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Adamson, M. J. (1997). Action research: the journey from enrolled nurse to registration and beyond. Discovering a process to promote self-efficacy and professional development. Ph.D. thesis, , .
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Alessi, L. (1990). The role of quality assurance strategies in the evaluation of New Zealand nursing services. Ph.D. thesis, , .
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Anderson, P. R. (1997). Perceived level and sources of stress in beginning Bachelor of Nursing students. Ph.D. thesis, , .
Abstract: A study to examine the effects of pre- information ( what a Nurse learns about a patient before they meet) on clinical inference and Nursing actions, in a simulated Nurse- Patient situation. It was hypothesized that the nature of the pre-information will influence the way the patient is perceived and the resulting Nursing actions. The research was conducted in an obstetrical setting. There were 55 subjects within three groups. Two groups comprised student midwives and the third group was of second year comprehensive Nursing students near completion of clinical experience in maternal and child health nursing. A 5 minute videotape sequence of a role played post natal patient was made for use in the research. All subjects were given the same initial pre-information, viewed the videotape and gave written description of what they saw on the videotape and their response ( as the Nurse in the situation). This data provided a base line for each subject. Subject were then given additional pre-information concerning the patient's physical condition, her baby's condition or formed part of the control group ( receiving no additional information) The procedure was repeated. These responses were then compared with the base line for each subject. Responses were coded by means of content analysis. Group data was analysed using multivariate one way analysis of variance graphical display. The results indicated support of the hypothesis that the nature of the pre-information does influence the way in which a Nurse perceives a patient and resulting Nursing actions. Implications of these findings for Nurses are discussed
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Archer, L. K. (2001). We talk what we do: An exploration of the value, role and function of storytelling in nursing from one nurse's practice perspective.
Abstract: The role of storytelling in any society fulfils multiple functions such as maintaining culture, holding history, teaching genealogical lessons, imparting wisdom, entertaining, passing on knowledge. The author suggests that nursing, historically described as a craft with an oral tradition, could be seen to be quietly moving away from the practice of storytelling. Or has it? She asked this question and began to realise that her practice and relationships with colleagues had always been based on stories and storying. To explore this phenomenon, she began to describe her day to day practice in story form, and began to position stories she had previously written. In her work of oncology palliative care nursing within a community setting in New Zealand, the stories proved crucial to her role as an educator, and companion of patients and their families. In this paper she examines how she uses story for her benefit, the patients' benefit, but mainly for the benefit of nursing. She examines from her own perspective, some underlying themes that reinforce the need to continue this ancient tradition and explore the role, value and function of storytelling within nursing.
Keywords: Nursing; Palliative care; Professional development
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Arcus, K. J. (2004). Often wearisome, sometimes saddening, but always interesting: A hundred years of district nursing in Wellington, 1903-2003. Ph.D. thesis, , .
Abstract: October 2003 marked the centenary of Wellington district nursing. Annie Holgate, a 'trained, professional' nurse, was employed to care for the sick poor in 1903. The Wellington St John Ambulance District Nursing Guild funded district nursing for over fifty years. The first president, Sarah Ann Rhodes, left a legacy of a solid financial and administrative base for the whole of the Guild's existence. From 1945 the Wellington Hospital Board assumed responsibility for district nursing and expanded the service to the greater Wellington region. In 1974 the Community Health Services were formed, with Pauline MacInnes as the nurse leader. Expansion of healthcare in the community ensued, with district nurses pivotal to client-centred, community-based, collaborative healthcare. This service was dismantled in the wake of health sector restructuring in 1989. The philosophy and operation of the Community Health Service of this period bears a striking resemblance to the current concept of Primary Health Care. Primary sources from Wellington St John, Kai Tiaki and data from official publications were used to compile this history. Emergent themes are the autonomy of district nurses' practice, the invisibility of district nursing and the impact of visionary leadership. All have implications for the future of district nursing. District nursing, initially dependent on philanthropy, has been publicly funded in New Zealand since 1944. District nursing is now an essential component of health care.
