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Author |
Evans, S. |
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Title |
Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes |
Type |
Journal Article |
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Year |
2003 |
Publication |
Pediatric Intensive Care Nursing |
Abbreviated Journal |
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Volume |
4 |
Issue |
2 |
Pages |
7 |
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Keywords |
Nursing specialties; Intensive care nursing; Equipment and Supplies |
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Abstract |
The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation. |
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Call Number |
NRSNZNO @ research @ |
Serial  |
926 |
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Author |
Wilson, S.K. |
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Title |
Reconstructing nurse learning using computer mediated communication (CMC) technologies: An exploration of ideas |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Computers; Technology; Nursing; Education |
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Abstract |
Computerised technology has become a way of life. As nurse graduates enter a computer driven health care system we have a responsibility as nurse educators to ensure that they are computer familiar as borne out by the recent discussion papers released by the Nursing Council of New Zealand (2000a), which define the requirements for the practitioner of the future. Concurrently there is a call from the discipline of nursing for practitioners who have a form of knowledge that will bring about change within the socio-political context of the discipline as an outcome of critically reflective knowledge skills. Jurgen Habermas' (1971) treatise on knowledge and human interests, which offers a multi-paradigmatic approach to three forms of knowledge culminating in the emancipatory form provides a conceptual framework for many under-graduate pre-registration nursing curricular in Aotearoa-New Zealand. This thesis explores the author's ideas about contemporary undergraduate pre-registration nursing preparation in Aotearoa-New Zealand, associated knowledge outcomes, and the consequent links with contemporary computer-mediated communication (CMC) technologies. It positions a framework for integrating CMC technologies and the action of critically reflective practice as a learning journey. The framework is hypothetical and pragmatic. It emerges from the exploration of the thesis and is posited as a way toward integrating CMC technologies within extant undergraduate pre-registration nursing curricular in Aotearoa-New Zealand. The learning journey is comprised of three dimensions, learning-for-practice, learning-from-practice and learning-with-practice and draws on four different cyber constructs: being, knowing, relating and dialoguing. Knowing, relating and dialoguing are ontological positions taken in relation to being. The learning journey sustains some derivation from Habermasian (1971) based conceptual framework. There is a need for nurse educators to consider this in relation to contemporary CMC technologies. The author hope that this framework will serve those with an interest in nurse education and who are interested in a future using CMC technologies within the realities of nursing practice and education. |
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Call Number |
NRSNZNO @ research @ |
Serial |
904 |
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Author |
McKenzie-Green, B. |
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Title |
Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study |
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Year |
2003 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Older people; Registered nurses; Nurse-patient relations |
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Abstract |
Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities. |
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Call Number |
NRSNZNO @ research @ 912 |
Serial |
896 |
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Author |
Mears, A. |
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Title |
The role of the clinical nurse co-ordinator |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of the Australasian Rehabilitation Nurses Association |
Abbreviated Journal |
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Volume |
6 |
Issue |
3 |
Pages |
24-25 |
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Keywords |
Nursing; Nursing specialties; Older people |
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Abstract |
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Call Number |
NRSNZNO @ research @ 907 |
Serial |
891 |
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Author |
Lui, D.M.K. |
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Title |
Nursing and midwifery attitudes towards withdrawal of care in a neonatal intensive care unit: Part 1. Literature review |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Neonatal Nursing |
Abbreviated Journal |
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Volume |
9 |
Issue |
2 |
Pages |
45-47 |
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Keywords |
Attitude of health personnel; Neonatal nursing; Ethics; Technology |
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Abstract |
This article seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Advanced technology results in the survival of increasingly premature babies with extremely low birthweights and this has inevitably led to an increase in the ethical dilemmas faced by neonatal staff as to whether continued treatment is actually in the best interests of these infants. Part 1 reviews the literature on this subject. Part 2 describes the results of a survey carried out in a New Zealand NICU. |
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Call Number |
NRSNZNO @ research @ 906 |
Serial |
890 |
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Author |
Ho, T.; Mok, J. |
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Title |
Condensate clearance from CPAP circuit: An examination of two methods of draining condensate from the inspiratory tubing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Neonatal Nursing |
Abbreviated Journal |
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Volume |
9 |
Issue |
4 |
Pages |
117-120 |
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Keywords |
Neonatal nursing; Infection control; Equipment and Supplies |
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Abstract |
