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Author |
Miles, M.A.P. |
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Title |
A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 |
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Year |
2005 |
Publication |
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Abbreviated Journal |
NZNO Library, University of Otago Library |
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Issue |
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Pages  |
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Keywords |
Primary health care; Interprofessional relations; Policy |
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Abstract |
This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory. The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture. The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions. The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries. Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators. The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing's perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine. The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions. |
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Call Number |
NRSNZNO @ research @ 1146 |
Serial |
1131 |
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Author |
Litchfield, M. |
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Title |
The nursing praxis of family health |
Type |
Book Chapter |
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Year |
2005 |
Publication |
Picard, C & Jones, D., Giving voice to what we know (pp.73-82) |
Abbreviated Journal |
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Issue |
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Pages |
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Keywords |
Nursing research; Nursing philosophy; Nurse-family relations |
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Abstract |
The chapter explores the process of nursing practice and how it contributes to health, derived from research undertaken in New Zealand. It presents the nature of nursing research as if practice – the researcher as if practitioner – establishing a foundation for the development of nursing knowledge that would make a distinct contribution to health and health care. It includes the philosophy and practicalities of nursing through the use of a case study of nursing a family with complex health circumstances. |
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Call Number |
NRSNZNO @ research @ 1185 |
Serial |
1170 |
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Author |
Smart, S. |
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Title |
Post-operative pain management knowledge and attitude of paediatric nurses: A New Zealand regional view |
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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 |
Pain management; Paediatric nursing; Hospitals; Pharmacology |
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Abstract |
This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn't carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice. While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses. |
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Call Number |
NRSNZNO @ research @ 1194 |
Serial |
1179 |
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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 |
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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 |
Type |
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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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Author |
Mosley, B. |
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Title |
Seclusion management in an acute in-patient unit |
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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 |
Psychiatric Nursing; Patient rights; Hospitals; Workplace violence |
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Abstract |
This study was developed to explore the use of seclusion in an acute in-patient unit for people with mental illnesses. Investigation into this issue was considered important due to an identified large increase in seclusion use over the previous two years. The study used a qualitative research methodology with a descriptive and interpretive approach. Data collection included a retrospective file audit of patients who had been secluded over the past seven years, and one-to-one staff interviews. It also includes the author's personal reflections of seclusion events. The principle reason for using seclusion was violence and aggression in the context of mental illness. It was also used for people who were at risk of, or who had previously absconded from the unit. A recovery approach and the use of the strengths model was fundamental to nurses' way of working with patients in the unit. Nurses believed that the strengths process should be adapted to the person's level of acuity and to their ability to engage in this approach in a tangible way. Seclusion continues to be a clinical management option in the unit that is the subject of this study. However, in many circumstances there are other options that could be explored so that the utmost consideration is given to the dignity, privacy and safety of that person. |
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Call Number |
NRSNZNO @ research @ 1227 |
Serial |
1212 |
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Author |
Gibson, C. |
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Title |
Hearing the adolescents' voice: A study evaluating the use of conjoint analysis for use with adolescents to determine preferences for inpatient hospital facilities |
Type |
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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 |
Adolescents; Hospitals; Patient satisfaction; Cancer |
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Abstract |
