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Author |
James, G.G. |
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Title  |
Woven threads: A case study of chemotherapy nursing practice in a rural New Zealand setting |
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Year |
2008 |
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 |
Case studies; Rural health services; Nursing specialties; Cancer; Oncology |
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Abstract |
This descriptive case study was undertaken to provide an account of chemotherapy practice in a nurse-led clinic located within a rural New Zealand area. The researcher, an oncology nurse specialist, worked alongside colleagues for thirteen months to enable practice development. This clinic developed out of a need to have services closer to rural patients in order to address issues of equity, access, care integration and the fiscal and social constraints associated with the cancer burden of care. Capturing the range of data applicable to this case; the ability to conceptualise it as a service within its context was possible using case study research methods. Four nurses involved in the chemotherapy clinic were participants in this study. The findings of this study reveal that what could be perceived as barriers to outcomes and practice can in essence be turned into opportunities to develop new ways of caring for the patient and supporting nursing practice. These nurses view their practice as safe within the clinic despite resource constraints. They work in many ways to support each other and to cushion the patient from the impact of situational and contextual influences. Nursing practice was shown to evolve as a direct result of internal and external influences which were the impetus for nurses taking responsibility for their own competency. This study also explored what it meant to be an experienced nurse but novice in a speciality practice. It challenges previously held assumptions that, to deliver chemotherapy successfully, a nurse needs to be operating from a previously held body of oncology nursing knowledge. Many challenges are faced on a day to day basis in a rural practice environment to just maintain consistent care and promote good patient outcomes. The nurses are well aware of their role in contributing to patients' quality of life and the roles they take to meet the growing needs of the patient as a consumer. This study delves into the multifarious nature of this nurse-led clinic and discusses the processes and relationships that are forged to deliver care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1166 |
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Author |
Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J. |
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Title |
Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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Volume |
17 |
Issue |
8 |
Pages |
1035-1043 |
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Keywords |
Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison |
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Abstract |
The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU. |
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Call Number |
NRSNZNO @ research @ |
Serial |
962 |
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Author |
Atherfold, C. |
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Title |
Will someone walk with me? A case study exploration of graduate nurses' perceptions of the preceptored experience |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Unitec New Zealand Library |
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Issue |
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Pages |
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Keywords |
Preceptorship; New graduate nurses |
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Abstract |
The transition from student to registered nurse is a challenging and often stressful time in a nurse's career. This thesis is a case study research project that explores the graduate nurses' perceptions of preceptorship as a strategy to support this transition at Lakes District Health Board (DHB). As a provider of graduate nurse programmes since 1995, Lakes DHB has provided preceptorship for the nurse in the initial period of clinical practice. Annual evaluation by questionnaire identified that this has been applied in a range of ways in different clinical settings with varying degrees of effectiveness. Further inquiry into graduate nurses' perceptions of the preceptored experience during the first twelve weeks of practice within Lakes DHB forms the basis of this research project. The intention is to utilise this insight to further inform the development of preceptor education programmes and application of the preceptor role in the practice setting. Using the case study research method, data has been collected from fourteen participants using semi-structured interviews, focus groups and secondary data from the previous year's questionnaire undertaken by preceptors and graduate nurses. Thematic analysis of the data has resulted in two categories, each with three associated themes. The first category relates to functional factors in the way the preceptorship role is applied. This explores the role of the Clinical Nurse Educator (CNE), organisation within the unit and the teaching of clinical skills. The second category relates to psychosocial considerations and includes the graduate's sense of being scared and advocacy of the preceptor, socialisation and team support, and the preceptor's own experience as a registered nurse. Recommendations from the research include the allocation of a dedicated preceptor selected with consideration for relational ability; complementary rostering and workload allocation to ensure that the preceptor and graduate nurse work together; early notification when preceptor arrangements break down; implementation of a clinical coaching plan; and strengthening the CNE's role as a leader facilitating and supporting preceptorship in the units. Opportunities for further research that arise from the study include the perceptions of the preceptors and the nursing leadership in clinical areas. Structuring the application of preceptorship, to ensure that all of these aspects are woven throughout the graduate nurse's transition results in Korowai Aroha, a cloak of covering for a supported transition that facilitates the development of practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
866 |
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Author |
DeSouza, R. |
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Title |
Wellness for all: The possibilities of cultural safety and cultural competence in New Zealand |
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Journal Article |
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Year |
2008 |
Publication |
Journal of Research in Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
2 |
Pages |
125-135 |
