Darbyshire, P. (2008). 'Never mind the quality, feel the width': The nonsense of 'quality', 'excellence', and 'audit' in education, health and research. Collegian: Journal of the Royal College of Nursing Australia, 15(1), 35–41.
Abstract: The author contends that health care and education have been colonised by 'The Audit Society' and managerialism. It is argued that under the benign guise of 'improving quality' and 'ensuring value for money' a more Orwellian purpose operates. Academics had to be transformed into a workforce of 'docile bodies', willing to scrutinise and survey themselves and their 'performance' as outcome deliverers and disciples of the new 'Qualispeak'. This paper critiques the current obsession with audit and performativity, and the constant and often pointless 'change' that is held to be so self-evidently 'a good thing' and identifies policy discussion as a linguistic wasteland.
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Walsh, K., Moss, C., Lawless, J., McKelvie, R., & Duncan, L. (2008). Puzzling practice: A strategy for working with clinical practice issues. International Journal of Law and Psychiatry, 14(2), 94–100.
Abstract: The authors share the evolution of innovative ways to explore, 'unpack' and re-frame clinical issues that exist in everyday practice. The elements of these processes, which they call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which they draw on and use in their practice development work and in research practice. This paper pays attention to a particular form of puzzling practice that they found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle; exploring the heart of out practice; formulating the puzzle question; visualising the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.
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Tielemans, W. (2008). Encouraging young women to have regular smear tests. Kai Tiaki: Nursing New Zealand, 14(7), 16–18.
Abstract: The author presents the results of a study carried out as part of a research project with two nurse researchers from Maastricht University in the Netherlands. The aim of this study was to examine awareness among female students aged 18 to 25 about cervical cancer and to identify factors associated with their decision or intention to enter the cervical screening programme. Students aged 18-25 were recruited from four tertiary institutions in the Wellington region. A questionnaire was available online and distributed by student health centres and the researchers. Questions covered the following areas: intentions, attitude, knowledge, awareness, modelling, and support systems and efficacy. Data was analysed using descriptive statistics, multiple regression and independent t-tests. The findings are presented, and factors associated with intention and participation in cervical screening are discussed. The results indicate that the information concerning the national screening programme needs to be adjusted for the different age groups.
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Sutton, D. M. (2008). Nurses have an important role in managing intermittent claudication. Kai Tiaki: Nursing New Zealand, 14(4), 20–22.
Abstract: The author reviews the diagnosis, treatment, and management of intermittent claudation. She uses a case study to illustrate successful management of the condition.
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Smith, M. C. (2008). Reviewing the role of a mental health nurse practitioner. Kai Tiaki: Nursing New Zealand, 14(3), 20–22.
Abstract: The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role.
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Webby, A. (2008). Should non-Maori research and write about Maori? Kai Tiaki: Nursing New Zealand, 14(5), 20–21.
Abstract: The author examines the complexities surrounding non-Maori nurse researchers working on Maori issues. She suggests that as long as respect and observation of Maori processes is shown, and work is undertaken collaboratively with Maori, then such a role is appropriate.
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DeSouza, R. (2008). Wellness for all: The possibilities of cultural safety and cultural competence in New Zealand. Journal of Research in Nursing, 13(2), 125–135.
Abstract: The author contends that responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prevent marginalised groups from utilising universal health services. A combination of approaches is suggested in this paper to meet these two imperatives. Cultural safety is one indigenous New Zealand nursing approach derived in response to inequalities for Maori, whereas cultural competence is an imported paradigm derived from a multicultural context. Furthermore, research and dialogue are required to examine points of complementarity and tension. This paper offers a beginning for this process.
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Gregory, R., & Kaplan, L. (2008). Understanding residuals in Guillain-Barre Syndrome. Kai Tiaki: Nursing New Zealand, 10(7), 16–18.
Abstract: The authors review the literature on the residual effects of Guillain-Barre Syndrome (GBS), which can include fatigue, foot drop or numbness, reduced mobility and nerve tingling. In GBS the peripheral nerves are attacked by the body's defence system, an auto-immune attack, and as a result, the myelin sheath and axons of nerves are impaired. The pathophysiology of the illness and long term effects are presented, and implications for nursing care and rehabilitation are discussed. Two case studies are included which illustrate coping with the long-term effects of GBS, the effect of GBS residuals on extreme fatigue and depression.
