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Evans-Murray, A. (2004). Meeting the needs of grieving relatives. Kai Tiaki: Nursing New Zealand, 10(9), 18–20.
Abstract: This article examines the role of nurses working in intensive care units who may need to work with families as they face the death of a loved one. How the nurse communicates with relatives during these crucial hours prior to the death can have profound implications on their grief recovery. Universal needs for families in this situation have been identified in the literature, and include: hope; knowing that staff care about their loved one; and having honest information about their loved one's condition. A case study is used to illustrate key skills and techniques nurses can employ to help meet these universal needs. In the first stage of grief the bereaved is in shock and may feel a sense of numbness and denial. The bereaved may feel confused and will have difficulty concentrating and remembering instructions, and they may express strong emotions. Studies on families' needs show that honest answers to questions and information about their loved one are extremely important. It is often very difficult for the nurse to give honest information when the prognosis is poor. Good communication skills and techniques are discussed, in which hope is not offered at the expense of truthfulness, and the nurse facilitates the process of saying goodbye and expressing emotions. Practical techniques, such as including the family in basic care such as foot massaging and simple hygiene routines, may also be used to move the family from being bystanders to the impending death, to comforters.
Keywords: Intensive care nursing; Grief; Communication
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Harding, T. S. (2004). Male nurses: The struggle for acceptance. Kai Tiaki: Nursing New Zealand, 9(4), 17–19.
Abstract: This article describes the role of men in the nursing profession in New Zealand from colonial times to the 1970s. It considers attitudes towards male nurses, the provision of training for men and the various laws and regulations dealing with the issue.
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Barber, A., Charleston, A., Anderson, N., Spriggs, D., Bennett, D., Bennett, P., et al. (2004). Changes in stroke care at Auckland Hospital between 1996 and 2001. Access is free to articles older than 6 months, 117(1190).
Abstract: The researchers repeat the 1996 audit of stroke care in Auckland Hospital to assess changes in stroke management since the introduction of a mobile stroke team. The audit prospectively recorded information for all patients with stroke from 1 June to 30 September 2001. They describe the work of the stroke team physician and the specialist stroke nurse and allied health staff who coordinate the multidisciplinary care of patients. Variables examined include time to arrival and medical assessment, investigations, acute management, inpatient rehabilitation, and stroke outcome. The researchers then describe recent developments in stroke care and the impact of the stroke service on patient management.
Keywords: Multidisciplinary care teams; Nursing specialties; Hospitals
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Honey, M. (2004). Flexible learning for postgraduate nurses: A basis for planning. Nurse Education Today, 24(4), 319–325.
Abstract: This paper describes a survey undertaken with postgraduate nursing students in a university-based school of nursing in 2002 to establish their access to and use of computers and information technology for study. Whilst there was minimal flexibility and use of technology to support student learning for postgraduate nurses in the school, the university proposed increasing flexibility across all courses. This is in part a response to the increased internationalisation of education and developments in technology affecting programme design, delivery and support that can benefit teachers and students. The author notes that the findings of this survey form a basis for planning the introduction of flexible learning. Results indicated that not all students have convenient access to technology for study purposes, nor are they at the same level in terms of using technology.
Keywords: Nursing; Education; Technology; Teaching methods
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Hughes, F., & Lockyer, H. (2004). Evidence and engagement in the introduction of nurse prescribing in New Zealand. Nurse Prescribing, 2(3), 131–136.
Abstract: The article reviews the extension of prescribing rights to nurses, which is described as a complex process from both a policy and a legal perspective. New Zealand, like many other jurisdictions, took time to develop and establish changes. The authors present a number of lessons that New Zealand has learned about the factors likely to contribute to success. They identify success factors as including building strong relationships with stakeholders; using robust evidence and information, including the latest developments internationally; and ensuring flexible policy and legal arrangements that can respond to change.
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Richardson, S. (2004). Aoteaoroa/New Zealand nursing: From eugenics to cultural safety. Nursing Inquiry, 11(1), 35–42.
Abstract: The concept of cultural safety offers a unique approach to nursing practice, based on recognition of the power differentials inherent in any interaction. Clarification of the concept is offered, together with a review of the historical shift in nursing attitudes that has led to the emergence of “cultural safety” as a viable and valued component of nursing practice. The argument is made that cultural safety has allowed for a more reflective, critical understanding of the actions of nursing to develop. This includes recognition that nurses' attitudes and values have inevitably been influenced by social and political forces, and as such are in part reflective of those within the wider community. Comparison between the support given by nurses in the early 1900s to the theory of eugenics and the current acceptance of cultural safety is used to highlight this point. An examination of the literature identifies that ideological and conceptual changes have occurred in the approach of Aoteaoroa/New Zealand nurses to issues with cultural implications for practice. A review of background factors relating to Maori health status and the Treaty of Waitangi is presented as a necessary context to the overall discussion. The discussion concludes with an acknowledgement that while the rhetoric of cultural safety is now part of nursing culture in New Zealand, there is no firm evidence to evaluate its impact in practice. Issues identified as impacting on the ability to assess/research a concept, such as cultural safety, are discussed. For cultural safety to become recognised as a credible (and indispensable) tool, it is necessary to further examine the “end-point” or “outcomes” of the process.
