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Budge, C., Carryer, J. B., & Wood, S. (2003). Health correlates of autonomy, control and professional relationships in the nursing work environment. Journal of Advanced Nursing, 42(3), 260–268.
Abstract: The aim of this study was to examine nursing in New Zealand and to see whether aspects of the work environment are associated with health status. A total of 225 registered nurses in a general hospital completed the Revised Nursing Work Index (NWI-R) and Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36). Ratings indicated that the New Zealand hospital environment was characterized by less autonomy and control and better nurse-physician relations than in USA hospitals. Results of correlations demonstrated that more positive ratings of the three workplace attributes were associated with better health status amongst the nurses. The results of regression analyses were indicative either of a confounding relationship or of a mediating relationship such that nurses' relations with physicians, administration and other departments mediate the associations between autonomy, control and health status.
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Carryer, J. B. (2001). Embodied largeness: A significant women's health issue. Nursing Inquiry, 8(2), 90–97.
Abstract: This paper describes a three-year long research project in which nine large-bodied women have engaged in a prolonged dialogue with the researcher about the experience of being 'obese'. The study involved an extensive review of the multidisciplinary literature that informs our understandings of body size. The literature review was shared with participants in order to support their critical understanding of their experience. The experience of participants raised questions as to how nursing could best provide health-care for large women. An examination of a wide range of literature pertinent to the area of study reveals widespread acceptance of the notion that to be thin is to be healthy and virtuous, and to be fat is to be unhealthy and morally deficient. According to the literature review, nurses have perpetuated an unhelpful and reductionist approach to their care of large women, in direct contradiction to nursing's supposed allegiance to a holistic approach to health-care. This paper suggests strategies for an improved response to women who are concerned about their large body size.
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Carryer, J. B. (1997). A feminist appraisal of the experience of embodied largeness: A challenge for nursing. Ph.D. thesis, , .
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Carryer, J. B., & Boyd, M. (2003). The myth of medical liability for nursing practice. Nursing Praxis in New Zealand, 19(4-12), 4–12.
Abstract: This article explores the complex nature of liability in the case of standing orders and vicarious liability by employers, and also when nurses and doctors are in management roles. The authors address misconceptions about medico-legal responsibility for nursing practice with the advent of nurse prescribers and nurse practitioners. They refer to the submission made by the College of Nurses Aotearoa (NZ) on the Health Practitioners Competence Assurance Act (2003), and discuss practice liability and nurse-physician collaboration.
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Carryer, J. B., Budge, C., & Russell, A. (2002). Measuring perceptions of the Clinical Career Pathway in a New Zealand hospital. Nursing Praxis in New Zealand, 18(3), 18–29.
Abstract: The authors outline the Clinical Career Pathways (CCPs) for nurses, which were first established in New Zealand during the late 1980s. This paper introduces a new instrument, the Clinical Career Pathway Evaluation Tool (CCPET) designed to assess nurses' and midwives' knowledge of and attitudes towards their Clinical Career Pathway. The 51 item instrument takes the form of a self-report questionnaire. The development of the CCPET is described and results from an initial application of the instrument with 239 nurses and midwives in a New Zealand hospital are presented. Results indicate that knowledge levels were moderate in this sample and were correlated with both positive and negative attitudes. Results of t-test comparisons indicated that, on average, the group who had already completed a CCP portfolio had greater knowledge and more positive attitudes than the group who had not.
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Carryer, J. B., Gardner, G., Dunn, S., & Gardner, A. (2007). The core role of the nurse practitioner: Practice, professionalism and clinical leadership. Journal of Clinical Nursing, 16(10), 1818–1825.
Abstract: This article draws on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. A study jointly commissioned by both countries' Regulatory Boards developed information of the newly created nurse practitioner role, to develop shared competency and educational standards. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner programme curricula and interviews with 15 nurse practitioners from the two countries. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care.
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Carryer, J. B., & Russell, L. (2007). Nurses' understandings of the Professional Development Recognition Programme. Nursing Praxis in New Zealand, 23(2), 5–13.
Abstract: Professional Development and Recognition Programmes (PDRP) for nurses have developed out of the Clinical Career Pathways (CCP) of the 1990s. The Health Practitioners Competence Assurance Act (2003) has now required all health professionals to provide evidence that their practice meets criteria set by the individual regulatory body, which, for nursing, is the Nursing Council of New Zealand. In 2002 a tool was developed to measure knowledge and attitudes of the then CCP which was tested with 239 nurses. This paper is a report on the second application of the tool in the same hospital in New Zealand. Results show that knowledge and attitudes of the PDRP are similar to those found in the previous study. It also suggests that greater understanding of the PDRP and the implementation process increases the likelihood of a positive response to the programme.
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Clear, G. M., & Carryer, J. B. (2001). Shadow dancing in the wings: Lesbian women talk about health care. Nursing Praxis in New Zealand, 17(3), 27–39.
