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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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Voice, D. M. (2006). Everyday district nurses' experiences revealed through distillation: Palliative care in the community. Ph.D. thesis, , .
Abstract: This modified action research inquiry focused on the everyday, palliative care practice experiences of a group of district nurses. The intent was to develop an understanding of common issues of concern for this group of district nurses when providing palliative home care in a specific community context and to implement practical, achievable strategies in response to these local issues. Five district nurses identified four broad areas for action through four praxis group meetings and comprising one full cycle. These four areas have been named as methods of enhancing support for people and families, possibilities for creatively managing workloads, mechanisms to enrich working partnership with other palliative care providers and possible vehicles for supporting nurses' self care. Implementation of action from this action research project focused on enhancing care and outcomes for people and family served by this group of district nurses in their local community. This study illuminates everyday essences of the district nurse role and the elements articulated by this group in supporting their practice in one New Zealand community. This study also reveals some of the tensions and messiness when employing an action research methodology with nurses in the workplace. The author notes that this research focused on a little known area (palliative care delivered by district nurses in New Zealand) in a local community (a culturally vibrant and ethnically diverse yet with poor health and socioeconomic statistics). She goes on to say that it has resonance with other nurses, particularly those working in community settings who may experience similar issues and concerns. This research also offers important insights for nurses working in any practice setting.
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Smit, C. (2017). Making self-care a priority. Whitireia Nursing and Health Journal, (24), 29–35.
Abstract: Highlights the importance of prioritising self-care for palliative care nurses whose prolonged exposure to work-related stress may result in burn-out. Recommends a self-care plan that addresses individual strengths and challenges, including physical, emotional, cognitive, relational and spiritual. Suggests the use of self-care strategies, such as the identification of professional and personal strengths, and the application of mindfulness and stress-reduction techniques to improve self-awareness.
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Sheward, K. A. (2005). Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying.
Abstract: The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.
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Rodgers, V., Marshall, B., Hey, F., Blackwell, A., & Lewer, P. (2017). Readiness for providing primary palliative care. Nursing Praxis in New Zealand, 33(3). Retrieved May 16, 2024, from www.nursingpraxis.org
Abstract: Undertakes a pilot study by specialist Supportive Education and Quality (SEQUAL) palliative care team in 5 aged residential care (ARC) facilities in regional NZ. Conducts a clinical staff survey and facility desktop document review to determine readiness, need for and level of support required, to enhance primary palliative care for residents. Identifies lack of experience and palliative care education among clinical staff.
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Richardson, C. A. (2005). Ever decreasing circles: Non-curative terminal illness, empowerment and decision making: Lessons for nursing practice. Ph.D. thesis, , .
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Norton, V. (2014). Don't wait until we are struggling: what patients and family caregivers tell us about using a syringe driver. Kai Tiaki Nursing Research, 5(1), 12–16.
Abstract: Undertakes a study to ascertain the experiences, perceptions and assumptions of patients and their family caregiver(s) about the use of a syringe driver in palliative care. Enrols hospice cancer patients who use syringe drivers to provide continuous delivery of drugs. Conducts interviews with 27 individuals: 12 patient/family caregiver pairs, and 3 caregivers. Uses thematic analysis to apply codes to data to reveal shared versus unique experiences.
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Nolan, M., Featherston, J., & Nolan, J. (2003). Palliative care: Palliative care philosophy in care homes: Lessons from New Zealand. British Journal of Nursing, 12(16), 974–979.
Abstract: Drawing on data from a large convenience sample of caregivers in New Zealand, this article argues for a reappraisal of the way in which care homes view death and dying and advocates the more widespread adoption of a palliative care philosophy. Increasing numbers of people are dying in care homes yet little is known about the nature and quality of their deaths. The limited research available suggests that there is a need to promote a philosophy of palliative care that is not confined to the terminal phase of life. However, adopting such an approach appears to be inhibited by a lack of understanding, education and training, as well as continuing reluctance to discuss issues of death and dying in an open and honest way.
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Meldrum, L. B. B. (2006). Navigating the final journey: Dying in residential aged care in Aotearoa New Zealand.
