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Author McKenna, B.; Smith, N.A.; Poole, S.; Coverdale, J.
Title Horizontal violence: Experiences of registered nurses in their first year of practice Type Journal Article
Year (up) 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 42 Issue 1 Pages 90-96
Keywords New graduate nurses; Workplace violence; Occupational health and safety
Abstract The aims of this study were to determine the prevalence of horizontal violence, or bullying, experienced by nurses in their first year of practice; to describe the characteristics of the most distressing incidents experienced; to determine the consequences, and measure the psychological impact, of such events; and to determine the adequacy of training received to manage horizontal violence. An anonymous survey was mailed to 1169 nurses in New Zealand who had registered in the year prior to November 2000 with a response rate of 47%. Many new graduates experienced horizontal violence across all clinical settings. Absenteeism from work, the high number of respondents who considered leaving nursing, and scores on the Impact of Event Scale all indicated the serious impact of interpersonal conflict. Nearly half of the events described were not reported, only 12% of those who described a distressing incident received formal debriefing, and the majority of respondents had no training to manage the behaviour.
Call Number NRSNZNO @ research @ Serial 706
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Author Clendon, J.
Title Nurse-managed clinics: Issues in evaluation Type Journal Article
Year (up) 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 44 Issue 6 Pages 558-565
Keywords Evaluation research; Nurse managers; Qualiltative research; Patient satisfaction
Abstract This article explores the importance of evaluation of nurse-managed clinics using the Mana Health Clinic in Auckland, as an example. Fourth generation evaluation is offered as an appropriate methodology for undertaking evaluation of nurse-managed clinics. Fourth generation evaluation actively seeks involvement of clients in the process and outcome of the evaluation, resulting in participation and empowerment of stakeholders in the service – a precept often forgotten in traditional evaluation strategies and of vital importance in understanding why people use nurse-managed clinics. The method proposed here also incorporates the need for quantitative data. The main argument is that a combination of qualitative and quantitative data sources is likely to give the greatest understanding of nurse-managed clinics' utilisation.
Call Number NRSNZNO @ research @ Serial 949
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Author Crowe, M.; Carlyle, D.
Title Deconstructing risk assessment and management in mental health nursing Type Journal Article
Year (up) 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 43 Issue 1 Pages 19-27
Keywords Psychiatric Nursing; Risk management; Policy; Culture
Abstract The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
Call Number NRSNZNO @ research @ Serial 1069
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Author Polaschek, N.
Title Living on dialysis: Concerns of clients in a renal setting Type Journal Article
Year (up) 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 41 Issue 1 Pages 44-52
Keywords Nurse-patient relations; Psychology; Attitude to health; Terminal care
Abstract This article reports a study that sought to understand the experience of a group of Caucasian men with end stage renal failure managing their own haemodialysis therapy in their homes. The study used a critical interpretive methodology. The renal setting was critically viewed as a specialised health care context constituted by several interrelated discourses. Although established by the dominant professional discourse, it also includes a number of others, in particular an obscure client discourse that is a response to the dominant discourse. Initially, participants' own interpretations of their individual experiences were outlined. These were then collectively reinterpreted by contextualising them in terms of the critical view of the renal setting, in order to discern their own views as renal clients that were obscured by the language and ideas of the dominant discourse with which they had been enculturated. From an analysis of the set of accounts derived from interviews with six participants, four concerns of the renal client discourse were identified. These concerns were: (1) suffering from continuing symptoms of end stage renal failure and dialysis; (2) limitations resulting from negotiating dialysis into their lifestyle; (3) ongoingness and uncertainty of life on dialysis; and (4) altered relationship between autonomy and dependence inherent in living on dialysis. One specific implication of this study is that the distinctive potential of the nursing role in renal settings lies beyond the performance of a range of technical tasks, in addressing the experience of people living on dialysis, described here as the concerns of the renal client discourse.