Abstract: A participatory approach, grounded in both critical social and feminist research, was used in this study of seven women who claim being lesbian as part of their identity. With the objective of providing information to enhance safe care provision for this marginalised group, the study explored factors which hindered or facilitated these women's sense of safety related to health care. The findings indicate that barriers to receiving health care exist for these women. As there is little local or international research on lesbians and healthcare, this work offers a starting place for future New Zealand nursing research involving lesbians. The authors encourage other nurses to explore previously ignored sections of our society in order to strive for safety for all those whom nursing serves.
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Flynn, L., Carryer, J. B., & Budge, C. (2005). Organisational attributes valued by hospital, home care, and district nurses in the United States and New Zealand. Journal of Nursing Scholarship, 37(1), 67–72.
Abstract: The aim of this study was to determine whether hospital-based, home care, and district nurses identify a core set of organisational attributes in the nursing work environment that they value as important to the support of professional practice. Survey data, collected in 2002 2003 from 403 home care nurses in the United States and 320 district nurses in New Zealand, were pooled with an existing data set of 669 hospital-based nurses to conduct this descriptive, nonexperimental study. The importance of organisational attributes in the nursing work environment was measured using the Nursing Work Index-Revised (NWI-R). The authors found that at least 80% of hospital-based, home care, and district nurses either agreed or strongly agreed that 47 of the 49 items comprising the NWI-R represented organisational attributes they considered important to the support of their professional nursing practice. Mean importance scores among home care nurses, however, were significantly lower than were those of the other two groups. The authors conclude that the overall, hospital-based, home care, and district nurses had a high level of agreement regarding the importance of organisational traits to the support of their professional practice. The intensity of the attributes' importance was less among home care nurses. Further research is needed to determine whether this set of organisational traits, measured using the NWI-R, is associated with positive nurse and patient outcomes in home care and district nursing practice, as has been shown in acute care settings.
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Gardner, A., Hase, S., Gardner, G., Dunn, S., & Carryer, J. B. (2008). From competence to capability: A study of nurse practitioners in clinical practice. Author copy available 12 months after publication from QUT ePrints, 17(2), 250–258.
Abstract: This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners.
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Gardner, G., Dunn, S., Carryer, J. B., & Gardner, A. (2006). Competency and capability: Imperative for nurse practitioner education. The author-version of article, available online from Queensland University of Technology ePrints arc, 24(1), 8–14.
Abstract: The objective of this study was to conduct research to inform the development of standards for nurse practitioner education in Australia and New Zealand and to contribute to the international debate on nurse practitioner practice. The research was conducted in all states of Australia where the nurse practitioner is authorised, and in New Zealand. The research was informed by multiple data sources including nurse practitioner programme curricula documents from relevant universities in Australia and New Zealand, interviews with academic convenors of these programmes and interviews with nurse practitioners. Findings include support for masters level of education as preparation for the nurse practitioner. These programs need to have a strong clinical learning component and in-depth education for the sciences of specialty practice. Additionally an important aspect of education for the nurse practitioner is the centrality of student directed and flexible learning models. This approach is well supported by the literature on capability.
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Richardson, F. I., & Carryer, J. B. (2005). Teaching cultural safety in a New Zealand nursing education program. Journal of Nursing Education, 44(5), 201–208.
Abstract: This article describes the findings of a research study on the experience of teaching cultural safety. As a teacher of cultural safety, the first author was interested in exploring the experience of teaching the topic with other cultural safety teachers. A qualitative approach situated in a critical theory paradigm was used for the study. The study was informed by the ideas of Foucault and feminist theory. Fourteen women between ages 20 and 60 were interviewed about their experience of teaching cultural safety. Five women were Maori and 9 were Pakeha. Following data analysis, three major themes were identified: that the Treaty of Waitangi provides for an examination of power in cultural safety education; that the broad concept of difference influences the experience of teaching cultural safety; and that the experience of teaching cultural safety has personal, professional, and political dimensions. These dimensions were experienced differently by Maori and Pakeha teachers.
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Wilson, S., & Carryer, J. B. (2008). Emotional competence and nursing education : A New Zealand study. Nursing Praxis in New Zealand, 24(1 (Mar)), 36–47.
Abstract: Explores the challenges encountered by nurse educators who seek to assess aspects related to emotional competence in nursing students. This emotional competence includes nurses managing their own emotional life along with the skill to relate effectively to the multiple colleagues and agencies that nurses work alongside. The research was designed to explore the views of nurse educators about the challenges they encounter when seeking to assess a student's development of emotional competence during the three year bachelor of nursing degree. Focus groups were used to obtain from educators evidence of feeling and opinion as to how theory and practice environments influence student nurses' development of emotional competence. The process of thematic analysis was utilised and three key themes arose as areas of importance to the participants. These were personal and social competence collectively comprises emotional competence in nursing; emotional competence is a key component of fitness to practise; and transforming caring into practice. The findings of the study indicate a need for definition of what emotional competence is in nursing. It is argued that educators and practicing nurses, who work alongside students, must uphold the expectation that emotional competence is a requisite ability and should themselves be able to role model emotionally competent communication.
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