Keywords: Cultural safety; History of nursing; Nursing philosophy
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Connor, M. (2004). The practical discourse in philosophy and nursing: An exploration of linkages and shifts in the evolution of praxis. Nursing Philosophy, 5(1), 54–66.
Abstract: This paper, firstly, examines the linkages and shifts in the evolution of of praxis. The concept of praxis, also known as the practical discourse in philosophy, has been expressed in different ways in different eras. However, the linkages from one era to another and from one paradigm to another are not well explicated in the nursing literature. Blurring of the linkages occurred from the popular association of praxis within the emancipatory paradigm. Integral to the concept of praxis, since the time of Aristotle, is the notion of phronesis: a process of moral reasoning enacted to establish the 'good' of a particular situation, often referred to as practical wisdom. Secondly, the paper, promotes and affirms the importance of praxiological knowledge development in the discipline. Furthermore, increased appreciation of the concept of praxis provides an important vehicle for the advancement of nursing as a moral endeavour and the nurse as moral agent.
Keywords: Nursing philosophy; Ethics; Nursing
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Spence, D. (2004). Advanced nursing practice through postgraduate education, part one. Nursing Praxis in New Zealand, 20(2), 46–55.
Abstract: In New Zealand the clinically focused postgraduate papers and programmes, available through universities and polytechnics, are evaluated from an educational perspective but little evaluation of the implications for practice has been undertaken. This paper is Part One of a report on a study that sought to illuminate the impact of clinically focused postgraduate education on advancing nursing practice. Hermeneutic methodology provided a framework for analysing both the perspectives of nurses who had undergone such education and those who had directly employed and worked alongside these nurses. Emerging themes are described here. In a second article the findings will be discussed in relation to literature. Constraining factors will be identified and strategies designed to maximise the benefits of education for advancing nursing practice will be recommended.
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Spence, D. (2004). Advancing nursing practice through postgraduate education, part two. Nursing Praxis in New Zealand, 20(3), 21–30.
Abstract: This paper continues presentation of the findings of a North Island based research project that explored the impact of clinically focused postgraduate education on advancing nursing practice. Like their international counterparts, increasing numbers of New Zealand nurses are enrolling in advanced practice programmes. Yet, despite international evidence supporting the usefulness of Masters level preparation for advancing clinical practice, questions about the need for such development persist. This paper argues that postgraduate education contributes to the development of courage and that this, in turn, is essential to overcoming the barriers that currently constrain the advancement of nursing practice.
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Mortensen, A., & Young, N. (2004). Caring for refugees in emergency departments in New Zealand. Nursing Praxis in New Zealand, 20(2), 24–35.
Abstract: This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours.
Keywords: Emergency nursing; Culture; Mental health; Health status
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Schroyen, B., & Finlayson, M. (2004). Clinical teaching and learning: An action research study. Nursing Praxis in New Zealand, 20(2), 36–45.
Abstract: Using an educational action research model, a nursing lecturer based in a polytechnic and ten students formed a research group to address one issue that was important to them. The research group chose to plan, implement and evaluate a practical change strategy aimed at improving the teaching and learning relationship between students and staff nurses in clinical settings. A sample of five staff nurses working closely with five students in the group was invited to join the study in order to gain their perspectives on the issues. The findings were that contract learning provides a strategy which, under certain conditions, offers both students and staff nurses an opportunity to improve the effectiveness of their interactions.
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Drake, M., & Stokes, G. (2004). Managing pre-registration student risk: A professional and legislative minefield. Nursing Praxis in New Zealand, 20(1), 15–27.
Abstract: This article reports data from 15 schools of nursing, surveyed to identify difficulties experienced by nurse educators with respect to entry, progression and programme completion of undergraduate nursing students. Risk assessment, along with a lack of clear policy and procedures were found to be the main problem areas. Difficulties were exacerbated for educators when there were challenges to their professional judgement, either from the Nursing Council of New Zealand or from within their own institution. The authors argue for more recognition of the dual role of nurse educators, and greater clarification of the Nursing Council of New Zealand role in regulating the student's programme entry and progression, and ultimate admission to the Register. It is suggested that the recently passed Health Practitioners Competence Assurance Act (2003) provides nursing with an opportunity to address some of these issues.
Keywords: Risk management; Education; Law and legislation; Nursing
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Clendon, J., & Krothe, J. (2004). The nurse-managed clinic: An evaluative study. Nursing Praxis in New Zealand, 20(2), 15–23.
Abstract: Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic.
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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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Wilkinson, J. A., & Huntington, A. D. (2004). The personal safety of district nurses: A critical analysis. Nursing Praxis in New Zealand, 20(3), 31–44.
Abstract: A workplace safety study of district nurses in New Zealand was conducted to explore personal safety experiences. A qualitative methodology informed by Critical Social Theory was employed. This paper details the findings and implications derived from data collected from six district nurses in two urban New Zealand health services who recalled incidents in which they felt their personal safety was compromised. Data were collected through individual interviews and a focus group discussion with the participants. Data analysis revealed two-fold risks to nurse safety; these were associated with client behaviour as well as risks embedded in the organisational structure. The findings suggest a number of practical issues involving basic security measures require urgent attention. The complex power relationships that shape the experience of nursing in a community impinged on the ability of the nurses in this study to confidently and safely fulfil their role. An organisational commitment to a culture of safety would help address the powerlessness experienced by district nurses.
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