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Author Blair, K.M.
Title Recognising the sick patient: An emergency nurses view: A research paper Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Emergency nursing; Patient safety; Diagnosis; Training; Clinical decision making
Abstract This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration.
Call Number NRSNZNO @ research @ Serial 467
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Author Keene, J.M.
Title The role of the nurse in the outpatient setting Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing; Nursing specialties
Abstract Outpatient nurses are often seen as nurses who are less important or skilled and can no longer physically cope with working in busy wards. This report is aimed to challenge this presumption and show that there are many educated and highly skilled nurses working in these departments. The diversity of the role of the nurse within the continued advancement of nursing practice in the outpatient department is evidence to disprove the perceptions other nurses have of the outpatient nurse. The purpose of this report was to discuss the changing role of the outpatient nurse from 'handmaiden' to 'autonomous practitioner', and secondly, to discuss nurse-led services and what experience and/or skills these nurses are expected to have to fulfill these roles. Literature was gathered to inform this report from the academic circles, policy from the Ministry of Health, the District Health Board website, and in relation to the author's own role with the outpatient department.
Call Number NRSNZNO @ research @ 493 Serial 479
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Author Blanchard, D.L.
Title Developing the place and role of family within the culture of critical care nursing: An action research approach Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Relationships; Nurse-family relations; Intensive care nursing; Nursing research
Abstract This research examines how nurses negotiate the context of the Intensive Care Unit (ICU) while working with families. The action research described in this thesis developed through a series of meetings and conversations where the conversations supported the reflexive intent of the research. In commissioning the research, the design of the meetings and conversations were as a series of overlapping actions. Data collection and data analysis occurred in the action research by meetings, reflective conversations, ad libitum observations, and in a research journal. Conceptual maps explain the progress and findings of the research in this thesis while categories distilled from the conversations also support the findings in the research. The Family Action Research Group that was established within this project proposed a Family Assessment Form for the family to provide an assessment of themselves and the patient. Implementing this assessment tool demonstrated that clear information was needed for the family in the ICU. Findings in this research focus on developing action research and family care in ICU. Findings also focused on the role of the researcher being of and not being of the context where action research is undertaken. Recommendations include staff examining relationships for potential asymmetries and seeking ways to address these to support families and staff. Suggested strategies for developing action research in a clinical context include detailed planning, clear focusing, transparency of data, and working to explain change initiatives through the research are also included.
Call Number NRSNZNO @ research @ 494 Serial 480
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Author Rolls, S.
Title An exploration of workplace violence in the emergency department: Are emergency nurses safe? Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Workplace violence; Emergency nursing; Guidelines
Abstract This thesis arises from the author's experience of several years of working in the emergency department and being exposed to workplace violence from patients and their families. Emergency nurses in New Zealand experience workplace violence every day. Registered nurses and the institutions in which they work manage workplace violence to varying degrees and in an ad hoc manner. The author notes that New Zealand has no national guidelines, or consensus on the management of workplace violence in the health sector. This research explores emergency nurses' encounters during their work when they have experienced workplace violence. The purpose of this study is to demonstrate the experience and the consequences when nurses are confronted with episodes of violence while working in the emergency department. The essence of this research is gaining an understanding of how registered nurses have managed workplace violence and the impact of that violence on themselves, their colleagues, and the patients in the emergency department. Recommendations are made regarding nationally consistent guidelines, education on the management of workplace violence, improved security, and emergency department design. The discussion concludes with suggestions for further research on workplace violence in the health sector
Call Number NRSNZNO @ research @ Serial 492
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Author Kerr, R.C.
Title Is the graduate nurse work-ready for emergency nursing? Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Mentoring; Preceptorship; Training; Emergency nursing
Abstract In this research paper for a Master of Nursing (Clinical), the author suggests that graduate nurses can successfully adapt to emergency nursing when supported with intensive domain-specific transition programmes to complement the national nursing entry to practice (NETP) programme in New Zealand. This outcome conflicts with the present traditional emergency department recruitment strategy that nurses must have two years acute care experience. The graduate believes they are prepared for practice for any healthcare setting but do need time to resolve the rift between theory and practice. This research project confirms the perpetuation of experienced nurses' perceptions that graduates are not work-ready but are unrealistically expected to hit the floor running following ad hoc orientation ranging from three days to four weeks. By creating domain-specific programmes with a minimum twelve-week staged rotation orientation package, graduate nurses can be nurtured as emergency nurses. The influential role of the organisation and experienced nurses is vital to limit reality shock and complement NETP. Preceptorship and mentorship programmes promote the graduates' confidence in themselves to become competent team members. Limits to this research are the non-differentiation between nurses new to emergency nursing and the graduate nurse in the published studies. Assumptions have therefore been made regarding successful transition in regard to newly qualified registered nurses in the emergency department. Further study and evaluation applicable in the New Zealand context is also recommended by the author where anecdotally only a few emergency departments are involved in socialising graduate nurses into the workforce regardless of the urgent need for more first-year-of-practice clinical placements.
