|
|
Grainger, J. (2007). Mind shift: Creating change through narrative learning cycles: A qualitative interpretive study of clinical conversation as an appraisal process for sexual and reproductive health nurses. Ph.D. thesis, , .
Abstract: This thesis explores the process of an annual appraisal strategy, 'clinical conversation', from the perspective of seven nurses who were assessed using this technique. The findings demonstrate that clinical conversation is a strategy which facilitates reflection, both as a solitary exercise and with others, to ensure that learning from experience is optimised. The research used a qualitative interpretive approach informed by the model of Grounded Theory espoused by Strauss and Corbin. All eight nurses who were assessed using the clinical conversation strategy were advanced practitioners working within the scope of sexual and reproductive health. Two of the actual appraisals were observed and seven of the nurses were interviewed within eight weeks of being assessed. The outcome of the clinical conversation was primarily one of learning; the acquisition of new insights into self as practitioner. The learning was facilitated through the process of narration; telling the story of clinical practice. Three distinct narrative cycles were identified, each an experiential learning episode. The experience of undertaking a variety of assessment activities created a narrative with self and triggered an internal reflective thinking process; the experience of working with a peer created an additional narrative, a mutual dialogue reflecting back on practice; the experience of sharing practice with an assessor created a further and final narrative, a learning conversation. Each narrative can be seen as a catalyst for change. Primarily, the nurses felt differently about themselves in practice, the way they saw themselves had shifted. Such a change can be described as an alteration in perspective. These alterations in perspective led all nurses to identify ways in which they would change their actual clinical practice. In this way the nurses attempted to align their espoused beliefs about practice with their actual practice. The author notes that the study shows that each nurse responded differently to each narrative learning cycle: for some the conversation with the assessor was more of a catalyst for change than for others. In this way clinical conversation may be flexible enough to respond to a variety of differing learning styles. Learning was person specific which is an imperative for the continued professional development of already highly skilled clinicians. The implication of the research is that whilst clinical conversation was designed as a tool for appraising clinical competence, its intrinsic value lies in supporting the professional development of nurses.
|
|
|
|
McArthur, J. Discursive understanding of knowledge within advanced nursing practice roles: A co-operative inquiry in an acute health care organisation. Ph.D. thesis, , .
|
|
|
|
Chick, D. N. P. (1974). Interpersonal needs, norms and performance in nursing. Ph.D. thesis, , .
|
|
|
|
Watson, S. L. (2007). Attitudinal shifting: A grounded theory of health promotion in coronary care. Ph.D. thesis, , .
Abstract: Current New Zealand health policy encourages collaborative health promotion in all sectors of health service delivery. The integrated approach to the acute management of coronary heart disease in a coronary care unit, combining medical therapy and lifestyle change, supports clinical health promotion. The aim of this study was to use the grounded theory approach to discover the main concerns of nurses' promoting health in an acute coronary care setting and to explain the processes that nurses used to integrate health promotional activities into their practice. Seventeen registered nurses from three coronary care units within a large metropolitan city in New Zealand were interviewed. Data were constantly compared and analysed using Glaser's emergent approach to grounded theory.The main concern for nurses promoting health within coronary care was ritualistic practice. In this study, ritualistic practice concerns the medically-based protocols, routines, language and technology that drives nursing practice in coronary care. This concern was resolved via the socio-cultural process of attitudinal shifting that occurs over time involving three stages. The three conceptual categories, environmental pressures, practice reality and responsive action are the main components of the theory of attitudinal shifting. In environmental pressures, nurses experience a tension between specialist medically-dominated nursing practice and the generalist nursing role of promoting health. In practice reality, nurses become aware that the individual needs of patients are not being met. This causes role conflict until the nurse observes colleagues who role model possibilities for practice, working with patients to promote health. Responsive action sees the nurse engaging in self-development, also focusing on the nurse-patient relationship, thereby enabling active patient involvement in individual health-promoting decisions. The author suggests that the findings from this research have implications for nursing practice and education. With the increasing specialisation in nursing practice, these findings may be of interest to nurses working in delegated medical roles where the reality of everyday practice precludes nurses from undertaking their essential nursing role. Health care facilities also need to ensure that there are opportunities for the personal and professional development of nursing staff. The place of health promotion within nursing undergraduate curricula needs to be examined, as many nurses found that they were ill prepared for undertaking health promotional activities.
|
|
|
|
McClelland, B. (2004). Critical factors that influence staff retention in an acute perioperative environment. Ph.D. thesis, , .
