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Author Shanks, A.
Title Stories within stories: What are client stories and how do community mental health nurses work with them? Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Mental health; Psychiatric Nursing; Nurse-patient relations
Abstract There is limited nursing research as to how mental health nurses work with client stories. Furthermore mental health nurses have not been asked how they would define a client story within their practice. Client's stories allow promotion of the storyteller's experience leading to increased self awareness by supporting growth, and personal development of the individual through exploration of their experience. While listening and working with these stories, mental health nurses are able to interpret, reframe and validate the experiences and meanings disclosed over time. Three community mental health nurses were interviewed about how they identified client stories within their clinical practice. They explained how they created an environment for stories to be told, and worked to enhance meanings, and view alternative possibilities by 'carrying' the story until the client was ready to explore it. By working and understanding stories, mental health nurses were able to work collaboratively with the client to provide humanistic care. Themes of therapeutic relationship, purposeful use of self, and narrative as therapy were identified within the nurse's stories, providing an understanding of how mental health nurses practice. This study was framed by narrative inquiry and influenced by Riessman and Polkinghorne. Core stories are presented from the analysis of the nurses stories about how they defined 'story' and worked with the client stories.
Call Number NRSNZNO @ research @ Serial 738
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Author Tuitea, I.
Title Solution focused nursing: An alternative model for assessing psychosis and mai aitu in mental health Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Pacific peoples; Mental health; Psychiatric Nursing; Culture
Abstract The objective of this paper is to establish if there is any documented research and literature evidence that describe what the presenting clinical symptoms of Mai Aitu is, and also to explore an alternative frame-work to assess Pacific Islanders who present to mental health in crisis. As a community mental health nurse in the Crisis Assessment and Treatment Team (CATT), the author reports being confronted almost every day with an increasing number of Pacific Islanders presenting in crisis with symptoms consistent with the well documented signs of psychosis. For instance, symptoms like hallucinations, delusion and paranoid ideation which are also well known for describing schizophrenia. Her concern is that mental health nurses may be compromising their practice, the safety of the Pacific Island population and possibly the credibility of the profession with what appears like a lack of knowledge and awareness regarding the clinical symptoms of some Pacific Island mental illness. In Tonga it is called Avea Avanga, in Fiji it is referred to as Lialia, in Samoa it is known as Mai Aitu. The author notes that the issue becomes apparent when Samoan clients present in crisis with what appears to be psychosis but the fanau believe their love one is not mentally unwell, that he or she is simply suffering a traditional Samoan illness. Therefore they insist he or she be treated at home, instead of through admission to the psychiatric hospital, and also that they be seen by a Samoan healer instead of a psychiatrist.
Call Number NRSNZNO @ research @ 753 Serial 739
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Author Lindsay, N.M.
Title Skeletal attraction: Childcare provisions and the recruitment and retention of orthopaedic nurses in New Zealand Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Recruitment and retention; Nursing specialties
Abstract New Zealand's ageing population is predicted to have increasing degenerative musculoskeletal changes affecting both mobility and morbidity. In response, the New Zealand government is supporting a one hundred per cent increase in the number of elective joint replacements performed across the country from 2004 to 2008. However, like other specialties, orthopaedic nursing is experiencing shortages. In order to improve the recruitment and retention of orthopaedic nurses, as with other nursing specialties, childcare is offered as a strategy for consideration. In 2005, New Zealand parents indicated in an online survey, that in order for them to work, they needed affordable, quality and conveniently located childcare. Nurses have similarly indicated the importance of childcare when considering and managing a balance between their work and home lives. This paper explores contextual work and home life balance dialogues in relationship to nursing recruitment and retention issues and New Zealand nursing. Childcare as a recruitment and retention strategy, is explored in the context of New Zealand nursing and compared with the childcare strategies employed for nurses by Britain and Australia – New Zealand's major competitors for New Zealand nurses. The author concludes that, in light of the international shortage of nurses, childcare is an important recruitment and retention strategy which is currently absent in many of New Zealand's district health boards. Recommendations are offered to support the balance between work and home life for nurses and reconcile orthopaedic nurses to the clinical setting in order to provide the quality and efficient care that is needed for New Zealand's ageing society.
Call Number NRSNZNO @ research @ Serial 740
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Author Dorofaeff, M.J.