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Keywords |
Cultural safety; Nursing models; Cross-cultural comparison; Maori |
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Abstract |
The author contends that responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prevent marginalised groups from utilising universal health services. A combination of approaches is suggested in this paper to meet these two imperatives. Cultural safety is one indigenous New Zealand nursing approach derived in response to inequalities for Maori, whereas cultural competence is an imported paradigm derived from a multicultural context. Furthermore, research and dialogue are required to examine points of complementarity and tension. This paper offers a beginning for this process. |
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Call Number |
NRSNZNO @ research @ 943 |
Serial |
927 |
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Author |
Farmer, D. |
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Title |
Wairarapa Primary Health Care Nursing Workforce Survey – 2007: A replication |
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Year |
2008 |
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 |
Primary health care; Nursing |
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Abstract |
The introduction of the 2001 New Zealand Primary Health Care Strategy has seen increased emphasis on the development of the national primary health care nursing workforce. National and local nursing workforce development initiatives, in response to the strategy, have seen evolving models of primary health care nursing practice in New Zealand. Research was undertaken in 2007 to review the current position of the Wairarapa primary health care nursing workforce. Quantitative, descriptive data was generated through the application, at a local level, of the 2001 Ministry of Health Primary Health Care and Community Nursing Workforce survey tool. Many of the regional challenges highlighted by survey respondents in 2007 are similar to those identified in the national 2001 survey. These include predominantly low numbers of Maori, Pacific and male primary health care nurses and a fragmented, part-time and aging workforce with many respondents indicating they undertake more than one nursing role in their organisation. Respondents were similarly unsure or did not have clear clinical career pathways available to them, a mechanism by which nurses can advance their clinical practice. Some unique service provision and workforce development issues related to Wairarapa's rural context include: geographical barriers, population spread and the high health needs of its rural population. Some unique regional differences compared to the 2001 data are: lower numbers of nurses studying toward further qualifications and specific barriers to accessing education opportunities that can be linked to living in a rural region. More respondents indicated they could work collaboratively with other nurses and health professionals within their own and other organisations. While many respondents were able to provide insightful examples of specific nursing strategies in their practice targeted towards reducing inequalities for groups at risk, others could not. Enrolled nurses remain part of the Wairarapa primary health care nursing workforce. Ten percent of the respondents were actively practising enrolled nurses with an average of 24 years experience in primary health care nursing. Direction and delegation requirements by registered nurses for this group and national attrition trends with corresponding loss of workforce experience of enrolled nurses highlight an area in the Wairarapa primary health care nursing workforce that requires further consideration. Overall this study contributes to current knowledge by establishing a regional nursing workforce baseline from which to measure and enable focused future workforce development initiatives and research. Regional findings can be used to inform recommendations within the Wairarapa Primary Health Care Nursing Action Plan 2006-11 to enhance the delivery of well-developed primary health care nursing services with benefits for the Wairarapa community. |
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Call Number |
NRSNZNO @ research @ |
Serial |
913 |
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Author |
Gregory, R.; Kaplan, L. |
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Title |
Understanding residuals in Guillain-Barre Syndrome |
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Journal Article |
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Year |
2008 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
10 |
Issue |
7 |
Pages |
16-18 |
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Keywords |
Diseases; Nursing; Management |
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Abstract |
The authors review the literature on the residual effects of Guillain-Barre Syndrome (GBS), which can include fatigue, foot drop or numbness, reduced mobility and nerve tingling. In GBS the peripheral nerves are attacked by the body's defence system, an auto-immune attack, and as a result, the myelin sheath and axons of nerves are impaired. The pathophysiology of the illness and long term effects are presented, and implications for nursing care and rehabilitation are discussed. Two case studies are included which illustrate coping with the long-term effects of GBS, the effect of GBS residuals on extreme fatigue and depression. |
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Call Number |
NRSNZNO @ research @ 1013 |
Serial |
997 |
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Author |
Murphy, S.E.E. |
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Title |
Through mothers' eyes: The lived experience of caring for a child who has undergone and recovered from a liver transplantation |
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Year |
2008 |
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 |
Parents and caregivers; Paediatric nursing; Children; Surgery |
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Abstract |
Mothers, whose children had undergone a liver transplant more than one year ago at time of interview and whose children were outpatients of Starship Children's Hospital, were invited to participate in this research. A Heideggerian hermeneutic phenomenological approach, informed by the work of van Manen (1990) was used. Three mothers of children who had received a liver transplant were interviewed to reveal the meanings of the phenomenon – what is the meaning of lived experience of mothers in caring for their child who has undergone and recovered following liver transplantation? Little previous study regarding mothers' lived experience of caring for their child, who had recovered from a liver transplant, was found in the literature. The emerging themes were punctuated with stress being a consistent feature. Utilising Ruddick's (1983) concepts of maternal thinking, the emerging themes were merged within the three interests governing maternal practice; preservation, growth and acceptability. The absolute capacity for attentive love draws the experience together. An essential theme identified out of the analysis was the concept of survival relating to the unique features of liver transplantation and the consequences of liver rejection and failure. The findings contribute to the understanding of the phenomenon, emphasising the need for good support systems for families of children who have undergone transplantation; assistance in the establishment of maternal coping strategies and regular feedback on the children's progress acknowledging the role and care provided by mothers. |
