| Records |
| Author |
Dearden, G. |
| Title |
When things go wrong: The experiences of mental health nurses who have had a patient die through suicide |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal  |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Mental health; Psychiatric Nursing; Nurse-patient relations; Case studies; Suicide |
| Abstract |
This thesis discusses the findings of a research study, informed by the work of van Manen (1997b), which explored the lived experiences of five mental health nurses who have had a patient die through suicide. Narrative was used as a method in interviews to uncover the essence of their lived experiences. Five interwoven themes uncovered in each of the interviews were: impact, support, feelings, closure and paradox. All of the nurses interviewed experienced a wide range of feelings about their patient's suicides, ranging from shock to guilt, to anger and sadness, and described their patient's suicide as having a significant impact on them. Support received by the nurses following their patient's suicide was variable, and they were often in the difficult position of trying to offer support to the patient's family. Common to all of the nurses was the lack of closure following the suicide. Paradox was found to be the overall essence of the experience of the mental health nurses interviewed. Three main paradoxical themes or statements were identified that are in many respects a summary of all of the themes that emerged. These were: unavoidable – responsible; inevitable – unprepared; duty of care – respect for patient's decision to end their life. The author suggests that the ability of the nurses interviewed to accept and reconcile the paradoxical issues that arise in relation to patient suicide, and accept the lack of closure they experience, is a fundamental element in their ability to continue to work in the mental health setting, despite the significant impact their patient's suicide has had on them. Four recommendations are made based on the insights gained from this research. These are: that every mental health service should have a suicide response policy; that undergraduate nursing education includes the impact of patient suicide; the development of policies which promote dialogue about suicide within the community; and the need for further research in this topic. |
| Call Number |
NRSNZNO @ research @ |
Serial |
602 |
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| Author |
Kwai, K. |
| Title |
The value of a programme of clinical supervision for graduate nurses: An evaluative study |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Clinical supervision; New graduate nurses; Mentoring |
| Abstract |
The function and implementation of clinical supervision in the practice setting presents a number of challenges for new graduate programmes for registered comprehensive nurses. There have been numerous reports and papers promoting its benefits as important and providing the impetus for change. Clinical supervision has been well established as part of social work, counselling, psychotherapy and psychoanalytic practice, and in mental health nursing and midwifery. Its utilisation for graduate nurses is clearly important and should be seen as integral to professional practice. This study evaluated a programme of clinical supervision as a component of a new graduate nurse programme in a secondary health care practice environment. The clinical supervision component aimed to support graduate registered nurses' transition from the role of student nurse to staff nurse in the context of professional clinical practice. This report is also intended to inform the ongoing provision of clinical supervision at Hutt Valley District Health Board. The evaluation process was guided by the work of Owen (1990) and used utilisation focussed evaluation as the framework on which to undertake the evaluation. A mix of quantitative and qualitative methodology was used to collect and analyse the data. Data were collected from nurse graduates of the new graduate programme using a postal questionnaire that covered three areas; clinical supervision, the Hutt Valley District Health Board new graduate programme and an evaluation of stakeholder roles. Twelve of the new graduates responded to the survey. Findings suggest clinical supervision provided professional support and assisted the new graduate in the identification of education needs. Difficulties associated with accessing the structured component of the new graduate programme and clinical supervision were highlighted. The recommendations made to Hutt Valley District Health Board to improve the programme include considering accessibility, consumer rights, acceptability, a comprehensive approach, the Treaty of Waitangi, efficiency and a coordinated approach. |
| Call Number |
NRSNZNO @ research @ |
Serial |
603 |
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| Author |
Lake, S.E. |
| Title |
Nursing prioritisation of the patient need for care: Tacit knowledge of clinical decision making in nursing |
Type |
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| Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Clinical decision making; Nursing |
| Abstract |
