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Wilson, D. S. (2001). Transforming nursing education: A legitimacy of difference. Ph.D. thesis, , .
Abstract: In 1973, two trial pre-registration nursing education programmes were piloted in New Zealand polytechnics. These represented an alternative to traditional hospital-sited schools of nursing. The establishment of nursing education in the tertiary sector marked a radical challenge to the cultural heritage of apprenticeship-style nursing training associated with paternal and medically-dominated health institutions. This thesis offers a Foucauldian and feminist poststructuralist analysis of discourses employed by fifteen senior nursing educators in the comprehensive registration programmes between 1973 and 1992. The women employed to teach in the comprehensive programmes faced unique challenges in establishing departments of nursing, in developing curricula that would promote a reorientation of nursing and in supporting candidates to attain their nursing registration. Through semi-structured interviews and discourse analysis methods, a set of unique characteristics shared by this group of early leading comprehensive nursing educators has emerged. The women's narratives were underpinned by discourses that centre around the valuing of education as a vehicle for emancipation and an upholding of a legitimacy of difference in nursing educators' work. The participants upheld the importance of clinical practice skills and drew on their own student nursing experiences as incentives for reforming nursing education. These nursing educators conceptualised an idealised type of graduate, and commonly employed an heroic metaphor to describe their experiences as senior comprehensive educators. Their engagement with such discourses and their shared characteristics demonstrate unique re-constitutions of power, knowledge and relations with their colleagues and clients throughout the education and health care sectors. The author proposes that these traits characterise the women as strategic and astute professionals who successfully negotiated the construction of comprehensive nursing programmes as a legitimate and transformative preparation for nursing registration.
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Walthew, P. (2004). Conceptions of critical thinking held by nurse educators. Journal of Nursing Education, 43(9), 408–411.
Abstract: This study investigated nurse educators' conceptions of critical thinking used in making judgment related to nursing. Twelve nurse educators from a large nursing school in an urban environment in New Zealand participated in this qualitative study. A semistructured questionnaire was used to explore the nurse educators' conceptions of critical thinking. The study found that the participants viewed rational, logical thinking as a central focus of critical thinking. However, in addition to these traditional perspectives, the nurse educators also included in their conceptions views more commonly held by feminist writers. These aspects focused on attention to intuition, subjective knowing, attention to context, emotions, and caring.
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Tustin-Payne, W. (2008). Self esteem, competence assessment and nurses ability to write reflectively: Is there any connection? Ph.D. thesis, , .
Abstract: The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection.
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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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Neehoff, S. M. (1999). Pedagogical possibilities for nursing. Ph.D. thesis, , .
Abstract: This thesis is about what the author terms the 'invisible bodies of nursing'. The physical body of the nurse, the body of practice, and the body of knowledge. The physical body of the nurse is absent in most nursing literature, it is sometimes inferred but seldom discussed. The contention is that the physical body of the nurse is invisible because it is tacit. Much nursing practice is invisible because it is perceived by many nurses to be inarticulable and is carried out within a private discourse of nursing, silently and secretly. Nursing knowledge is invisible because it is not seen as being valid or authoritative or sanctioned as a legitimate discourse by the dominant discourse. These issues are approach through an evolving 'specular' lens. Luce Irigaray's philosophy of the feminine and her deconstructing and reconstructing of psychoanalytic structures for women inform this work. Michel Foucault's genealogical approach to analysing discourses is utilized, along with Maurice Merleau-Ponty's phenomenology. Nursing's struggle for recognition is ongoing. The author discusses strategies that nurses could use to make themselves more 'visible' in healthcare structures. The exploration of the embodied self of the nurse and through this the embodied knowledge of nursing is nascent.
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McEldowney, R. A. (2002). Shape-shifting: Stories of teaching for social change in nursing. Ph.D. thesis, , .
Abstract: This research explores why and how nurse educators teach for social change. Critical feminist educators provide a useful framework for theorising about teaching for change that addresses issues of hegemony, agency, praxis, individual voice, difference, justice and equity. Six women Pakeha/Tauiwi nurse educators from throughout New Zealand volunteered to participate in this research and share their lived experiences of teaching for social change. In-depth conversations over two years unfolded new and rich material about how and why these six women continue to teach the evaded subjects, like mental health, women's health, community development and cultural safety. All teach in counter-hegemonic ways, opening students' eyes to the unseen and unspoken. Among the significant things to emerge during the research was the metaphorical construct of shape-shifting as an active process in teaching for social change. It revealed the connectedness and integrity between life as lived and the moral imperative that motivates the participants to teach for difference. Shape-shifting was also reflected in other key findings of the study. As change agents, the participants have had significant shape-shifting experiences in their lives; they live and work as shape-shifters within complex social and political structures and processes to achieve social justice; and, they deal with areas of health practice where clients are socially and politically displaced. The research also generated new methods for gathering life-stories and new processes for analysis and interpretation of life-stories. It is hoped that this research will open pathways for other nurse educators to become shape-shifters teaching for social change.
