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Manning, E. (2006). Work-role transition: From staff nurse to clinical nurse educator. Ph.D. thesis, , .
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Murrell-McMillan, K. A. (2006). Why nurses in New Zealand stay working in rural areas. New Zealand Family Physician, 33(3), 173–175.
Abstract: The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues.
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Pool, L. (2006). Why do young people choose nursing as a career? Whitireia Nursing Journal, 13, 25–33.
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Kempthorne, A. (2006). Why do nurse graduates choose to work in the area of mental health? Ph.D. thesis, , .
Abstract: The low numbers of nurses attracted to work in mental health is a concern particularly with the increased demand for mental health services. Strategies are required to increase recruitment to this less popular area of nursing to ensure that a high quality of care is provided for people suffering from mental illness. The World Health Organisation is aware that this area of health has been neglected and that it is time to promote mental health. This study aimed to examine the influences involved in nurses choosing to work in this area. A descriptive survey using a questionnaire was given to seven groups of new graduates enrolled in the New Graduate Mental Health Nursing programme through five educational institutes. At the time of writing there were no published studies around this topic in New Zealand. This study will attempt to inform nurses, the Nursing Council of New Zealand, tertiary institutions and the government of New Zealand that there is evidence of a need to develop and change practices to address the predicted workforce decline.
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Johnstone, S. (2006). Undergraduate nursing and death education. Ph.D. thesis, , .
Abstract: Death education encompasses many complex realities, for both the students and lecturers involved. This quantitative research explored the experiential and didactic preparation of nursing students through a content analysis, of one New Zealand, three year Bachelor of Nursing programme, in relation to death education. The Otago Polytechnic Bachelor of Nursing programme incorporates compulsory and optional courses, with the courses taught as an integrated programme with a progressive, sequential approach. This approach builds on content, deepening understanding from year to year, as well as providing opportunities for experiential learning and broadening of understanding. The literature review discusses three dominant themes of undergraduate death education: education, death, and transition. The data collection tool incorporates eighteen key terms, ten teaching methods and ten assessment methods. The programme and individual course documents, which define course content, teaching and assessment were scanned and analysed. The findings initially showed limited evidence of death education in course documents, however deeper analysis of the documents showed further evidence over the three year programme. The existence of death education is implied rather than overt throughout many course documents, through the use of broad practice statements. Content analysis is one way of shedding light on programme content in relation to death education. Limitations of the content analysis approach mean measuring experiential and didactic learning is not fully achievable from documentation analysis only. Further development of Bachelor of Nursing death education is an ongoing challenge, with current programmes very full and possibly lacking the capacity to increase content. Bachelor of Nursing programmes are discussed, highlighting the need for student focused learning with emphasis on acquiring and processing information, rather than mastery of content.
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Blackmore, L. A. (2006). Triaging patients away from the emergency department: A review of the issues.
Abstract: With the intention of decreasing emergency department demand, there has been a focus on determining those patients who do not require the services of the emergency department so they can be redirected away to an alternative health care provider or facility. Co-locating an after-hours primary health care facility near to the emergency department is a model under consideration in some district health boards. This model suggests that a substantial proportion of the patients currently managed in the emergency department can be assessed and managed in a general practice setting. It is envisaged that by redirecting the lower acuity patients away from the emergency department, overcrowding will be relieved. This is despite evidence demonstrating that low acuity patients are not the cause of emergency department overcrowding. Moreover, being treated at the emergency department is the only safety net for many people in the community who cannot afford alternative care. This research report discusses the literature regarding the practice of referring or redirecting patients away from the emergency department and the issues associated with this model. In doing this, it looks at the Australasian Triage Scale, the system used to ensure patients are seen in order of clinical urgency, because it has been suggested that this system could be used as a tool to refer patients away from the emergency department. The author concludes that even though some people could be seen by another health care provider, the triage system is not an appropriate tool for achieving this. While it is tempting to believe that patients in the lower triage categories are prime candidates for being referred away, there is evidence from hospital statistics that patients in these categories have a high number of hospital admissions and in-hospital death rates. Additionally, to complicate matters, there is no universal definition of what constitutes an 'appropriate' emergemcy department presentation and no consensus of opinion amongst health professionals in deciding patients' 'appropriateness'. For these reasons it is unethical to expect nurses who administer the triage system to use it for the purpose of referring people away from the emergency department.
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Polley, H. (2006). Treating wounds with oxygen. Kai Tiaki: Nursing New Zealand, 12(2), 16–17.
Abstract: This article overviews the use of hyperbaric oxygen treatment in New Zealand primarily for chronic wounds, those who have had radiation therapy and those who are having or who have had head and neck surgery. In New Zealand there are just three hyperbaric oxygen treatment units: The Devonport Naval Base and The Oxygen Therapy Clinic, both in Auckland; and the Hyperbaric Medicine Unit in Christchurch; thus access to this treatment is limited.
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Wiffin, L. (2006). Treating depression during pregnancy: Cognitive behavioural therapy as a treatment option. Available online from Eastern Institute of Technology, 14(1), 8–12.
