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Author |
Dennis, J. |
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Title |
How will transformative primary health care nursing leadership facilitate better health outcomes for Southlanders? |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Leadership; Nursing; Primary health care |
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Abstract |
Changes within the New Zealand health system have led to an emphasis on primary health care. The New Zealand government and the Southland District Health Board have identified that nurses can make significant contribution to improving the primary health outcomes for New Zealanders. However, within Southland there exist barriers to nurses influencing health outcomes. A Southland draft Primary Health Care Nursing Strategic Plan 2005 recommended that the employment of a primary health care nursing leader would reduce these barriers and lead to a comprehensive primary health care nursing service. This dissertation argues, using literature, that the employment of a transformative nursing leader, using a facilitative style, would implement changes that would develop a community responsive nursing service, establish a primary health care educational structure and ensure quality nursing care. Successful implementation would occur as the leader facilitates experiential learning within groups and with individuals to review current experiences and implement transformative primary health care nursing changes that improves health for all. The dissertation introduces the background to the changing primary health care environment in New Zealand and to the Southland current situation in chapter one. Chapter two describes the unique features of transformative leadership style and how it is applies to nursing and specifically to Southland's changing primary health care environment. The chapter specifically emphasises the role of and the art of facilitation which is a critical transformative leadership process. Chapter three describes the process of the experiential learning cycle, which the author argues will improve health outcomes, when used by the transformative leader to enable nurses to learn from their experiences and make nursing changes that improve health care. Chapter four addresses the dissertation question by describing how transformative leadership will facilitate the experiential learning process to Southlanders and improve health outcomes, reduce inequalities and increase accessibility through a comprehensive primary health care nursing service. |
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Call Number  |
NRSNZNO @ research @ |
Serial |
920 |
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Author |
Huntington, A.D.; Gilmour, J.A. |
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Title |
A life shaped by pain: Women and endometriosis |
Type |
Journal Article |
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Year |
2005 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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Volume |
14 |
Issue |
9 |
Pages |
1124-1132 |
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Keywords |
Female; Diseases; Nurse practitioners; Pain management; Endometriosis; Feminist critique |
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Abstract |
The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition. |
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Call Number |
NRSNZNO @ research @ |
Serial |
940 |
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Author |
Cook, N.; Phillips, B.N.; Sadler, D. |
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Title |
The Tidal Model as experienced by patients and nurses in a regional forensic unit |
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Journal Article |
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Year |
2005 |
Publication |
Journal of Psychiatric & Mental Health Nursing |
Abbreviated Journal |
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Volume |
15 |
Issue |
5 |
Pages |
536-540 |
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Keywords |
Psychiatric Nursing; Nursing models; Evaluation; Nurse-patient relations |
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Abstract |
This study looks at the effect of implementing the Tidal Model at Rangipapa, a regional secure mental health forensic unit. A phenomenological study was undertaken to obtain reflective description of the nursing care experience from the perspective's of four registered nurses and four “special patients”. Five major themes were identified that appeared to capture the experiences of the participants. The themes show changes to the unit's unique culture and values following implementation of the model. These changes engendered a sense of hope, where nurses felt they were making a difference and patients were able to communicate in their own words their feelings of hope and optimism. Levelling was experienced as an effect emerging from individual and group processes whereby a shift in power enhanced a sense of self and connectedness in their relationships. These interpersonal transactions were noted by the special patients as being positive for their recovery. This enabled effective nurse-patient collaboration expressed simply as working together. The participants reported a feeling of humanity, so that there was a human face to a potentially objectifying forensic setting. Implications arising from this study are that the use of the model enables a synergistic interpersonal process wherein nurses are professionally satisfied and patients are validated in their experience supporting their recovery. |
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Call Number |
NRSNZNO @ research @ |
Serial |
941 |
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Author |
DeSouza, R. |
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Title |
Transforming possibilities of care: Goan migrant motherhood in New Zealand |
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Journal Article |
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Year |
2005 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
20 |
Issue |
1 |
Pages |
87-101 |
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Keywords |
Pregnancy; Transcultural nursing; Quality of health care; Attitude to health |
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Abstract |
This paper reports on a study of the maternity care experiences of women from Goa (India) in Auckland. Multiple research strategies were incorporated into the process to prevent reproduction of deficiency discourses. Interviews were carried out with Goan women who had experiences of migration and motherhood. The findings revealed that as a consequence of motherhood and migration, migrant mothers were able to reclaim and re-invent innovative solutions. Nurses and other health professionals can have a significant role in supporting women and their families undergoing the transition to parenthood in a new country and develop their knowledge and understanding of this dual transition. |
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Call Number |
NRSNZNO @ research @ |
Serial |
942 |
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Author |
Giddings, D.L.S. |
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Title |
Health disparities, social injustice, and the culture of nursing |
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Journal Article |
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Year |
2005 |
Publication |
Nursing Research |
Abbreviated Journal |
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Volume |
54 |
Issue |
5 |
Pages |
304-312 |
