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Author McNab, M.
Title The nursing roles in respect of tuberculosis in New Zealand from 1928 to 1966 Type (up)
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords History; Nursing; Tuberculosis
Abstract In this thesis the nursing roles in respect of tuberculosis in New Zealand from 1928 to 1966 are identified, and then examined by contextualising them in relation to the changing social, political, demographic, scientific and technological environments in which the treatment and prevention of tuberculosis took place. The history of the various institutions is described in order to show some of the circumstances that led to the evolution of the roles of dispensary nurse, district nurse, school nurse, public health nurse, sanatorium nurse, and hospital nurse. 1928 to 1966 covers a sufficiently long period of intensive activity and change in the detection, treatment and research of pulmonary tuberculosis in New Zealand, to enable comparisons between nursing roles to be made. It was found that nurses had an individualised approach to their work. This was defined by the physical environments within which they worked, whether it was a hospital, sanatorium, dispensary, school or in a patient's home. Also, the medical treatments advocated and implemented by the medical practitioners, the rules and regulations which governed the various work areas, and the availability of staff, funds, facilities and resources all had an impact upon how nurses were able to work and how their respective roles developed. In addition, some of the factors which contributed to nurses getting tuberculosis and the initiatives to improve the nurse's conditions of work are examined, because these had an impact on the performance of the nurse's work and evolution of her role. Apart from practical nursing care, nurses also had a role in the on-going inspection, monitoring, notification, emotional support of patients and families, morale boosting and education. Each role had these components. The differences were in the time and emphasis given to each.
Call Number NRSNZNO @ research @ Serial 660
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Author Lake, S.E.
Title Nursing prioritisation of the patient need for care: Tacit knowledge of clinical decision making in nursing Type (up)
Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Clinical decision making; Nursing
Abstract Effective nursing prioritisation of the patient need for care is integral to daily nursing practice but there is no formal acknowledgement or study of this concept. Utilising the retroductive research strategy of critical realism, this thesis explores the nursing literature for the tacit knowledge of the discipline about nursing prioritisation and proposes a 'fit' for nursing prioritisation of the patient need for care within the bigger picture of nurse clinical decision-making. The tacit knowledge discerned within the literature indicates that nurses use discretionary judgment and ongoing assessment to determine the relative importance of the many aspects of individual patient situations as they unfold. Such nursing prioritisation takes place concurrently between the competing or even conflicting needs of the several individual patient presentations within the nurse's caseload. Varied frames of reference within different practice settings create specific imperatives on this dynamic and non-sequential process. Starting with an initial set of studies in the 1960s, study of clinical decision-making in nursing has created a significant body of knowledge encompassing a range of approaches. Nursing prioritisation of the patient need for care is most readily discerned in the interpretive perspective and in the plain language descriptions of nurse decision-making. Within the selected literature it is apparent that nursing prioritisation of the patient need for care is an advanced skill of nursing that is developed in practice and honed through experiential learning.
Call Number NRSNZNO @ research @ Serial 661
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Author Bleach, A.
Title Nurses talk the walk: An exploration of nurses' perception of advanced nursing practice on acute mental health inpatient units in New Zealand Type (up)
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Mental health; Nursing; Policy; Registered nurses; Advanced nursing practice; Psychiatric Nursing
Abstract The last twenty years, particularly the early 1990s, ushered in major mental health sector reforms inclusive of deinstitutionalisation policies and subsequent development of community services. Concurrent changes to student nurses' education left registered nurses as the workforce mainstay on inpatient units. However, the author suggests, an emerging global shortage of nurses and implementation of the Employment Contracts Act (1991) negatively impacted on recruitment and retention of registered nurses. Inpatient nurses either left nursing or moved to community positions for better money and increased job status. The author suggests that, as a consequence, the 'critical mass' of experienced and skilled nurses who traditionally provided nursing leadership disappeared resulting in compromised standards of care for patients. As the manager of an inpatient unit, the author proposed the establishment of advanced nursing practice roles as one initiative to provide nursing leadership in order to attract and retain nurses. This study explored five inpatient nurses' perceptions of advanced practice and whether these roles could assist to provide leadership and improve standards of care. The research was a qualitative exploratory descriptive study using a focus group interview as the data collection method. A thematic analysis of the group discussion transcription revealed three key themes: 1) the 'makeup' of advanced nursing practice, 2) moving forwards: establishing roles, 3) moving sideways: barriers to role development. The themes are critically discussed in relation to selected literature. The thesis includes recommendations that could be used by nurses responsible for planning and implementing advanced practice roles on inpatient units.