Clinical studies on adult ventilated patients demonstrate that bacterial contamination of the condensate occurs in ventilator circuits. The purpose of this research is to find out if this is also true of the condensate in the Continuous Positive Airway Pressure (CPAP) circuit. It aims to determine whether there is bacterial contamination in the humidifier reservoir of the CPAP system when the condensate is drained back into the humidifier reservoir without disconnecting the circuit, or when the inspiratory tubing is disconnected to drain out the condensate. |
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Call Number |
NRSNZNO @ research @ |
Serial |
889 |
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Author |
Pirret, A.M. |
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Title |
A preoperative scoring system to identify patients requiring postoperative high dependency care |
Type |
Journal Article |
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Year |
2003 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
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Volume |
19 |
Issue |
5 |
Pages |
267-275 |
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Keywords |
Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment |
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Abstract |
The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions. |
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Call Number |
NRSNZNO @ research @ 904 |
Serial |
888 |
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Author |
Wepa, D. |
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Title |
An exploration of the experiences of cultural safety educators in New Zealand: An action research approach |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Transcultural Nursing |
Abbreviated Journal |
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Volume |
14 |
Issue |
4 |
Pages |
339-348 |
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Keywords |
Cultural safety; Nursing; Education; Teaching methods; Organisational culture; Maori |
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Abstract |
This research is a study of the experiences of four cultural safety educators in nursing education in Aotearoa, New Zealand. Action research methods assisted the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action, and reflecting. The findings of the research revealed that the participants not only coped with everyday stressors of teaching but were also required to formulate knowledge for cultural safety. For the Maori participants, their stress was confounded with recruiting and retaining Maori students and macro issues such as commitment to their iwi (tribe). Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that many issues were organisational in nature and out of their control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations include the following: support for cultural safety educators to have a dialogue on a regular basis, the introduction of nurse educator programmes, paid leave provisions for educators to conduct and publish research so that a body of knowledge can be developed, and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burnout. |
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Call Number |
NRSNZNO @ research @ |
Serial |
887 |
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Author |
Day, W. |
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Title |
Women and cardiac rehabilitation: A review of the literature |
Type |
Journal Article |
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Year |
2003 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
16 |
Issue |
1-2 |
Pages |
92-101 |
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Keywords |
Cardiovascular diseases; Gender; Nursing; Research |
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Abstract |
This literature review explores some of the issues related to women's experience of cardiac rehabilitation and demonstrates that women's experience may be different to that of men. Much of the research related to coronary heart disease (CHD) has been performed using either exclusively male populations or such small numbers of women that the results from the women studied were unable to be analysed independently. The author advocates that nurses working within this area of practice require an understanding of women's experience of recovery from a heart attack in order to better meet their needs. |
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Call Number |
NRSNZNO @ research @ |
Serial |
879 |
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Author |
Smythe, E. |
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Title |
Uncovering the meaning of 'being safe' in practice |
Type |
Journal Article |
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Year |
2003 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
196-204 |
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Keywords |
Childbirth; Patient safety; Advanced nursing practice; Midwifery |
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Abstract |
This paper moves away from the prevalent discourse of competence to consider the meaning of the experience of 'being safe' within the context of childbirth. It offers findings from a doctoral study, informed by the philosophies of Heidegger and Gadamer. Following ethical approval, the data was collected in New Zealand by tape-recorded interviews of 5 midwives, 4 obstetricians, 1 general practitioner and 10 women. The method was informed by van Manen. The findings reveal that in seeking the meaning of being safe one needs to be aware that the unsafety may already be present in the situation. Practitioners may be able to do little to rectify the unsafeness. There is, however, a spirit of safe practice, explicated in this paper, that is likely to make practice as safe as it can possibly be. Wise practitioners are ever mindful that a situation may be or become unsafe, and are always aware of their own limitations. |
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Call Number |
NRSNZNO @ research @ |
Serial |
877 |
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Author |
Farrell, E. |
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Title |
A lamp to light the way: Public health nurses' perceptions and experiences of professional/clinical supervision |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Auckland University of Technology |
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Volume |
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Issue |
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Pages |
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Keywords |
