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McRae, B. H. T. K. (1998). Peer review: organisational learning for nurses. Ph.D. thesis, , .
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Nelson, C. M. (1998). Nursing the stranger you know. Ph.D. thesis, , .
Abstract: Nursing the Stranger You Know demonstrates how combining aspects of nursing theory, the work of Ken Wilber, a leading writer in the field of transpersonal psychology and my own reflections have enhanced how I am able to experience and practice nursing in a primary health care setting.This study acknowledges and values the power of the connections which link us all together. The greatest strength of this work is that it shows, through the use of personal writing, how it is possible to nurse beyond the present and beyond the obvious when clinical, theoretical and self knowledge are all equally respected and incorporated into nursing practice
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McManus, L. M., Cuthbertson, S., & Streat, S. J. (1998). When the lights went out in Auckland. Ph.D. thesis, , .
Abstract: As the clinical consequences of power failure in intensive care are seldom documented we reviewed the effects of a power failure on patient care, outcomes and the adequacy of our disaster plan. We reviewed clinical records of all ten patients in our department during a 20-minute total hospital power failure, determined the impact of the failure on the therapies being given, and the costs of failed equipment. We assessed the departments disaster plan and identified the causes of the power failure.Nine patients were intubated; six ventilated (one receiving nitric oxide) and three receiving continuous positive airway pressure. Two patients were ventilated by Servo 300,? which continued on batteries, the other four patients were ventilated manually. Six patients were receiving nine inotrope infusions through IMED Gemini,? (battery life 30 minutes). One patient was receiving high volume ultrafiltration using a Gambro? haemodialysis system, which failed. Blood flow to prevent clotting was maintained by turning the roller pump manually. All networked monitoring (SpaceLabs?) failed and three haemodynamically unstable patients were monitored by transport monitors (SpaceLabs Scout?). No patient suffered any ill effect. Failed electronic circuits cost $NZ11,724. The disaster plan was implemented and functioned well. The aged cables supplying Auckland Central failed during an El Nino summer. The hospital generators, supplying power to the city grid, failed to switch over to the hospital. During power failure infusion pumps should be only for inotropes. We now have external 12-volt battery backup. With good pre-planning, safe intensive care continued during a short power failure
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Idour, D. M. G. (1998). Stepping beyond the known – the lived experience of returning registered nurse students: an interpretive descriptive study.
Abstract: A Heideggerian Hermeneutical Analysis (HHA) approach was used for a study of returning registered nurse students (RRNS) from a nursing/health management context. In essence a descriptive interpretive study the intent has been to unveil the common meanings embedded in the lived experience of RRNS return to formal (advanced) studies. The phenomenon or issue of interest was pursued in the form of a question: What is meaningful and significant for participant RRNS in their everyday world on re-engaging in formal (advanced) nursing studies?Research from the RRNS viewpoint is scarce, so the focus of the study was to understand what RRNS themselves found to be the highlights of the experience. Participants included RRNS coming from a management background and, therefore, very much at the cutting edge of rapid and continuing change in health care provision. In addition to personal and professional reasons for returning to study, what the narratives disclosed was the compelling need experienced by the RRNS to increase understanding of changing requirements in the workplace. They looked for new possibilities to transform management of nursing/health services and for learning experiences favorable to that purpose. A key aspect of their concern related to the interactive nature of their lived experience as a RRNS with the entire context of their everyday world, that is, with the connections and relations between the study-work-homespace.Fourteen RRNS from an established university nursing programme participated in an expended non-structured interviews lasting 60 – 90 minutes. The interviews were held during 1993 in places selected by participants, some in the home but mostly in the work setting. With the consent of the participants interviews were audiotaped and then transcribed. The texts (transcriptions) were analysed hermeneutically using Heideggerian phenomenology, a particular tradition of philosophy whose concern is the meaning of Being. The concern is to make visible participants' experience of their 'world'. In this instance, it was the everyday 'world' of the participant RRNS and the lived meanings of what they experienced on return to formal (advanced) studies. Hence everyday lived experience is the focus of attention in Heiedeggerian phenomenology. In this research approach what is sought is understanding not explanation. It is a premise of phenemenology that, in general, an understanding of the meaning and significance of the lived experience can be required from the 'things' (the phenomena under study) themselves. Approaching a participant as an expert by virtue of directly experiencing the phenomenon, is basic to phenomenology. Hermeneutic analysis of the texts of the participant RRNS affirmed the authenticity of those assumptions.The study revealed several common or major themes, two relational themes and one constitutive pattern were identified through the process of textual interpretation. The constitutive pattern expressing the full complexity of the relations and connections between the themes, was found to be present in all fourteen texts; the nature of a constitutive pattern being 'that it's always there'. The constitutive pattern 'Nursing is Dwelling in Thoughtful Concern as Context Calls Forth', emerged as the major finding of the study. This pattern witnesses to the pragmatism that is inherent in nursing and commonly found in nurses' responses to the challenges presented by continuing and rapid change. For the participant RRNS nursing had become a way of engaging their energies in the workplace as appropriate to a given place, time and culture. The two relational themes accent particular aspects of the constitutive pattern. 