Call Number NRSNZNO @ research @ Serial 663
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Author Holbrook, P.
Title Nurse initiated analgesia in an emergency department: Can nurses safely decrease door to analgesia times by providing analgesia before medical assessment? Type (up)
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Emergency nursing; Drug administration; Nursing; Pain management
Abstract Pain management practices within emergency departments require a more patient focused approach due to extended waiting times for analgesia. This dissertation questions current methods of providing timely and appropriate delivery of analgesia. Nurses represent the biggest resource in emergency departments therefore are in a position to be able to access patients in a timely fashion. A review of the literature pertaining to nurse initiated analgesia protocols has been evaluated and information relating to efficiency and safety utilised to discuss the processes for planning and implementation of a similar protocol. The author finds that the literature provides no evidence that nurse initiated analgesic practices prior to medical assessment compromises patient safety or delays diagnosis. A discussion of the benefits to patients, nurses and the institution has been included to highlight the appropriateness of extending nursing roles.
Call Number NRSNZNO @ research @ Serial 664
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Author Sheridan, N.F.
Title Mapping a new future: Primary health care nursing in New Zealand Type (up)
Year 2005 Publication Abbreviated Journal University of Auckland Library
Volume Issue Pages
Keywords Primary health care; Chronic diseases; Community health nursing; Nursing models
Abstract The aim of the study was to determine the practice of nurses employed in integrated care projects in New Zealand from late 1999 to early 2001. Integrated care was a major health reform strategy that emphasised primary health care as a means to improve service provision between the health sectors. An investigation of nurses' practice sought to determine the extent to which primary health care principles had been adopted in practice, as a comprehensive primary health care approach has been advocated globally in the management of chronic conditions; the leading cause of disability throughout the world and the most expensive problems faced by health care systems. The philosophical basis of the research was postpositivism. The study employed a quantitative non-experimental survey design because it allowed numeric descriptions of the characteristics of integrated care projects to be gained for the purpose of identifying nurses' practice. The unit of inquiry was the integrated care project, and 80 comprised the study population. Data were obtained on projects from expert informants (n=27) by telephone survey using a structured interview questionnaire developed by the researcher. Data obtained from interviews were statistically analysed in two stages. First, data were produced to comprehensively describe the characteristics of integrated care projects and nurses practice. The 'Public health interventions model' was used as a framework to analyses the interventions (activities) and levels of population-based practice of nurses. Following this, the social values embedded in nurses' practice were determined using 'Beattie's model of health promotion' as a framework for analysis. A strong association was found between nurses' practice in projects and strategies used in integrated care, such as information sharing, guideline development and promotion, and case management, and projects with an ethnic focus, low income focus, chronic condition focus, and well-health focus. Whilst nurses undertook interventions most frequently at the individual practice level they were also strongly associated with the small proportion of interventions that were undertaken at the community level. The majority of interventions by nurses reflected the health promotion value of health persuasion, indicating a paternalist and individual-oriented philosophy. Nurses were engaged in two interventions that indicated a collective-oriented philosophy – coalition building and community development, the latter reflecting health promotion values of negotiation, partnership and empowerment. The study demonstrated that nurses' practice in projects was predominantly centred on individual-focused population-based practice suggesting the need for a framework to assist nurses to transition their practice to include more activity at the community and systems levels. Without a reorientation of practice, nurses will remain limited in their ability to achieve health gains for populations. In response to this conclusion, and drawing on research results and reviewed literature, a new model, The 'Primary Health Care interventions model' was constructed. Recommendations include advocacy for the acceptance of the model by the health funder, professional nursing bodies, health organisations, educational institutions, nurses, communities, and individuals.