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Huntington, A. D., & Gilmour, J. A. (2005). A life shaped by pain: Women and endometriosis. Journal of Clinical Nursing, 14(9), 1124–1132.
Abstract: The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.
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Huntington, A. D. (2000). Blood, sweat and tears: Women as nurses nursing women in the gynaecology ward: A feminist interpretive study. Ph.D. thesis, , .
Abstract: This feminist study is an exploration of the subjectivity of women working as nurses within the gynaecological ward. Gynaecology has a long history as a unique area of concern to the health practitioners of any given period. However, the author suggests, recently with the development of modern gynaecology, this specialty has become based on male knowledge and male texts, women either as patients or nurses appear voiceless within this canon. Major tests within nursing mirror a medical construction of gynaecology, with the women involved in the discourse again absent from the literature. To explore the nurses' reality within the gynaecological ward, the author has undertaken a feminist interpretive study. To contribute to this debate the author drew on certain specific notions from feminist and postmodern epistemologies. These notions of the Other, difference, the body and discourse provided a unique way of viewing the practice of the nurses in this gynaecological setting. These epistemological concepts were then interwoven with feminist strategies to undertake the research. Through the process of feminist praxis, which included the author working alongside the nurses and conducting in-depth interviews, three areas of general concern to the nurses emerged. Firstly the relationships, that is their relationships with each other as nurses and with their women patients. Secondly, the difficulties inherent in nurses' practice in this setting due to the nature of the experiences of the women they were nursing. These difficulties arose in relation to two particular situations, nursing women experiencing a mid-trimester termination and nursing women with cancer. Thirdly, the relationship with/in the medical discourse and individual doctors which, according to nurses, had a major impact on their work. This study contributes to nursing knowledge by providing a forum for the voices of women as nurses, who nurse women in the gynaecological ward, to be heard. The author concludes that nursing and feminism have much to offer each other and share an emancipatory goal of positive action to support and assist people in their lives.
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Harker, D. Y. (2000). Nurses as patients: The stories of two woman nurse educators as recipients of nursing care. Ph.D. thesis, , .
Abstract: In this research two nurse-patients have engaged in a conversation about their experience of 'being nursed'. The project sets out to address the following questions: How might our experiences as nurses who have been hospitalised be drawn upon to influence positive changes in nursing practice? What effect might our experiences of hospitalisation have on us as nurses and on our nursing practice? The study utilises narrative as inquiry and the method of story telling and auto/biography to tell the stories of Maria (a pseudonym) and the researcher herself. This interpretive research has been informed by the feminist process and sits within a postmodern framework. Maria's stories were audio taped and transcribed before being prepared for analysis using 'core story creation', and the process of 'emplotment' (Emden, 1998b). The author's reflective topical autobiographical narrative was constructed through the processes described by Johnstone (1999). Three distinct qualities emerged from both experiences. The first, 'knowing as nurse-patient' contains the three sub-themes of 'having knowledge', 'expectations of being nursed', and 'knowledge gained'. The second distinct quality 'being nursed' contains the two sub-themes of 'feeling safe and cared for' and 'presencing'; and the third, 'not being nursed', contains the four sub themes 'feeling vulnerable', 'invisibility of nurses', 'getting out' and 'feeling let down'. The sub-theme 'getting out' includes three additional sub themes of 'wanting to get out and not wanting to be there', 'leaving and the need for closure' and 'not wanting to go back'. The author notes that nursing does make a difference to patient care. However, for patients to receive therapeutic care, new graduate nurses must be preceptored/mentored by experienced nurses in supportive programmes. Suggestions for further research have been identified.
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Giddings, D. L. S. (2005). Health disparities, social injustice, and the culture of nursing. Nursing Research, 54(5), 304–312.