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Call Number |
NRSNZNO @ research @ 1242 |
Serial |
1227 |
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Author |
Curtis, K.; Donoghue, J. |
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Title |
The trauma nurse coordinator in Australia and New Zealand: A progress survey of demographics, role function, and resources |
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Journal Article |
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Year |
2008 |
Publication |
Journal of Trauma Nursing |
Abbreviated Journal |
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Volume |
15 |
Issue |
2 |
Pages |
34-42 |
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Keywords |
Emergency nursing; Personnel; Nurse managers; Economics |
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Abstract |
An initial profile of the demographics and current practice of Australian trauma nurse coordinators (TNCs) was conducted in 2003. The study identified common and differing role components, provided information to assist with establishing national parameters for the role, and identified the resources perceived necessary to enable the role to be performed effectively. This article compares the findings of the 2003 study with a 2007 survey, expanded to include New Zealand trauma coordinators. Forty-nine people, identified as working in a TNC capacity in Australia and New Zealand, were invited to participate in February 2007. Participation in the research enabled an update of the previously compiled Australia/New Zealand trauma network list. Thirty-six surveys (71.5% response rate) were returned. Descriptive statistics were undertaken for each item, and comparisons were made among states, territories, and countries. Participants reported that most of their time was spent fulfilling the trauma registry component of the role (27% of total hours), followed by quality and clinical activities (19% of total hours), education, and administration. The component associated with the least amount of time was outreach (3% of total hours). Although the proportion of time has almost halved since 2003, TNCs still spend the most time maintaining trauma registries. Compared to the 2003 survey, Australian and New Zealand TNCs are working more unpaid overtime, spending more time performing quality and clinical activities and less time doing data entry. Despite where one works, the role components identified are fulfilled to a certain extent. However, the authors conclude that trauma centres need to provide the TNC with adequate resources if trauma care systems are to be optimally effective |
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Call Number |
NRSNZNO @ research @ |
Serial |
964 |
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Author |
Honeyfield, Margy |
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Title |
The necessity of effective nursing leadership for the retention of professional hospital nurses |
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Year |
2008 |
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 |
64 |
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Keywords |
Recruitment and retention; Leadership; Nursing; Policy |
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Abstract |
The author notes that it is widely accepted that there is a global shortage of nurses, and there are many studies in the health workforce literature about the negative aspects of nurse work environments, nursing workloads, decreased job satisfaction of nurses and the impact these have on patient health outcomes. In the past five years there has also been international and New Zealand-specific research into the effects of health restructuring on nursing leadership, retention of nurses, and on patient care. Much of this research has shown that countries with very different health care systems have similar problems, not only with retention of qualified nursing staff due to high levels of job dissatisfaction, but also with work design and the provision of good quality patient care in hospitals. This dissertation explores the many detrimental effects on nurses and nursing leadership, of extensive, and continuing, public health restructuring in New Zealand. The context of this dissertation is New Zealand public hospitals, with references pertaining to medical and surgical areas of nursing practice. Health reforms have negatively impacted on patient care delivery systems, patient health outcomes, and retention of educated nurses in the workforce. In order to resolve these issues, coordinated efforts are required in New Zealand district health boards to develop and sustain effective nursing leaders, who will promote and assist in the development of strong, healthy organisational cultures to retain and support professional nurses and the ways in which they wish to practise. |
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Call Number |
NRSNZNO @ research @ |
Serial |
868 |
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Author |
Jamieson, I. |
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Title |
The mobile operating theatre project |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp.81-97) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Surgery; Training; Evaluation |
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Abstract |
This chapter firstly presents the development of a mobile operating theatre project, which was implemented in 2002 to provide rural day-stay surgery. Secondly, it discusses the process and findings of a research project undertaken with the purpose of evaluating a perioperative (theatre and recovery) reskilling programme offered to 42 rural nurses from nine secondary hospitals, conducted over nine months in 2001. The training was given to nurses prior to the introduction of a mobile operating theatre service, and was seen as a key part of the service contract. |
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Call Number |
NRSNZNO @ research @ 769 |
Serial |
753 |
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Author |
Water, T. |
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Title |
The meaning of being in dilemma in paediatric practice: A phenomenological study |
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Year |
2008 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Volume |
