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Author |
Robertson, A.M. |
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Title |
Meeting the maternity needs of rural women: Negotiating the reality of remote rural nursing and midwifery practice |
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Year |
2006 |
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  |
Rural nursing; Midwifery |
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Abstract |
Recent changes to the way that health services are provided and issues related to the rural health workforce are creating an international crisis in the availability of rural maternity care. International trends show a workforce decline in rural general practitioner obstetric specialists and rural midwives, as well as a decline in rural births. The aim of this study is to highlight the maternity needs of rural New Zealand women. Further, it discusses how the changes to maternity services in New Zealand, over the last sixteen years, have impacted on the rural nurse and midwife role and therefore on service provision. This information is intended to identify issues that could be used as the basis for development of a uniquely rural model of maternity care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
510 |
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Author |
Dillon, D.R. |
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Title |
Islands, islandness and nursing: Advanced nursing practice in rural remote and small island areas |
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Year |
2006 |
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 |
Rural nursing; Primary health care |
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Abstract |
This dissertation focuses on the concepts of island, island-ness, and isolation. It aims to further advance the national and international literature relating to the health beliefs of island people as linked to the provision of primary health care services within New Zealand. New Zealand is an island nation made up of two main islands and numerous outlying islands, relatively isolated from the rest of the world by water. This geography means going anywhere from New Zealand involves traveling either “over” or “on” the sea. All people of New Zealand since the first inhabitants, whether residents or visitors, have arrived to New Zealand either by sea or more recently by plane. The population of New Zealand is 25% rural, with most of these rural dwellers residing in the South Island, and several of the smaller off shore Islands. This builds a sense of culture of the people, or tangata whanua (the people of the land), for whom there are degrees of island-ness, and the characteristics of this can be seen amongst the people of New Zealand. A further challenge which is discussed comes in the form of the “island penalty” which encompasses high transport costs, long distances to travel to main centres, lack of specialists and trained health workers, effects of migration and tourism, and communication difficulties. The more isolated people are, the tougher the challenges become. Most rural island populations are served by lay care workers, volunteers, and rural and remote nurses. Nurses are often the main health care providers to small island populations, and they demonstrate advanced nursing practice which is acknowledged internationally as meeting Nurse Practitioner competencies. As a group these nurses possess knowledge of the extrinsic and intrinsic factors involved in the health needs and health determinants of these island communities. Researching these advanced nursing roles adds to the body of knowledge around isolated and island communities. The author suggests that studying the concepts of islands, islandness, and isolation in relation to health beliefs will bring more understanding of services for the advanced rural nurse to consider in developing appropriate, accessible, affordable and adaptable Primary Health Care which is fair and equitable. |
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Call Number |
NRSNZNO @ research @ |
Serial |
507 |
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Author |
Murrell-McMillan, K.A. |
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Title |
Why nurses in New Zealand stay working in rural areas |
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Journal Article |
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Year |
2006 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
33 |
Issue |
3 |
Pages |
173-175 |
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Keywords |
Rural nursing; Recruitment and retention; Job satisfaction; Teamwork; Primary health care |
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Abstract |
The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues. |
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Call Number |
NRSNZNO @ research @ |
Serial |
530 |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse (PHCRN) interface with secondary care doctors |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Rural health services; Relationships |
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Abstract |
A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors as a component of rural nursing practice and representative of the primary-secondary care interface. Crucial to patient centred care, the premise was that the quality of this interface would be variable due to multiple influences such as: the historical nurse/doctor relationship that has perpetuated medical dominance and nursing subordination; current policy direction encouraging greater inter-professional collaboration; and changing role boundaries threatening traditional professional positioning. A total of 11 nurses representing 10 separate rural areas participated in semi-structured interviews. Rural nurses typically interact with secondary care doctors for acute clinical presentations with two tiers of interaction identified. The first tier was presented as a default to secondary care doctors for assistance with managing primary care level clinical presentations in the absence of access to a general practitioner or an appropriate Standing Order enabling appropriate management. The second tier presented itself as situations where, in the professional judgement of the nurse, the client status indicated a need for secondary level expertise and/or referral to secondary care. The needs of the rural nurse in these interactions were identified as access to expertise in diagnosis, therapy and management, authorisation to act when intervention would exceed the nurse's scope of practice; the need to refer clients to secondary care; and the need for reassurance, encompassing emotional and professional issues. The quality of the interactions was found to be variable but predominantly positive. Professional outcomes of positive interactions included professional acknowledgement, support and continuing professional development. For the patient, the outcomes included appropriate, timely, safe intervention and patient centred care. The infrequent but less than ideal interactions between the participants and secondary care doctors led to professional outcomes of intraprofessional discord, a sense of invisibility for the nurse, increased professional risk and professional dissatisfaction; and for the client an increased potential for deleterious outcome and suffering. Instead of the proposition of variability arising from interprofessional discord and the current policy direction, the data suggested that variability arose from three interlinking factors; appropriate or inappropriate utilisation of secondary care doctors; familiarity among individuals with professional roles and issues of rurality; and acceptance by the primary care doctor of the sole on-call primary health care rural nurse role and the responsibility to assist with the provision of primary health care. Recommendations for improving interactions at the interface include national, regional and individual professional actions. |