Call Number NRSNZNO @ research @ Serial 1072
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Author Polaschek, N.
Title Negotiated care: A model for nursing work in the renal setting Type Journal Article
Year (up) 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 42 Issue 4 Pages 355-363
Keywords Chronically ill; Nursing models; Nurse-patient relations; Communication
Abstract This article outlines a model for the nursing role in the chronic health care context of renal replacement therapy. Materials from several streams of literature are used to conceptualise the potential for nursing work in the renal setting as negotiated care. In order to present the role of the renal nurse in this way it is contextualised by viewing the renal setting as a specialised social context constituted by a dominant professional discourse and a contrasting client discourse. While performing specific therapeutic activities in accord with the dominant discourse, renal nurses can develop a relationship with the person living on dialysis, based on responsiveness to their subjective experience reflecting the renal client discourse. In contrast to the language of noncompliance prevalent in the renal setting, nurses can, through their relationship with renal clients, facilitate their attempts to negotiate the requirements of the therapeutic regime into their own personal life situation. Nurses can mediate between the dominant and client discourses for the person living on dialysis. Care describes the quality that nurses actively seek to create in their relationships with clients, through negotiation, in order to support them to live as fully as possible while using renal replacement therapy. The author concludes that within chronic health care contexts, shaped by the acute curative paradigm of biomedicine, the model of nursing work as negotiated care has the potential to humanise contemporary medical technologies by responding to clients' experiences of illness and therapy.
Call Number NRSNZNO @ research @ Serial 1186
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Author Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N.
Title Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand Type Journal Article
Year (up) 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 46 Issue 1 Pages 95-109
Keywords Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori
Abstract The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
Call Number NRSNZNO @ research @ Serial 1060
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Author Carter, H.; MacLeod, R.; Brander, P.; McPherson, K.
Title Living with a terminal illness: Patients' priorities Type Journal Article
Year (up) 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 45 Issue 6 Pages 611-620
Keywords Terminal care; Quality of life; Nursing models; Cancer
Abstract The aim of this paper is to report on an exploratory, qualitative study exploring what people living with terminal illness considered were the areas of priority in their lives. Ten people living with terminal cancer were interviewed. Analysis of the interviews incorporated principles of narrative analysis and grounded theory. Over 30 categories were identified and collated into five inter-related themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge) encompassing the issues of importance to all participants. Each theme focused on 'life and living' in relation to life as it was or would be without illness. Practical issues of daily living and the opportunity to address philosophical issues around the meaning of life emerged as important areas. The central theme, 'taking charge', concerned with people's levels of life engagement, was integrally connected to all other themes. The findings suggest that the way in which health professionals manage patients' involvement in matters such as symptom relief can impact on existential areas of concern. The findings challenge some aspects of traditional 'expert-defined' outcome measures. As this was an exploratory study, further work is needed to test and develop the model presented.
Call Number NRSNZNO @ research @ Serial 1061
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Author Kinealy, T.; Arroll, B.; Kenealy, H.; Docherty, B.; Scott, D.; Scragg, R.; Simmons, D.
Title Diabetes care: Practice nurse roles, attitudes and concerns Type Journal Article
Year (up) 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 48 Issue 11 Pages 68-75
Keywords Diabetes Type 2; Practice nurses; Attitude of health personnel; Primary health care
Abstract The aim of this paper is to report a study to compare the diabetes-related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care. Questionnaires were mailed to all 146 practice nurses in South Auckland in 1990 and to all 180 in 1999, asking about personal and practice descriptions, practice organisation, time spent with patients with diabetes, screening practices, components of care undertaken by practice nurses, difficulties and barriers to good practice, training in diabetes and need for further education. The 1999 questionnaire also asked about nurse prescribing and influence on patient quality of life. More nurses surveyed in 1999 had post-registration diabetes training than those in 1990, although most of those surveyed in both years wanted further training. In 1999, nurses looked after more patients with diabetes, without spending more time on diabetes care than nurses in 1990. Nevertheless, they reported increased involvement in the more complex areas of diabetes care. Respondents in 1999 were no more likely than those in 1990 to adjust treatment, and gave a full range of opinion for and against proposals to allow nurse prescribing. The relatively low response rate to the 1990 survey may lead to an underestimate of changes between 1990 and 1999. Developments in New Zealand primary care are likely to increase the role of primary health care nurses in diabetes. Research and evaluation is required to ascertain whether this increasing role translates into improved outcomes for patients.
