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Author |
Dr Jill Clendon and Dr Léonie Walker |
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Title |
Young nurses in Aotearoa New Zealand |
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2011 |
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Abbreviated Journal  |
Download from: http://www.nzno.org.nz/services/resources/publications |
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54 pp |
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Abstract |
The NZNO Younger Nurse survey examined the characteristics of younger nurse members of NZNO (aged under 30) in order to identify potential recruitment and retention strategies for these nurses, and provide information on how best to support younger members to become involved in NZNO activities.
The findings indicate that while most younger nurses enjoy their work and find it rewarding, they also face a range of challenges in the workplace due to their age ? including bullying and poor choice of shifts. Many younger nurses do not feel appropriately paid for the work they do and believe there are insufficient nurses to provide safe care. Over 10 percent of younger nurses are considering leaving the nursing profession. Many younger nurses feel the emotional challenge of nursing was more than they anticipated and that their education did not prepare them well to manage this.
A range of recommendations are made, including the need to improve undergraduate curriculum content on managing the emotional challenges of nursing, the need to implement clinical supervision for all nurses but particularly for those under 30, the need to develop and implement activities to address bullying in the workplace, and the need to improve pay progression scales in employment contracts. |
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Call Number |
NZNO @ research @ |
Serial |
1372 |
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Author |
Dr Jill Clendon and Dr Léonie Walker |
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Title |
Research Advisory Paper: Highlights of the 2011 Younger Nurse Study |
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Report |
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Year |
2011 |
Publication |
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Abbreviated Journal |
Download from: http://www.nzno.org.nz/services/resources/publications |
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Pages |
6 pp |
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Abstract |
The NZNO Younger Nurse survey examined the characteristics of younger nurse members of NZNO (aged under 30) in order to identify potential recruitment and retention strategies for these nurses, and provide information on how best to support younger members to become involved in NZNO activities.
The findings indicate that while most younger nurses enjoy their work and find it rewarding, they also face a range of challenges in the workplace due to their age ?including bullying and poor choice of shifts. Many younger nurses do not feel appropriately paid for the work they do and believe there are insufficient nurses to provide safe care. Over 10% of younger nurses are considering leaving the nursing profession. Many younger nurses feel the emotional challenge of nursing was more than they anticipated and that their education did not prepare them well to manage this.
A range of recommendations are made including the need to improve undergraduate curriculum content on managing the emotional challenges of nursing, the need to implement clinical supervision for all nurses but particularly for those under 30, the need to develop and implement activities to address bullying in the workplace, and the need to improve pay progression scales in employment contracts.
Further research is required to explore why there is a discrepancy between female and male nurses?postgraduate qualifications by age, the particular needs of younger Indian and South East Asian nurses, the discrepancy between younger nurses and older nurses perceptions of insufficient nurses, and what type of emotional stress younger nurses find most challenging. |
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Call Number |
NZNO @ research @ |
Serial |
1373 |
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Author |
Dr Léonie Walker |
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Title |
Vital Signs: Research Advisory Paper: Highlights of the NZNO Employment Survey, 2011 |
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Report |
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Year |
2011 |
Publication |
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Abbreviated Journal |
Download from: http://www.nzno.org.nz/services/resources/publications |
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6 pp |
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Abstract |
This report documents the results of a survey of a random sample of NZNO members.
A 10% sample was drawn by computer from the 45,000 membership, representing nurses and care givers from across New Zealand. Midwives were excluded from the
sample on this occasion.
Issues related to age demographics, low pay, increasing workload, and significant
organisational restructuring continue to contribute to a considerable part of the nursing workforce who will be looking to leave nursing, to nurse overseas, or to retire within the next ten years. These appear to be balanced for now partly by other factors leading to nurses continuing to work long past the normal retirement age.
Changes to the Enrolled Nurse scope of practice (including a drop in employment
opportunities as Enrolled Nurses), difficulties experienced by some newly qualified New Zealand nurses finding suitable employment or supported Nurse Entry to Practice places, and evidence for a drop in the availability of paid access to continuing professional development particularly in the DHB sector, if not addressed urgently, may have longer term implications for the New Zealand nursing workforce and the health service.