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Call Number |
NRSNZNO @ research @ |
Serial |
493 |
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Author |
O'Brien, A.J.; Kar, A. |
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Title |
The role of second health professionals under New Zealand mental health legislation |
Type |
Journal Article |
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Year |
2006 |
Publication |
Journal of Psychiatric & Mental Health Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
3 |
Pages |
356-363 |
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Keywords |
Scope of practice; Psychiatric Nursing; Nurse-patient relations |
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Abstract |
The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for the second health professional role is suggested as a way of supporting clinical practice in this area. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1045 |
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Author |
Neville, S.J.; Henderson, H.M. |
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Title |
Perceptions of lesbian, gay and bisexual people of primary healthcare services |
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Journal Article |
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Year |
2006 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
55 |
Issue |
4 |
Pages |
407-415 |
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Keywords |
Sexuality; Attitude of health personnel; Primary health care |
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Abstract |
This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people. |
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Call Number |
NRSNZNO @ research @ 1059 |
Serial |
1043 |
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Author |
Goulding, M.T. |
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Title |
The influence of work-related stress on nurses' smoking: A comparison of perceived stress levels in smokers and non-smokers in a sample of mental health nurses |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Smoking; Psychiatric Nursing; Stress; Mental health |
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Abstract |
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Call Number |
NRSNZNO @ research @ 701 |
Serial |
687 |
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Author |
Marcinkowski, K.; McDonald, B. |
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Title |
Changing blood transfusion practice in elective joint arthroplasty: A nursing initiative |
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Journal Article |
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Year |
2006 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
22 |
Issue |
3 |
Pages |
15-21 |
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Keywords |
Surgery; Hospitals; Economics |
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Abstract |
This study analysed the use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. The researchers anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty. |
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Call Number |
NRSNZNO @ research @ 533 |
Serial |
519 |
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Author |
Vallant, S.R.; Neville, S.J. |
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Title |
The relationship between student nurse and nurse clinician: Impact on student learning |
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Journal Article |
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Year |
2006 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
22 |
Issue |
3 |
Pages |
23-33 |
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Keywords |
Teaching methods; Students; Nursing |
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Abstract |
The purpose of this descriptive interpretive study was to explore relationships between student nurses and nurse clinicians. Eleven student nurses at the end of a three year Bachelor of Nursing programme in one institution participated in focus group interviews. Data gathered from the three focus groups were analysed using an inductive approach. Five categories, namely 'being invisible in the relationship', 'not stepping on toes', 'lost opportunities for learning', 'nurturance' and 'reciprocity' emerged from data analysis. These are presented with appropriate quotes to demonstrate the essence of participant experiences. Findings indicated that when students experienced relationships with clinicians as not being positive, this inhibited learning. Conversely, when students saw the clinician as participating actively and positively in the student/clinician relationship then student learning was enhanced. This evidence forms the basis for recommending further complementary research into the clinician's attitudes and perceptions related to their teaching role. |
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Call Number |
NRSNZNO @ research @ |
Serial |
529 |
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Author |
McLauchlan, M.F. |
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Title |
Mobile computing in a New Zealand Bachelor of nursing programme |
Type |
Book Chapter |
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Year |
2006 |
Publication |
Consumer-Centered Computer-Supported Care for Healthy People. Studies in health technology and informatics, 122 (pp. 605-608) |
Abbreviated Journal |
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Volume |
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Issue |
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Pages |
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Keywords |
Technology; Curriculum; Nursing; Education; Professional competence |
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Abstract |