Call Number NRSNZNO @ research @ Serial 1100
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Author McBride-Henry, K.; Foureur, M.
Title Medication administration errors: Understanding the issues Type Journal Article
Year (up) 2006 Publication Australian Journal of Advanced Nursing Abbreviated Journal
Volume 23 Issue 3 Pages 33-41
Keywords Nursing; Patient safety; Medical errors; Drug administration; Quality assurance
Abstract This literature review focused on research that primarily addresses the issues related to medications that arise in tertiary care facilities. It finds that investigations into medication errors have primarily focused on the role of nurses, and tended to identify the nurse as deliverer of unsafe practice. Over the past few years a shift in how medication errors are understood has led to the identification of systems-related issues that contribute to medication errors. The author suggests that nurses should contribute to initiatives such as the 'Quality and Safe Use of Medicines' and develop nursing led research, to address some of the safety related issues with a view to enhancing patient safety.
Call Number NRSNZNO @ research @ Serial 715
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Author Crowe, M.
Title Psychiatric diagnosis: Some implications for mental health nursing care Type Journal Article
Year (up) 2006 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 53 Issue 1 Pages 125-131
Keywords Psychiatric Nursing; Diagnosis; Culture; Gender; Socioeconomic factors; Nursing models
Abstract This article explores some of the functions of psychiatric diagnosis and the implications this has for mental health nursing care. It critiques the psychiatric diagnosis as a categorisation process that maintains oppressive power relations within society, by establishing and enforcing normality through gender, culture and class biases. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is used to illustrate some of the inherent biases in the diagnostic process. The author argues that mental health nursing practice needs to demonstrate an awareness of the power relations inherent in any diagnostic process and make attempts to redress these at both the individual and sociopolitical levels. To create a true patient-centred partnership in mental health nursing, the nursing focus should be on the patient's experience rather than the psychiatric diagnosis with which the experience is attributed. NB this is a reprint of article first published in Journal of Advanced Nursing, 2000 Mar; 31(3), 583-9.
Call Number NRSNZNO @ research @ Serial 837
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Author Gardner, G.; Dunn, S.; Carryer, J.B.; Gardner, A.
Title Competency and capability: Imperative for nurse practitioner education Type Journal Article
Year (up) 2006 Publication Australian Journal of Advanced Nursing Abbreviated Journal The author-version of article, available online from Queensland University of Technology ePrints arc
Volume 24 Issue 1 Pages 8-14
Keywords Nursing; Education; Nurse practitioners; Curriculum
Abstract The objective of this study was to conduct research to inform the development of standards for nurse practitioner education in Australia and New Zealand and to contribute to the international debate on nurse practitioner practice. The research was conducted in all states of Australia where the nurse practitioner is authorised, and in New Zealand. The research was informed by multiple data sources including nurse practitioner programme curricula documents from relevant universities in Australia and New Zealand, interviews with academic convenors of these programmes and interviews with nurse practitioners. Findings include support for masters level of education as preparation for the nurse practitioner. These programs need to have a strong clinical learning component and in-depth education for the sciences of specialty practice. Additionally an important aspect of education for the nurse practitioner is the centrality of student directed and flexible learning models. This approach is well supported by the literature on capability.
Call Number NRSNZNO @ research @ Serial 882
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Author Neville, S.J.; Henderson, H.M.