Call Number NRSNZNO @ research @ 679 Serial 665
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Author Horner, C.
Title Maintaining rural nurses' competency in emergency situations Type (up)
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Emergency nursing; Nurse practitioners; Rural nursing; Education
Abstract On call emergency health services are becoming routinely provided by some rural nurses, predominantly within the South Island. Rural nurses have been advancing their practice to accommodate the limited availability of general practitioners in rural communities. Although this is becoming routine practice, the author has been providing a service such as this for the past 12 years. This dissertation describes this practice in relationship to the present social-political context, advancing nurse competencies and her experience of rural nursing in a rural town within the South Island. Particular significance for the rural nurse is the required independent practice and overall responsibility when remote from traditional medical oversight. Providing on call emergency care with the possibility of a broad spectrum of emergency situations while maintaining competence for the unpredictable frequency (or lack of frequency) of the rural emergency is the focus of this dissertation. The professional and personal risks are high for rural nurses when placed in situations they are not prepared for or unable to remain competent to manage. Implications resulting from the critique of the health service literature on this subject are identified. Firstly, rural nurses need to be insightful of their own emergency on call expertise and limitations. Secondly, rural nurses require ongoing education and thirdly that appropriate education is available and accessible to rural nurses. Lastly, rural nurses require maintenance of competency so these emergency skills are not lost. This dissertation and the resulting recommendations embrace Nursing Council of New Zealand Nurse Practitioner Competencies. The resulting outcomes fulfilling the rural nurse's need for maintenance of competency for emergency on call care, the community's need for safe appropriate emergency care and national legislation requirements.
Call Number NRSNZNO @ research @ Serial 666
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Author Wilson, B.
Title Maintaining equilibrium: The community mental health nurse and job satisfaction Type (up)
Year 2005 Publication Abbreviated Journal University of Otago Library
Volume Issue Pages
Keywords Community health nursing; Mental health; Job satisfaction; Stress
Abstract
Call Number NRSNZNO @ research @ 681 Serial 667
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Author Davies, M.
Title Lived experiences of nurses as they engage in practice at an advanced level within emergency departments in New Zealand Type (up)
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Emergency nursing; Nurse practitioners; Advanced nursing practice
Abstract
Call Number NRSNZNO @ research @ 682 Serial 668
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Author Richardson, C.A.
Title Ever decreasing circles: Non-curative terminal illness, empowerment and decision making: Lessons for nursing practice Type (up)
Year 2005 Publication Abbreviated Journal University of Otago Library
Volume Issue Pages
Keywords Nursing; Palliative care; Terminal care; Psychology
Abstract
Call Number NRSNZNO @ research @ 683 Serial 669
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Author Betts, J.A.
Title Establishing and evaluating a nurse practitioner leg ulcer clinic: The journey Type (up)
Year 2005 Publication Abbreviated Journal University of Auckland Library
Volume Issue Pages
Keywords Nurse practitioners; Community health nursing
Abstract
Call Number NRSNZNO @ research @ 684 Serial 670
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Author Jacobs, S.
Title Advanced nursing practice and the nurse practitioner: New Zealand nursing's professional project in the late 20th century Type (up)
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Nurse practitioners; History; Policy; Leadership; Advanced nursing practice
Abstract This thesis examines the forces influencing the development of contemporary advanced nursing practice in New Zealand. It begins with an historical approach to explore the various meanings of advanced nursing practice from the late 1800s through the first years of the 21st century. Seven historical understandings of the meaning of 'advanced' nursing practice emerge. The author's analysis of the broad scope of New Zealand nursing history, including a case study of the development and implementation of the nurse practitioner, draws on theoretical perspectives from sociology, political science, and nursing. She develops a “framework of critical factors for nursing to take into account when considering how to ensure the profession is able to deliver on its great potential to improve the health of New Zealand communities”. Examining the work of a range of nursing leaders, past and present, and drawing on the work of political scientist, John Kingdon, the author describes the work of several nurses as “policy entrepreneurship.”