Title Shared status and advocating practices: Nurses who work with clients who have a co-existing intellectual disability and mental health problem Type
Year 2007 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Mental health; Psychiatric Nursing
Abstract This research is informed by the interpretive phenomenology of van Manen, and explores the lived experience of nursing from the perspective of nurses who provide care for people with a co-existing intellectual disability and mental health problem. Although nursing research is commonly informed by phenomenology, there is a dearth of literature of any description written from the perspective of nurses who provide care for people with intellectual disabilities and mental health problems. As a result of the closure of many large institutions in New Zealand there are not many nurses who work with people who have intellectual disabilities and co-existing mental health problems. The study participants were four nurses purposefully selected because they provided care for people with intellectual disabilities and mental health problems. Data was collected using semi-structured interviews, and the researcher identified and wrote about the recurring themes in the transcribed interview data, which best captured the lived experience of the participants. The themes were: criticism of services, holistic caring, working with the client, issues of status, need for specialist knowledge, enduring relationships, diagnostic issues, advocating, modelling good practice; and working alongside. After further analysis the themes were encompassed within the larger interrelated themes of “Status and positioning” and “Advocating practices”, and finally within a single theme of: “The status and positioning of the nurse and the client leads to advocating practices.” These themes were found to be consistent with the nursing literature and with the researcher's own lived experience as a nurse who works in a specialist mental health intellectual disability service. The findings of this research have implications for a number of groups in New Zealand. Among the author's conclusions are that input is required from the Nursing Council of New Zealand, the nursing profession, nurse educators and the government to raise the status of clients with co-existing intellectual disabilities and mental health problems and the nurses who work with this client group. In addition, the roles for nurses who work with this client group are emerging and are likely to be diverse and there is a need for further research to capture the different experiences of these nurses.
Call Number NRSNZNO @ research @ Serial 747
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Author McLean, J.M.
Title Pushing the boundaries: Relationships with adolescents Type
Year 2007 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Psychiatric Nursing; Mental health; Adolescents; Nurse-patient relations
Abstract Therapeutic relationships are central to mental health nursing. The nurse's role in maintaining professional yet therapeutic boundaries within this relationship can be challenging. When therapeutic boundaries are breeched within the nurse adolescent relationship the adolescent's safety within this relationship is compromised. There is currently limited literature on how nurses are managing professional boundaries in relationships with adolescents in this setting. The adolescent's nature is to push boundaries; therefore the nurse needs to be acutely aware of this boundary pushing in everyday practice settings. For the safety of the adolescent and the nurse it is vital the nurse understands her role in managing the professional boundary. This thesis explores, through the use of narrative inquiry, four adolescent mental health nurses' experiences of assessing, understanding and maintaining therapeutic boundaries with adolescents in a mental health setting in New Zealand. The unique and specific implications for adolescent mental health nursing are discussed. Three key themes emerged from the analysis and findings: the importance of the nurse clarifying his/her role; the learning that occurs throughout the practice journey; and the role of the nurse in keeping the adolescent and the nurse safe. These findings highlight the importance of clinical supervision and open communication with senior nurses and mentors, which assist the nurse in monitoring practice. When nurses do not have sufficient knowledge of the fundamental principles of adolescent mental health nursing; such as knowledge and skills in both adolescent development and psychodynamic nursing, they are at risk of boundary crossings. Recommendations from this research include more emphasis on psychodynamic nursing principles in nursing education and nursing practice. There is a need for specialised education for nurses in child and adolescent mental health nursing. Nursing entry to practice programmes for new graduate nurses working in mental health, could assist in providing this. There is a call for further research into therapeutic relationships and professional boundaries in this complex nursing specialty.
Call Number NRSNZNO @ research @ 762 Serial 748
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Author Lee, S.V.