Abstract: New Zealand statistics project that the aging population of people aged 65 years and over will more than double in the next decade. This has implications for palliative care providers including hospices and hospitals because long-term inpatient care is not generally provided by hospitals and hospices. When dying patients need long-term care, residential settings become an option. The level of palliative care in these facilities is dependent on staff training and numbers. In general, staff are not trained in palliative care, neither do they provide the multidisciplinary facets that define palliative care as undertaken by hospices. This paper describes a practice development initiative using storytelling as the vehicle for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient into residential aged care settings. With the emergence of a reflective paradigm in nursing the concept of storytelling as a teaching/learning tool has grown. Many staff in residential care settings come from diverse ethnic backgrounds where for some, English is their second language. Storytelling therefore can be a useful approach for learning because it can increase their communication skills. The author suggests that the Liverpool Care Pathway for the dying patient is a model that can be translated across care settings, hospice, hospital, and community. It can demonstrate a framework that facilitates multiprofessional communication and documentation and embraces local needs, culture and language to empower health care workers to deliver high quality care to dying patients and their family/whanau and carers. This paper also explores the role of a facilitator as an agent of change and discusses how the interplay of evidence, context and facilitation can result in the successful implementation of the LCP into residential aged care settings.
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McLoughlin, N. (2007). Dying to know: Advancing palliative care nursing competence with education in elderly health settings. Ph.D. thesis, , .
Abstract: This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities.
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McDonald, C. (2018). Working collaboratively in hospice and palliative care: Sharing time; a grounded theory. Doctoral thesis, Auckland University of Technology, Auckland. Retrieved May 16, 2024, from http://researcharchive.wintec.ac.nz/6223/
Abstract: Addresses the concerns of health professionals working collaboratively in palliative care. Conducts 25 interviews wit 23 participants to arrive at a theory of sharing time to explain the social process of collaboration while individually managing and maintaining their own areas of concern. Explains the concept of health professionals making time in their work days for and with each other to find common ground.
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McCormick, G., & Thompson, S. R. (2019). Provision of palliative and end-of-life care by paramedics in New Zealand communities: a review of international practice and the New Zealand context. Whitireia Journal of Nursing, Health and Social Services, (26), 51–57.
Abstract: Reviews the international literature on paramedic preparedness to provide palliative and EOL care in in the community, and applies it to the NZ context. Finds that paramedics would like improved education and better integration with traditional care providers, encompassing patients, family, whanau and carers. and that they stress the psychological, spiritual and cultural needs of their patients.
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McClunie-Trust, P. (2010). Negotiating Boundaries: The Nurse Family Member Caring for Her Own Relative in Palliative Care. Ph.D. thesis, , .
Abstract: This research illuminates the challenges of living well within one's own family as a nurse caring for her own relative who is dying of a cancer-related illness. Developing a deeper awareness of the consequences of this caring work has been the central focus for inquiry in this research. Nursing requires epistemologies that encompass new ways of understanding how we live within our own families and communities and practice as nurses. The theoretical framework that guides this research interprets the French Philosopher Michel Foucault's (1926-1984) critical history of thought as an ethical project for nursing. It uses conceptual tools developed in his later writing and interviews to draw attention to how discursive knowledge and practices constitute subjectivity in relations of truth, power and the self's relation to the self. The first aspect of the analysis, landscapes of care examines the techniques of discourse as relations of power and knowledge that constitute nurse family members as subjects who have relationships with their own families and other health professionals. The second aspect analyses care of the self and others as self work undertaken to form the self as a particular kind of subject and achieve mastery over one's thoughts and actions.As an exploration of the complex and contradictory subjectivities of the nurse family member, this research illuminates the forms and limits of nursing practice knowledge. It shows how nursing is practised, and the identity of the nurse is created, through intellectual, political and relational work, undertaken on the self in relation to others, as modes of ethical engagement.
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McChesney, R., & McClunie-Trust, P. (2021). Anticipatory prescribing in community palliative and end-of-life care: a realist review. Kai Tiaki Nursing Research, 12(1), 32–43.
Abstract: Argues that anticipatory prescribing and an interdisciplinary workforce could transform primary palliative care. Aims to identify the factors influencing such prescribing in palliative and end-of-life community care. Conducts a meta-synthesis of 7 primary research studies using a critical realist framework. Identifies expertise, teamwork and prioritisation as the factors influencing anitcipatory prescribing in end-of-life care.
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Maries, V. J. (2004). Chosen moments: A reflective journey illustrating terminally ill patients choosing the moment to die.
Abstract: In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result. The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars. This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time.
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