Call Number NRSNZNO @ research @ Serial 494
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Author Voice, D.M.
Title Everyday district nurses' experiences revealed through distillation: Palliative care in the community Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords District nursing; Palliative care; Community health nursing; Nursing
Abstract This modified action research inquiry focused on the everyday, palliative care practice experiences of a group of district nurses. The intent was to develop an understanding of common issues of concern for this group of district nurses when providing palliative home care in a specific community context and to implement practical, achievable strategies in response to these local issues. Five district nurses identified four broad areas for action through four praxis group meetings and comprising one full cycle. These four areas have been named as methods of enhancing support for people and families, possibilities for creatively managing workloads, mechanisms to enrich working partnership with other palliative care providers and possible vehicles for supporting nurses' self care. Implementation of action from this action research project focused on enhancing care and outcomes for people and family served by this group of district nurses in their local community. This study illuminates everyday essences of the district nurse role and the elements articulated by this group in supporting their practice in one New Zealand community. This study also reveals some of the tensions and messiness when employing an action research methodology with nurses in the workplace. The author notes that this research focused on a little known area (palliative care delivered by district nurses in New Zealand) in a local community (a culturally vibrant and ethnically diverse yet with poor health and socioeconomic statistics). She goes on to say that it has resonance with other nurses, particularly those working in community settings who may experience similar issues and concerns. This research also offers important insights for nurses working in any practice setting.
Call Number NRSNZNO @ research @ 520 Serial 506
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Author Baker, K.O.
Title A journey: Experienced respiratory nurses working with patients with chronic breathlessness Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing specialties; Nurse-patient relations
Abstract Respiratory nursing has, as a core clinical concern, the alleviation of distress and suffering associated with respiratory disease. This research describes the ways in which experienced New Zealand respiratory nurses understand, assess, manage and support patients suffering from chronic breathlessness. It reviews the professional context in which these nurses practice, and examines the experiences and beliefs that have lead them to, and maintain them in, this area of practice. This study has been stimulated by the realisation that the skills, understandings and practice wisdom exhibited by experienced Respiratory Nurses is poorly described in the published research literature. This qualitative, grounded theory research is based upon data gathered from in-depth interviews with six experienced New Zealand respiratory nurses. A constructivist research position is adopted. Analysis of these interviews revealed distinct phases of developing respiratory nurse practice including preparing and entering respiratory nursing practice, comprehension of the phenomena of chronic breathlessness and the effect upon the patient and the seeking of possibilities which may alleviate and modify the debilitating effects of chronic breathlessness. Consistent values and beliefs are identified, which are captured in the concepts of professional caring and the movement towards developing expertise in practice. The unifying concept of journeying is employed to draw together these conceptual elements and develop a substantive model describing the work of experienced respiratory nurses with patients with chronic breathlessness. Implications for practice and the health system, and suggestions for further research, are discussed.
Call Number NRSNZNO @ research @ Serial 508
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Author Bryson, L.W.
Title Nurse-led heart failure services: A review of the literature Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing specialties; Management; Nurse practitioners; Cardiovascular diseases
Abstract This research paper reports on the findings of a literature review conducted to establish and analyse the international magnitude, context and effectiveness of nurse-led heart failure initiatives. The research revealed that the underlying philosophy in establishing nurse-led disease management programmes of care is that, by treating chronic heart failure as a continuum, it is possible to decrease exacerbations and improve patient outcomes. Regardless of the type of heart failure management programme, critical components of care include a collaborative supportive approach that educates and empowers the patient (including family/whanau) to recognise the early indicators of exacerbation, access expedient care, and to adhere to evidence based treatments. The author points to significant evidence to support the establishment of nurse-led heart failure programmes. The positive outcomes associated with this model of care delivery include decreased readmissions, reduction in mortality, and cost efficiencies. However, the organisational model of care, or programme components that are the most effective in optimising patient outcomes, need to be selected on the basis of local healthcare infrastructure, services and resources. The author suggests that New Zealand has a unique opportunity to encompass the recent emergence of the Nurse Practitioner role in facilitating, coordinating and monitoring of heart failure programmes across the continuum of care. The delivery of evidence-based, cost effective, heart failure programmes is a prerequisite to improving the delivery of optimal treatment and ensuring that heart failure patients have the opportunity to attain quality care outcomes.