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Keywords |
Cross-cultural comparison; Racism; Attitude of health personnel; Feminist critique |
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Abstract |
The aim of this cross-cultural study was to collect stories of difference and fairness within nursing. The study used a life history methodology informed by feminist theory and critical social theory. Life story interviews were conducted with 26 women nurses of varying racial, cultural, sexual identity, and specialty backgrounds in the United States (n = 13) and Aotearoa New Zealand (n = 13). Participants reported having some understanding of social justice issues. They were asked to reflect on their experience of difference and fairness in their lives and specifically within nursing. Their stories were analysed using a life history immersion method. Nursing remains attached to the ideological construction of the “White good nurse.” Taken-for-granted ideals privilege those who fit in and marginalise those who do not. The nurses who experienced discrimination and unfairness, survived by living in two worlds, learned to live in contradiction, and worked surreptitiously for social justice. For nurses to contribute to changing the systems and structures that maintain health disparities, the privilege of not seeing difference and the processes of mainstream violence that support the construction of the “White good nurse” must be challenged. Nurses need skills to deconstruct the marginalising social processes that sustain inequalities in nursing and healthcare. These hidden realities-racism, sexism, heterosexism, and other forms of discrimination-will then be made visible and open to challenge. |
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Call Number |
NRSNZNO @ research @ |
Serial |
943 |
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Author |
Giddings, D.L.S. |
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Title |
A theoretical model of social consciousness |
Type |
Journal Article |
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Year |
2005 |
Publication |
Advances in Nursing Science |
Abbreviated Journal |
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Volume |
28 |
Issue |
3 |
Pages |
224-239 |
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Keywords |
Attitude of health personnel; Feminist critique; Nursing models |
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Abstract |
The article presents a theoretical model of social consciousness developed from nurses' life histories. A 3-position dialectical framework (acquired, awakened, and expanded social consciousness) makes visible the way people respond to social injustice in their lives and in the lives of others. The positions coexist, are not hierarchical, and are contextually situated. A person's location influences her or his availability for social action. Nurses who could most contribute to challenging social injustices that underpin health disparities are relegated to the margins of mainstream nursing by internal processes of discrimination. The author suggests that more inclusive definitions of “a nurse” would open up possibilities for social change. |
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Call Number |
NRSNZNO @ research @ |
Serial |
944 |
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Author |
Murphy, R. |
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Title |
A day in the life of an acute hospital psychiatric nurse |
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Journal Article |
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Year |
2005 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
11 |
Issue |
9 |
Pages |
24-25 |
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Keywords |
Nursing; Psychiatric Nursing; Interprofessional relations; Mental health; Multidisciplinary care teams |
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Abstract |
A nurse presents a personal account of a typical day at Middlemore Hospital's 50-bed acute inpatient mental health unit Tiaho Mai. The article covers aspects of shift handover, working with multidisciplinary teams, developing care plans, working with families, and responding to emergencies. |
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Call Number |
NRSNZNO @ research @ |
Serial |
957 |
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Author |
Richardson, S. |
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Title |
Coping with outbreaks of the norovirus |
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Journal Article |
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Year |
2005 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
11 |
Issue |
7 |
Pages |
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Keywords |
Infection control; Risk management; Occupational health and safety; Hospitals |
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Abstract |
The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages. |
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Call Number |
NRSNZNO @ research @ |
Serial |
981 |
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Author |
McCloskey, B.A.; Diers, D. |
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Title |
Effects of New Zealand's health reengineering on nursing and patient outcomes |
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Journal Article |
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Year |
2005 |
Publication |
Medical Care |
Abbreviated Journal |
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Volume |
43 |
Issue |
11 |
Pages |
1140-1146 |
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Keywords |
Patient safety; Organisational change; Nursing; Hospitals |
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Abstract |
This study sought to examine the effects that hospital re-engineering may have on adverse patient outcomes and the nursing workforce. In 1993, New Zealand implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. All medical and surgical discharges from New Zealand's public hospitals (n=3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n=65,221 nurse responses) from 1993 through 2000 were examined. Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. The authors conclude that in the chaotic environment created by re-engineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organisational change plays in patient outcomes, the unintended consequences of health care re-engineering and market approaches in health care, and nursing's unique contribution to quality of care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1052 |
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Author |
Gasquoine, S.E. |
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Title |
Mothering a hospitalized child: It's the 'little things' that matter |
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Journal Article |
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Year |
2005 |
Publication |
Journal of Child Health Care |
Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
9 |
Issue |
3 |
Pages |
186-195 |
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Keywords |
Nurse-family relations; Parents and caregivers; Paediatric nursing; Children |
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Abstract |
