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Ihimaera, L. V. (2004). He ara ki te ao marama : a pathway to understanding the facilitation of taha wairua in mental health services. Held by Lakes DHB Library (ROM), .
Abstract: A thesis submitted in partial fulfilment of the requirements for a Masters of Arts, Massey University, Palmerston North, New Zealand.
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Johns, S. (2004). Being constrained and enabled: A study of pre-registration nursing students ethical practice. Ph.D. thesis, , .
Abstract: This study uncovers the experience of being ethical from the perspective of pre-registration nursing students. Using the qualitative methodology of phenomenology, specifically that outlined by van Manen, it seeks to show how students act ethically within everyday practice. Providing nursing care is an ethically charged undertaking and despite ethics taking an increasingly important place in nursing education, the author suggests that few studies show the contextual nature of ethical practice from the perspective of students. This study aims to partly redress this situation. In this study the author has interpreted the experiences of twelve pre-registration students. Using seventeen stories shared by the student participants, the author's personal understandings and literature, the meaning of being ethical has been illuminated. Three themes emerged from the interpretation. These include 'keeping things 'nice'', 'being true to yourself' and 'being present'. This thesis asserts that the overarching theme within these themes is that of 'being constrained and enabled'. Being constrained shows the experiences of students as they live through the tensions of being and doing as they strive to be ethical. Being enabled shows the experience of self-determination. Finally the study maintains that the shaping of ethical practice for undergraduate students may be enhanced when their reality is positioned and valued within educational processes.
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Joyce, M. (2004). The Strengths Perspective: Relevance and application to mental health nursing and crisis resolution work. Ph.D. thesis, , .
Abstract: This research paper aims to explore the contribution of the Strengths Perspective to mental health nursing practice. The Strengths Perspective emerged from the area of social work and is primarily concerned with emphasising the strengths and resources of the person, as they define them. The premise is that if a person is able to identify and call on those strengths then he or she is able to improve the quality of their life. The paper outlines the historical, philosophical and moral foundations of the Strengths Perspective and discusses the humanistic approach to mental health nursing. The aim is to demonstrate that the Strengths Perspective and mental health nursing have a strong alignment, particularly with regard to a person-centred approach to care. The influence and constraints of the biomedical model on both mental health nursing and strengths based practice is a theme of the paper. The contention is that the biomedical or pathological approach to care can often disable, not enable consumers of health care, whereas an approach that centres on a person and their strengths is more likely to empower and liberate. The paper concludes with a discussion of themes that emerged from reflection on the literature and propositions are then made about how mental health nurses might orientate their thinking and practice to utilise the Strengths Perspective to augment their clinical work.
Keywords: Psychiatric Nursing; Nursing models; Evidence-based medicine
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Kinealy, T., Arroll, B., Kenealy, H., Docherty, B., Scott, D., Scragg, R., et al. (2004). Diabetes care: Practice nurse roles, attitudes and concerns. Journal of Advanced Nursing, 48(11), 68–75.
Abstract: The aim of this paper is to report a study to compare the diabetes-related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care. Questionnaires were mailed to all 146 practice nurses in South Auckland in 1990 and to all 180 in 1999, asking about personal and practice descriptions, practice organisation, time spent with patients with diabetes, screening practices, components of care undertaken by practice nurses, difficulties and barriers to good practice, training in diabetes and need for further education. The 1999 questionnaire also asked about nurse prescribing and influence on patient quality of life. More nurses surveyed in 1999 had post-registration diabetes training than those in 1990, although most of those surveyed in both years wanted further training. In 1999, nurses looked after more patients with diabetes, without spending more time on diabetes care than nurses in 1990. Nevertheless, they reported increased involvement in the more complex areas of diabetes care. Respondents in 1999 were no more likely than those in 1990 to adjust treatment, and gave a full range of opinion for and against proposals to allow nurse prescribing. The relatively low response rate to the 1990 survey may lead to an underestimate of changes between 1990 and 1999. Developments in New Zealand primary care are likely to increase the role of primary health care nurses in diabetes. Research and evaluation is required to ascertain whether this increasing role translates into improved outcomes for patients.
