Booher, J. (2003). Professional practice models: Shared governance and magnet hospitals. Vision: A Journal of Nursing, (June).
Abstract: This article explores the application of professional practice models in nursing. Particular reference is made to the magnet hospital model and the concept of shared governance. Key principles from these models are explored in relation to the implementation of a professional practice model in an intensive care environment. Historical, cultural and professional factors that may be seen as barriers to the implementation of this professional practice model are also explored. In conclusion, the article identifies recommendations that may contribute to a successful implementation and duration of a model in practice.
|
Crowe, M. (2006). Psychiatric diagnosis: Some implications for mental health nursing care. Journal of Advanced Nursing, 53(1), 125–131.
Abstract: This article explores some of the functions of psychiatric diagnosis and the implications this has for mental health nursing care. It critiques the psychiatric diagnosis as a categorisation process that maintains oppressive power relations within society, by establishing and enforcing normality through gender, culture and class biases. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is used to illustrate some of the inherent biases in the diagnostic process. The author argues that mental health nursing practice needs to demonstrate an awareness of the power relations inherent in any diagnostic process and make attempts to redress these at both the individual and sociopolitical levels. To create a true patient-centred partnership in mental health nursing, the nursing focus should be on the patient's experience rather than the psychiatric diagnosis with which the experience is attributed. NB this is a reprint of article first published in Journal of Advanced Nursing, 2000 Mar; 31(3), 583-9.
|
O'Brien, A. J. (2001). The therapeutic relationship: Historical development and contemporary significance. Journal of Psychiatric & Mental Health Nursing, 8(2), 129–137.
Abstract: This article examines the therapeutic relationship, a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realised in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualisations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses.
|
Wright, R. (2001). Linking theory with practice. Kai Tiaki: Nursing New Zealand, 7(2), 14–15.
Abstract: This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family.
|
Hoare, K., Fairhurst-Winstanley, W., Horsburgh, M., & McCormack, R. (2008). Nurse employment in primary care: UK and New Zealand. The Royal New Zealand College of General Practitioners website, 35(1), 4–10.
Abstract: The researchers evaluate and compare the organisation of general practice in the UK and New Zealand. A key aim of the Primary Health Care Strategy is a reduction in health inequalities. Locally, some nurse leaders suggest that changing nurse practice employment from general practitioners to Primary Health Organisations will achieve this aim. The authors take lessons from the UK and suggest that nurses organising themselves into peer groups, remuneration of general practices for the attainment of positive patient outcomes, and a statutory duty of clinical governance, all contributed to the development of practice nurses' roles and expansion of numbers of nurse practitioners in general practice. Nurses have become partners with general practitioners in general practice in the UK, which the authors suggest is a much preferable alternative for some than employment by a Primary Health Organisation.
|
Lindley, G. (2007). Using frameworks to critically analyse the advancement of rural practice: One nurse's experience. Ph.D. thesis, , .
Abstract: The process of describing her scope of practice led the author to become interested in just how she has advanced her practice and the journey that unfolded. The author was introduced to a number of models or frameworks and these frameworks have been critiqued within this dissertation.
|
Hughes, F., & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki: Nursing New Zealand, 13(4), 14–16.
Abstract: The authors review the contemporary notion of obesity and suggest that the nursing approach, with an emphasis on treatment, are shaped by a culture located within “western” views of ideal body shape. The biomedical framework regards obesity as disease and obese people as the cause of their own health problems. The authors note varying cultural interpretations of obesity, and suggest that by viewing obesity as a disease, the cultural, social or economic determinants of obesity are not acknowledged. Nursing needs to broaden the concept of the categories of difference to respond in a culturally safe way to obesity. Cultural safety asks that nurses care for people “regardful” of difference. This means nurses must reflect on the care given, so that the biomedical model is not just replicated. Nurse-led clinics offer an opportunity for practices based on nursing values of care and cultural safety. Such clinics are based on nursing's social model of health, rather than a biomedical, disease-focused model.
|
Lyford, S., & Cook, P. (2005). The Whanaungatanga model of care. Nursing Praxis in New Zealand, 21(2), 26–36.
Abstract: The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme.
|
Horsburgh, M., Goodyear-Smith, F., & Yallop, J. (2008). Nursing initiatives in primary care: An approach to risk reduction for cardiovascular disease and diabetes. The Royal New Zealand College of General Practitioners website, 35(3), 176–182.
Abstract: The authors evaluated a nurse-led cardiovascular disease and diabetes (CVD) management project. The Ministry of Health funded the project to implement models of nurse service delivery, with care pathways for risk reduction of CVD and diabetes based on national guidelines, with quality assurance, audit and nurse leadership. The paper presents the components required to implement and sustain a nurse CVD risk assessment and management service, which were identified and clarified through the action research process.
|
Christensen, D. J. C. (1999). Integrating the terminology and titles of nursing practice roles: Quality, particularity and levelling. Nursing Praxis in New Zealand, 14(1), 4–11.
