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Clunie, S. (2006). The current trend and importance of postgraduate education for nurses. coda, An Institutional Repository for the New Zealand ITP Sector, 10, 18–23.
Abstract: The purpose of this essay is to examine why postgraduate education has become so important, to examine some of the issues around mandatory continuing education and the practical effect of this on a nursing career. Four strategies from the Ministry of Health, designed to facilitate changing nurse education, are discussed. The importance of Professional Development Recognition programmes is discussed along with the need for strong nursing leadership.
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Bassett-Smith, J. L. (1988). Midwifery practice: authenticating the experience of childbirth. Ph.D. thesis, , .
Abstract: The purpose of this grounded theory study was to identify, describe and provide a conceptual explanation of the process of care offered by midwives and the effects of that care on women's experiences of childbirth on hospital. Ten couple participants and their attendant midwives provided the major source of data. The primary data collection methods used in this study were participant observation during each couple's experience of labour and birthing, antenatal, hospital and postnatal interviews with couples along with formal and informal interviews with midwives.Constant comparative analysis of data eventuated in the identification, in the context of this study denotes a process that is engaged in by both midwives and birthing women in order to establish practice, and the experience of giving birth, as being individually genuine and valid.Authenticating is multifaceted and is seen to include the intertwined and simultaneously occurring phases of 'making sense', 'reframing', 'balancing' an 'mutually engaging'.The process of authenticating is proposed as a possible conceptual framework for midwifery practice. It identifies the unique contribution the midwife can make to a couple's experience of childbirth and serves in a conceptual way to unite the technical and interpersonal expertness of the midwife. The conceptual framework of authenticating legitimizes 'being with' women in childbirth and facilitates a women-centred approach to care with consequent implications for practice, education and research
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Schumacher, A. T. (2001). More than meets the eye: Explicating the essence of gerontology nursing. Ph.D. thesis, , .
Abstract: The purpose of this hermeneutic phenomenological was to unveil a deeper meaning and understanding of gerontology nursing, thus contributing to its value and worth as a speciality area of nursing. Conversations with four gerontology nurses were taped, transcribed and then analysed using van Manen's (1990) approach to researching lived experience. From the analysis, four cardinal elements emerged: true acceptance, personal knowing, being present, and being alive. Those four cardinal elements were reworked and further analysed to reveal three central aspects or essences of gerontology nursing. These essences were the centrality of temporality, the interconnectedness of human relationships, and the significance of the lived body. Temporality is demonstrated by nursing application of objective, or clock time, as well as subjectively in regards to the lived time of the clients. Interconnectedness is the lived human relationship between nurse and client and is represented by commitment, presencing/giving of self, connecting, and knowing the client holistically. The third essence is corporeality, which is portrayed by the gerontology nurses' distinguishing characteristics and their perception of the lived body of the nursed. The final analysis unveiled caring for the body, the act of seeing, and the joy of care as emergent essences of gerontology nursing. Language of nursing in relationship to 'basic nursing care' is critiqued for its potential to devalue gerontology nursing and, by association, old people.
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Logan, C. M. (2000). Anaesthetic nursing: Focusing perioperative practice on the patient.
Abstract: The purpose of this literature review is to generate a picture of what is known and what needs to be investigated further about anaesthetic nursing in the perioperative nursing role in New Zealand, and to examine this in relation to international trends. Nurse anaesthetists in the United States are described in American nursing literature, and recognised as one of the four advanced nurse practitioner roles. In New Zealand, recent efforts to provide appropriate post-graduate education for the perioperative nurse have been challenged by other inter-professional interests, thus restricting the development of an expanded role. The author notes that this has caused concern for New Zealand's perioperative nurses who consider anaesthetic nursing is an integral part of perioperative practice. Anaesthetic nursing forms a substantial component of the basic competencies required of a registered nurse working in the operating theatres. Orientation programmes and ongoing education at all levels of professional development incorporate anaesthetic nursing competencies to provide continuity of patient care and support perioperative practice. Care of the patient undergoing anaesthesia is an area where nurses demonstrate their advanced assessment skills and clinical judgement and is included in perioperative specialist or nurse practitioner job descriptions. The Perioperative Nurses Association in New Zealand is concerned to develop postgraduate education in their area of speciality to support their application for 'College' status within the New Zealand Nurses Organisation. For this to happen in a cogent fashion, information and knowledge generated from research, are required to clarify perioperative nursing's current position and determine how practice can be shaped to best care for patients undergoing surgical interventions. Evidence from research supports nurses in the anaesthetic role by demonstrating that the preoperative visits and assessments they undertake can reduce patients' anxieties, decrease the need for pain relief and shorten hospital stays. This review includes literature sources that explore disparities between the development of New Zealand anaesthetic nursing and international models. The author suggests that information and understanding gained from conducting this review will allow future developments in anaesthetic nursing practice to be informed by previous initiatives and projects and identifies areas for further research.
