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Fahey, M. (2003). Family centred care in the newborn intensive care unit: Creating a supportive environment. Ph.D. thesis, , .
Abstract: The environment of the Newborn Intensive Care Unit (NICU) is a stressful one for families and is often designed to provide technical care for the infant rather than facilities that would enable and support parental and family participation in infant care. Furthermore, the author notes that the environment of the NICU emerged in literature as an obstacle to meaningful family involvement in care. However, she goes on to say that a philosophy of Family Centred Care in the NICU can offer a framework of care that supports family involvement in the infant's care and family presence in the NICU. It also promotes parental participation in decision-making for the infant and gives recognition to the importance of perspectives provided by the family. This dissertation explores the difficulties associated with the practice of Family Centred Care in the environment of the NICU. It offers recommendations for features of unit design that can promote Family Centred Care by supporting and sustaining the presence of families in the NICU and therefore facilitating their involvement in the care of their infant.
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Kenny, G. (2003). Fellowship report. Nursing Education and Ressearch Foundation. Margaret May Blackwell Fellowship [Prevention of child abuse and family violence]. Margaret May Blackwell Travel Study Fellowship Reports. Wellington, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: Travels to the US, Europe, Canada and Australia to study services in the area of child abuse/child protection and family violence. Part of the Margaret May Blackwell Scholarship Reports series.
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Mackay, B. (2003). General practitioners' perceptions of the nurse practitioner role: An exploratory study. Access is free to articles older than 6 months, and abstracts., 116(1170).
Abstract: This study explores perceptions of general practitioners in the Northland District Health Board (NDHB) regarding the nurse practitioner role, identifying their knowledge of and perceived problems with that role, and their experience of nurses in advanced practice. A purposive sample of all 108 general practitioners in NDHB was undertaken, with a response rate of 46.3%. General practitioners favourably viewed nurse practitioner functions traditionally associated with nursing, such as health teaching, home visiting, obtaining health histories, and taking part in evaluation of care, but less favourably viewed those functions associated with medicine, such as prescribing, ordering laboratory tests, and physical assessment. While expecting few problems with patient acceptance, the general practitioners felt that funding and doctors' acceptance would be problematic. Most general practitioners indicated they had knowledge of the nurse practitioner role and had experienced working with a nurse in advanced practice, but some uncertainty and lack of knowledge about the nurse practitioner role was evident. The author recommends more education and discussion with Northland general practitioners to ensure they are fully informed about the nurse practitioner role and its potential positioning in primary healthcare, to reduce uncertainty, minimise role confusion and promote collaboration between general practitioners and nurse practitioners.
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Nicol, M. J. (2003). Genetics and nursing: Preparing for future health care development. Nursing Praxis in New Zealand, 19(2), 27–40.
Abstract: The author discusses the impact of 'new genetic knowledge' on society and how molecular and clinical genetics are having an increasing influence on routine health care. Increasingly, nurses will be exposed to this new genetic knowledge and challenged to integrate it into their clinical practice in order to ensure that patients and families receive the best health care available. The paper reports the percentage of undergraduate nursing curricula devoted to teaching about genetics and considers how the fundamental principles of molecular genetics and the clinically relevant areas of genetics can be incorporated into pre- or post-registration education.
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Fielden, J. (2003). Grief as a transformative experience: Weaving through different lifeworlds after a loved one has completed suicide. International Journal of Mental Health Nursing, 12(1), 74–85.
Abstract: This research is an exploration and interpretation of the lived experiences of family members since they lost a close family member to suicidal death. The findings have implications for nurses and counsellors working in the area of suicide bereavement. Heidegger's hermeneutic phenomenology was utilised and informed by van Manen's and Benner's work. Data from in-depth interviews with six participants, the researcher's journal entries and published literature were analysed. Findings gave rise to a grief model where suicide survivors moved through four modes of being-in-the-world characterized by 13 lifeworlds or themes. Surviving suicide was a transformative process that in time enabled survivors to discover new ways of understanding and relating to the world.
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Radka, I. M. (2003). Handover and the consumer voice: The importance of knowing the whole, full story. Ph.D. thesis, , .
Abstract: In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare.
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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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McKenna, B., Smith, N. A., Poole, S., & Coverdale, J. (2003). Horizontal violence: Experiences of registered nurses in their first year of practice. Journal of Advanced Nursing, 42(1), 90–96.
Abstract: The aims of this study were to determine the prevalence of horizontal violence, or bullying, experienced by nurses in their first year of practice; to describe the characteristics of the most distressing incidents experienced; to determine the consequences, and measure the psychological impact, of such events; and to determine the adequacy of training received to manage horizontal violence. An anonymous survey was mailed to 1169 nurses in New Zealand who had registered in the year prior to November 2000 with a response rate of 47%. Many new graduates experienced horizontal violence across all clinical settings. Absenteeism from work, the high number of respondents who considered leaving nursing, and scores on the Impact of Event Scale all indicated the serious impact of interpersonal conflict. Nearly half of the events described were not reported, only 12% of those who described a distressing incident received formal debriefing, and the majority of respondents had no training to manage the behaviour.