Effective nursing prioritisation of the patient need for care is integral to daily nursing practice but there is no formal acknowledgement or study of this concept. Utilising the retroductive research strategy of critical realism, this thesis explores the nursing literature for the tacit knowledge of the discipline about nursing prioritisation and proposes a 'fit' for nursing prioritisation of the patient need for care within the bigger picture of nurse clinical decision-making. The tacit knowledge discerned within the literature indicates that nurses use discretionary judgment and ongoing assessment to determine the relative importance of the many aspects of individual patient situations as they unfold. Such nursing prioritisation takes place concurrently between the competing or even conflicting needs of the several individual patient presentations within the nurse's caseload. Varied frames of reference within different practice settings create specific imperatives on this dynamic and non-sequential process. Starting with an initial set of studies in the 1960s, study of clinical decision-making in nursing has created a significant body of knowledge encompassing a range of approaches. Nursing prioritisation of the patient need for care is most readily discerned in the interpretive perspective and in the plain language descriptions of nurse decision-making. Within the selected literature it is apparent that nursing prioritisation of the patient need for care is an advanced skill of nursing that is developed in practice and honed through experiential learning. |
| Call Number |
NRSNZNO @ research @ |
Serial |
661 |
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| Author |
Meldrum, L.B.B. |
| Title |
Navigating the final journey: Dying in residential aged care in Aotearoa New Zealand |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Palliative care; Older people; Rest homes |
| Abstract |
New Zealand statistics project that the aging population of people aged 65 years and over will more than double in the next decade. This has implications for palliative care providers including hospices and hospitals because long-term inpatient care is not generally provided by hospitals and hospices. When dying patients need long-term care, residential settings become an option. The level of palliative care in these facilities is dependent on staff training and numbers. In general, staff are not trained in palliative care, neither do they provide the multidisciplinary facets that define palliative care as undertaken by hospices. This paper describes a practice development initiative using storytelling as the vehicle for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient into residential aged care settings. With the emergence of a reflective paradigm in nursing the concept of storytelling as a teaching/learning tool has grown. Many staff in residential care settings come from diverse ethnic backgrounds where for some, English is their second language. Storytelling therefore can be a useful approach for learning because it can increase their communication skills. The author suggests that the Liverpool Care Pathway for the dying patient is a model that can be translated across care settings, hospice, hospital, and community. It can demonstrate a framework that facilitates multiprofessional communication and documentation and embraces local needs, culture and language to empower health care workers to deliver high quality care to dying patients and their family/whanau and carers. This paper also explores the role of a facilitator as an agent of change and discusses how the interplay of evidence, context and facilitation can result in the successful implementation of the LCP into residential aged care settings. |
| Call Number |
NRSNZNO @ research @ |
Serial |
683 |
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| Author |
Elliott, M.M. |
| Title |
Model of care development: Moving between liaison and complex care coordination in the community health setting |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Community health nursing; Nursing models |
| Abstract |
Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services. |
| Call Number |
NRSNZNO @ research @ |
Serial |
684 |
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| Author |
Martin, H.E. |
| Title |
Marking space: A literary psychogeography of the practice of a nurse artist |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Psychiatric Nursing; Mental health; Nurse-patient relations |
| Abstract |
The author suggests that the thesis as a production of disciplined work presented in a creative style is congruent with performance and presentation best practice in community arts. As a practising nurse artist the author describes creating spaces of alternate ordering within the mental health field environment. “I also inhabit the marginal space of the artist working in hospital environments. This Other Place neither condones nor denies the existence of the mental health field environment as it is revealed. Yet, it seeks to find an alternative to the power and subjectivity of the [social] control of people with an experience of mental illness that inhabit this place both voluntarily and involuntarily. I have used a variety of texts to explore the experience and concept of Otherness. The poems are intended to take you, as a reader where you could not perhaps emotionally and physically go, or might have never envisaged going. They also allow me as the author to more fully describe the Otherness of place that is neither the consumer story nor the nurse's notation, but somewhere alternately ordered to these two spaces. Drawing on the heuristic research approaches of Moustakas and literary psychogeography , particularly the work of Guy Debord, this thesis creates the space to explore the possibilities of resistance and change and the emergence of the identity of the nurse artist within the mental health field environment”. |
| Call Number |
NRSNZNO @ research @ |
Serial |
685 |
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| Author |