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Wilson, H. V. (2003). Paradoxical pursuits in child health nursing practice: Discourses of scientific mothercraft. Critical Public Health, 13(3), 281–293.
Abstract: The purpose of this paper is to examine the discourses of scientific mothercraft and their implications for the nurse-mother relationship, drawing on the author's recent research into surveillance and the exercise of power in the child health nursing context. The application of Foucauldian discourse analysis to the texts generated by interviews with five New Zealand child health nurses confirms that this paradoxical role has never been fully resolved. Plunket nurses primarily work in the community with the parents of new babies and preschool children. Their work, child health surveillance, is considered to involve routine and unproblematic practices generally carried out in the context of a relationship between the nurse and the mother. However, there are suggestions in the literature that historically the nurse's surveillance role has conflicting objectives, as she is at the same time an inspector and family friend.
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Nichols, J. (2004). An exploration of clinical supervision within mental health nursing. Vision: A Journal of Nursing, (November).
Abstract: The purpose of this paper is to shed some light on the concept of clinical supervision specifically in relation to mental health nursing. The author talks briefly about the naming and history of clinical supervision and aims to provide some clarity around defining the concept. There is discussion around the role, value and objectives of clinical supervision before critical examination of two models of clinical supervision within two different contexts. Finally the strengths and weaknesses of each model are discussed, and the differences illustrate some of the contextual factors of clinical supervision.
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Jones, M. (1985). The complexities of post operative pain management and a study of the effectiveness of continuous intravenous narcotic infusion pumps as a means of pain relief in the first 48 hours post operatively. Ph.D. thesis, , .
Abstract: The purpose of this paper was to observe the effectiveness of continuous intravenous narcotic infusions as a means of pain relief in the first 48 hours post operatively. 12 patients who had experienced major thoracic or abdominal surgery participated in the study. Pain was assessed at rest and on activity on visual analogues at 5 specific times daily for up to 48 hours post operatively. Data was also collected from a structured interview within the first 48 hours and a retrospective interview when the infusion was discontinued. Results indicated- 1. Very little correlation of changes in pain relief dose to the assessment of pain intensity. 2. Documentation and assessment was not always thoroughly completed. 3. Inadequate treatment of pain post operatively was evident especially on activity. It should be emphasised that pain management could be improved through a focus in interdisciplinary consultation, continuing in service education on pain management and accountability in procedure.
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Hollows, K. (1995). The lived experience of registered nurses involved in the withdrawal of nutrition and hydration in a persistant vegetative state (PVS) patient. Nursing Praxis in New Zealand, 10(1), 28–37.
Abstract: The purpose of this phenomenological study was to describe the experience of five Registered Nurses involved in the withdrawal of nutrition and hydration in a persistant vegetative state (PVS) patient. Three female and two male nurses who had been involved in the care of a PVS patient within the last ten years were interviewed. The phenomenological design was used because it provided richness and clarity to the issues raised. Three major findings were identified as positive significant experiences for these nurses: support through 'talking': coping through 'thinking': and, decision making being kept 'in-house' (family and central care giving team)"
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Elbe, E. (2002). The private world of nursing related to incident reporting. Ph.D. thesis, , .
Abstract: The purpose of this project was to explore the experience of nurses related to incident reporting. The reporting of incidents is important as it identifies professional risks for nurses. A descriptive qualitative approach was the methodology used and individual interviews of five senior nurses was the method of data collection. Attention was given to finding out about the supports for and barriers against nurses in reporting incidents; the outcomes for nurses of incident reporting; and the organisational culture and scope of 'professional' behaviour of nurses around incident reporting. The findings revealed that nurses identified themselves as the major reporters of incidents. They considered there was not 'a level playing field' for all professionals around who, how and why incidents were reported, investigated and within the post incident processes. The nurses reported that they made daily decisions about what was an incident, and whether to report events as incidents. They identified aids and supports to the decisions they made such as the medium for reporting and fear of what happened when the incident form left the nurse and went to management. A number of significant implications were identified for nursing, management and organisations in this research. Nurses need to feel they work in organisations which have a culture of safety around incident reporting. Management need to clearly communicate policies, processes and organisational expectations related to incident reporting. This should include how incidents will be reported, investigated and the purposes for which management use incident reporting information. It is also important that adequate structures are in place to support nurses when an incident occurs as thay can have stressful consequences for the nurses involved.
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McLeland, A., & Williams, A. (2002). An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries. Contemporary Nurse, 12(2), 185–193.
Abstract: The purpose of this qualitative study was to analyse the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalisation; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalisation. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability.
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Wilkinson, J. A. (2007). The New Zealand nurse practitioner polemic: A discourse analysis. Ph.D. thesis, , .