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Peri, K., Kerse, N., Kiata, L., Wilkinson, T., Robinson, E., Parsons, J., et al. (2008). Promoting independence in residential care: Successful recruitment for a randomized controlled trial. Journal of the American Medical Directors Association, 9(4), 251–256.
Abstract: The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success.
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Hardcastle, J. (2008). 'Back to the bedside': Graduate level education in critical care. Nurse Education in Practice, 8(1), 46–53.
Abstract: This paper explores the relationships within teaching, learning and practice development in critical care nursing and questions the popular assumption that 'post graduate (Master's level) education fits all'. The need for critical care nurses to apply advanced knowledge and technical skills to complex and dynamic practice situations necessitates the development of critical thinking and a problem-solving approach to clinical practice that can be fostered through education and experience. Discussion focuses on the successful development and implementation of graduate level education for critical care nurses in the South Island of New Zealand and how this development is challenging existing approaches to the provision and evaluation of formal critical care education in New Zealand.
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McKenna, B., Thom, K., & O'Brien, A. J. (2008). Return to nursing programmes: Justifications for a mental health specific course. Intensive & Critical Care Nursing, 5(1), 1–16.
Abstract: This paper presents the findings from research that investigated the feasibility of developing a specialty return to mental health nursing programme in New Zealand. This was achieved through a scoping of existing return to nursing programmes; a survey of non-active nurses; and stakeholder consultation via interviews or focus groups. Existing generic programmes fail to attract non-active nurses wishing to focus on mental health nursing. The non-active nurses survey found 142 nurses who presently would or might possibly return to mental health nursing and participate in a programme. Most stakeholders supported the idea of implementing such a programme. The findings from this research indicate both feasibility and enthusiasm for the introduction of return to mental health nursing programmes. It is recommended that all aspects of this course mirror the service user focused 'recovery paradigm' that is a central tenet in contemporary mental health service delivery.
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Howie, L. (2008). Rural society and culture. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 3-18 ). [Dunedin]: Rural Health Opportunities.
Abstract: The author takes a multidisciplinary approach to examine how the location and concept rural is defined and provides a critique of the disparate definitions available. Definitions encompass different disciplines such as sociology and anthropology, and there are national distinctions based on historical factors. The chapter also investigates the way researchers speak about rural people, particularly as the human aspect of health is a primary concern to nursing. The focus is on the socio-cultural, occupational, ecological, and health aspects of rurality. The Rural Framework Wheel is introduced, which is a method to categorise rural contextual definitions. Rurality is presented as a variable and evolving concept that provides particular challenges to nursing practice.
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Dillon, D. R. (2008). Rural contexts: Islands. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 19-30). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter explores the concept of islands particularly in relation to rurality, individual and community identities, and nursing. The author argues that all New Zealanders are islanders, and considers the implications of this on personal and community values, when they are shaped by geographic isolation and structural separateness. She explores commonalities between islanders and rural peoples in areas such as identity, isolation, and health, and outlines the impacts this has on rural nursing practice and competencies. A case study of a nurse on Stewart Island is briefly discussed.
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Kidd, J. D. (2008). Aroha mai: Nurses, nursing and mental illness. Ph.D. thesis, , .
Abstract: This research takes an autoethnographical approach to exploring the connections between being a nurse, doing nursing work, and experiencing a mental illness. Data is comprised of autoethnographical stories from 18 nurses. Drawing on Lyotard's (1988) postmodern philosophy of 'regimes of phrases' and 'genres of discourse,' the nurses' stories yielded three motifs: Nursing, Tangata Whaiora (people seeking wellness) and Bullying. Interpretation of the motifs was undertaken by identifying and exploring connected or dissenting aspects within and between the motifs.
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Howie, L. (2008). Contextualised nursing practice. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 33-49). [Dunedin]: Rural Health Opportunities.
Abstract: This is the first of three chapters that describe nursing practice. The author presents the Rural Framework Wheel to elaborate aspects of the rural context. The Framework comprises four systems which describe aspects of rurality; being are socio-cultural, occupational, ecological, and health. These systems each comprise of subsystems, which provide a detailed analysis of the way nursing practice is particular in diverse rural settings. The Framework is presented as a work in progress, and is grounded in international nursing literature. It highlights rural nursing as a unique and challenging field, with the dominant themes of partnership and nursing emerging as underpinning the practice when nurses live and work in small, sometimes isolated communities.
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