Abstract: The aim of this cross-cultural study was to collect stories of difference and fairness within nursing. The study used a life history methodology informed by feminist theory and critical social theory. Life story interviews were conducted with 26 women nurses of varying racial, cultural, sexual identity, and specialty backgrounds in the United States (n = 13) and Aotearoa New Zealand (n = 13). Participants reported having some understanding of social justice issues. They were asked to reflect on their experience of difference and fairness in their lives and specifically within nursing. Their stories were analysed using a life history immersion method. Nursing remains attached to the ideological construction of the “White good nurse.” Taken-for-granted ideals privilege those who fit in and marginalise those who do not. The nurses who experienced discrimination and unfairness, survived by living in two worlds, learned to live in contradiction, and worked surreptitiously for social justice. For nurses to contribute to changing the systems and structures that maintain health disparities, the privilege of not seeing difference and the processes of mainstream violence that support the construction of the “White good nurse” must be challenged. Nurses need skills to deconstruct the marginalising social processes that sustain inequalities in nursing and healthcare. These hidden realities-racism, sexism, heterosexism, and other forms of discrimination-will then be made visible and open to challenge.
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Giddings, D. L. S. (2005). A theoretical model of social consciousness. Advances in Nursing Science, 28(3), 224–239.
Abstract: The article presents a theoretical model of social consciousness developed from nurses' life histories. A 3-position dialectical framework (acquired, awakened, and expanded social consciousness) makes visible the way people respond to social injustice in their lives and in the lives of others. The positions coexist, are not hierarchical, and are contextually situated. A person's location influences her or his availability for social action. Nurses who could most contribute to challenging social injustices that underpin health disparities are relegated to the margins of mainstream nursing by internal processes of discrimination. The author suggests that more inclusive definitions of “a nurse” would open up possibilities for social change.
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Cleary, H. (2001). Caring and bioethics: Perspectives, predicaments and possibilities. Ph.D. thesis, , .
Abstract: This thesis presents an explorative study of the place of caring in bioethics. Through the examination of various sources of literature from the disciplines of nursing, feminist theory and ethics, and bioethics, a case is developed that argues for a valid respected place for caring, as an ethic of care in bioethical decision-making. The case is built by providing evidence to support the fundamental importance of caring to human life, health, relationships, and survival at the broad societal level. This is presented from the feminist and nursing perspectives, along with a critique of the negative aspects of caring practices. The next stage of the case presents a layout of the discipline of bioethics, using an historical perspective to illuminate the influences of bioethics' deep past, as it still affects the discipline in the present. The development of contemporary bioethics' current status is presented along with critiques from bioethicists themselves, and nursing and feminist theory and ethics. In the case at this point, from a bioethical perspective, two major predicaments appear to prevent an ethic of care obtaining a valid place in ethical decision-making in bioethics. These are the justice/care duality, and the conflict between different conceptions of care and autonomy. The bioethical objections and arguments put forward regarding these predicaments are examined and refuted, and the author suggests a case is established for the inclusion of an ethic of care in bioethical decision-making.
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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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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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Brookes, K. (2001). Moving stories from nurses in flight. Ph.D. thesis, , .
Abstract: This thesis contains a collection of stories gifted by four New Zealand Retrieval Team nurses who are experienced in the transport of patients. These nurses are commonly called flight nurses and they assist in the transport of patients via helicopter, fixed-wing aeroplane, large commercial aeroplanes and ambulances. While their practice is not exclusively in the helicopter there is an emphasis on this mode of transport in this thesis. Flight nursing is a scope of nursing practice where the use, and visibility, of nurses' stories is rare. The specific context of this research is positioned in one tertiary intensive care unit in New Zealand but it is anticipated that the stories from four flight nurses and the author's subsequent thoughts on them will resonate with flight nurses in other regions. The stories were collected using a storytelling methodology that has been informed by qualitative and feminist perspectives. The stories were either gathered and shaped using interview and transcription techniques with the storyteller and the researcher, or written by the storyteller. The thesis has been written as a narrative and chronicles the journey to the point of receiving the stories and the lines of inquiry in which they subsequently directed the author. The stories are central to this research and appear in their entirety. The reader is encouraged to create their own meaning from the stories. The stories themselves have several common threads, which are planning, communication, teamwork and the unexpected. The threads underpinning the stories are not unique to flight nursing practice and have been discussed in other scopes of practice. One area the author has chosen to explore in more depth is the impacts of technology, privacy, narrative pedagogy and disenfranchisement on the visibility of flight nurses' stories. The other area she has chosen for discussion is advanced and specialty nursing practice as it relates to flight nurses. As a result of this discussion she proposes her own view for advanced and specialty practice in flight nursing.
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