Specific issues for nurses under 30 years of age, particularly related to shift work practices and family responsibilities, were explored in more detail in a separate report Young Nurses in Aotearoa New Zealand and specific recommendations made for the long term retention of these skilled and vital health workers. |
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Call Number |
NZNO @ research @ |
Serial |
1374 |
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Author |
Bradley, F.V.; Blakey, V.M. |
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Title |
Analysis of public health nurses' home visits |
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Year |
1978 |
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Abbreviated Journal |
District Health Office, Dunedin
A2 - |
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Call Number |
NRSNZNO @ research @ 32 |
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32 |
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Author |
Chappell, A.L. |
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Title |
Towards hope: identifying the healing role of the nurse in promoting psychosocial adaptation in serious illness |
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Year |
1982 |
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Abbreviated Journal |
Department of Nursing Studies, Massey University |
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Call Number |
NRSNZNO @ research @ 139 |
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139 |
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Author |
Pybus, M.W.; Thomson, M. |
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Title |
Health awareness and health actions of parents health |
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Year |
1979 |
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Abbreviated Journal |
Department of Nursing Studies Archives 68.101/68.3 |
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Abstract |
The parents of 238 children in standard one (7 – 8 year olds) in two localities in New Zealand (one group chosen randomly, the other a census of a small community) were interviewed about health matters. Objectives of the study were:1. To describe parents understanding of the nature of health.2. Their understanding of threats to their health.3. To describe actions they take to promote their own and their children's health.Few respondents describe health as being just the absence of illness: the concept of energy is important in many descriptions of health. Threats to the health of children are seen as coming more from the environment as compared with adults, for whom more threats are seen as having a physiological origin. Only 13% of adults thought that they put a lot of effort into keeping healthy. The underlying rationale is the recognition of the importance of people's own actions in the attainment and maintenance of health |
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Call Number |
NRSNZNO @ research @ 60 |
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60 |
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Author |
King, B.E.; Fletcher, M.P. |
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Title |
The nursing workforce in New Zealand 1980 |
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Year |
1981 |
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Abbreviated Journal |
Department of Health, Wellington |
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Factual information of the size and composition of the Nursing workforce in New Zealand as well as on the distribution of Nurses, their qualifications and their employment. Two basic factors affecting the workforce, external migration and long term absences, are also discussed. This is the first issue of a planned series, to be updated annually by the division of Nursing, Department of Health |
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Call Number |
NRSNZNO @ research @ 334 |
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334 |
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Author |
King, B.E.; Fletcher, M.P. |
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Title |
The work life of qualified nurses in one metropolitan hospital – a pilot project |
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Year |
1980 |
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Abbreviated Journal |
Department of Health Library, Wellington; Universi |
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The two interrelated objectives of the project were first to develop and test an approach to obtain relevant data on the characteristics and work patterns of qualified Nurses in New Zealand. Secondly, to institute a system to provide objective data as a basis for management and planning |
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Call Number |
NRSNZNO @ research @ 131 |
Serial |
131 |
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Author |
Crowe, M. |
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Title |
Doing what no normal woman would do |
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Year |
1999 |
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Abbreviated Journal |
Department of Film,Media &Cultural Studies Griffit |