Abstract: This article reviews the use of cognitive behavioural therapy (CBT) for pregnant women suffering from depressive symptoms. CBT provides a structured, short-term, collaborative process between clinician and client, using strategies and techniques to identify dysfunctional thinking and beliefs, challenge and change these beliefs, then implement new rational beliefs and behaviours. A process of engagement, assessment and conceptualisation is followed by treatment planning and implementation, and modification of dysfunctional thinking and behaviours. Use of CBT to treat depression in women during pregnancy is supported by the literature, especially where pharmacological intervention is declined or contraindicated. Pregnancy can bring stressors that combine with biological factors and core beliefs to contribute to depressive symptoms.
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Litchfield, M. (2006). Towards a people-pivotal paradigm for healthcare: Report of the Turangi primary health care nursing innovation 2003-2006.
Abstract: This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice.
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Trimmer, W. C. (2006). The way things are done around here: Perceptions of clinical leadership in mental health nursing. Whitireia Nursing Journal, 13, 68–69.
Abstract: Based on the author's thesis, this research project explored nurses' perceptions of clinical leadership in mental health nursing practice. From personal experience and discussion with colleagues the author argues that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses.
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Trimmer, W. C. (2006). The way things are done around here: Perceptions of clinical leadership in mental health nursing. Ph.D. thesis, , .
Abstract: This research project explored nurses' perceptions of clinical leadership in mental health nursing practice. Within New Zealand no research exists that evaluates the role and impact the clinical leadership has in mental health nursing practice. From personal experience and discussion with colleagues the author argues that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses. The prime objective of this study was to increase knowledge about clinical leadership in mental health nursing practice. This research used a quantitative descriptive methodology, utilising survey design. A questionnaire was used to rank the attributes of the person the respondents identified as a clinical leader. The data was collected from 30 registered nurses working in mental health settings within the central region of New Zealand. Findings indicate that there is room for improvement with regard to clinical leadership in mental health nursing practice. Clinical leadership is perceived to be more effective by nurses in their second year of practice and in community settings. A statistically significant difference was indicated between nurses in their second year of practice and nurses in their third year of practice in terms of their ranking of clinical leadership abilities. Overall the respondents perceived poor communication and poor attitude as the biggest barriers to effective leadership. Support and good role models were said to influence nursing practice positively and the skills that were identified as being helpful in assisting and retaining nurses were mentorship and good communication. The results of the study are discussed in relation to the literature on transformational leadership skills. Finally, the general limitations of the study are outlined and implications for future research are discussed.
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Keene, J. M. (2006). The role of the nurse in the outpatient setting.
Abstract: Outpatient nurses are often seen as nurses who are less important or skilled and can no longer physically cope with working in busy wards. This report is aimed to challenge this presumption and show that there are many educated and highly skilled nurses working in these departments. The diversity of the role of the nurse within the continued advancement of nursing practice in the outpatient department is evidence to disprove the perceptions other nurses have of the outpatient nurse. The purpose of this report was to discuss the changing role of the outpatient nurse from 'handmaiden' to 'autonomous practitioner', and secondly, to discuss nurse-led services and what experience and/or skills these nurses are expected to have to fulfill these roles. Literature was gathered to inform this report from the academic circles, policy from the Ministry of Health, the District Health Board website, and in relation to the author's own role with the outpatient department.
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O'Brien, A. J., & Kar, A. (2006). The role of second health professionals under New Zealand mental health legislation. Journal of Psychiatric & Mental Health Nursing, 13(3), 356–363.
Abstract: The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for the second health professional role is suggested as a way of supporting clinical practice in this area.
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Vallant, S. R., & Neville, S. J. (2006). The relationship between student nurse and nurse clinician: Impact on student learning. Nursing Praxis in New Zealand, 22(3), 23–33.
Abstract: The purpose of this descriptive interpretive study was to explore relationships between student nurses and nurse clinicians. Eleven student nurses at the end of a three year Bachelor of Nursing programme in one institution participated in focus group interviews. Data gathered from the three focus groups were analysed using an inductive approach. Five categories, namely 'being invisible in the relationship', 'not stepping on toes', 'lost opportunities for learning', 'nurturance' and 'reciprocity' emerged from data analysis. These are presented with appropriate quotes to demonstrate the essence of participant experiences. Findings indicated that when students experienced relationships with clinicians as not being positive, this inhibited learning. Conversely, when students saw the clinician as participating actively and positively in the student/clinician relationship then student learning was enhanced. This evidence forms the basis for recommending further complementary research into the clinician's attitudes and perceptions related to their teaching role.
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Horsburgh, M., Perkins, R., Coyle, B., & Degeling, P. (2006). The professional subcultures of students entering medicine, nursing and pharmacy programmes. Journal of Interprofessional Care, 20(4), 425–431.
Abstract: This study sought to determine the attitudes, beliefs and values towards clinical work organisation of students entering undergraduate medicine, nursing and pharmacy programmes in order to frame questions for a wider study. University of Auckland students entering medicine, nursing and pharmacy programmes completed a questionnaire based on that used by Degeling et al. in studies of the professional subcultures working in the health system in Australia, New Zealand, England and elsewhere. Findings indicate that before students commence their education and training medical, nursing and pharmacy students as groups or sub-cultures differ in how they believe clinical work should be organised. Medical students believe that clinical work should be the responsibility of individuals in contrast to nursing students who have a collective view and believe that work should be systemised. Pharmacy students are at a mid-point in this continuum. There are many challenges for undergraduate programmes preparing graduates for modern healthcare practice where the emphasis is on systemised work and team based approaches. These include issues of professional socialisation which begins before students enter programmes, selection of students, attitudinal shifts and interprofessional education.
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