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Kwai, K. (2004). The value of a programme of clinical supervision for graduate nurses: An evaluative study. Ph.D. thesis, , .
Abstract: The function and implementation of clinical supervision in the practice setting presents a number of challenges for new graduate programmes for registered comprehensive nurses. There have been numerous reports and papers promoting its benefits as important and providing the impetus for change. Clinical supervision has been well established as part of social work, counselling, psychotherapy and psychoanalytic practice, and in mental health nursing and midwifery. Its utilisation for graduate nurses is clearly important and should be seen as integral to professional practice. This study evaluated a programme of clinical supervision as a component of a new graduate nurse programme in a secondary health care practice environment. The clinical supervision component aimed to support graduate registered nurses' transition from the role of student nurse to staff nurse in the context of professional clinical practice. This report is also intended to inform the ongoing provision of clinical supervision at Hutt Valley District Health Board. The evaluation process was guided by the work of Owen (1990) and used utilisation focussed evaluation as the framework on which to undertake the evaluation. A mix of quantitative and qualitative methodology was used to collect and analyse the data. Data were collected from nurse graduates of the new graduate programme using a postal questionnaire that covered three areas; clinical supervision, the Hutt Valley District Health Board new graduate programme and an evaluation of stakeholder roles. Twelve of the new graduates responded to the survey. Findings suggest clinical supervision provided professional support and assisted the new graduate in the identification of education needs. Difficulties associated with accessing the structured component of the new graduate programme and clinical supervision were highlighted. The recommendations made to Hutt Valley District Health Board to improve the programme include considering accessibility, consumer rights, acceptability, a comprehensive approach, the Treaty of Waitangi, efficiency and a coordinated approach.
Keywords: Clinical supervision; New graduate nurses; Mentoring
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Lauder, G. C. (2004). Health in the workplace: An exploration of healthy options for an aged care setting.
Abstract: People working in aged care settings in New Zealand spend approximately 30% of their lives in their workplace. There is a challenge for workplaces to support people to maintain and improve their health status. This project investigated the question: How can workplaces support staff to maintain health in an aged care environment? The project concerned two considerations: primarily what people can do for themselves and how the organisation can assist their interest and maintain their investment in health based activities and secondly what workplaces can do to make the organisations more healthy. The philosophy and the realities of the workplace were reviewed and the project addressed the strategies that could be adopted by the workplace. The study identifies a series of practical activities and outcomes that aged care facilities can undertake for nurses/caregivers or other members of staff working in the workplace. The findings lead to recommendations about healthy outcomes and managing health and creating a positive climate for health within the workplace.
Keywords: Geriatric nursing; Health behaviour; Workplace
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Lindsay, L. (2004). Atrocity tales: The language of terrorism in nursing (Vol. 11). Ph.D. thesis, , .
Abstract: In this paper, the author explores the concept of 'professional terrorism'. He exposes discrimination against male nurses as being a form of professional terrorism, primarily as it is enacted through use of language. He presents the concept of horizontal violence as a way to understand why nurses, as a marginalised group, perform oppressive acts towards male nurses, who are similarly oppressed. He outlines the cost of such a culture on nursing practice and presents strategies for change.
Keywords: Gender; Male nurses; Culture
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Litchfield, M. (2004). Achieving health in a rural community: A case study of nurse – community partnership. Wellington: Litchfield Healthcare Associates.
Abstract: This study describes rural, nurse-led health services provided by the Takapau Health Centre (Central Hawkes Bay) and its outreach, Norsewood & District Health Centre. The study looks at its model of service delivery through to 2002. It examines the establishment, development, funding and management of the service, along with the nursing practice and the healthcare people received. The book is a snapshot of nursing initiative and survival through a decade of change in health policy and service funding and delivery. The information was subsequently used to move the health centre service into the new paradigm of primary health care launched in the New Zealand Health Strategy.
