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Barber, M. (2007). Exploring the complex nature of rural nursing. Kai Tiaki: Nursing New Zealand, 13(10), 22–23.
Abstract: This article reports the results of a research study undertaken to examine how nurses manage their professional and personal selves while working in small rural communities. The participants were a small group of rural nurses on the West Coast. The rationale for the study was the long-term sustainability and viability of the service to this remote area. The research showed that the rural nurse specialists' role is a complex and challenging one, performed within the communities in which nurses live.
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Wilkinson, A. (2007). New age informatics & the management of perioperative nursing documentation. Dissector, 35(1), 20–23.
Abstract: Investigates the requirements for documentation by nurses. Research by Millar & Araquiza (1999) suggests that nurses spend an estimated 30% of their time documenting patient care.
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Dellagiacoma, T. (2007). Contracting as a career option for nurses. Kai Tiaki: Nursing New Zealand, 13(1), 20–22.
Abstract: A nurse presents research and her own experiences of contracting. Contracting, as defined in this article, refers to a nurse not employed permanently on a wage. It covers agency nursing, short and long fixed-term contracts and secondments. The author identifies the need to continue to develop professionally, which is now a mandatory requirement under the Health Practitioners Competence Assurance (HPCA) Act. Contractors have little, if any financial support to develop professionally, and time taken to do courses is not paid. Taking study leave within a contract may also not be an option. Options for managing professional development in these conditions are offered, including goal setting, investing in education or training, and considering some longer contracts. Practical financial advice and examples are given, including managing accounts and consideration of employment law. The author recommends that skilled nurses looking for interesting ways to develop their careers and to branch out in an entrepreneurial way should seriously consider taking up contract work.
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Floyd, S., & Meyer, A. (2007). Intramuscular injections: What's best practice? Kai Tiaki: Nursing New Zealand, 13(6), 20–22.
Abstract: The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
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Tritschler, E., & Yarwood, J. (2007). Relating to families through their seasons of life: An indigenous practice model. Kai Tiaki: Nursing New Zealand, 13(5), 18–3.
Abstract: In this article the authors introduce an alternative way that nurses can be with families, using a relational process that can enhance nurses' responses when working with those transitioning to parenthood. Seasons of Life, a framework adapted from the Maori health model He Korowai Oranga, emerged from practice to offer a compassionate and encouraging stance, while at the same time respecting each family's realities and wishes. The model allows the exploration of the transition to parenthood within a wellness model, and takes a strengths-based approach to emotional distress. This approach provides a sense of “normality”, rather than of pathology, for the emotions experienced by new parents. The specific issues men may face are discussed, where despite recent culture change that allows men a more nurturing parental role, there is still no clear understanding of how men articulate their sense of pleasure or distress at this time. Practitioners are encouraged to examine their own assumptions, values and beliefs, and utilise tools such as reflective listening, respect, insight and understanding. The most significant aspect of relationship between nurse and parents is not the outcome, but how nurses engage with families. Examples from practice will demonstrate some of the differing ways this relational process framework has been effective.
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Finlayson, M., & Aitken, L. H. (2007). New Zealand nurses' reports on hospital care: An international comparison. Nursing Praxis in New Zealand, 23(1), 17–28.
Abstract: The authors present the results of a 2001 New Zealand survey on nurses' perception of staffing, work organisation and outcomes, comparing this with the 2001 International Hospital Outcomes Study (US, Canada, England, Scotland and Germany). The report describes the findings for job dissatisfaction, burnout and the intent to leave, the work climate in hospitals, workforce management, the structure of nurses' work, and quality of care. The authors discuss these findings and their implications for nursing in New Zealand.
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Levien, J. (2007). Maori health: One area of risk. Available online at coda, An Institutional Repository for the New Zealand ITP Sector, 11, 17–21.
Abstract: This essay explores the social and historical context of the continued incidence of rheumatic fever amongst Maori. This communicable disease is associated with poverty, inadequate housing and overcrowding. These risk factors are all higher for indigenous populations. The article traces the effects of colonisation on Maori health, and presents the Te Whare Tapa Wha health model, which is grounded in a Maori world view, and provides a framework to examine this issue. The implications for nursing practice are explored.
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Crawley, J. (2007). Tales full of treasure: Children's picture books as flexible learning tools for tertiary students. Free to download, registration required, 1, 16–23.
Abstract: The author describes the use of children's picture books as a flexible learning resource within the undergraduate nursing programme at Otago Polytechnic. This technique is demonstrated by the use of the book 'Mummy Laid An Egg', by Babette Cole, to explore the concept of sexuality with first year nursing students.
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Shaw, S. (2007). Constructing media images of nursing: How does the media represent nurses when reporting on nurse prescribing? Kai Tiaki: Nursing New Zealand, 13(1), 16–18.