Keywords: District nursing; History
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Bailey, A. M. (2004). The New Zealand practice nurse in the primary health environment of the 21st century.
Abstract: This paper is a culmination of the author's inquiry, reflection and critical thinking on the transitional phase that practice nursing is currently undergoing as part of the New Zealand Primary Health Strategy. The paper utilises both reflection-in-action and reflection-on-action as well as reflection-before-action, as a process. The author's starting point for this inquiry was attending the New Zealand Nurses Organisation Primary Health Conference in Wellington and reading a report from the Expert Advisory Group on Primary Health Care Nursing. Knowing that practice nurses are the majority of nurses working in primary health, she was concerned that changes to primary health were being driven with little reference or participation by them. The paper explores how practice nursing evolved in New Zealand and the developments that have occurred in the 30 plus years since its inception. It describes the role and current work of practice nursing in general practice, and highlights the constraints that have held back development and continue to do so. The 2002 New Zealand Primary Health Strategy is shown to provide an opportunity for development and enhancement, if some of the constraints are removed. As part of looking to the future the possibilities for practice nurses to lead the way in primary health development are explored.
Keywords: Policy; Practice nurses; Primary health care
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Baker, K. O. (2006). A journey: Experienced respiratory nurses working with patients with chronic breathlessness. Ph.D. thesis, , .
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.
Keywords: Nursing specialties; Nurse-patient relations
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Beale, T. M. (1995). Psychiatric nurses: the influence of their personal life experiences on therapeutic readiness. Ph.D. thesis, , .
Abstract: This research investigates the impact of fifteen psychiatric nurses' personal experiences on their therapeutic relationships with clines. A hermeneutic phenomenological methodology informed by Heidegger is employed to gain an understanding of the human experience of these nurses in the context of the therapeutic relationship.The research illuminates the significant impact of these nurses' experiences on their relationships. Some experiences are found to enhance therapeutic readiness while the other personal experiences impede it, some impeding it to a degree that nurses are unable to work therapeutically with certain clients. The stories that describe the personal experiences that lead towards therapeutic readiness care special, as are the accounts of the professionalism and care that these nurses bring to their clients
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Beaton, T. (2004). Postnatal depression: Four women's experiences of care from a nurse. Ph.D. thesis, , .
Abstract: Postnatal depression is a term used loosely to describe disorders of mood and distressing symptoms for women in the postpartum, yet it has its own distinct symptoms. It is thought to affect between 10 and 20 percent of new mothers in New Zealand. In order to deliver effective nursing care that has a positive impact on the health of women who experience postnatal depression, nurses need knowledge and theory to underpin practice. This study explores the experience of four women who experienced postnatal depression and the care they received from a nurse. A postmodern feminist position informed the research project. Women became actively involved in a focus group to explore their experiences. A thematic analysis of the focus group transcripts revealed the women's experiences of care from nurses and health professionals as not always helpful. The themes that arose from the analysis were knowledge, perception, care and self. Knowledge examined the women's and significant others' knowledge of postnatal depression as well as women's own knowledge of themselves. Perception identified the women's beliefs of and views on mental illness, as well as their expectations of motherhood. Care as a concept was examined as to how it was provided by nurses. This encompassed a lack of care and, in contrast, supportive care as impacting on the women's individual experiences. Self described the experiences of a loss of self as women experienced their distress in the postpartum, and that a regaining of self was identified by women as difficult, and this is where they required support. The themes are discussed and critiqued with literature that identifies the nursing role with women who experience postnatal depression. There are recommendations for ongoing research and development of the nursing role in order to promote the health and wellbeing of women in the postpartum.
Keywords: Female; Mental health; Nurse-patient relations; Feminist critique
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Blackmore, L. A. (2006). Triaging patients away from the emergency department: A review of the issues.
