Spence, D., & Smythe, E. (2007). Courage as integral to advancing nursing practice. Nursing Praxis in New Zealand, 23(2), 43–55.
Abstract: This paper focuses on the illumination of courage in nursing. The authors suggest it is a fundamental component of nursing, yet it is seldom mentioned or recognised in the literature, or supported in practice. Data from a hermeneutic analysis of nurses' practice stories is integrated with literature to assist deeper understanding of the meaning of courage in contemporary nursing practice. The purpose is to make visible a phenomenon that needs to be actively fostered if nursing is to effectively contribute to an improved health service.
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Jackson, H. (2001). Compassion: A concept exploration. Nursing Praxis in New Zealand, 17(1), 16–23.
Abstract: This paper explores the nature of compassion and posits it as a moral virtue that requires the nurse to act in the presence of suffering. Compassion is defined in relation to suffering and reciprocity, and distinguished from sympathy and pity.
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Connor, M. (2004). The practical discourse in philosophy and nursing: An exploration of linkages and shifts in the evolution of praxis. Nursing Philosophy, 5(1), 54–66.
Abstract: This paper, firstly, examines the linkages and shifts in the evolution of of praxis. The concept of praxis, also known as the practical discourse in philosophy, has been expressed in different ways in different eras. However, the linkages from one era to another and from one paradigm to another are not well explicated in the nursing literature. Blurring of the linkages occurred from the popular association of praxis within the emancipatory paradigm. Integral to the concept of praxis, since the time of Aristotle, is the notion of phronesis: a process of moral reasoning enacted to establish the 'good' of a particular situation, often referred to as practical wisdom. Secondly, the paper, promotes and affirms the importance of praxiological knowledge development in the discipline. Furthermore, increased appreciation of the concept of praxis provides an important vehicle for the advancement of nursing as a moral endeavour and the nurse as moral agent.
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Lui, D. M. K. (2003). Nursing and midwifery attitudes towards withdrawal of care in a neonatal intensive care unit: Part 1. Literature review. Journal of Neonatal Nursing, 9(2), 45–47.
Abstract: This article seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Advanced technology results in the survival of increasingly premature babies with extremely low birthweights and this has inevitably led to an increase in the ethical dilemmas faced by neonatal staff as to whether continued treatment is actually in the best interests of these infants. Part 1 reviews the literature on this subject. Part 2 describes the results of a survey carried out in a New Zealand NICU.
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Lui, D. M. K. (2003). Nursing and midwifery attitudes towards withdrawal of care in a neonatal intensive care unit: Part 2. Survey results. Journal of Neonatal Nursing, 9(3), 91–96.
Abstract: Discontinuation of life support measures for an extremely low birthweight or very premature baby is controversial and difficult for both the parents and the healthcare professional involved in caring for the infant. This study seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Part 1 reviewed the literature on this subject. Part 2 reports the results of a survey carried out in a New Zealand NICU.
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McCallum, C. (2002). Balancing technology with the art of caring. Kai Tiaki: Nursing New Zealand, 8(7), 21–23.
Abstract: The author examines the role of technology in high dependency units, which can alienate nurses from patients. The ethical issues raised by technology are reviewed, particularly the allocation of expensive interventions, and the implications of life-sustaining technology on the application of informed consent. The author highlights the challenge facing nurses to bridge the gap between medical technology and humane caring.
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Ho, T. (2000). Ethical dilemmas in neonatal care. Kai Tiaki: Nursing New Zealand, 6(7), 17–19.
Abstract: The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment.
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Lewer, D. (1999). Analysing the Mental Health Act. Kai Tiaki: Nursing New Zealand, 5(8), 14–16.
Abstract: Changes brought by the Mental Health Act (MHA) to clinical practice, and some of the problems it has created for nurses, are examined in this article. Compulsory assessment and treatment orders (CATO) and the role of Duly Authorised Officers (DAO), and moral dilemmas that can arise as a consequence of CATOs used by DAOs are examined. The requirement for DAOs to act as patient advocates and to safeguard cultural beliefs are highlighted. The MHA promotes self responsibility and a treatment philosophy rather than detention of the mentally ill.
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Wareham, P., McCallin, A., & Diesfeld, K. (2005). Advance directives: The New Zealand context. Nursing Ethics, 12(4), 349–359.