Mulcahy, D.M. |
| Title |
Journeys cross divides: Nurses and midwives' experiences of choosing a path following separation of the professions |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Midwifery; Nursing; Policy; Careers in nursing |
| Abstract |
In 2003 the Health Practitioners Competence Assurance Act was introduced and established separate regulatory authorities for nursing and midwifery. This study is designed to explore the experiences of dually registered practitioners affected by this divide, as now there are two separate and possible paths, and two corresponding sets of competencies to fulfil. The design for this qualitative descriptive study utilised the written and oral narratives of three practitioners affected by this professional regulation and demonstrated its impact on their career development. Individual storytelling, as narrative, provided a theoretical lens aiding insight into their experience and pattern of decision making. In addition, symbolic consideration of the study data was provided by collective storytelling via the perennial myth of the hero journey. Shifting professional ground following the Health Practitioners Competence Act 2003 generated a focus for the inquiry into practitioners' modes of adjustment. For the practitioners in the study, transition between the occupational roles of nursing and midwifery comprised the possible career trajectories. A status passage, as the process of change from one social status to another, is described and includes the transitional experience of anticipation, expectation, contrast, and change. The author suggests that the findings from this research provide illumination of the nuances of professional decision making as a lived experience, and highlight how these practitioners dealt with shifting meaning, values, awareness, choices, and relationships. Aspects of group agency and identity, change management, and professional role transition were revealed. Life pattern, revealed through narrative, was an important research construct for exposing the ways in which the participants negotiated change, and displayed the function of their thinking and reasoning through dilemmas. Perception of individual and group identity revealed attitudes of esteem to the dominant discourse, and exposed dynamic tension between work patterns and life stage. Renegotiating arrangements of personal and professional commitment resulted from this dynamic interplay, and the relationship to stress and burnout was explored. |
| Call Number |
NRSNZNO @ research @ 700 |
Serial |
686 |
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| Author |
Watkins, B.E. |
| Title |
Making meaning of a personal experience of discrimination in relation to a disability: An exploration of the literature |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
People with disabilities; Nursing |
| Abstract |
This paper explores the reaction of the author's colleagues when she returned to work disabled after recovering from an injury. In order to understand the new experience of disability and discrimination and to help answer what changed the behaviour of colleagues, the author considered evidence from the published literature. After considering many different models of disability, the social model of disability helped clarify and frame her own experience. Reflecting on this literature and personal experience, she suggests that there is acknowledgement that society's attitudes are changing slowly through governmental action and the activism of the disabled. However, she goes on to say, it is only through progressing education, experiencing disability, and continuing emancipatory research that progress will be made to release people with disabilities from their bonds of prejudice and oppression. |
| Call Number |
NRSNZNO @ research @ 734 |
Serial |
720 |
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| Author |
Scott, W. |
| Title |
Listen to the beat of my heart: The lived experience of panic attack in undergraduate nursing students: An interpretive inquiry |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Psychology; Students; Nursing; Midwifery |
| Abstract |
This interpretive inquiry explores the lived experience of 3 undergraduate nursing students and one midwifery student who have panic attacks. The aim of the research is to give voice to these students and to raise awareness among nurse educators about the impact that panic attacks may have for them. The research question asks, “what is the lived experience of panic attack in undergraduate nursing students?” A semi structured interview was conducted with each student in order to gain significant data. The research identified four key themes implicit to the lived experience of panic attack analysis: Listen to the beat of my heart (embodiedness), fearfulness, shamefulness, and holding one's own (coping). The findings suggest that the lived experience of panic attack is embedded in the lifeworld of lived body, lived time, lived relation, and lived space. Panic attack affects students physically and emotionally and interpersonally. The significant finding is that nurse educators need be aware of the coping or non-coping strategies used by students and, most importantly, recognise the impact that panic attacks have on their study. |
| Call Number |
NRSNZNO @ research @ 735 |
Serial |
721 |
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| Author |
Chapman, C. |
| Title |
The elective way: An exploration of pre-operative education for orthopaedic joint replacements |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Patient satisfaction; Surgery; Education |