Abstract: The author reconsiders the meaning of expert, specialist and advanced practice. She proposes that they are distinctive and complementary aspects of every nursing role and suggests a set of attributes for each. Expertise is discussed in terms of the quality of performance, speciality in relation to particularity of performance, and advanced practice with regard to the level of performance.
|
Bishop, J. (2005). Motivation: An essential element of learning. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp. 83-100). Dunedin: Otago Polytechnic.
Abstract: The author defines extrinsic and intrinsic motivators, describes motivational theories, and introduces Wlodkowski's Motivational Framework, which is specifically developed for adult learners. She goes on to explore the implementation of this model within a nursing education context. At the end of the chapter, discussion questions are provided by Janice McDrury.
|
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.
|
Giddings, D. L. S. (2005). A theoretical model of social consciousness. Advances in Nursing Science, 28(3), 224–239.
Abstract: The article presents a theoretical model of social consciousness developed from nurses' life histories. A 3-position dialectical framework (acquired, awakened, and expanded social consciousness) makes visible the way people respond to social injustice in their lives and in the lives of others. The positions coexist, are not hierarchical, and are contextually situated. A person's location influences her or his availability for social action. Nurses who could most contribute to challenging social injustices that underpin health disparities are relegated to the margins of mainstream nursing by internal processes of discrimination. The author suggests that more inclusive definitions of “a nurse” would open up possibilities for social change.
|
Carter, H., MacLeod, R., Brander, P., & McPherson, K. (2004). Living with a terminal illness: Patients' priorities. Journal of Advanced Nursing, 45(6), 611–620.
Abstract: The aim of this paper is to report on an exploratory, qualitative study exploring what people living with terminal illness considered were the areas of priority in their lives. Ten people living with terminal cancer were interviewed. Analysis of the interviews incorporated principles of narrative analysis and grounded theory. Over 30 categories were identified and collated into five inter-related themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge) encompassing the issues of importance to all participants. Each theme focused on 'life and living' in relation to life as it was or would be without illness. Practical issues of daily living and the opportunity to address philosophical issues around the meaning of life emerged as important areas. The central theme, 'taking charge', concerned with people's levels of life engagement, was integrally connected to all other themes. The findings suggest that the way in which health professionals manage patients' involvement in matters such as symptom relief can impact on existential areas of concern. The findings challenge some aspects of traditional 'expert-defined' outcome measures. As this was an exploratory study, further work is needed to test and develop the model presented.
|
Sheridan, N. F. (2005). Mapping a new future: Primary health care nursing in New Zealand. Ph.D. thesis, , .
Abstract: The aim of the study was to determine the practice of nurses employed in integrated care projects in New Zealand from late 1999 to early 2001. Integrated care was a major health reform strategy that emphasised primary health care as a means to improve service provision between the health sectors. An investigation of nurses' practice sought to determine the extent to which primary health care principles had been adopted in practice, as a comprehensive primary health care approach has been advocated globally in the management of chronic conditions; the leading cause of disability throughout the world and the most expensive problems faced by health care systems. The philosophical basis of the research was postpositivism. The study employed a quantitative non-experimental survey design because it allowed numeric descriptions of the characteristics of integrated care projects to be gained for the purpose of identifying nurses' practice. The unit of inquiry was the integrated care project, and 80 comprised the study population. Data were obtained on projects from expert informants (n=27) by telephone survey using a structured interview questionnaire developed by the researcher. Data obtained from interviews were statistically analysed in two stages. First, data were produced to comprehensively describe the characteristics of integrated care projects and nurses practice. The 'Public health interventions model' was used as a framework to analyses the interventions (activities) and levels of population-based practice of nurses. Following this, the social values embedded in nurses' practice were determined using 'Beattie's model of health promotion' as a framework for analysis. A strong association was found between nurses' practice in projects and strategies used in integrated care, such as information sharing, guideline development and promotion, and case management, and projects with an ethnic focus, low income focus, chronic condition focus, and well-health focus. Whilst nurses undertook interventions most frequently at the individual practice level they were also strongly associated with the small proportion of interventions that were undertaken at the community level. The majority of interventions by nurses reflected the health promotion value of health persuasion, indicating a paternalist and individual-oriented philosophy. Nurses were engaged in two interventions that indicated a collective-oriented philosophy – coalition building and community development, the latter reflecting health promotion values of negotiation, partnership and empowerment. The study demonstrated that nurses' practice in projects was predominantly centred on individual-focused population-based practice suggesting the need for a framework to assist nurses to transition their practice to include more activity at the community and systems levels. Without a reorientation of practice, nurses will remain limited in their ability to achieve health gains for populations. In response to this conclusion, and drawing on research results and reviewed literature, a new model, The 'Primary Health Care interventions model' was constructed. Recommendations include advocacy for the acceptance of the model by the health funder, professional nursing bodies, health organisations, educational institutions, nurses, communities, and individuals.
|