Mobile computing is rapidly becoming a reality in New Zealand health care settings. Personal Digital Assistants (PDAs) are the most frequently used of these mobile technologies, giving nurses access to clinical learning resources, including drug references, medical encyclopaedias and diagnostic information. The implementation of mobile computing at Waikato Institute of Technology (Wintec) will ensure graduates of our Bachelor of Nursing Programme are able to meet health care service demands for knowledge in contemporary information technologies as well as the information technology requirements defined by the Nursing Council of New Zealand and the Health Practitioners Competency Assurance Act 2003 for registration as a nurse in New Zealand. This paper presents strategies for the implementation of mobile computing as a core element of the curriculum for the Bachelor of Nursing Programme at Wintec in Hamilton. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1192 |
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Author |
Polley, H. |
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Title |
Treating wounds with oxygen |
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Journal Article |
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Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
2 |
Pages |
16-17 |
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Keywords |
Technology; Evidence-based medicine |
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Abstract |
This article overviews the use of hyperbaric oxygen treatment in New Zealand primarily for chronic wounds, those who have had radiation therapy and those who are having or who have had head and neck surgery. In New Zealand there are just three hyperbaric oxygen treatment units: The Devonport Naval Base and The Oxygen Therapy Clinic, both in Auckland; and the Hyperbaric Medicine Unit in Christchurch; thus access to this treatment is limited. |
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Call Number |
NRSNZNO @ research @ 1012 |
Serial |
996 |
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Author |
Johnstone, S. |
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Title |
Undergraduate nursing and death education |
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Year |
2006 |
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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Volume |
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Issue |
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Pages |
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Keywords |
Terminal care; Nursing; Education |
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Abstract |
Death education encompasses many complex realities, for both the students and lecturers involved. This quantitative research explored the experiential and didactic preparation of nursing students through a content analysis, of one New Zealand, three year Bachelor of Nursing programme, in relation to death education. The Otago Polytechnic Bachelor of Nursing programme incorporates compulsory and optional courses, with the courses taught as an integrated programme with a progressive, sequential approach. This approach builds on content, deepening understanding from year to year, as well as providing opportunities for experiential learning and broadening of understanding. The literature review discusses three dominant themes of undergraduate death education: education, death, and transition. The data collection tool incorporates eighteen key terms, ten teaching methods and ten assessment methods. The programme and individual course documents, which define course content, teaching and assessment were scanned and analysed. The findings initially showed limited evidence of death education in course documents, however deeper analysis of the documents showed further evidence over the three year programme. The existence of death education is implied rather than overt throughout many course documents, through the use of broad practice statements. Content analysis is one way of shedding light on programme content in relation to death education. Limitations of the content analysis approach mean measuring experiential and didactic learning is not fully achievable from documentation analysis only. Further development of Bachelor of Nursing death education is an ongoing challenge, with current programmes very full and possibly lacking the capacity to increase content. Bachelor of Nursing programmes are discussed, highlighting the need for student focused learning with emphasis on acquiring and processing information, rather than mastery of content. |
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Call Number |
NRSNZNO @ research @ |
Serial |
735 |
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Author |
Rolls, S. |
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Title |
An exploration of workplace violence in the emergency department: Are emergency nurses safe? |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Workplace violence; Emergency nursing; Guidelines |
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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 |
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Call Number |
NRSNZNO @ research @ |
Serial |
492 |
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Author |
Pepers, M.G. |
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Title |
A grey zone: The experience of violence in remote nursing practice |
Type |
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Year |
2006 |
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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Volume |
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Issue |
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Pages |
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Keywords |
Workplace violence; Rural health services; Rural nursing |
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Abstract |
This dissertation explores the issues affecting the exposure of isolated rural nurses working in New Zealand to violence from members of the local community, including the visiting public. Discussion on the collaborative role with the New Zealand Police is thematic in the issues presented. Challenges presented include the unique community dynamics of the Stewart Island nursing practice on the Island, with scope of practice, isolation and practice issues included. Role definition, present-day health-care delivery, the potential for violence including causation and reporting are presented. Incident management and risk strategies, including de-escalation are rationalised and described. Evidence for the nurse-police inter-service relationship along with issues including confidentiality and legislation are reviewed. Recommendations and conclusion are provided. The thread and theme of the dissertation is to encourage discussion within nursing circles on the provision of satisfactory safety standards for nurses working in remote isolated parts of New Zealand. |
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Call Number |
NRSNZNO @ research @ |
Serial |
688 |
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