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Author |
Miles, M.A.P. |
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Title |
A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
NZNO Library, University of Otago Library |
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Issue |
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Pages |
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Keywords |
Primary health care; Interprofessional relations; Policy |
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Abstract |
This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory. The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture. The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions. The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries. Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators. The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing's perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine. The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions. |
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Call Number |
NRSNZNO @ research @ 1146 |
Serial |
1131 |
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Author |
Morgan, F.A. |
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Title |
Primary health care nurses supporting families parenting pre-term infants |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
NZNO Library, University of Otago Library |
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Issue |
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Pages |
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Keywords |
Primary health care; Community health nursing; Paediatric nursing; Premature infants |
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Abstract |
This thesis reviews the role of primary health care nurses, who have an opportunity to play a unique role in teaching, touching and empowering families with newly discharged pre-term babies. Birth of a baby earlier than 37 weeks gestation ushers in a period of uncertainty and stress for parents. Uncertainties may centre on whether their infant will survive and what ongoing growth and developmental issues their infant will face. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1132 |
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Author |
Mc Drury, J. |
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Title |
Self assessment and reflective practice: exploring the meaning of self assessment and developing tools to facilitate reflective practice in nursing using a socio-cultural perspective |
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Year |
1997 |
Publication |
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Abbreviated Journal |
University of Otago |
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Issue |
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Pages |
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Call Number |
NRSNZNO @ research @ 228 |
Serial |
228 |
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Author |
Caygill, J. |
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Title |
Professional care: structure, strategy and the moral career of the nurse in a psychiatric institution |
Type |
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Year |
1989 |
Publication |
New Zealand Sociology |
Abbreviated Journal |
University of Otago Library |
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Volume |
8 |
Issue |
2 |
Pages |
137-165 |
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Keywords |
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Abstract |
This thesis presents the job of psychiatric nursing from the nurse's point of view, as derived from the author's personal experience and from interviews with thirty five other staff within a particular psychiatric institution.The first part of the thesis is reconstructed narrative account of an afternoon and a day shift in an acute admission ward. In the second part, the basic situation on the ward and some of the exigencies of nurse-patient and nurse-staff relations are discussed from structuralist and strategic conduct perspectives.The discussion that follows Anthony Giddens' (1976, 1979, 1984) conceptual framework of power, legitimation and signification, with particular attention to the strategic implications of ward routines, nursing practices, and interpersonal relations, as well as the duality of clinical and moralistic interpretive themes. The third part of the thesis 'the nurse's progress' over time. Characteristic changes in understanding and awareness take place with the movement from the 'backwards' to the 'acute' area and from the student to staff nurse. This is portrayed as a 'moral career' analogous to that suggested by Goffman (1968) for psychiatric patients; marked by 'happenings' that generate revised conceptions of self and others, and including those experiences of duality and contradiction discussed in part Two. While acknowledging the diversity of nurses' attitudes and approaches, with variations according to individual temperament, past experiences and the current setting, the suggestion is made of a common and distinctive 'meta-awareness' that develops with the fob |
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Call Number |
NRSNZNO @ research @ 223 |
Serial |
223 |
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Author |
Howie, E. |
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Title |
A nutritional education needs assessment of child health nurses |
Type |
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Year |
1989 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Call Number |
NRSNZNO @ research @ 229 |
Serial |
229 |
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Author |
Papps, E. |
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Title |
The doctoring of childbirth and the regulation of midwifery |
Type |
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Year |
1992 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
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Abstract |
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Call Number |
NRSNZNO @ research @ 233 |
Serial |
233 |
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Permanent link to this record |
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Author |
Bray, M.L. |
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Title |
Nurses' knowledge of and attitudes to medicine |
Type |
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Year |
1995 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
University of Otago Library |
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Volume |
8 |
Issue |
3 |
Pages |
19-23 |
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Keywords |
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Abstract |
Abstract information about attitudes to, and knowledge of, prescribed medication from a group of 70 students and 24 registered nurses at Otago Polytechnic. Employs a self-administered questionnaire previously used in a community survey in Southampton, UK |
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Call Number |
NRSNZNO @ research @ 234 |
Serial |
234 |
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Permanent link to this record |
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Author |
Beckingham, C.R. |
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Title |
One great network: the family as an environmental influence in the prose works of Thomas Hardy |