| Abstract |
This research paper provides a description and analysis of literature and research focusing on pre-operative education programmes available internationally and nationally for patients receiving total joint replacements. This discussion differentiates between pre-assessment and pre-operative education to provide an understanding that both aspects are important in there own right. Together pre-assessment and pre-operative education complement each other to provide total care for patients awaiting total joint replacement surgery. One way of alleviating apprehension experienced by the patient about their surgery is by providing appropriate joint replacement education programmes that meet their needs. This type of programme is a form of empowerment which provides patients with appropriate and relevant information. This allows the patient to be actively involved in their own care and enable them to make informed decisions. The importance of education, information and communication; anxiety and pain; family and peer support; mobility and insecurity is a common thread in the literature where patients describe their experiences and concerns following a total joint replacement. These concepts are discussed and related to why pre-operative education programmes are recommended to help alleviate patients concerns and are important in providing a total multidisciplinary approach to care. |
| Call Number |
NRSNZNO @ research @ 736 |
Serial |
722 |
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| Author |
Ramsamy, K. |
| Title |
Colonisation: The experience of a psychiatric nurse through the lens of reflective autobiography |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Cultural safety; Colonisation; History; Nursing |
| Abstract |
The author points to the oppression of colonisation living on in the daily lives of colonised people, and goes on to say that it is vital for nurses to understand the effects of that oppression, as well as the restrictive impacts, and dislocation from one's land and culture to-day. Nurses come from both the descendants of colonisers and the colonised. This thesis is a journey and a quest for insights into the impacts and significances of colonisation by looking at historical and socio-political contexts that have bearing on the health of colonised people who remain mostly powerless and marginalised. It is prompted in response to a cultural safety model which advocates that nurses should become familiar with their own background and history in order to be culturally safe in practice. This reflective autobiographical account is a personal effort and provides the foundation for an exploration of issues during nursing practice encounters, from a colonised ethnic minority perspective. The method was informed by Moustakas research approach and Johnstone's Reflective Topical Autobiographical process. The selection of specific events are deliberate, to make visible some of the many barriers that exist within our health structures as pertinent issues for non-dominant cultures that remain on the margin of our society. Maori issues provide a contrast and became a catalyst for the author while working for kaupapa Maori services. The intention of this thesis is to generate new knowledge about what it means to be a nurse from an ethnic minority working in a kaupapa Maori mental health service, and to encourage other nurses to explore these issues further. Some recommendations are made for nurses in the last chapter. |
| Call Number |
NRSNZNO @ research @ 739 |
Serial |
725 |
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| Author |
Noble-Adams, R. |
| Title |
Being and becoming an exemplary nurse: An authentic journey |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Nursing philosophy; Nursing; Education |
| Abstract |
The aims of this study were to illuminate the joint constructions of exemplary nurses and their lived experiences of being and becoming one. Inherent in being 'exemplary' was the notion of 'becoming', which involved the integration of knowledge and experiences through reflecting on the day-to-day of 'being a nurse'. Being exemplary was not about perfection but learning from every experience and integrating these into becoming. The author developed a creative qualitative and participatory method. Ten exemplary nurses were recruited and interviewed three times. They also provided supplementary data such as photos, poetry and writings. Analysis occurred through first and second level categorising and the use of writing as method. Writing became a way of knowing – assisting discovery and allowing reflection on the data in order to connect the categories and themes together in a coherent and workable whole. The author reports that the above method led to the following emergent findings. The pivotal construct was Authentic Being, through living a reflective life, surrounded by the major constructs of Love of Nursing, Making a Difference, Critical Friends, Walking the Talk and Backpack patients. These constructs directed a specific and comprehensive review of both the philosophical and nursing literature. This review was not used to expand or enlarge the findings but to enlighten, illuminate and clarify. Significant philosophical ideas were extended, developed and synthesised with the findings. The author suggests that the new knowledge that emerged from this research has profound implications for everyday nursing practice, undergraduate and post graduate nursing education, and for Charge Nurses and Senior Nurses, who are of vital importance as role models, mentors and critical friends. The results are significant and are important for nurses and the nursing profession and contribute to, and advance, nursing knowledge. |