Abstract: The purpose of this research has been to trace the development of the nurse practitioner role in New Zealand. Using a discourse analytical approach informed by the work of Michel Foucault, the study foregrounds the discourses that have constructed the nurse practitioner role within the New Zealand social and political context. The author suggests that discourses of nursing and of medicine have established systems of disciplinary practices that produce nurses and physicians within defined role boundaries, not because of legislation, but because discourse has constructed certain rules. The nurse practitioner role transcends those boundaries and offers the possibility of a new and potentially more liberating identity for nurses and nursing. A plural approach of both textuality and discursivity was used to guide the analysis of texts chosen from published literature and from nine interviews conducted with individuals who have been influential in the unfolding of the nurse practitioner role. Both professionally and industrially and in academic and regulatory terms dating back to the Nurses Registration Act, 1901, the political discourses and disciplinary practices serving to position nurses in the health care sector and to represent nursing are examined. The play of these forces has created an interstice from which the nurse practitioner role in New Zealand could emerge. In combination with a new state regime of primary health care, the notion of an autonomous nursing profession in both practice and regulation has challenged medicine's traditional right to surveillance of nursing practice. Through a kind of regulated freedom, the availability of assessment, diagnostic and prescribing practices within a nursing discourse signals a radical shift in how nursing can be represented. The author concludes that the nurse practitioner polemic has revolutionised the nursing subject, and may in turn lead to a qualitatively different health service.
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Barrington, J. (2008). Shapeshifting: Prostitution and the problem of harm: A discourse analysis of media reportage of prostitution law reform in New Zealand in 2003. Ph.D. thesis, , .
Abstract: The purpose of this research is to examine the cultural context which makes violence and abuse against women and children possible. In 2003, the public debate on prostitution law reform promised to open a space in which discourses on sexuality and violence, practices usually private or hidden, would publicly emerge. Everyday discourses relating to prostitution law reform reported in the New Zealand Herald newspaper in the year 2003 were analysed using Foucauldian and feminist post-structural methodological approaches. Foucauldian discourse analysis emphasises the ways in which power is enmeshed in discourse, enabling power relations and hegemonic practices to be made visible. The research aims were to develop a complex, comprehensive analysis of the media discourses, to examine the construction of harm in the media debate, to examine the ways in which the cultural hegemony of dominant groups was secured and contested and to consider the role of mental health nurses as agents of emancipatory political change. Mental health promotion is mainly a socio-political practice and the findings suggest that mental health nurses could reconsider their professional role, to participate politically as social activists, challenging the social order thereby reducing the human suffering which interpersonal violence and abuse carries in its wake.
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Crowe, M., O'Malley, J., & Bigwood, S. (2002). Nursing mental health consumers in the community. Kai Tiaki: Nursing New Zealand, 8(8), 14–15.
Abstract: The purpose of this research was to describe the characteristics of community mental health nursing care in the community. Twenty six nurses were enrolled in a study consisting of semi-structured interviews about the nature of their care. Responses were analysed to identify categories of skills. These were characterised as: establishing connectedness; promoting individual and family resilience, promoting citizenship; and addressing structural issues. Responses from the nurses are used to illustrate these categories.
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Bramley, C. J. (1981). The nurse and the problem drinker: a study of helping behaviour. Ph.D. thesis, , .
Abstract: The purpose of this study is to examine aspects of the behaviour of Nurses towards persons with alcohol related problems. Similarities and differences in helpful and unhelpful behaviour as perceived by providers and users of care are identified using the behaviour to alcoholism management ( B.R.A.M.) scale. The research covers two phases. In phase One 27 Registered Nurses and 12 members of Alcoholics Anonymous completed critical incident questionnaires which furnished a list of helpful behaviours and a list of unhelpful behaviours. These have been analysed and a set of descriptive statements prepared which constitutes the B.R. A.M. scale. In Phase Two this has been administered to 67 Registered Nurses and 46 members of Alcoholics Anonymous and the results assessed. The findings show that Nurses and Problem Drinkers view the same behaviour as helpful. There is however a significant difference between the two groups on the types of behaviour they consider to be unhelpful. This finding has consequences for those who provide care for problem Drinkers and for Teachers and students in education programs for Nurses
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Stokes, C. (1997). The role of student self-assessment in a Bachelor of Nursing Degree programme. Beginning Journeys: A Collection of Work, 3.
Abstract: The purpose of this study was to determine if there was commonality amongst teachers, in perceptions of the role of student self-assessment in the nursing programme. Four nurse educators, who were teaching and supervising students undertaking self-assessment in clinical practice, participated in a semi-structured interview. Three focus questions guided the interviews and addressed the individual teachers perception of self-assessment, what the teacher considered the benefits of self-assessment to be, and how the teacher used student's self-assessment's in their role as clinical supervisor. The taped interviews were transcribed, and coded and general themes identified. The findings revealed a high degree of consensus amongst the teachers in regard to the co-operative nature of self-assessment, and the teacher's role as a facilitator. The need for students to develop skills of analysis and reflection on their performance as well as the need to furnish students with clear guidelines on what to self-assess, were highlighted
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