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Year |
1983 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Issue |
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Pages |
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Abstract |
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Call Number |
NRSNZNO @ research @ 240 |
Serial |
240 |
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Author |
Wood, P.J. |
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Title |
Constructing colonial dirt: a cultural history of dirt in the nineteenth century colonial settlement of Dunedin, New Zealand |
Type |
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Year |
1997 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
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Abstract |
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Call Number |
NRSNZNO @ research @ 331 |
Serial |
331 |
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Author |
Richardson, A. |
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Title |
Health promotion and public health nursing |
Type |
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Year |
1998 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
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Abstract |
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Call Number |
NRSNZNO @ research @ 405 |
Serial |
405 |
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Author |
Henderson, A.P. |
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Title |
Nursing a colonial hangover: towards bicultural planning in New Zealand |
Type |
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Year |
1994 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
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Abstract |
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Call Number |
NRSNZNO @ research @ 409 |
Serial |
409 |
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Permanent link to this record |
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Author |
Lilley, S. |
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Title |
Experiences of mentoring in primary health care settings: Registered nurses' and students' perspectives |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mentoring; Students; Registered nurses; Primary health care |
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Abstract |
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Call Number |
NRSNZNO @ research @ 505 |
Serial |
491 |
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Permanent link to this record |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse (PHCRN) interface with secondary care doctors |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Rural health services; Relationships |
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Abstract |
A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors as a component of rural nursing practice and representative of the primary-secondary care interface. Crucial to patient centred care, the premise was that the quality of this interface would be variable due to multiple influences such as: the historical nurse/doctor relationship that has perpetuated medical dominance and nursing subordination; current policy direction encouraging greater inter-professional collaboration; and changing role boundaries threatening traditional professional positioning. A total of 11 nurses representing 10 separate rural areas participated in semi-structured interviews. Rural nurses typically interact with secondary care doctors for acute clinical presentations with two tiers of interaction identified. The first tier was presented as a default to secondary care doctors for assistance with managing primary care level clinical presentations in the absence of access to a general practitioner or an appropriate Standing Order enabling appropriate management. The second tier presented itself as situations where, in the professional judgement of the nurse, the client status indicated a need for secondary level expertise and/or referral to secondary care. The needs of the rural nurse in these interactions were identified as access to expertise in diagnosis, therapy and management, authorisation to act when intervention would exceed the nurse's scope of practice; the need to refer clients to secondary care; and the need for reassurance, encompassing emotional and professional issues. The quality of the interactions was found to be variable but predominantly positive. Professional outcomes of positive interactions included professional acknowledgement, support and continuing professional development. For the patient, the outcomes included appropriate, timely, safe intervention and patient centred care. The infrequent but less than ideal interactions between the participants and secondary care doctors led to professional outcomes of intraprofessional discord, a sense of invisibility for the nurse, increased professional risk and professional dissatisfaction; and for the client an increased potential for deleterious outcome and suffering. Instead of the proposition of variability arising from interprofessional discord and the current policy direction, the data suggested that variability arose from three interlinking factors; appropriate or inappropriate utilisation of secondary care doctors; familiarity among individuals with professional roles and issues of rurality; and acceptance by the primary care doctor of the sole on-call primary health care rural nurse role and the responsibility to assist with the provision of primary health care. Recommendations for improving interactions at the interface include national, regional and individual professional actions. |
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Call Number |
NRSNZNO @ research @ |
Serial |
493 |
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Permanent link to this record |
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Author |
Patel, R. |
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Title |
Evaluation and assessment of the online postgraduate intensive care nursing course |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Education; Intensive care nursing; Nursing specialties |
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Abstract |
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Call Number |
NRSNZNO @ research @ 519 |
Serial |
505 |
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Permanent link to this record |
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Author |
Miles, M.A.P. |
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Title |
A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Policy; Nursing |
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Abstract |
This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory. The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture. The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions. The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries. Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators. The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing's perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine. The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions. |
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Call Number |
NRSNZNO @ research @ 596 |
Serial |
582 |
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Permanent link to this record |