efforts to focus on ways of ensuring that mental health nurses are seen as a legitimate authority by the media.
Call Number NRSNZNO @ research @ Serial 692
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Author (up) Fielden, J.
Title Grief as a transformative experience: Weaving through different lifeworlds after a loved one has completed suicide Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 1 Pages 74-85
Keywords Grief; Psychology; Nursing specialties; Suicide
Abstract This research is an exploration and interpretation of the lived experiences of family members since they lost a close family member to suicidal death. The findings have implications for nurses and counsellors working in the area of suicide bereavement. Heidegger's hermeneutic phenomenology was utilised and informed by van Manen's and Benner's work. Data from in-depth interviews with six participants, the researcher's journal entries and published literature were analysed. Findings gave rise to a grief model where suicide survivors moved through four modes of being-in-the-world characterized by 13 lifeworlds or themes. Surviving suicide was a transformative process that in time enabled survivors to discover new ways of understanding and relating to the world.
Call Number NRSNZNO @ research @ Serial 702
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Author (up) Fourie, W.; McDonald, S.; Connor, J.; Bartlett, S.
Title The role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality Type Journal Article
Year 2005 Publication International Journal of Mental Health Nursing Abbreviated Journal Available online from Coda: An institutional repository for the ITP sector
Volume 14 Issue 2 Pages 134-141
Keywords Psychiatric Nursing; Nurse-patient relations; Organisational change
Abstract This study compared the perceptions that registered psychiatric nurses have of their roles with their actual practice. Following the closure of large scale psychiatric institutions in New Zealand, there was was an increased demand for limited beds in acute inpatient facilities for acutely mentally ill patients. This change in location and downsizing of acute inpatient beds challenged traditional roles of mental health nursing, resulting in confusion over what roles mental health nurses should now perform in the new context of care. This qualitative descriptive exploratory study observed nursing practice on three selected wards and used focus group interviews to establish from registered nurses what they perceived their roles to be. A key finding of this study was that many of the nursing roles related to delivering care from a crisis management perspective, which covers aspects such as assessment, stabilisation of symptoms and discharge planning. Participants also believed that the therapeutic relationship was a fundamental role in inpatient care. Nurses used any opportunity to make it a reality such as kitchen organisation, medications, or dealing with a challenging patient. This study highlighted the complexity of the roles that nurses performed and went some way to give voice to what at times seems an invisible practice.
Call Number NRSNZNO @ research @ Serial 875
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Author (up) Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J.
Title The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 4 Pages 259-270
Keywords Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research
Abstract This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.
Call Number NRSNZNO @ research @ Serial 1064
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Author (up) McKenna, B.; O'Brien, A.J.; Dal Din, T.; Thom, K.
Title Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992 Type Journal Article
Year 2006 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 15 Issue 2 Pages 128-134
Keywords Advanced nursing practice; Psychiatric Nursing; Law and legislation
Abstract The objectives of this research were to determine how many registered nurses are working as 'responsible clinicians', under what phases of the legislation they are functioning, and to describe the enabling processes and barriers to nurses undertaking this statutory role. An anonymous descriptive survey was distributed to the 11 nurses who were currently responsible clinicians as well as five senior nurses selected from each of the 21 district health boards and the Auckland Regional Forensic Psychiatry Services (n=121). The response rate was 88.4% (n=107). The survey questioned respondents on statutory roles currently undertaken. Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain it. They were also asked which competencies of the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. Of the approximately 395 responsible clinicians nationally, 11 (2.8%) are nurses. Most nurses viewed the role as legitimate. However, many were unaware of competencies for the role and credentialing processes, and were somewhat ambivalent about achieving the role due to current workload, role conflict and lack of remuneration. Competency deficits were highlighted. The authors conclude that there are grounds to encourage nurses as responsible clinicians given the intent of the legislation. This will require the promulgation of appropriate mental health policy, and a concerted effort by major stakeholders in mental health service delivery.
Call Number NRSNZNO @ research @ Serial 1044
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Author (up) McKenna, B.; Poole, S.; Smith, N.A.; Coverdale, J.; Gale, C.
Title A survey of threats and violent behaviour by patients against registered nurses in their first year of practice Type Miscellaneous
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 1 Pages 56-63
Keywords New graduate nurses; Workplace violence; Occupational health and safety; Training; Mental health; Psychiatric nursing
Abstract For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes.
Call Number NRSNZNO @ research @ Serial 649
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Author (up) O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J.
Title Clinical indicators as measures of mental health nursing standards of practice in New Zealand Type Journal Article
Year 2004 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 13 Issue 2 Pages 778-788
Keywords Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth
Abstract This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
Call Number NRSNZNO @ research @ Serial 1059
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Author (up) Palmer, S.G.
Title Application of the cognitive therapy model to initial crisis assessment Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 1 Pages 30-38
Keywords Mental health; Clinical assessment; Psychiatric Nursing
Abstract This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
Call Number NRSNZNO @ research @ 1085 Serial 1070
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Author (up) Rydon, S.E.
Title The attitudes, knowledge and skills needed in mental health nurses: The perspective of users of mental health services Type Journal Article
Year 2005 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 14 Issue 2 Pages 78-87
Keywords Patient satisfaction; Psychiatric Nursing; Attitude of health personnel
Abstract In this study a qualitative descriptive methodology with focus group interviews was used to explore with users of mental health services, the attitudes, knowledge and skills that they need in mental health nurses. Users of mental health services valued the therapeutic work of mental health nurses, and identified positive attitudes towards users of mental health services as essential in mental health nurses. However, they did not consistently experience a therapeutic approach in their interactions with mental health nurses. In a sociopolitical climate where the views of users of mental health services are increasingly incorporated into education and the planning and delivery of services, there is a need for more research that reflects the perspective of users.
Call Number NRSNZNO @ research @ 961 Serial 945
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