| Call Number |
NRSNZNO @ research @ |
Serial |
729 |
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| Author |
Dal Din, A. |
| Title |
Accepting the challenge: Registered nurses' experiences of undertaking the statutory role of Responsible Clinician in New Zealand |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Mental health; Registered nurses; Nursing specialties; Scope of practice |
| Abstract |
This aim of this thesis was to explore and describe registered nurses' experiences of undertaking the statutory role of Responsible Clinician under the Mental Health (Compulsory Assessment and Treatment) Act 1992. The role of Responsible Clinician has been available to nurses since 1992 yet to date there has been little research into nurses' experiences of undertaking this role. An exploratory descriptive approach was therefore used in this study. A convenience sample of four nurses who had been undertaking the role of Responsible Clinician was recruited. Their experiences were elicited through in-depth interviews. Analysis of the interview material revealed the themes of legitimacy, relationships, expanding practice, responsibility and accountability, approaches to care, nurses' responsiveness to the role and support of the role. The author points to this research being important to nurses who are working in the psychiatric mental health area so that they can understand the role more fully. In this way, more nurses may choose to undertake the role of Responsible Clinician. |
| Call Number |
NRSNZNO @ research @ 745 |
Serial |
731 |
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| Author |
Kempthorne, A. |
| Title |
Why do nurse graduates choose to work in the area of mental health? |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Careers in nursing; Psychiatric Nursing; Mental health |
| Abstract |
The low numbers of nurses attracted to work in mental health is a concern particularly with the increased demand for mental health services. Strategies are required to increase recruitment to this less popular area of nursing to ensure that a high quality of care is provided for people suffering from mental illness. The World Health Organisation is aware that this area of health has been neglected and that it is time to promote mental health. This study aimed to examine the influences involved in nurses choosing to work in this area. A descriptive survey using a questionnaire was given to seven groups of new graduates enrolled in the New Graduate Mental Health Nursing programme through five educational institutes. At the time of writing there were no published studies around this topic in New Zealand. This study will attempt to inform nurses, the Nursing Council of New Zealand, tertiary institutions and the government of New Zealand that there is evidence of a need to develop and change practices to address the predicted workforce decline. |
| Call Number |
NRSNZNO @ research @ |
Serial |
733 |
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| Author |
Blackmore, L.A. |
| Title |
Triaging patients away from the emergency department: A review of the issues |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Emergency nursing |
| Abstract |
With the intention of decreasing emergency department demand, there has been a focus on determining those patients who do not require the services of the emergency department so they can be redirected away to an alternative health care provider or facility. Co-locating an after-hours primary health care facility near to the emergency department is a model under consideration in some district health boards. This model suggests that a substantial proportion of the patients currently managed in the emergency department can be assessed and managed in a general practice setting. It is envisaged that by redirecting the lower acuity patients away from the emergency department, overcrowding will be relieved. This is despite evidence demonstrating that low acuity patients are not the cause of emergency department overcrowding. Moreover, being treated at the emergency department is the only safety net for many people in the community who cannot afford alternative care. This research report discusses the literature regarding the practice of referring or redirecting patients away from the emergency department and the issues associated with this model. In doing this, it looks at the Australasian Triage Scale, the system used to ensure patients are seen in order of clinical urgency, because it has been suggested that this system could be used as a tool to refer patients away from the emergency department. The author concludes that even though some people could be seen by another health care provider, the triage system is not an appropriate tool for achieving this. While it is tempting to believe that patients in the lower triage categories are prime candidates for being referred away, there is evidence from hospital statistics that patients in these categories have a high number of hospital admissions and in-hospital death rates. Additionally, to complicate matters, there is no universal definition of what constitutes an 'appropriate' emergemcy department presentation and no consensus of opinion amongst health professionals in deciding patients' 'appropriateness'. For these reasons it is unethical to expect nurses who administer the triage system to use it for the purpose of referring people away from the emergency department. |
| Call Number |
NRSNZNO @ research @ |
Serial |
736 |
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