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This text begins with a discourse analysis of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, 1994 – DSM -IV- to illustrate the discursive construction of mental disorder. The analysis identifies how productivity, moderation, entariness and rationality are constructed by this psychiatric discourse as the fundamental attributes of normality. It is argued that this discursive construction of normality has particular implications for the subject positions available to women.The text explores how those subject positions are constituted by analysing the narratives of women who have been diagnosed as having a mental disorder. Its object is to explore how the categories 'mental disorder' and 'women' are constituted; the effect this has on some women's experiences; and to offer a feminist interpretation of those experiences. The text explores the meaning of these women's experiences and proposes that their responses can be regarded as tactical responses to the non-recognition, or disconfirming recognition, accorded to the subject positions available to them.The women's tactical responses although taking different forms, reveal some commonalities in their responses to a lack of recognition for their performances: shame regarding the body which marks them as women; a sense of meaningless and emptiness in the available performances; a sense of themselves as objects for the use of others; passive performances as self-protective tactics; a need to suppress anger; and a tension between cultural expectations of normality and their own subjective experiences. The tactical responses that these women had employed take the form of over-conformity, withdrawal and resistance. They reflect that Sass (1992:58) describes as attempts to escape the 'form of the real'. It is the women's body which establishes her engendered subjectivity and it is through the body that the tensions related to her expected performances emerge. Each women's tactical response is imbued with multiple and sometimes contradictory meanings that may represent their ambivalence in relational to the cultural expectations for productive, moderate, unitary and rational performances. To enable the meaning of the women's distress to emerge it is necessary that it be recognised by interpretations that reflect their multiple and contradictory form.Alternative readings of these women's tactical responses position the desire for recognition as central. It proposes that it is necessary to pay attention to both the literal and figurative functions of language. The possibility of 'advancing our understanding of social life' (Gergen, women constructed as mentally disordered. These readings of the narratives require an understanding of the context and construction of the narrator's life and opens up the possibility for multiple understandings that do not necessarily privilege productivity, moderation, unitariness and rationality.By attending to the significance of the women's narratives this text proposes that the DSM-IV's (1994) construction of mental disorder of effectively marginalises women's experiences of their culturally determined subject positions. It acknowledges the need to understand how women symbolize their distress in a way that creates and communicates meaning |
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Call Number |
NRSNZNO @ research @ 352 |
Serial |
352 |
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Author |
Francis, H. |
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Title |
Exploring continuity of wound care: a critical approach |
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Year |
1998 |
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Abbreviated Journal |
Deakin University Library, Eastern Institute of Te |
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This study aimed to explore the range of issues that surround the continuity of wound care between hospital and community care settings in a provincial area of New Zealand, from the perspective of the health care professionals providing the wound care. Previous research into continuity of care concentrated predominantly upon purely nursing issues. This means that both the profound implications of the interprofessional relationships of the various health care professionals involved in wound care, and the far-reaching effects of the socio-economic context within which wound care was given were often not considered. A critical ethnographic approach was employed to explore continuity of care in this community. Health professionals were interviewed twice. A first interview discussed some of the unacknowledged power relations and the contextual issues that effect continuity of wound care, as well as offering the opportunity for the participants to reflect on the issues that emerged. Following preliminary analysis of the data from the first interview, a summary of findings was given to each of the participants which served as a focus for the second interview. Following these, the data were analysed, and the main themes that influenced the continuity of wound care for the participants were identified. Analysis of the data revealed all the participants practicing under considerable socio-political constraints which interfered with their ability to provide high quality wound care for their patients: these constraints dictated both who gave the wound care and how they were able to do it. The data also revealed the various relationships between the different professionals as another major area of influence upon continuity of wound care. Medical dominance was identified as having a profound impact upon nurses ability to optimise continuity of wound care. The study concluded there are a number of areas that need to be addressed in order to optimise continuity of wound care, at both local and governmental level. The development of a nurse-led wound clinic is one initiative that would go a long way to address these issues |