Abstract: This research presents a discourse analysis of articles published in the New Zealand Herald between October 1999 and September 2005. The terms “nurse prescribing” and “prescribing fights” identified seven articles published which referred specifically to this issue. They were predominantly editorial comments and statements attributed to senior doctors. Examples of comments from these articles are presented and discussed in this article, and three inter-related themes are identified – competence, responsibility and competition. Discussion on competence centred on education, skill and experience level of nurses, as described by editorial comment and senior doctors. Positive international research and experience of nurse prescribing did not feature. A number of comments in the articles analysed could be seen to represent concerns about competition between medicine and nursing. One interpretation of the comments contained in these articles is to see medical practitioner groups defending their status and desire to define and control nursing practice. The media has the power to select the information conveyed and, in these instances, appears to have demonstrated a bias towards the medical community's perspective.
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Bradshaw, W. (2007). Helping clients move towards health change. Kai Tiaki: Nursing New Zealand, 13(7), 16–18.
Abstract: The author reflects on his use of the American psychotherapist James Prochaska's stages of change theory. This model deals with individuals and how they move towards change, through stages of pre-contemplation to maintenance of changed behaviours. He presents examples of his use of the model with clients, when dealing with issues of smoking cessation and weight loss. He analyses his practice and interactions with clients, and affirms that stages of change model can be a useful tool to bring about change within clients. He suggests it gives clients the opportunity to contemplate change and gives nurses working in health promotion the opportunity to be part of the change process.
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Evans, S. (2007). Silence kills: Challenging unsafe practice. Kai Tiaki: Nursing New Zealand, 13(3), 16–19.
Abstract: The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals.
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Vernon, R. A., Jacobs, S., & Papps, E. (2007). An innovative initiative for advanced nursing practice roles. Available online from Eastern Institute of Technology, 14(2), 16–17.
Abstract: This paper reports an initiative which is an example of partnership between education and health organisations resulting in the implementation of a jointly funded advanced nursing practice role. The model is for community based Nurse Practitioner-managed health care for primary health and disease management. The key partners in this project are the Eastern Institute of Technology, Hawke's Bay District Health Board, and a Primary Health Organisation (Tu Meke – First Choice). This article summarises the objectives, implementation, evaluation and benefits of the programme.
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Hughes, F., & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki: Nursing New Zealand, 13(4), 14–16.
Abstract: The authors review the contemporary notion of obesity and suggest that the nursing approach, with an emphasis on treatment, are shaped by a culture located within “western” views of ideal body shape. The biomedical framework regards obesity as disease and obese people as the cause of their own health problems. The authors note varying cultural interpretations of obesity, and suggest that by viewing obesity as a disease, the cultural, social or economic determinants of obesity are not acknowledged. Nursing needs to broaden the concept of the categories of difference to respond in a culturally safe way to obesity. Cultural safety asks that nurses care for people “regardful” of difference. This means nurses must reflect on the care given, so that the biomedical model is not just replicated. Nurse-led clinics offer an opportunity for practices based on nursing values of care and cultural safety. Such clinics are based on nursing's social model of health, rather than a biomedical, disease-focused model.
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Surtees, R. (2007). Developing a therapeutic alliance in an eating disorders unit. Kai Tiaki: Nursing New Zealand, 13(10), 14–16.
Abstract: The author presents the approach of a nursing team at Christchurch's Princess Margaret Hospital, in the regional specialist service for people with anorexia nervosa. This unit provides the only specialist inpatient unit in the country, consisting of a six or seven-bed facility that shares a unit with a mother and baby unit. A multidisciplinary team of psychiatric nurses, dietitians, occupational therapists, psychiatrists, psychologists and social workers all make significant contributions. The Christchurch unit uses a cognitive-behavioural therapy model (CBT) across the disciplines, a multidimensional approach incorporating psychotherapeutic, psychoeducational, biomedical and behaviourist paradigms. This occurs within a “lenient flexible approach”. Within the Unit, the eight nurses constitute what could be seen as an “intra”-disciplinary team within the wider “inter”-disciplinary or MDT team. They apply an evidence-based nursing approach with a commitment to partnership and advocacy with their patients. They use collaborative techniques for defining shared goals, and the careful management of the introduction of food. As one of the team members, the author envisages that the job of specialised nurses is to form a therapeutic alliance with patients, which takes account of the dynamic ways that patients may negotiate their own complex understandings of health, care, and recovery.
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Fisher, M. (2007). Resuscitation guidelines: Managing change in practice. Pediatric Intensive Care Nursing, 8(1), 7–10.
Abstract: This article describes the effect of an education programme for Paediatric Intensive Care Unit (PICU) staff, developed as part of the roll out of revised clinical guidelines. In 2005, the International Liaison Committee on Resuscitation released advisory statements and a revised universal algorithm for Infant, Child and Adult Cardiopulmonary Resuscitation (CPR). Subsequently the New Zealand Resuscitation Council developed and disseminated revised guidelines for use within the New Zealand Healthcare System. Within the PICU the challenge of integrating new practice standards whilst ensuring compliance with CPR guidelines, was how to disseminate information to over 80 staff nurses working 12 hour shifts. Following implementation of an education programme, a survey completed by 20 staff members demonstrated that staff felt well supported with the introduction of the new CPR guidelines (90%) and confident that they understood the changes to the resuscitation guidelines (90%). Staff identified that the poster display (95%) and the mail sleeve “flyer” (80%) helped them understand the changes to CPR.
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