Public health; Nursing; Clinical supervision; Professional competence |
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Abstract |
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Call Number |
NRSNZNO @ research @ 887 |
Serial |
871 |
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Author |
Van der Harst, J. |
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Title |
Inside knowledge: A qualitative descriptive study of prison nursing in New Zealand |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing specialties |
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Abstract |
Analysis of the research literature on prison nursing revealed a paucity of research, both in New Zealand and internationally. The aim of this research was to describe the working life of the nurse in a New Zealand prison and provide an understanding of and documentation on prison nursing in New Zealand. A qualitative descriptive study was undertaken to determine what it is like to nurse in a New Zealand prison. Ten nurses working at two public prisons and one private prison took part in the study. Data was collected by the use of semi-structured interviews and analysed thematically into four main themes. The participants' descriptions of their working lives as prison nurses expose the multifaceted nature of this work and the inherent relational dynamics. These dynamics determine the nurse's ability to practise effectively in the prison setting. Findings highlighted many paradoxical situations for nurses when working in this environment. The very aspects of the work that participants described as negative were also identified, in some instances, as challenging and satisfying. |
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Call Number |
NRSNZNO @ research @ 886 |
Serial |
870 |
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Author |
Stuart, J. |
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Title |
How can nurses address generalist/specialist/nursing requirements of the urban/rural population of Southland |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing specialties; Policy; Technology; Scope of practice; Community health nursing |
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Abstract |
This study, which is undertaken in the Southland area, explores the effect of the increasing specialisation of nursing services in what is a rural/urban environment. It is indicated in the literature that systemic changes in health, such as the health reforms, and the increase in the use of technology have meant that nurses are required to function in disease oriented roles rather than according to their more traditional generalist roots. A significant event, which also affected nursing scope of practice, was the transfer of nurse education to the tertiary education institutions environment from the hospitals in the mid 1970s. The traditional nursing hierarchy and its nurse leadership role disappeared and the adoption of specialist nurse titles increased, and identified with a disease or disorder, for example 'diabetes' nurse. The increase in specialist categories for patients contributed to the nurse shortage by reducing the available numbers of nurses in the generalist nursing pool. The nurses in this rural/urban environment require generalist nurse skills to deliver their nursing services because of the geographical vastness of the area being a barrier to specialist nurses. Workforce planning for nurses in the rural/urban then must focus on how to reshape the nursing scope of practice to utilise the existing resources. This study explores how key areas of health services could be enhanced by reclaiming the nurse role in its holistic approach, in mental health, public health, geriatric services and psychiatric services. |
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Call Number |
NRSNZNO @ research @ 885 |
Serial |
869 |
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Author |
Radka, I.M. |
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Title |
Handover and the consumer voice: The importance of knowing the whole, full story |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Communication; Patient satisfaction; Nurse-patient relations |
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Abstract |
In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare. |
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Call Number |
NRSNZNO @ research @ 883 |
Serial |
867 |
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Author |
Laracy, K. |
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Title |
Exploration of the self: The journey of one pakeha cultural safety nurse educator |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Cultural safety; Teaching methods; Nursing; Education; Professional development; Transcultural nursing; Maori; Identity |
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Abstract |
Cultural safety is taught in all undergraduate nursing programmes in Aotearoa/New Zealand. There is a predominance of Pakeha nurse educators in teaching this content. There is little explanation of what being Pakeha entails. This perpetuates a silence and continues the dominant hegemonic position of Pakeha in Aotearoa/New Zealand. This study suggests that as Pakeha cultural safety nurse educators we examine our dominance and critique the delivery of cultural safety education. This autobiographical study undertakes to explore the Pakeha identity of a cultural safety nurse educator. The author discusses identity in the context of a globalised world, and challenges the idea of a definitive Pakeha identity. There are multiple descriptions of Pakeha, all underdeveloped and inadequate for the purposes of cultural safety education. In this study, the author uses the heuristic process of Moustakas (1990) and Maalouf's (2000) ideas of vertical and horizontal heritage to locate and present the essence of the self. In keeping with the purpose of cultural safety education, the author considers her ethnic cultural self as described by Bloch (1983) and explores Helms' (1990) theory of White racial identity development. This thesis describes the position of one Pakeha in the context of teaching cultural safety in an undergraduate nursing degree programme in Aotearoa/New Zealand. For Pakeha cultural safety nurse educators the author argues that exploration of one's heritages and location of a personal Pakeha identity is pivotal to progressing the enactment of cultural safety in Aotearoa /New Zealand. |
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Call Number |
NRSNZNO @ research @ |
Serial |
864 |
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