Title Perceptions of lesbian, gay and bisexual people of primary healthcare services Type Journal Article
Year (up) 2006 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 55 Issue 4 Pages 407-415
Keywords Sexuality; Attitude of health personnel; Primary health care
Abstract This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.
Call Number NRSNZNO @ research @ 1059 Serial 1043
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Author Harding, T.S.
Title The construction of men who are nurses as gay Type Journal Article
Year (up) 2007 Publication Journal of Advanced Nursing Abbreviated Journal Coda: An institutional repository for the New Zealand ITP sector
Volume 60 Issue 6 Pages 636-644
Keywords Male nurses; Prejudice; Sexuality
Abstract This paper is a report of a study to determine the construction of male nurses as gay, and to describe how this discourse impacts on a group of New Zealand male nurses. This social constructionist study drew on data collected from existing texts on men, nursing and masculinity and interviews with 18 New Zealand men conducted in 2003-2004. Discourse analysis, informed by masculinity theory and queer theory, was used to analyse the data. Despite the participants' beliefs that the majority of male nurses are heterosexual, the stereotype persists. A paradox emerged between the 'homosexual' general nurse and the 'heterosexual' pyschiatric nurse. The stigma associated with homosexuality exposes male nurses to homophobia in the workplace. The heterosexual men employed strategies to avoid the presumption of homosexuality; these included: avoiding contact with gay colleagues and overt expression of their heterosexuality. These stigmatising discourses create a barrier to caring and, aligned with the presence of homophobia in the workplace, deter men's entry into the profession and may be important issues with respect to their retention.
Call Number NRSNZNO @ research @ Serial 647
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Author McBride-Henry, K.; Foureur, M.
Title A secondary care nursing perspective on medication administration safety Type Journal Article
Year (up) 2007 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 60 Issue 1 Pages 58-66
Keywords Patient safety; Drug administration; Organisational culture; Nursing
Abstract This paper reports on a study to explore how nurses in a secondary care environment understand medication administration safety and the factors that contribute to, or undermine, safe practice during this process. Data were collected in 2005 using three focus groups of nurses that formed part of a larger study examining organisational safety and medication administration from a nursing perspective. A narrative approach was employed to analyse the transcripts. Participants had good understandings of organisational culture in relation to medication safety and recognised the importance of effective multi-disciplinary teams in maintaining a safe environment for patients. Despite this, they acknowledged that not all systems work well, and offered a variety of ways to improve current medication practices. These findings highlight the meaningful contribution nurses can make to patient safety and emphasise the importance of including the nursing voice in any quality improvement initiatives.
Call Number NRSNZNO @ research @ Serial 648
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Author Giddings, D.L.S.; Roy, D.E.; Predeger, E.
Title Women's experience of ageing with a chronic condition Type Journal Article
Year (up) 2007 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 58 Issue 6 Pages 557-565
Keywords Chronic diseases; Age factors; Gender; Nursing
Abstract This paper is a report of a study to explore the experiences of 'almost old' women as they grow older while living with a chronic condition. Little is known about the contextual effects of ageing and how it shapes and is shaped by a woman's chronic illness experience. Seven women aged between 50 and 58 years participated in this interpretive descriptive study that explored the issues of ageing with a chronic condition. Three focus groups were held between March 2003 and March 2004. Transcriptions were analysed after each focus group. Participants were given the opportunity to respond to the findings as the analysis progressed. The experience of living with a chronic illness foreshadowed what was to come with ageing and embodied the ageing process: it was just part of their lives. Alongside this, the women now felt less out of place. Their peers were catching up and beginning to experience aspects of participants' everyday reality. The women, however, experienced double jeopardy because ageing amplified the ongoing vulnerabilities of living with a chronic condition. The authors conclude that nurses who recognise the resourcefulness and expertise of women who live with a chronic condition can effectively be co-strategists in helping them to age well.
Call Number NRSNZNO @ research @ Serial 880
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