This research used the economic technique of conjoint analysis and an informal discussion to canvas opinions regarding ideal combination of inpatient facilities and the use of cell phones in hospital. The content of the conjoint analysis was, with the exception of the inclusion of the question regarding the use of cell phones, derived from the literature. Because conjoint analysis does not appear to have been used with adolescents one of the questions to be answered was whether this was a method of research that could be used with adolescents. The research was undertaken with 29 young people, most of who were from CanTeen (the adolescent cancer support group) in Wellington. The conjoint analysis, and discussion with the adolescents supported the general findings from the literature that adolescents do not want to be nursed in either overtly paediatric or, in their words, 'dull adult wards', as they enjoy bright lively surrounds. Ideally they would like to be nursed with their peer group and so have the opportunity to interact with young people of their age. The research demonstrated that adolescents are able to understand the concept of conjoint analysis and also supported findings from overseas that these healthcare consumers value having their opinions canvassed and are well able to give constructive and well thought out opinions. A report on the findings of this research will be presented to Capital and Coast District Health Board with the expectation that it will be considered when the final decisions are made regarding the upgrading of Wellington Hospital's present facilities as it is anticipated that these facilities will contain dedicated adolescent beds within the paediatric unit. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1225 |
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Author |
Lewis, T. |
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Title |
Euthanasia: A Foucauldian analysis |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
ScholarlyCommons@AUT |
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Volume |
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Issue |
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Pages |
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Keywords |
Law and legislation; Euthanasia; Ethics; Pain management; Terminal care; Nursing; Palliative care |
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Abstract |
This study drew upon the theoretical insights of Michel Foucault to provide a discursive analysis of the term euthanasia, and the issues surrounding the “right-to-die”. It involved an analysis of primary texts from; nursing, general, and legal literature as well as the media between the years 2002-2004. Drawing upon data researched, the study analyses the main discourses regarding the practice of euthanasia for terminally ill individuals. The two competing discourses that emerged were what the author termed the sanctity-of life-discourse and the right-to-die discourse. The aim of the study was to uncover the discourses understanding of “truth” regarding the right-to-die. The analysis revealed that a small percentage of cancer sufferers (5%) die with their pain insufficiently treated and the right-to-die discourse claims that no individual should have to suffer needlessly, asserting the individuals right to autonomy. Directly opposing this is the sanctity-of life-discourse which states all life is sacred and nothing can justify euthanasia as an acceptable practice in society. These findings indicate the need for effective palliative care and pain management when caring for the terminally ill individual. The legal, ethical and moral implications of euthanasia are many and this study discusses the effects these may have on health professionals involved with the care of terminally ill patients. The study revealed an increasing deployment of the right-to-die discourse in the media and revealed concerns regarding the nursing profession's lack of preparation to deal with euthanasia if it becomes a legal option in end of life care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1226 |
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Author |
Vandergoot, A. |
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Title |
From ward nurse to proficient critical care nurse: a narrative inquiry study |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Held by Lakes DHB Library (ROM) |
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Volume |
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Issue |
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Pages |
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Keywords |
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Abstract |
A dissertation [thesis] presented in partial fulfillment of the degree of Master of Health Science. |
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Call Number |
NZNO @ research @ |
Serial |
1367 |
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Author |
Bland, M.F. |
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Title |
The challenge of feeling 'at home' in residential aged care in New Zealand |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
3 |
Pages |
4-12 |
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Keywords |
Rest homes; Older people; Patient satisfaction; Nursing; Identity |
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Abstract |
In this research report, a resident reveals the challenges associated with firstly becoming a nursing home resident, and then trying to establish a new sense of 'home'. The story supports a conclusion that nurses' knowledge of the unique 'admission story' of each resident, and their individual understandings of home, is essential in promoting their ongoing comfort. Although approximately 30,000 older adults live in residential aged care, little research has been done on their experience. |
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Call Number |
NRSNZNO @ research @ 862 |
Serial |
846 |
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Author |
MacDonald, R. |
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Title |
Mammography screening for breast cancer: Does it reduce the mortality rate? |
Type |
Journal Article |
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Year |
2005 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online from Eastern Institute of Technology |
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Volume |
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Issue |
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Pages |
8-12 |
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Keywords |
Breast cancer; Screening; Risk management; Health education; Cancer |
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Abstract |