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Issue |
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Pages |
259 pp |
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Keywords |
Psychology; Paediatric nursing; Paedetric practice; Problem solving |
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Abstract |
This study explores the phenomenon of dilemma in paediatric practice. Using a hermeneutic phenomenological method informed by the writings of Heidegger [1889-1976] and Gadamer [1900-2002] this study provides an understanding of the meaning of 'being in dilemma' from the perspective of predominantly paediatric health care professionals but also families in New Zealand. Study participants include four families who had a child requiring health care and fifteen health care practitioners from the disciplines of medicine, nursing, physiotherapy, play specialist and occupational therapy who work with families and children requiring health care. Participants' narratives of their experiences of 'being in dilemma' were captured via audio taped interviewing. These stories uncover the everyday realities facing health professionals and families and provide an ontological understanding for the notion of dilemma. The findings of this study suggest that experience of dilemma for health professionals reveals a world that is uncertain and questionable where they are thrown into having to make uncomfortable choices and must live with the painful consequences of their actions. The consequences of being in such dilemma are having to find ways of living with the angst, or risk becoming too sensitive or desensitizing. For families the experience of dilemma reveals a similar phenomenon most evident in circumstances where they feel totalized by the impact of heath care encounters. This study has uncovered that the perspectives that health professionals and families bring to the experience of dilemma reveal different concerns and commitments and may be hidden from each other. This thesis proposes that health professionals and families need support in living with their own personal encounters of enduring experiences of dilemma. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1234 |
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Author |
Fitzwater, A. |
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Title |
The impact of tourism on rural nursing practice |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 137-43) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Tourism; Advanced nursing practice; Occupational health and safety |
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Abstract |
This chapter reviews some effects of the growth of tourism, including adventure tourism and the numbers of tourists over 50, on rural nursing practice. Tourism contributes to socio-cultural change within a community, and health resources that previously met the needs of the local community may not meet the expectations of growing numbers of tourists. The transient visitor includes both the tourist and the seasonal worker, and has become a feature of rural nursing. Major effects on rural nurses include the increased volume of work, the advanced scope of practice required to meet more complex needs of visitors, and challenges to personal and professional safety. |
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Call Number |
NRSNZNO @ research @ 773 |
Serial |
757 |
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Author |
Jacobs, S.; Boddy, J.M. |
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Title |
The genesis of advanced nursing practice in New Zealand: Policy, politics and education |
Type |
Journal Article |
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Year |
2008 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
24 |
Issue |
1 (Mar) |
Pages |
11-22 |
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Keywords |
Nurse practitioners; History of nursing; Policy; Scope of practice |
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Abstract |
This contemporary historical study examines the health sector environment of the 1990s and the turn of the 21st century, and assesses the policy initiatives undertaken to advance nursing in New Zealand during that period. The authors look at the conditions and forces that saw nursing achieve a new emphasis on advanced and expanded scope of nursing practice, less than a decade after the commencement of New Zealand's first pre-registration nursing degrees. |
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Call Number |
NRSNZNO @ research @ |
Serial |
452 |
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Author |
Maw, H. |
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Title |
The challenge of developing primary health care nurse practitioner roles in rural New Zealand |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 201-214) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Rural health services; Interprofessional relations; Policy |
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Abstract |
The author traces the development of the nurse practitioner role in New Zealand, which was finally introduced in 2001. It traces the key events, from early debates on the issue, the influence of the Centre for Rural Health, and a series of government investigations into nursing which noted the untapped potential of the nursing workforce and the lack of ongoing clinical career pathways. Barriers to rural nurses becoming endorsed as primary health care nurse practitioners are examined, and some of the solutions to this issue are explored. Relationships between nurse practitioners and the local general practitioners, and community resistance are areas that need management. Education is seen as a key response to many of these issues. |
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Call Number |
NRSNZNO @ research @ |
Serial |
762 |
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Author |
Barton, Pipi; Wilson, Denise |
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Title |
Te Kapunga Putohe (the restless hands) : a Maori centred nursing practice model |
Type |
Journal Article |
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Year |
2008 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
24 |
Issue |
2 (Jul) |
Pages |
6-15 |
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Keywords |
Maori-centred practice; Nursing model; Maori health; Indigenous; Kaupapa Maori; Maori health |
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Abstract |
Notes an absence of nursing practice models focussing on the traditional beliefs of Maori amongst nursing literature. Presents Te Kapunga Putohe (the restless hands) model of Maori centred nursing practice. Illustrates how Maori knowledge and nursing knowledge can be incorporated to deliver nursing care that is both culturally appropriate and can improve the nursing experience for Maori clients. |
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Call Number |
NZNO @ research @ |
Serial |
1434 |
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