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Lowson, S. (2004). Sacred memories: Creative art therapy for children in grief. Ph.D. thesis, , .
Abstract: This paper explores the creative opportunities children might have to attend to their emotions and feelings following the death of a parent, grandparent or close friend. It presents the position that often children are left out of the process of caring for an adult when they are terminally ill and that has long term psychological implications. It also suggests that this has antecedents for the white New Zealand culture that were noted historically. In this research the author describes a personal journey that has shaped her current work as a hospice practice manager. The writer explores literature in psychological aspects of removing children from the dying room, creative therapies and the importance of sacred memories for the living child. The need to create memory that will embrace the child as a cloak enfolds them in their crisis stimulated the writer to offer a text in the personal narrative form. This text is presented in this form to enable other clinicians to access their own memories as survivors of grief in their own families. It is suggested that by enabling children and family to explore the importance of relating in the palliative phase of a person's life journey, good memories are created for the survivors.
Keywords: Children; Grief; Nursing; Terminal care; Psychology
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Lynes, H. (2004). Partnership or collaboration? Exploring professional relationships between public health nurses and school staff in Otago, New Zealand. Ph.D. thesis, , .
Abstract: School staff are a conduit by which children and families can access the public health nursing service and the public health nurses can access children and their families. The author notes that, to benefit children, public health nurses need more than knowledge of health issues; they need to understand how to work well with staff from the education sector. A good professional relationship between public health nurses and school staff will therefore ultimately result in a benefit to children's health. This thesis reviews the literature using an interpretive lens to examine the position of public health nurses and schools. It argues that public health nurses need to access expertise from other sources besides nursing in order to develop and sustain the skills of relating professionally to staff from the education sector. It proposes collaboration as a model of public health nursing practice with school staff but recognises that further research on inter-sectorial collaboration is necessary.
Keywords: Public health; Nursing; Nurse-family relations; School nursing
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Mackay, B. (2004). An analysis of innovative roles in primary health care nursing. Ph.D. thesis, , .
Abstract: An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process.
Keywords: Nurse practitioners; Primary health care; Maori; Policy; Careers in nursing
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Malcolm, H. (2004). Patient privacy in a shared hospital room: Right or luxury? Nursing Praxis in New Zealand, 20(1), 28–35.
Abstract: In this article the author discusses the New Zealand legislation aimed at protecting the individual's right to privacy and concludes that practice may place healthcare consumers' rights at risk. While patient privacy should be of concern to all health professionals, the focus here is on the nurse's role in relation to recently formulated competencies published by the Nursing Council of New Zealand, which includes the recommendation that care be seen to exhibit an awareness of healthcare consumers' rights to privacy alongside the expectation that nurses question practices that compromise patient privacy.
Keywords: Patient rights; Law and legislation; Nursing; Hospitals
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Maloney-Moni, J. (2004). Kia Mana: A synergy of wellbeing. Ph.D. thesis, , .
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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.
Keywords: Terminal care; Palliative care; Nurse-patient relations
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Maxwell-Crawford, K. (2004). Huarahi whakatu: Maori mental health nursing career pathway (Vol. (Trm/04/15)). Palmerston North: Te Rau Matatini.
Abstract: Huarahi whakatu describes a pathway for recognising the expertise of nurses working in kaupapa Maori mental health services and recommends a professional development programme that can lead to advancement along the pathway. An emphasis on dual competencies – cultural and clinical – underlies the rationale for regarding kaupapa Maori mental health nursing as a sub-specialty. Eight levels of cultural competencies and twelve levels of clinical competencies are used to differentiate career stages and it is recommended that movement from one level to another should be matched by increased remuneration. The report also contains a recommended professional development programme to support the operationalisation of the career pathway.
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