Abstract: Advance directives convey consumers' wishes about accepting or refusing future treatment if they become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may arise regarding a consumer's competence and the document's validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers' and providers' perspectives, and the medical and nursing positions in New Zealand.
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Kyle, W. (2001). The influence of technology in nursing practice with elder care facilities. Vision: A Journal of Nursing, 7(12), 20–23.
Abstract: This article firstly describes the application of technological care practices in elder care, and then looks at the attitudes of the elderly and their families towards this care. The value of the equipment in terms of quality of care is considered, and a discussion of the continuing education needs of nurses is presented. The ethical questions around the use of technology are examined, along with possible strategies to deal with such issues.
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Connor, M. (2003). Advancing nursing practice in New Zealand: A place for caring as a moral imperative. Nursing Praxis in New Zealand, 19(3), 13–21.
Abstract: The author argues that the framework of competencies required for advanced nursing practice should include a moral dimension in order to take account of relational as well as functional competencies. There is no recognition of the relational competencies required to practice caring as a moral imperative. The Nursing Council of New Zealand expects that nurses will practise 'in accord with values and moral principles'. The paper explores the history of two nursing discourses, that which sees nursing as a functional occupation and that which emphasises the relationship between nurse and patient. A practice exemplar is used to demonstrate positive outcomes from advanced relational competencies.
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White, G. E., & Su, H. - R. (2000). Am I dying, nurse? Nursing Praxis in New Zealand, 15(1), 33–40.
Abstract: This paper addresses the concept of truth, and debates who should tell it and how it should be told. It explores the cultural aspects of knowing the truth about dying. The question of whether nurses have a moral obligation to tell the truth is explored, and suggests the lack of New Zealand research in this area should be addressed.
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Bland, M. F. (2002). Patient observation in nursing home research: Who was that masked woman? [corrected] [published erratum appears in Contemporary Nurse 2002 Apr; 12(2): 135]. Contemporary Nurse, 12(1), 42–48.
Abstract: This article discusses the issues that one nurse researcher faced during participant observation in three New Zealand nursing homes. These include the complexity of the nurse researcher role, the blurring of role boundaries, and various ethical concerns that arose, including the difficulties of ensuring that all those who were involved in the study were kept informed as to the researcher's role and purpose. Strategies used to maintain ethical and role integrity are outlined, with further debate and discussion around fieldwork issues and experiences for nurse researchers called for.
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Paterson, M. (2000). Dealing with life and death decisions. Kai Tiaki: Nursing New Zealand, 6(7), 14–16.
Abstract: This article examines the implications for nurses of not-for-resuscitation orders and orders to withdraw treatment. The rights of patients and correct procedure in the case of not-for-resuscitation or do-not-resuscitate orders are considered, as well as the ethical dilemma facing nurses in cases of the withdrawal of treatment. Guidelines are offered to assist nurses in reaching an ethical decision to withdraw treatment. Euthanasia is defined and case law decisions on not-for-resuscitation and treatment withdrawal are cited.
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Lawless, J., & Moss, C. (2007). Exploring the value of dignity in the work-life of nurses. Contemporary Nurse, 23(2), 225–236.
Abstract: In this paper the authors draw attention to the value and understandings of nurse dignity in the work-life of nurses. A review of nursing literature and a theoretical lens on worker dignity derived from recent work by Hodson (2001) was used to explore these questions. In the context of current and international workforce issues associated with recruitment and retention, analysis of the construct of worker dignity within the profession takes on a strong imperative. Findings of this inquiry reveal that while there is a degree of coherence between the nursing research and elements of Hodson's (2001) research on worker dignity, the dignity of nurses, as a specific construct and as an intrinsic human and worker right has received little explicit attention. Reasons for this may lie partly in approaches that privilege patient dignity over nurse dignity and which rely on the altruism and self-sacrifice of nurses to sustain patient care in environments dominated by cost-control agendas. The value of dignity in the work-life of nurses has been under-explored and there is a critical need for further theoretical work and research. This agenda goes beyond acceptance of dignity in the workplace as a human right towards the recognition that worker dignity may be a critical factor in sustaining development of healthy workplaces and healthy workforces. Directing explicit attention to nurse dignity may benefit the attainment of both nurse and organisational goals. Hodson's (2001) framework offers a new perspective on dignity in the workplace.
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