Call Number NRSNZNO @ research @ Serial 558
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Author Meldrum, L.B.B.
Title Navigating the final journey: Dying in residential aged care in Aotearoa New Zealand Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Palliative care; Older people; Rest homes
Abstract New Zealand statistics project that the aging population of people aged 65 years and over will more than double in the next decade. This has implications for palliative care providers including hospices and hospitals because long-term inpatient care is not generally provided by hospitals and hospices. When dying patients need long-term care, residential settings become an option. The level of palliative care in these facilities is dependent on staff training and numbers. In general, staff are not trained in palliative care, neither do they provide the multidisciplinary facets that define palliative care as undertaken by hospices. This paper describes a practice development initiative using storytelling as the vehicle for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient into residential aged care settings. With the emergence of a reflective paradigm in nursing the concept of storytelling as a teaching/learning tool has grown. Many staff in residential care settings come from diverse ethnic backgrounds where for some, English is their second language. Storytelling therefore can be a useful approach for learning because it can increase their communication skills. The author suggests that the Liverpool Care Pathway for the dying patient is a model that can be translated across care settings, hospice, hospital, and community. It can demonstrate a framework that facilitates multiprofessional communication and documentation and embraces local needs, culture and language to empower health care workers to deliver high quality care to dying patients and their family/whanau and carers. This paper also explores the role of a facilitator as an agent of change and discusses how the interplay of evidence, context and facilitation can result in the successful implementation of the LCP into residential aged care settings.
Call Number NRSNZNO @ research @ Serial 683
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Author Elliott, M.M.
Title Model of care development: Moving between liaison and complex care coordination in the community health setting Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Community health nursing; Nursing models
Abstract Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services.
Call Number NRSNZNO @ research @ Serial 684
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Author Martin, H.E.
Title Marking space: A literary psychogeography of the practice of a nurse artist Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Psychiatric Nursing; Mental health; Nurse-patient relations
Abstract The author suggests that the thesis as a production of disciplined work presented in a creative style is congruent with performance and presentation best practice in community arts. As a practising nurse artist the author describes creating spaces of alternate ordering within the mental health field environment. “I also inhabit the marginal space of the artist working in hospital environments. This Other Place neither condones nor denies the existence of the mental health field environment as it is revealed. Yet, it seeks to find an alternative to the power and subjectivity of the [social] control of people with an experience of mental illness that inhabit this place both voluntarily and involuntarily. I have used a variety of texts to explore the experience and concept of Otherness. The poems are intended to take you, as a reader where you could not perhaps emotionally and physically go, or might have never envisaged going. They also allow me as the author to more fully describe the Otherness of place that is neither the consumer story nor the nurse's notation, but somewhere alternately ordered to these two spaces. Drawing on the heuristic research approaches of Moustakas and literary psychogeography , particularly the work of Guy Debord, this thesis creates the space to explore the possibilities of resistance and change and the emergence of the identity of the nurse artist within the mental health field environment”.
Call Number NRSNZNO @ research @ Serial 685
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Author Mulcahy, D.M.