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Stuart, J. (2003). How can nurses address generalist/specialist/nursing requirements of the urban/rural population of Southland.
Abstract: This study, which is undertaken in the Southland area, explores the effect of the increasing specialisation of nursing services in what is a rural/urban environment. It is indicated in the literature that systemic changes in health, such as the health reforms, and the increase in the use of technology have meant that nurses are required to function in disease oriented roles rather than according to their more traditional generalist roots. A significant event, which also affected nursing scope of practice, was the transfer of nurse education to the tertiary education institutions environment from the hospitals in the mid 1970s. The traditional nursing hierarchy and its nurse leadership role disappeared and the adoption of specialist nurse titles increased, and identified with a disease or disorder, for example 'diabetes' nurse. The increase in specialist categories for patients contributed to the nurse shortage by reducing the available numbers of nurses in the generalist nursing pool. The nurses in this rural/urban environment require generalist nurse skills to deliver their nursing services because of the geographical vastness of the area being a barrier to specialist nurses. Workforce planning for nurses in the rural/urban then must focus on how to reshape the nursing scope of practice to utilise the existing resources. This study explores how key areas of health services could be enhanced by reclaiming the nurse role in its holistic approach, in mental health, public health, geriatric services and psychiatric services.
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Evans, S. (2003). Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes. Pediatric Intensive Care Nursing, 4(2), 7.
Abstract: The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
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Van der Harst, J. (2003). Inside knowledge: A qualitative descriptive study of prison nursing in New Zealand. Ph.D. thesis, , .
Abstract: Analysis of the research literature on prison nursing revealed a paucity of research, both in New Zealand and internationally. The aim of this research was to describe the working life of the nurse in a New Zealand prison and provide an understanding of and documentation on prison nursing in New Zealand. A qualitative descriptive study was undertaken to determine what it is like to nurse in a New Zealand prison. Ten nurses working at two public prisons and one private prison took part in the study. Data was collected by the use of semi-structured interviews and analysed thematically into four main themes. The participants' descriptions of their working lives as prison nurses expose the multifaceted nature of this work and the inherent relational dynamics. These dynamics determine the nurse's ability to practise effectively in the prison setting. Findings highlighted many paradoxical situations for nurses when working in this environment. The very aspects of the work that participants described as negative were also identified, in some instances, as challenging and satisfying.
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McCallin, A. (2003). Interdisciplinary team leadership: A revisionist approach for an old problem? Journal of Nursing Management, 11(6), 364–370.
Abstract: In this paper the author argues that the term interdisciplinary team leadership should be embraced cautiously. Preliminary research suggests that interdisciplinary team leadership is a model of shared leadership that requires more development if it is to become the cornerstone of interdisciplinary team practice in a radically reforming health sector. Stewardship is proposed as a potential philosophy for interdisciplinary team leadership, and a new, shared leadership role of practice leader is suggested.
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Mercer, C. (2003). Interpreting the phenomenology of out-of-town hospitalisation using a Heideggerian framework. Available online from Eastern Institute of Technology, 11(17), 20–25.
Abstract: This article is presented in two parts. In the first, an outline of Heidegger's approach to phenomenology is offered. A basic premise of hermeneutic phenomenology is that people make sense of the world through the narratives they tell to themselves and to others. When the researcher uses this philosophical approach, persons communicate their experiences; the researcher interprets the experience and communicates that understanding in writing. In the second part of the paper, the experiences of four people whose partners were hospitalised out of town is described.
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Polaschek, N. (2003). Living on dialysis: Concerns of clients in a renal setting. Journal of Advanced Nursing, 41(1), 44–52.
Abstract: This article reports a study that sought to understand the experience of a group of Caucasian men with end stage renal failure managing their own haemodialysis therapy in their homes. The study used a critical interpretive methodology. The renal setting was critically viewed as a specialised health care context constituted by several interrelated discourses. Although established by the dominant professional discourse, it also includes a number of others, in particular an obscure client discourse that is a response to the dominant discourse. Initially, participants' own interpretations of their individual experiences were outlined. These were then collectively reinterpreted by contextualising them in terms of the critical view of the renal setting, in order to discern their own views as renal clients that were obscured by the language and ideas of the dominant discourse with which they had been enculturated. From an analysis of the set of accounts derived from interviews with six participants, four concerns of the renal client discourse were identified. These concerns were: (1) suffering from continuing symptoms of end stage renal failure and dialysis; (2) limitations resulting from negotiating dialysis into their lifestyle; (3) ongoingness and uncertainty of life on dialysis; and (4) altered relationship between autonomy and dependence inherent in living on dialysis. One specific implication of this study is that the distinctive potential of the nursing role in renal settings lies beyond the performance of a range of technical tasks, in addressing the experience of people living on dialysis, described here as the concerns of the renal client discourse.
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Trotter, A. (2003). Mary Potter's Little Company of Mary: The New Zealand experience, 1914-2002. Wellington: Bridget Williams.
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