Abstract: There are a number of factors recognised as significant for nursing staff retention. These include, a lack of organisational care, bullying (commonly referred to as horizontal violence), and high workload acuity. However, there does not appear to be any indication that these factors influence the retention of nurses within the speciality of acute perioperative nursing. A descriptive study using postpositivist methodology and triangulation of methods was designed to answer the question: What are the critical factors that influence staff retention in an acute perioperative environment? Forty-eight perioperative nurses answered a questionnaire in relation to individual needs, provision of nursing care and administration and management. Four nurses subsequently participated in a focus group interview that explored in more depth, the survey data related to the following characteristics: Educational opportunities; Level of workload acuity; Rostering flexibility; Management; Established policies/Quality assurance; Graduate orientation programs and Professional relationships in an acute perioperative setting. Data analysis revealed that > 90% of respondents agreed that these characteristics are important for job satisfaction and influence staff retention in an acute perioperative environment. A sense of belonging appears to be the most important theme that emerged from the qualitative data. Job satisfaction and staff retention are attained when nurses have a sense of belonging in the workplace. To achieve this nurses need to identify barriers, develop their communication and leadership skills and determine the ideal professional practice model. The author suggests that the themes “Finding time” and increased “sick leave”, in relation to workload acuity are new findings that provide a platform for future research.
|
|
|
|
Sye, J. (2008). A fine balance. Ph.D. thesis, , .
Abstract: The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates.
|
|
|
|
McKenzie-Green, B. (2003). Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study. Ph.D. thesis, , .
Abstract: Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities.
|
|
|
|
Kapoor, S. D. (1979). A study on planning and programming for nursing services in New Zealand: priorities for the period 1980-1985. Ph.D. thesis, , .
|
|
|
|
Kapoor, S. D. (1978). Application of the process in the care of an alcohol dependent client. Ph.D. thesis, , .
Abstract: Feasibility for Nursing studies component of B.A. degree, Wellington Victoria University, Wellington 1978. With health workers and clients in 4 different health districts, an Industry, Health Centre, Intermediate School and University Health and Counselling
|
|
|
|
Duthie, J. M. (1976). Domicilary nursing services of a hospital board. Ph.D. thesis, , .
Abstract: A Study undertaken to determine the need to extend the Domiciliary Nursing Services of a Hospital Board to include the provision of a 24 hour nursing service in the city area
|
|
|
|
Burrell, S. (1977). Kenepuru Hospital: nursing manpower. Ph.D. thesis, , .
Abstract: A study undertaken with the purpose of looking at Nursing manpower in Wellington Hospital Board, West Coast Region
|
|
|
|
Nelson, K., & Cook, N. (1986). Nursing research questionnaire: Diploma of Nursing research component. Ph.D. thesis, , .
Abstract: In October, 1986 the fifteen technical institutes that run Nursing programs in New Zealand were sent questionnaire that were designed to find out about the Nursing Research Component in the Diploma of Nursing, The Advanced Diploma of Nursing and other Nursing Courses. The same questions were asked of each of these courses. Twelve replies were received and eleven were analysed in this report. Two general observations emerged from the Diploma of Nursing: 1. The questionnaires varied greatly in the detail provided in answers. 2. Where there were small numbers enrolled in the Diploma of Nursing, the questionnaire answers suggest there is less emphasis placed on Nursing research as a separate component in the course. This small project provides us with some information about the Nursing Research Component in the Diploma of Nursing courses offered in New Zealand
|
|
|
|
Takarangi, J. (1985). Nursing workforce. Ph.D. thesis, , .
Abstract: An indepth appraisal of the nursing workforce planning report (1985) has been made which challenges some of the basic assumptions. The report findings have been reconsidered using the primary health care perspective
|
|
|
|
Kapoor, S. D. (1979). The development of effective learning to help nurses achieve their professional obligation. Ph.D. thesis, , .
Abstract: Research paper presented as part of the requirements for Nursing Studies component of a B.A. Degree Wellington Victoria University, Wellington
|
|
|
|
Watson, P. B. (1990). Care or control questions and answers for psychiatric nursing practice (Vol. 6). Ph.D. thesis, , .
Abstract: An existential phenomenological approach is used to study the experience of six adults hospitalised with acute mental illness which they considered contribute to the stress of, or coping with mental illness. The phenomenological research methods used is described. The analysis of the data reveals that consumers of acute mental health care view being controlled as contributing to the stress of mental illness, and caring as contributing to them coping with mental illness. The implications of these findings for nursing practice and further research are discussed
|
|