Title The advanced practitioners' guide to integrating physical and mental health: Introducing the role of the mental health consultation liaison nurse Type
Year 2005 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Advanced nursing practice; Mental health; Nursing specialties
Abstract Evidence within the literature highlights that staff within the general hospital wards are not necessarily equipped to assess and meet the needs of patients with mental health or behavioural problems. The author notes that this is cause for concern as a number of people requiring admission to the general wards often have a complex, interrelated combination of physical and mental health problems. Within New Zealand there have also been a number of changes to health care policies that have increased general nurses contact with mental health patients over the last decade. The Mental Health Consultation Liaison Nurse is an advanced nurse specialist who can meet this need. Having reviewed the literature and communicated with Mental Health Consultation Liaison Nurses in New Zealand and Australia, the author says it is clear that the availability of a mental health nurse within the district health board general wards would be advantageous to all. The role has been shown to positively influence the care of patients and benefit other health care professionals. It provides an improved system of care that is co-ordinated, integrated and responsive to the needs of patients and health care staff. The implementation of the Mental Health Consultation Liaison Nurse role has the potential to cut costs in relation to decreasing length of stay with untreated mental health issues, and reduce the cost of continued use of 'specialling' unnecessarily. Also of importance is the fact that such a position would assist the district health board to comply with the standards of health care provision as directed by the Mental Health Commission and the Ministry of Health. The author suggests that the introduction of the Mental Health Consultation Liaison Nurse role represents a change in traditional ways of providing general nursing and consequently there are a number of issues that may hinder its success. This dissertation aims to increase the visibility of mental health nursing and provide a resource for others debating the development and implementation of the Mental Health Consultation Liaison Nurse role.
Call Number NRSNZNO @ research @ Serial 771
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Author Sheward, K.A.
Title Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying Type
Year 2005 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Palliative care; Hospitals; Communication; Nurse-patient relations
Abstract The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.
Call Number NRSNZNO @ research @ Serial 772
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Author Maries, V.J.
Title Chosen moments: A reflective journey illustrating terminally ill patients choosing the moment to die Type
Year 2004 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Terminal care; Palliative care; Nurse-patient relations
Abstract In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result. The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars. This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time.
Call Number NRSNZNO @ research @ Serial 773
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Author McKergow, C.R.W.
Title Preparing to care in the 21st century: A personal search for the meaning of ontological competency through an embodied journey of the soul Type
Year 2002 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing; Professional development; Breast cancer; Cancer
Abstract This thesis is a philosophical inquiry that reflects a personal search for the meaning of ontological competency undertaken by the author after developing breast cancer. The text weaves together in creative synthesis, a collection of academic and personal writing undertaken during an MA (Applied) in Nursing degree process. Using the work of Dowling Singe (1999), Watson (1999), and Wilber (1985, 1990, 1991 & 2000), the thesis seeks, through the use of reflective autobiographical inquiry (Johnstone 1999a), to explore the personal meaning-making activities engaged in during this time to throw light upon the nature of nurse / nursing being. Exploring developmental schemata drawn from personal experience and illuminated by theory, nurses and nursing are challenged to become more self-reflective and self-aware. To facilitate the personal and professional growth that underpins notions of ontological competency, various aids in the form of maps and models are provided to support a transformative journey into awareness. From this position of expanding consciousness, the nurse / nursing is encouraged to reach beyond current paradigms, metaparadigms, epistemologies, and restrictive philosophies and to yield to the evolutionary imperative that seeks to prepare for a 21st century clinical practice where caring / healing becomes embodied enactment from “the Ground of All Being”.
Call Number NRSNZNO @ research @ Serial 774
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Author Kupa, S.
Title Psychogeriatric nursing: A review of the literature Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Mental health; Older people; Geriatric nursing; Age factors
Abstract This paper is a literature review of the psychogeriatric specialty and describes the clinical role, practice and knowledge of the psychogeriatric nurse. Literature reviews provide a useful means for evaluating what is currently known and understood in a particular area of interest to help nurses' build current opinion into practice. Psychogeriatric nursing is a specialised field of practice that focuses on the mental health needs of people over the age of 65 (including younger people who have acquired needs that are similar in 'like' and age and 'interest'). The literature asserts the urgent need to develop the role and practice of the psychogeriatric nurse in order to address the complex needs of our ageing population in areas such as home care, hospitals, primary health, and long term care institutions. The findings highlight aspects of nursing care that are essential to the role and practice of the psychogeriatric nurse. Knowledge that is necessary for best practice in psychogeriatric nursing care is drawn mainly from the field of general psychiatry and gerontology but also from general medicine, psychology, neurology, and disability. Nurses' working with older adults affected by psychogeriatric conditions must possess a broad knowledge of physical and mental health issues that affect the elderly, including also knowledge and understanding of psychosocial risk factors that can also have an impact on the health and behaviour of older people and their carers. Despite these literal assertions however there appears to be a dearth of literature available to support the requirements for developing the psychogeriatric nursing specialty in clinical practice, research, and education. The author notes that authorities in this specialised field of practice generally agree that with an increasing aging population looming in the future more research in the field of “old age psychiatry” will be critical.
