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Adams, K. (2003). A postmodern/poststructural exploration of the discursive formation of professional nursing in New Zealand 1840 – 2000. Ph.D. thesis, , .
Abstract: This study examines the discursive formation of professional nursing in one country, as revealed by the history of nursing in New Zealand. Michel Foucault's approach to historical research signifies a different level of analysis from conventional approaches, focusing not on the history of ideas but on an understanding of the present, a history of the present. A genealogical method derived from Foucauldian poststructuralism reveals how different understandings of nursing have occurred and have governed nursing practices and scholarship in different historical contexts. The archaeological investigation in this study reveals two moments of epistemic transformation, that is, two intervals of mutation and discontinuity. The Nightingale era in the 1880s precipitated the first epistemic shift – premodernism to modernism. The transfer of nursing education from hospital based training to the tertiary education sector, followed by the introduction of the baccalaureate degree, precipitated the second epistemic shift in the 1990s, the advent of postmodernism. Encompassing these two epistemes, six historical contexts are identified, where significant disruptions to the nursing discourses overturned previously held assumptions about what constituted a nurse. Each historical context is identified by specific discursive constructs. The first is colonial caring, the second the Nightingale ethos and the third heroic, disciplined obedience. In the fourth context, nursing is framed by, and within, discourses of skilled, humanistic caring, in the fifth, scientific, task focused managerialism, and in the 1990s, the sixth context, by multiple realities in an age of uncertainty.
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Beveridge, S. (2003). The development of critical thinking: A roller coaster ride for student and teacher in nursing education. Ph.D. thesis, , .
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Bishop, D., & Ford-Bruins, I. (2003). Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study. International Journal of Mental Health Nursing, 12(3), 203–212.
Abstract: This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
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Booher, J. (2003). Professional practice models: Shared governance and magnet hospitals. Vision: A Journal of Nursing, (June).
Abstract: This article explores the application of professional practice models in nursing. Particular reference is made to the magnet hospital model and the concept of shared governance. Key principles from these models are explored in relation to the implementation of a professional practice model in an intensive care environment. Historical, cultural and professional factors that may be seen as barriers to the implementation of this professional practice model are also explored. In conclusion, the article identifies recommendations that may contribute to a successful implementation and duration of a model in practice.
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Booher, J. (2003). Care of the patient following coronary artery grafts. Available online from the Eastern Institute of Technology website, 10(16), 15–18.
Abstract: This case study outlines the care of Mr. M, a sixty-six year old ventilated patient admitted to an Intensive Care Unit for management following coronary artery grafts. Mr. M's health history and risk factors are explored, in particular how they contributed to his presentation. Mr. M's post operative problems are identified and the rationale for his management is discussed with emphasis on the nursing care provided.
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Bresaz, D. M. (2003). Environmental influences on inpatient assaultive behaviour. Ph.D. thesis, , .
Abstract: This retrospective quasi-experimental study reviewed assaults in two adult mental health inpatient rehabilitation units. The majority of clients in this area experience enduring mental health illnesses and have complex physical health issues. The service comprises of an intensive rehabilitation unit and a secure extended rehabilitation unit. Between May and August 2001 the service moved to purpose built facilities. The opportunity was taken to review clients' assaultive behaviour in the new environment and to compare the incidents with those in the old environment to see if there had been any significant changes. Data on assault incidents including time of assault, place of assault, who was involved and what preventative actions were suggested were collected from the Incident and Accident Hazard Reports (IAHR) dating from 1 April 2000 until 31 May 2002. Staff were expected to complete IAHR reports on all assault incidents. The research examined whether the change in environmental conditions impacted on clients' wellbeing in relation to assaultive behaviour. Trends within the IAHR reports were also examined in order to compare these to similar studies completed in other parts of the world. There were 141 IAHR reports of assault incidents. Fifty of these occurred in the pre move period, 38 in the transition phase and 53 in the post move. There was no significant difference in the rate of assaults in the pre-move to post move period. Completion of the IAHR forms was seen to be very problematic, especially in relation to legal status of perpetrators and documentation of prevention strategies. An urgent audit of existing practice is now required to establish if problems found with the quality and completion of the IAHR forms continues to be evident in the rehabilitation service and if present staff education is needed to improve the standard of documentation. Research is also needed to establish the extent to which staff implement strategies to prevent assaults, and to reduce recidivism.
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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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Burrell, B. (2003). Mixed-sex rooms: Invading patients' privacy? Kai Tiaki: Nursing New Zealand, 9(4), 26–28.
Abstract: The author considers the issue of mixed-sex rooming (MSR) in New Zealand hospitals. A review of the literature is presented, with a focus on the attitudes and experiences of patients in the UK, where the issue has been most practised and studied. Findings of a survey of a group of New Zealand female patients are presented. The patients feelings of embarrassment and loss of dignity and privacy are discussed. The legal issues are explored, with the practice evaluated against the patient's rights detailed in the Code of Health and Disability Services and the Privacy Act 1993.
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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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Chick, D. N. P. (2003). Rural district nurses as rehabilitationists. Ph.D. thesis, , .
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Clendon, J. (2003). Nurse-managed clinics: Issues in evaluation. Journal of Advanced Nursing, 44(6), 558–565.
Abstract: This article explores the importance of evaluation of nurse-managed clinics using the Mana Health Clinic in Auckland, as an example. Fourth generation evaluation is offered as an appropriate methodology for undertaking evaluation of nurse-managed clinics. Fourth generation evaluation actively seeks involvement of clients in the process and outcome of the evaluation, resulting in participation and empowerment of stakeholders in the service – a precept often forgotten in traditional evaluation strategies and of vital importance in understanding why people use nurse-managed clinics. The method proposed here also incorporates the need for quantitative data. The main argument is that a combination of qualitative and quantitative data sources is likely to give the greatest understanding of nurse-managed clinics' utilisation.
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Coleman, R., & Sim, G. (2003). The sacredness of the head: Cultural implications for neuroscience nurses. Australasian Journal of Neuroscience, 16(2), 20–22.
Abstract: The aim of this paper is to increase neuroscience nurses' awareness of how the head is perceived as sacred by some cultures. This article will outline a definition of culture, discussion around the sanctity of the head for some cultures, the cultural significance of common neuroscience interventions, the use of traditional healing methods, and prayer. Examples will be provided of how nursing interactions and interventions affect some cultures, looking primarily at a Maori and Pacific Island perspective. The focus of this paper is within a New Zealand paediatric setting.
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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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Cowan, L. M., Deering, D., Crowe, M., Sellman, D., Futterman-Collier, A., & Adamson, S. (2003). Alcohol and drug treatment for women: Clinicians' beliefs and practice. International Journal of Mental Health Nursing, 12(1), 48–55.
Abstract: The present paper reports on the results of a telephone survey of 217 alcohol and drug treatment clinicians on their beliefs and practice, in relation to service provision for women. Nurses comprised the second largest professional group surveyed. Seventy-eight percent of clinicians believed that women's treatment needs differed from men's and 74% reported a range of approaches and interventions, such as assisting with parenting issues and referral to women-only programmes. Several differences emerged in relation to approaches and interventions used, depending on clinician gender, work setting and proportion of women on clinicians' caseload. Implications for mental health nursing include the need to more systematically incorporate gender-based treatment needs into practice and undergraduate and postgraduate education and training programmes.
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Crowe, M., & Carlyle, D. (2003). Deconstructing risk assessment and management in mental health nursing. Journal of Advanced Nursing, 43(1), 19–27.
Abstract: The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
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