Title Journeys cross divides: Nurses and midwives' experiences of choosing a path following separation of the professions Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Midwifery; Nursing; Policy; Careers in nursing
Abstract In 2003 the Health Practitioners Competence Assurance Act was introduced and established separate regulatory authorities for nursing and midwifery. This study is designed to explore the experiences of dually registered practitioners affected by this divide, as now there are two separate and possible paths, and two corresponding sets of competencies to fulfil. The design for this qualitative descriptive study utilised the written and oral narratives of three practitioners affected by this professional regulation and demonstrated its impact on their career development. Individual storytelling, as narrative, provided a theoretical lens aiding insight into their experience and pattern of decision making. In addition, symbolic consideration of the study data was provided by collective storytelling via the perennial myth of the hero journey. Shifting professional ground following the Health Practitioners Competence Act 2003 generated a focus for the inquiry into practitioners' modes of adjustment. For the practitioners in the study, transition between the occupational roles of nursing and midwifery comprised the possible career trajectories. A status passage, as the process of change from one social status to another, is described and includes the transitional experience of anticipation, expectation, contrast, and change. The author suggests that the findings from this research provide illumination of the nuances of professional decision making as a lived experience, and highlight how these practitioners dealt with shifting meaning, values, awareness, choices, and relationships. Aspects of group agency and identity, change management, and professional role transition were revealed. Life pattern, revealed through narrative, was an important research construct for exposing the ways in which the participants negotiated change, and displayed the function of their thinking and reasoning through dilemmas. Perception of individual and group identity revealed attitudes of esteem to the dominant discourse, and exposed dynamic tension between work patterns and life stage. Renegotiating arrangements of personal and professional commitment resulted from this dynamic interplay, and the relationship to stress and burnout was explored.
Call Number NRSNZNO @ research @ 700 Serial 686
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Author Watkins, B.E.
Title Making meaning of a personal experience of discrimination in relation to a disability: An exploration of the literature Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords People with disabilities; Nursing
Abstract This paper explores the reaction of the author's colleagues when she returned to work disabled after recovering from an injury. In order to understand the new experience of disability and discrimination and to help answer what changed the behaviour of colleagues, the author considered evidence from the published literature. After considering many different models of disability, the social model of disability helped clarify and frame her own experience. Reflecting on this literature and personal experience, she suggests that there is acknowledgement that society's attitudes are changing slowly through governmental action and the activism of the disabled. However, she goes on to say, it is only through progressing education, experiencing disability, and continuing emancipatory research that progress will be made to release people with disabilities from their bonds of prejudice and oppression.
Call Number NRSNZNO @ research @ 734 Serial 720
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Author Scott, W.
Title Listen to the beat of my heart: The lived experience of panic attack in undergraduate nursing students: An interpretive inquiry Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Psychology; Students; Nursing; Midwifery
Abstract This interpretive inquiry explores the lived experience of 3 undergraduate nursing students and one midwifery student who have panic attacks. The aim of the research is to give voice to these students and to raise awareness among nurse educators about the impact that panic attacks may have for them. The research question asks, “what is the lived experience of panic attack in undergraduate nursing students?” A semi structured interview was conducted with each student in order to gain significant data. The research identified four key themes implicit to the lived experience of panic attack analysis: Listen to the beat of my heart (embodiedness), fearfulness, shamefulness, and holding one's own (coping). The findings suggest that the lived experience of panic attack is embedded in the lifeworld of lived body, lived time, lived relation, and lived space. Panic attack affects students physically and emotionally and interpersonally. The significant finding is that nurse educators need be aware of the coping or non-coping strategies used by students and, most importantly, recognise the impact that panic attacks have on their study.
Call Number NRSNZNO @ research @ 735 Serial 721
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Author Chapman, C.
Title The elective way: An exploration of pre-operative education for orthopaedic joint replacements Type
Year 2006 Publication Abbreviated Journal (down) Victoria University of Wellington Library
Volume Issue Pages
Keywords Patient satisfaction; Surgery; Education
Abstract This research paper provides a description and analysis of literature and research focusing on pre-operative education programmes available internationally and nationally for patients receiving total joint replacements. This discussion differentiates between pre-assessment and pre-operative education to provide an understanding that both aspects are important in there own right. Together pre-assessment and pre-operative education complement each other to provide total care for patients awaiting total joint replacement surgery. One way of alleviating apprehension experienced by the patient about their surgery is by providing appropriate joint replacement education programmes that meet their needs. This type of programme is a form of empowerment which provides patients with appropriate and relevant information. This allows the patient to be actively involved in their own care and enable them to make informed decisions. The importance of education, information and communication; anxiety and pain; family and peer support; mobility and insecurity is a common thread in the literature where patients describe their experiences and concerns following a total joint replacement. These concepts are discussed and related to why pre-operative education programmes are recommended to help alleviate patients concerns and are important in providing a total multidisciplinary approach to care.
Call Number NRSNZNO @ research @ 736 Serial 722
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