'Nursing' is a whole pile of things'; and 'Curriculum: Reflective Openness' reveal the inherent meanings of the constitutive pattern. Firstly, that nursing is diverse in practice and has many dimensions; and,, secondly, that a curriculum befitting the diversity of nursing requires us to constantly challenge ad test the learning experiences we provide for RRNS.The fourteen participants traversed diverse pathways to acquire the understanding and skills required for altered health care structures. Adopting new relationships and 'leaping-ahead' (Heidegger, 1962), to be able to see the whole picture of what was being experienced in nursing/health care, reveals the RRNS becoming-as interpreters for both colleagues and clients. Leaping-ahead is reflective of thoughtful concern as the pattern of responding to presenting need. This way of living a life transforms work. The participant RRNS disclose that, dwelling in such a way in nursing/health work opens up a future of possibilities which brings all the presenting needs into focus. Sharing the story of their lifeworld as RRNS, the participants have exemplified the ' reflective openness' Senge(1990) advocates, as being a pre-requisite for 'learning organisations'. Contemporary oganisations require us to challenge our own thinking as well as being free to speak our minds ('participant openness'). Since, however much we value our daily life practices and understandings, they need to be 'always subject to test and improvement'. In effect, what the participants have bestowed on us is that, within the framework of a curriculum for RRNS and the content learning of a given course, we must generate a process of learning amenable to both individual and group requirements
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McKinlay, E. M. (1998). Within the circle of care: the patient's lived experience of receiving palliative care. Ph.D. thesis, , .
Abstract: The objective of this research was to determine aspects of hospice based palliative care which patients described as being important and valued. This research is to be the basis of future work on the development of consumer generated quality indicators. Palliative care managers could use these to evaluate hospice based care, and provide output measures for health providers. The methodology used by the researcher was qualitative descriptive informed by phenomenology. Six recently discharged hospice patients who had at least two episodes of palliative care were interviewed about their experience of care. The resulting data, after reflection, formed a representation; the circle of care. This included aspects of valued care generated by actions of the interdisciplinary staff, and other aspects of care generated within the palliative care environment which the patient perceived as being meaningful and important. In conclusion, the reality of people receiving palliative care is characterised by a number of supportive traditional and non-traditional aspects of caring. Although some characteristics have been described within general health and the palliative care literature, some appear to have been generated by these particular participants as part their reality. The researcher believes that the resulting representation of care requires further research in other palliative care settings. The process of interviewing terminally ill people although not without concern to the interviewer, and inherently difficult for the patients, appeared to allow the patient to tell the story of both their illness and care
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Neville, S. J. (1998). Well-being in the older male: an investigation of mental, social and physical well-being indicators in Wanganui men. Ph.D. thesis, , .
Abstract: New Zealand's older population is gradually increasing. This will men the number of people with problems related to psychological and general well-being will also rise. When compared to women, men do not live as long, are more likely to die from intentional injury and use primary health services less. There is a paucity of research on older men, particularly within a New Zealand context. Because nurses work closely with people in primary, secondary and tertiary care settings they are well placed to undertake research and utilise research findings from studies relating to the older adult to promote health and well -being. The intention of the present study was to gain a greater understanding of those factors which impact on the well-being in older men. Based on Wan, Odell and Lewis's (1992) model of general well-being, mental, social and physical well-being indicators were investigated to examine their relationships to overall psychological well-being and physical health.The data for the present study was collected from a non-probability sample of 217 males (over 65 years) residing in the Wanganui area. Multiple regression analysis reveled that of the mental, social and physical indicators only satisfaction with social supports and number of visits to the doctor in the previous 12 months were significantly related to psychological well-being, and number of medications and illness/disabilities were significantly related to physical health as measured by self ratings of health.Findings are discussed in relation to the literature. It ids clear that nurses, and other health professionals, need to be aware of the relationship between objective health status and subjective well-being, and the distinction between the quality and quantity of support in order to provide effective care to older men. Finally the general limitations and future research implications are discussed
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Guilliland, K. (1998). A demographic profile of independent (self-employed) midwives in New Zealand Aotearoa. Ph.D. thesis, , .