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Call Number |
NRSNZNO @ research @ 325 |
Serial |
325 |
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Author |
Key, R.; Habashi, S.; Baber, C.; Cuthbertson, S.; Streat, S.J. |
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Title |
Long-term follow-up after Bjork flap tracheostomy |
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Year |
1994 |
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Abbreviated Journal |
DCCM, Private Bag 92024, Auckland |
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Because of concern about long-term complications of bjork flap tracheostomy we followed-up 136 intensive care patients who had Bjork flap tracheotomy in 1992 a median of 117 (range 5-402) hours after intubation. Twenty died in hospital, none as a result of tracheostomy. Twenty- six patients were lost to follow-up and eleven declined. The remaining 79 had measures of health status, a quality of life questionnaire, respiratory function testing and physical examination of the neck and upper airway 9-27 months (median 14) later. Various health status measures deteriorated in 9 to 51 of 77 patients. Forty-two of 77 patients were taking prescription medication and 15/32 smokers had stopped smoking. FEV1, FVC and FEV1/FVC were significantly reduced from predicted normal (n=70, 2.8+ 1.1 vs 3.2 +0.9 p<.0001, 3.7 + 1.3 vs 4.0 + 1.0 p<.0001, 76 +11vs 79 +3 p= 0.035 respectively). Pulse oximetry was normal (>92%) in 73/74 patients tested. The median horizontal scar dimension was 45mm (range 20 to 75 mm). Nine had a median vertical scar dimension 15mm (range 8 to 25mm). Nineteen scars were hypertrophic, 56 were tethered. Two patients had already undergone tracheal scar revision at follow-up and further 13 accepted scar revision. Ten patients had abnormal voice examination, four abnormal cough, two stridor, three vocal cord lesions, three tracheal polyps and fourteen asymptomatic tracheal narrowing from 10-60% (median 25%) of the tracheal luminal diameter. Patients surviving critical illness with bjork flap tracheostomy have reduced quality of life and respiratory function and poor cosmetic result but a low incidence of important airway problems |
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Call Number |
NRSNZNO @ research @ 201 |
Serial |
201 |
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Author |
McManus, L.M.; Cuthbertson, S.; Streat, S.J. |
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Title |
When the lights went out in Auckland |
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Year |
1998 |
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Abbreviated Journal |
DCCM, Private Bag 92024 Auckland |
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As the clinical consequences of power failure in intensive care are seldom documented we reviewed the effects of a power failure on patient care, outcomes and the adequacy of our disaster plan. We reviewed clinical records of all ten patients in our department during a 20-minute total hospital power failure, determined the impact of the failure on the therapies being given, and the costs of failed equipment. We assessed the departments disaster plan and identified the causes of the power failure.Nine patients were intubated; six ventilated (one receiving nitric oxide) and three receiving continuous positive airway pressure. Two patients were ventilated by Servo 300,? which continued on batteries, the other four patients were ventilated manually. Six patients were receiving nine inotrope infusions through IMED Gemini,? (battery life 30 minutes). One patient was receiving high volume ultrafiltration using a Gambro? haemodialysis system, which failed. Blood flow to prevent clotting was maintained by turning the roller pump manually. All networked monitoring (SpaceLabs?) failed and three haemodynamically unstable patients were monitored by transport monitors (SpaceLabs Scout?). No patient suffered any ill effect. Failed electronic circuits cost $NZ11,724. The disaster plan was implemented and functioned well. The aged cables supplying Auckland Central failed during an El Nino summer. The hospital generators, supplying power to the city grid, failed to switch over to the hospital. During power failure infusion pumps should be only for inotropes. We now have external 12-volt battery backup. With good pre-planning, safe intensive care continued during a short power failure |
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Call Number |
NRSNZNO @ research @ 206 |
Serial |
206 |
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Author |
Pearce, L.; Cuthbertson, S.; Streat, S.J.; Hay, D. |
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Title |
Dental hygiene in the critically ill: a randomised controlled trial of three methods |
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Year |
1996 |
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Abbreviated Journal |
DCCM, Auckland Hospital, Private Bag 92024, Auck |