Call Number NRSNZNO @ research @ Serial 671
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Author Pirret, A.M.
Title The use of knowledge of respiratory physiology in critical care nurses' clinical decision-making Type (up)
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Intensive care nursing; Clinical decision making
Abstract
Call Number NRSNZNO @ research @ 686 Serial 672
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Author Ross, M.E.
Title A study into the effects of the New Zealand health reforms of the 1990's on the role of the nurse manager Type (up)
Year 2005 Publication Abbreviated Journal University of Otago Library
Volume Issue Pages
Keywords Nurse managers; History; Policy
Abstract
Call Number NRSNZNO @ research @ 687 Serial 673
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Author Taua, C.
Title Revisiting the past: A focused ethnography of contemporary dual diagnosis nursing practice Type (up)
Year 2005 Publication Abbreviated Journal Copy downloadable from the NZNO Library
Volume Issue Pages
Keywords Psychiatric Nursing
Abstract As has been the case internationally, deinstitutionalisation of dual diagnosis (intellectual disability and mental illness) services has also occurred in New Zealand. Inpatient services have been redefined to respond to the more acute focus that has arisen out of this deinstitutionalisation process and nurses are having to redefine their roles in response. This study was undertaken to explore and describe the culture of nursing practice in a dual diagnosis inpatient unit in one psychiatric hospital. A focused ethnographic approach was used to triangulate data gathered from fieldwork observations, review of documents and semi-structured interviews. Schein's (1985) levels of culture model, was used to identify and explore the artifacts, values and assumptions evident in this nursing practice. Analysis presents three key themes categorised as 'communication', 'assessment' and 'safety'. While these key themes are shown to be evident in the everyday practice of the nurses, how these relate to the notion of 'dual diagnosis nursing' is not clear. Therefore, the author describes the major finding of this study as revealing a nursing culture holding tight to traditional psychiatric and psychopaedic nursing practices and struggling to develop a distinctive culture in the absence of a defined dual diagnosis knowledge base. The author concludes that these findings suggest an urgent need to provide nurses with support in gaining contemporary knowledge regarding dual diagnosis nursing. Support for nurses in advancing these areas then impacts on support for the patients. It is suggested that additional research is undertaken to assess the learning needs of the nurses in order to develop clinical practice guidelines for this area. Further recommendations are made to address system issues which are contributing to the gap in knowledge.
Call Number NRSNZNO @ research @ Serial 674
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Author Hansen, S.
Title The reality: Doctors and nurses in general practice in New Zealand Type (up)
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords History; Nurse practitioners; Primary health care; Physicians
Abstract Provision of a primary health care system that delivers timely, appropriate, affordable and effective care is a challenge throughout the world. The purpose of this work is to discuss the realities of collaborative practice in primary health care, where care is delivered by doctors and nurses in general practice settings in New Zealand. The close relationship between the two professions has been historically marked by the dominance of medicine over nursing. Unclear articulation of nursing practice by the nursing profession along with historical gender issues has further hindered a more collegial relationship between medicine and nursing. The author suggests that historical gender inequalities have also contributed to a system which has disadvantaged nurses in the execution of their work. Collaboration occurs when mutual respect is present between two parties intent on furthering mutual goals. Collaboration is not supervision or co-operation. It is therefore, the author suggests, questionable that collaboration exists in the New Zealand system other than through the good will of individual practitioners. An examination of these issues using the work of Jurgen Habermas and Michel Foucault offers insight into how the current working situation between medicine and nursing came about. The author concludes that the emergence of the nurse practitioner role in New Zealand along with a change in the way that primary health care is being managed nationally provides opportunities for the nursing profession to move into emancipatory collaborative practice roles.
Call Number NRSNZNO @ research @ Serial 676
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