This paper critically examines the literature on mammography as a breast cancer screening modality. It looks at what the New Zealand consumer is being told about the scientific uncertainties about the effectiveness of mammography and the substantial risks involved with it. This literature review raises concerns about the lack of information available for healthy women to make a fully informed decision about mammography screening. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1304 |
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Author |
McPherson, G.; Horsburgh, M.; Tracy, C. |
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Title |
A clinical audit of a nurse colposcopist: Colposcopy, cytology, histology correlation |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
3 |
Pages |
13-23 |
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Keywords |
Nurse practitioners; Professional competence; Diagnosis; Advanced nursing practice |
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Abstract |
A clinical audit was undertaken to assess the diagnostic skills of the nurse colposcopist measuring colposcopy: histology: cytology correlation. At National Women's Health the first New Zealand nurse colposcopist training programme was developed in 2000. A retrospective audit of the colposcopy clinical records was performed during the nurse's training programme between July 2000 and March 2002. An 82% (82/100) histology: cytology: colposcopy correlation was achieved by the nurse in the third phase of her training programme. The results are comparable with other reported studies involving medical and nurse colposcopists. Expertise in colposcopy examination can be incorporated into the broader role of a Nurse Practitioner working in the area of women's health. |
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Call Number |
NRSNZNO @ research @ 548 |
Serial |
534 |
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Author |
Scrymgeour, G. |
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Title |
Using diagnostic reasoning in nursing practice: Ectopic pregnancy: A case study approach |
Type |
Journal Article |
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Year |
2005 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online at Eastern Institute of Technology |
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Volume |
13 |
Issue |
1 |
Pages |
13-17 |
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Keywords |
Nursing; Pregnancy; Clinical assessment |
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Abstract |
This paper explores, through the use of a case study, an evidence-based diagnostic reasoning process utilising the framework followed by Dains, Baumann and Scheibel (1998). This framework, as described by these authors, involves an inductive process of reasoning, which leads to formulation of a hypothesis that is then analysed using an evidence-based approach. From this analysis, a likely diagnosis can be made and appropriate therapeutic intervention initiated. This research demonstrates that although an evidence-based approach is the ideal, sometimes clinical intuition is equally important to the clinical outcome. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1305 |
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Author |
Hughes, M.; Farrow, T. |
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Title |
Invisible borders: Sexual misconduct in nursing |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
2 |
Pages |
15-25 |
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Keywords |
Patient safety; Nursing; Guidelines |
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Abstract |
This paper identifies the issue of sexual misconduct by nurses in New Zealand. There is evidence that some nurses have been involved in sexual misconduct, resulting in disciplinary proceedings against them. Despite this, there is an absence of guidelines and discussion for New Zealand nurses to prevent such occurrences. This article identifies difficulties in naming and defining sexual misconduct, and discusses sexual misconduct as an abuse of power by nurses. New Zealand and international literature about sexual misconduct by nurses and other health professionals is described, as are guidelines designed to prevent sexual misconduct. Finally, the authors make recommendations for actions needed to facilitate New Zealand nurses in identifying and avoiding sexual misconduct in practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
537 |
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Author |
Flint, V. |
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Title |
The place of ECT in mental health care |
Type |
Journal Article |
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Year |
2005 |
Publication |
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Abbreviated Journal |
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Volume |
11 |
Issue |
9 |
Pages |
18-20 |
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Keywords |
Psychiatric Nursing; Trauma; Mental health |
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Abstract |
The author reviews the controversial treatment of electroconvulsive therapy (ECT) which has re-emerged as a safe and effective treatment for major depressive disorders. She first addresses the popular conceptions of ECT, which are based on early misuse of the treatment when it was delivered unmodified, or forcefully and without anaesthetic. She then uses a case study to illustrate the benefits of ECT for catatonia and catatonic states. Diagnostic criteria for catatonia include motoric immobility, excessive motor activity, extreme negativism or mutism, peculiarities of voluntary movement, and echolalia or echopraxia. The treatment of a patient is detailed, and the role of the ECT nurse is outlined. The ECT nurse is a co-ordinator, an educator, liaises with other services and families, and is a point of contact about ECT within the mental health service generally and in the ECT unit in particular. The case study showed successful use of ECT. A series of eight ECT treatments were administered to the catatonic patient, after which he was discharged home with minor depression and showing signs of enjoying life once again. |
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Call Number |
NRSNZNO @ research @ 1011 |
Serial |
995 |
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