Call Number NRSNZNO @ research @ Serial 775
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Author O'Reilly, A.F.
Title Relinquishing personhood in dementia: Discordant discourses: A nurse's inquiry Type
Year 2002 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Dementia; Nursing; Nurse-patient relations; Relationships
Abstract This thesis traces the journey of the author's inquiry into family members' experience of the relinquishment of the personhood of a loved one with a dementia; a journey in which she reports that her own prior understandings were significantly challenged. The study was prompted by her experience of working in the area of dementia care and hearing, in the course of the working day, comments such as 'there's nobody there' made in relation to someone suffering from severe dementia. Such comments appear to imply that the person of the dementia sufferer in some way is no longer present. They are comments which relate to the very nature of personhood. The study takes impetus from the fact that the ways in which nurses view the personhood of dementia sufferers has significant consequences for the ways in which they respond to dementia sufferers and their families. This thesis, which retells the stories of four family members who each have a loved one with a dementia illness, reveals that rather than there being a unified concept of personhood in dementia, and in spite of the fact that particular understandings of dementia and personhood dominate our cultural conversations, in their day to day lives these four family members managed and made sense of their experience through particular and different ways of looking at the impact dementia has on the personhood of dementia sufferers. Not all did, in fact, relinquish the personhood of their family member. In their lived lives, the four research participants had recourse, each in different ways, to multiple discourses of personhood. For some, in addition to loss, there was also unexpected gain. This finding necessitated and shaped further inquiry into discourse and the role of discourse in shaping, constraining and opening up possibilities for meaning, and into the two substantive areas of dementia and personhood. Nurses work closely alongside the family of dementia sufferers who are daily faced with the challenge of managing and making meaning of that situation. It is critically important that they are able to recognise, validate and support the variety of needs that family members have. Nurses, whose education is traditionally based on a biomedical framework, are nevertheless often required to mediate between different understandings. Not only do they need currency of knowledge in the rapidly changing biomedical field of dementia, but they need also an understanding of the role and the power of discursive constructions of both dementia and personhood. Such understanding will provide insight into alternate ways of understanding these concepts. However, although such understanding is critical for nurses working in this area, the author suggests that nursing literature has not brought these discussions to the fore.
Call Number NRSNZNO @ research @ 792 Serial 776
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Author Archer, L.K.
Title We talk what we do: An exploration of the value, role and function of storytelling in nursing from one nurse's practice perspective Type
Year 2001 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing; Palliative care; Professional development
Abstract The role of storytelling in any society fulfils multiple functions such as maintaining culture, holding history, teaching genealogical lessons, imparting wisdom, entertaining, passing on knowledge. The author suggests that nursing, historically described as a craft with an oral tradition, could be seen to be quietly moving away from the practice of storytelling. Or has it? She asked this question and began to realise that her practice and relationships with colleagues had always been based on stories and storying. To explore this phenomenon, she began to describe her day to day practice in story form, and began to position stories she had previously written. In her work of oncology palliative care nursing within a community setting in New Zealand, the stories proved crucial to her role as an educator, and companion of patients and their families. In this paper she examines how she uses story for her benefit, the patients' benefit, but mainly for the benefit of nursing. She examines from her own perspective, some underlying themes that reinforce the need to continue this ancient tradition and explore the role, value and function of storytelling within nursing.
Call Number NRSNZNO @ research @ Serial 788
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Author Logan, C.M.