This article reports one aspect of a phenomenological study that described the lived experience of mothering a child hospitalised with acute illness or injury. The significance for mothers that nurses do the 'little things' emerged in considering the implications of this study's findings for nurses in practice. Seven mothers whose child had been hospitalised in the 12 months prior to the first interview agreed to share their stories. The resulting data were analysed and interpreted using van Manen's interpretation of phenomenology. This description of mothering in a context of crisis is useful in the potential contribution it makes to nurses' understanding of mothers' experience of the hospitalisation of their children. It supports the philosophy of family-centred care and highlights the ability of individual nurses to make a positive difference to a very stressful experience by acknowledging and doing 'little things', because it is the little things that matter to the mothers of children in hospital. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1053 |
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Author |
Gallagher, P. |
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Title |
Rethinking the gap: Investigating the theory-practice relationship in nursing |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Coda |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Education; Nursing models; Nursing philosophy |
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Abstract |
A Grounded Theory approach was taken to explore the concept of the gap between theory and practice, whereby they are seen to be discrete entitites. For this study, the first phase of data collection was a series of computer mediated group discussions, and the second a number of individual interviews. In both sets of interviews participants were asked to describe how they experienced and managed differences they perceived between theory and practice in nursing. The participants referred to different types of theory relevant and central to effective nursing practice. The first was private theory; the second was formal theory and third was situational theory. For the students it was a conflict that produced uncomfortable emotions, distrust of others and personal self doubt. In an effort to reduce this discomfort the students sought an explanation for the differences between theory and practice, some of which challenged their key personal values. However, the most emotionally neutral explanation that also preserved the integrity of their key values was that there was a gap between the theory and the practice of nursing. The theory Negotiating Different Experiences has implications for the education of nurses in that personal knowledge and experiences must be incorporated in a programme of study and the feelings evoked by learning must be acknowledged as a catalyst to enhance learning. Further, the different forms of theory to which students will be exposed must be made explicit and nursing educators who must involve the individual student as an active partner in the mapping of a personalised programme, which includes the creation of individual assessment methods. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1104 |
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Author |
Stokes, G. |
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Title |
Who cares? Accountability for public safety in nurse education |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Online at Research Space @ Auckland University |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Education; Accountability; Patient safety |
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Abstract |
The focus of this study is the management of unsafe nursing students within the tertiary education context. The moral dilemmas experienced by nurse educators, specifically linked to the issue of accountability for public safety, are explored. The theoretical framework for the thesis is informed by the two moral voices of justice and care identified by Gilligan and further developed using the work of Hekman and Lyotard. Case study methodology was used and data were collected from three schools of nursing and their respective educational organisations. Interviews were conducted with nurse educators and education administrators who had managed unsafe nursing students. Interviews were also conducted with representatives from the Nursing Council of New Zealand and the New Zealand Nurses Organisation to gain professional perspectives regarding public safety, nurse education and unsafe students. Transcripts were analysed using the strategies of categorical aggregation and direct interpretation. Issues identified in each of the three case studies were examined using philosophical and theoretical analyses. This thesis explores how students come to be identified as unsafe and the challenges this posed within three educational contexts. The justice and care moral voices of nurse educators and administrators and the ways in which these produced different ways of caring are made visible. Different competing and conflicting discourses of nursing and education are revealed, including the discourse of safety – one of the language games of nursing. The way in which participants positioned themselves and positioned others within these discourses are identified. Overall, education administrators considered accountability for public safety to be a specific professional, nursing responsibility and not a concern of education per se. This thesis provides an account of how nurse educators attempted to make the educational world safe for patients, students, and themselves. Participants experienced different tensions and moral dilemmas in the management of unsafe students, depending upon the moral language games they employed and the dominant discourse of the educational organisation. Nurse educators were expected to use the discourses of education to make their case and manage unsafe students. However, the discourses of nursing and education were found to be incommensurable and so the moral dilemmas experienced by nurse educators were detected as differends. This study bears witness to these differends. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1106 |
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Author |
Cobham, J. |
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Title |
Why do nurses stay in nursing? A test of social identity, equity sensitivity and expectancy theory |
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Year |
2005 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Recruitment and retention; Identity |
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Abstract |
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Call Number |
NRSNZNO @ research @ |
Serial |
1107 |
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Author |
Holloway, K. T.; Pearson, J.R. |
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Title |
Trailblazers: Primary health care programme evaluation |
Type |
Conference Article |
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Year |
2005 |
Publication |
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Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
Paper presented June 2004 at Royal New Zealand Plu |
Issue |
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Pages |
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Keywords |
New graduate nurses; Primary health care; Evaluation research; Professional development |
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Abstract |
This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1200 |
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Author |
Rudd, J. |
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Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
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Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Hospitals; Risk management; Patient safety |
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Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
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