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Wilson, C. (1998). Reflections on care: Older people speak about experiences of nursing care in acute medical and surgical wards. Ph.D. thesis, , .
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Sherrard, I. M. (1998). Death of a colleague in the workplace. Ph.D. thesis, , .
Abstract: Questionnaires were completed by participants who had had a colleague die. Participants reported that some were still having difficulty with the loss of a work collogue. Participants wanted managers to provide both managerial and emotional support during their time of grieving
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Sherrard, I. M. (1998). Chronic illness: a challenge to manage in the workplace. Ph.D. thesis, , .
Abstract: Questionnaires were completed in the work place. The participants had all experienced a chronic illness. The results revealed that the manager has the responsibility to deal openly with the staff member who is ill, and for some managers this is difficult to do
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Simpson, J. (1998). Hospice nurses responses to patient non-acceptance of treatment or care. Ph.D. thesis, , .
Abstract: Hospice nurses in New Zealand provide supportive care to patients of settings. In doing so, the hospice nurse and team are likely to have an ideal of a “good death” that guides their practice.A 'good death“ is one where symptons are well controlled without over medicalisation, where there is an acceptance of death by the patient and loved ones and where appropriatepreparation and completion of unfinished business has occurred. The death itself is peaceful and the loved ones are present. However, patients or their families do not always accept the treatment or care that the nurses offer to facilitate the best quality of life and a ”good death“ for the patient. This may leave the nurses involved feeling distressed and confused, as they are confronted with the conflict between the patients' path and the nurses' ideals.This study employs critical incident technique to explore how nurses respond and feel when the patients decline the treatment or care the nurse feels will improve their quality of life and eventually lead to a ”good death“. The findings illustrate a broad range of treatment or care that is declined by either patients or their families in the first instance. This study uncovers a number of action responses nurses use in these situations, which demonstrate acceptance of patient choice but also need to help the patient experience a ”good death". In addition it demonstrates that nurses experience a gamut of emotional responses to such situations, some of which are painful for the nurse and have the potential to cause stress. Recommendations are made which may assist nurses limit the distress they experience when patients of their families decline the treatment or care, and empower nurses with further strategies to use in such situations
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Caldwell, S. (1998). From “beloved imbecile” to critical thinker: producing the politicized nurse. Ph.D. thesis, , .
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Beck, A. (1998). Organisational outcomes of burnout among nurses. Ph.D. thesis, , .
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Francis, H. (1998). Exploring continuity of wound care: a critical approach. Ph.D. thesis, , .
Abstract: This study aimed to explore the range of issues that surround the continuity of wound care between hospital and community care settings in a provincial area of New Zealand, from the perspective of the health care professionals providing the wound care. Previous research into continuity of care concentrated predominantly upon purely nursing issues. This means that both the profound implications of the interprofessional relationships of the various health care professionals involved in wound care, and the far-reaching effects of the socio-economic context within which wound care was given were often not considered. A critical ethnographic approach was employed to explore continuity of care in this community. Health professionals were interviewed twice. A first interview discussed some of the unacknowledged power relations and the contextual issues that effect continuity of wound care, as well as offering the opportunity for the participants to reflect on the issues that emerged. Following preliminary analysis of the data from the first interview, a summary of findings was given to each of the participants which served as a focus for the second interview. Following these, the data were analysed, and the main themes that influenced the continuity of wound care for the participants were identified. Analysis of the data revealed all the participants practicing under considerable socio-political constraints which interfered with their ability to provide high quality wound care for their patients: these constraints dictated both who gave the wound care and how they were able to do it. The data also revealed the various relationships between the different professionals as another major area of influence upon continuity of wound care. Medical dominance was identified as having a profound impact upon nurses ability to optimise continuity of wound care. The study concluded there are a number of areas that need to be addressed in order to optimise continuity of wound care, at both local and governmental level. The development of a nurse-led wound clinic is one initiative that would go a long way to address these issues
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Papps, E. (1998). Knowledge, power, and nursing education in New Zealand: a critical analysis of the construction of the nursing identity. Ph.D. thesis, University of Otago, Dunedin.
Abstract: Describes and critically analyses the construction of the nursing identity through curriculum and social relations of power. Conducts a critical analysis using Foucault's power/knowledge problematic to unmask power relations positioning the nurse in the discourses of medicine and gender. Analyses the construction of the nursing identity through curriculum and the social relations of power, using the Foucauldian notion of governmentality.
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