Title Anaesthetic nursing: Focusing perioperative practice on the patient Type
Year 2000 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing specialties; Advanced nursing practice; Nurse-patient relations; Nursing; Education
Abstract The purpose of this literature review is to generate a picture of what is known and what needs to be investigated further about anaesthetic nursing in the perioperative nursing role in New Zealand, and to examine this in relation to international trends. Nurse anaesthetists in the United States are described in American nursing literature, and recognised as one of the four advanced nurse practitioner roles. In New Zealand, recent efforts to provide appropriate post-graduate education for the perioperative nurse have been challenged by other inter-professional interests, thus restricting the development of an expanded role. The author notes that this has caused concern for New Zealand's perioperative nurses who consider anaesthetic nursing is an integral part of perioperative practice. Anaesthetic nursing forms a substantial component of the basic competencies required of a registered nurse working in the operating theatres. Orientation programmes and ongoing education at all levels of professional development incorporate anaesthetic nursing competencies to provide continuity of patient care and support perioperative practice. Care of the patient undergoing anaesthesia is an area where nurses demonstrate their advanced assessment skills and clinical judgement and is included in perioperative specialist or nurse practitioner job descriptions. The Perioperative Nurses Association in New Zealand is concerned to develop postgraduate education in their area of speciality to support their application for 'College' status within the New Zealand Nurses Organisation. For this to happen in a cogent fashion, information and knowledge generated from research, are required to clarify perioperative nursing's current position and determine how practice can be shaped to best care for patients undergoing surgical interventions. Evidence from research supports nurses in the anaesthetic role by demonstrating that the preoperative visits and assessments they undertake can reduce patients' anxieties, decrease the need for pain relief and shorten hospital stays. This review includes literature sources that explore disparities between the development of New Zealand anaesthetic nursing and international models. The author suggests that information and understanding gained from conducting this review will allow future developments in anaesthetic nursing practice to be informed by previous initiatives and projects and identifies areas for further research.
Call Number NRSNZNO @ research @ Serial 790
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Author McClunie-Trust, P.
Title Body boundaries and discursive practices in life threatening illness: Narratives of the self Type
Year 2000 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Nurse-family relations; Nursing; Ethics
Abstract This thesis tells a story from within and between the boundaries of my professional work as a nurse and my private life as the wife of a patient with life threatening illness. The events related in the thesis are told using a technique I have called writing back to myself, where my own journals and stories of the experience of living with life threatening illness provide data for analysis. The reader is invited to participate in these representations and to consider the potential for the skilful practice of nursing which may be read in the stories, and the analysis I have developed from them. I have developed the theoretical and methodological positionings for the thesis from the work of Foucault (1975,1979,1982,1988), Deleuze (1988), Ellis (1995), Richardson (1998) and other writers who utilise genealogical or narrative approaches. The analysis of my own stories in the thesis explores the philosophical and contextual positionings of the nurse as a knowledge worker through genealogies of practice and the specific intellectual work of the nurse. Local and contextual epistemologies are considered as ways of theorising nursing practice through personal knowledge, which is surfaced through the critical analysis of contextual positionings and the process of writing as inquiry.
Call Number NRSNZNO @ research @ Serial 791
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Author Robertson, G.
Title Disquiet in the development of clinical supervision for professional development in nursing practice: A literature review Type
Year 2000 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Clinical supervision; Professional development; Nursing
Abstract Nursing literature reflects that nurses have been exploring and experiencing the process of clinical supervision for well over a decade. Nurses in the United States, United Kingdom, Scandinavia, and Australasia have written much over the past fifteen years. However, the author notes that nurses grapple with what clinical supervision is within nursing development and disquiet continues to emerge in the literature. This literature review expands on themes that surround this disquiet. These centre on continued confusion and lack of clear definition; whether psychotherapy is implemented under the guise of clinical supervision, who uses it, and the dearth of empirical evaluation of its effectiveness. The lack of significant empirical evidence of its ability to assist practitioners to deliver improved patient/client care continues despite claims of improved professional and personal development, therapeutic relationship, and occupational stress management. These claims come from both supervisees and supervisors. The manner in which clinical supervision is portrayed in nursing in that it is frequently referred to as a support system, rather than one of learning a complex set of communication skills is also highlighted. The continued debate on what model(s) best suit nurses, or whether line management should provide clinical supervision as a means to ensure quality standards and control over nursing practice and optimal patient care is discussed. Whether nursing should stop borrowing from other fields and develop their own model(s) is also raised. Two emerging stances focus on a process that is practice-based as identified by senior staff and management, or one that continues along the lines of what psychotherapy has developed with practitioner-identified developmental needs. These issues raise many questions for further development in nursing, one being are nurses developed enough in their self-awareness to understand what they are to adopt into their practice? Authentic voices from those nurses experienced in the practice of providing and receiving clinical supervision, are shaping therapeutic practice for nurses in the future, and continue to sharpen the debate. Some reference to unpublished data and local practice in the Wellington area have been included as a stimulus for further incorporation of clinical supervision in local practice development.
Call Number NRSNZNO @ research @ Serial 794
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