Abstract: With the intention of decreasing emergency department demand, there has been a focus on determining those patients who do not require the services of the emergency department so they can be redirected away to an alternative health care provider or facility. Co-locating an after-hours primary health care facility near to the emergency department is a model under consideration in some district health boards. This model suggests that a substantial proportion of the patients currently managed in the emergency department can be assessed and managed in a general practice setting. It is envisaged that by redirecting the lower acuity patients away from the emergency department, overcrowding will be relieved. This is despite evidence demonstrating that low acuity patients are not the cause of emergency department overcrowding. Moreover, being treated at the emergency department is the only safety net for many people in the community who cannot afford alternative care. This research report discusses the literature regarding the practice of referring or redirecting patients away from the emergency department and the issues associated with this model. In doing this, it looks at the Australasian Triage Scale, the system used to ensure patients are seen in order of clinical urgency, because it has been suggested that this system could be used as a tool to refer patients away from the emergency department. The author concludes that even though some people could be seen by another health care provider, the triage system is not an appropriate tool for achieving this. While it is tempting to believe that patients in the lower triage categories are prime candidates for being referred away, there is evidence from hospital statistics that patients in these categories have a high number of hospital admissions and in-hospital death rates. Additionally, to complicate matters, there is no universal definition of what constitutes an 'appropriate' emergemcy department presentation and no consensus of opinion amongst health professionals in deciding patients' 'appropriateness'. For these reasons it is unethical to expect nurses who administer the triage system to use it for the purpose of referring people away from the emergency department.
Keywords: Emergency nursing
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Blair, K. M. (2006). Recognising the sick patient: An emergency nurses view: A research paper.
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.
Keywords: Emergency nursing; Patient safety; Diagnosis; Training; Clinical decision making
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Blair, S. (1999). The human cost of 'caring' care for registered nurses in clinical practice. Ph.D. thesis, , .
Abstract: This research utilized a focus group methodology to discover what nurses in clinical practice considered 'caring' care meant for them. Six registered nurses volunteered to participate in the project. They practiced over a wide variety of real settings within the public hospital, which provided both acute and elective surgical and medical services, including an extensive elderly population. Taking these important 'caring' statements, I then explored with the group what factors in their work environment hindered of enhanced their identified 'caring' care in clinical practice as did their overseas counterparts. This study also highlighted the impact the health reforms had on the individual clinical practice at this hospital. The effects of the institutional changes in response to the health reforms were far reaching at both the personal and professional level. Caring is an important concept found in nursing practice. It has been widely documented By nurse scholars, researchers and nurse authors that care is at the core of nursing practice.Some have even referred to care as being the heart of nursing. The finding from the present research indicates the importance nurses place on caring in their day to day encounters with patients. It also demonstrates how nurses express their care and their perceptions of the importance of care has in the clinical practice
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Blanchard, D. L. (2006). Developing the place and role of family within the culture of critical care nursing: An action research approach. Ph.D. thesis, , .
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.
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Blanchard, D. L. (1995). Nursing practice in the changing health care environment “just keep going until you see it right”. Ph.D. thesis, , .
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Booth, W. (1997). Towards partnerships in praxis. Ph.D. thesis, , .
Abstract: This action research project explored the factors that helped or hindered student nurse clinical learning from the perspective of nurse educators, practitioners and students. Participant analysis of their own discussions identified both common and disparate views regarding the student's learning experience. Researcher analysis identified five practical and three organizational issues that influenced the development of more effective partnerships between these three stakeholder groups that would facilitate student clinical learning. The practical issues were how to deal with the 'problem' people in the learning process, how to clarify and develop the various roles in the learning context, how to generate more effective communication, how to respond more effectively to the impact of the changing environment, and how to maximize 'moments of learning'. The organizational issues were identified as the schisms between the disparate personal and organizational cultures that direct the way educators, practitioners and students, perceive, think, feel and act
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