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Introduction Critically ill patients cannot clean their own teeth. A variety of methods are used but as the best method is unknown we performed a prospective randomised double-blind controlled trial of three methods.Method Of 359 consecutive admissions to the Department of Critical Care Medicine between 31/01/97 and 25/05/97, 222 were excluded (62 edentulous, 6 unexaminable, 142 transferred alive and 12 dead or dying at 24 hours). The remaining 137 patients had quantitative (picture-linked, ordinal score) assessment of caries, peridontal status and plaque (in 12 segments of teeth) before randomisation (to the use of either toothbrush, jumbo swab or sonic toothbrush) by pre-assigned sealed envelopes. All teeth were cleaned (prescribed four hourly) with 0.2% chlorhexidine solution. Daily plaque scores were obtained (by an assessor (SC) blind to treatment allocation) until withdrawal, death or transfer.Results Toothbrush Jumboswab SonicPatients assigned 50 48 39Withdrawn within 24hrs. 9 3 5Patients remaining 41 45 34Percentage of teeth segments thatare pristine: pre treatment 45 50 51 after 2 days 74 57 90 F(2.63) = 5.00 p = 0.0097 More withdrawals for patient noncompliance after randomisation occurred in the sonic group (5/34 versus 3/86). Conclusion. By the second day the sonic toothbrush was the most effective in plaque removal with the toothbrush the next most effective method |
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Call Number |
NRSNZNO @ research @ 203 |
Serial |
203 |
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Author |
Pearce, L.; Kirkham, S.; Cuthbertson, S. |
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Title |
Quality of follow-up for self-poisoning patients after discharge from intensive care: 1996, one year later |
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Year |
1996 |
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Abbreviated Journal |
DCCM, Auckland Hospital, P.O.Box 92024, Auckland |
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In 1995 we conducted a retrospective audit on a prospectively collated database to find out which intensive care patients missed out on psychiatric care after self poisoning. Our results showed that 57 patients in 1995 may not have received psychiatric follow-up assessment. Department of Critical Care Medicine (DCCM) follow-up was also less successful for this particular group. It was recommended that on admission to intensive care, all self poisoning patients would be referred to the Liaison Psychiatry Service (LPS).In 1996 we reviewed the databases of DCCM and LPS to determine if the quality of psychiatric follow-up had improved after the initial 1995 audit. In 1996 124 patients had 149 admissions (85F, age range 14.6-85.3, median 35, median GCS 9, 99 ventilated, 3 deaths). Thirteen patients had 25 admissions within 6 months of their index admission , 7/13 had a major psychiatric disorder. Mixed poisoning remained common. Forty-five admissions took cyclic antidepressants, 21 sedatives, 52 other medications, 25 ethanol (median 43 mmol/l ), 30 carbon monoxide and 5 took various non-prescription poisons.Thirteen went home, 32 to other hospitals, 4 to psychiatric hospitals and 97 were transferred to wards within Auckland Hospital. Psychiatric follow-up assessment was successful in 96/97 patients prior to discharge from Auckland Hospital. Those discharged to other hospitals or home were referred and followed up by LPS teams or other Mental Health Services.DCCM follow-up 4-6 weeks post discharge was more successful for 1996 with 120/146 contacted of which 33/120 were receiving ongoing psychiatric care. |
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Call Number |
NRSNZNO @ research @ 207 |
Serial |
207 |
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Author |
Key, R.; Cuthbertson, S.; Streat, S.J. |
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Title |
Feasibility of a nurse-based critical care follow-up clinic |
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Year |
1994 |
Publication |
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Abbreviated Journal |
DCCM, Auckland Hospital Private Bag 92024 Aucklan |
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We are about to implement a nurse-based critical care follow-up service and used a follow-up study of tracheostomy to determine the feasibility of such a service. Nine to 27 months median 14 after intensive care admission we attempted to follow-up 116 of our most severely ill survivors. Twenty six could not be found, 11 declined follow-up. A questionnaire, interview and limited examination were used to determine health status. Ten patients unable to come to a clinic were seen at home. Interview time varied between patients but 79 patients took 100 nurse-hours. Ninety percent of patients co-operated with respiratory function testing. Pulse oximetry identified one with severe chronic respiratory failure. In this highly selected group of patients with on going problems (perceived poor health, dependency, disability, changes in appearance, deterioration in personal relationships, poor sleep, pain, altered diet, unaddressed chronic health problems, poor access to health services, and continuing prescription medication) were common, and addressed to some extent by appropriate referral. Approximately 20% of patients reported improvement in their health and personal relationships after critical illness and half of the smokers had given up. Factors contributing to follow-up difficulty included distance, delay in initial contact, change of address (255 of this group), disability and poverty. A nurse-run critical care follow-up clinic is feasible, time consuming but productive. A register of current addresses and phone numbers is recommended. The optimal time for follow-up will vary with patients conditions but early follow-up with protocol- based lines of referral is recommended to reduce persistent health problems |
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Call Number |
NRSNZNO @ research @ 205 |
Serial |
205 |
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