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Author |
Yarker-Hitchcock, V. |
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Title |
Clinical supervision in a home care context |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Issue |
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Pages |
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Keywords |
Clinical supervision; Home care; Rural nursing; Rural health services |
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Abstract  |
Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in relation to its effect on clinical practice. It is not clear whether supervision actually produces a change in clinician behaviour, or whether it produces benefits in terms of client outcomes. This thesis evaluates the impact of clinical supervision on five co-ordinators in a rural home care setting. It looks at the impact clinical supervision has on their practice and professional growth. The nurses all belong to one organisation, Access Homehealth Ltd. The study builds on the findings of a clinical supervision pilot, which was trialed within the organisation in 2002. The pilot examined which model of supervision was most beneficial for Access Homehealth staff. Clinical Supervision is defined as a designated interaction between two or more practitioners within a supportive environment, that enhances reflective practice and professionalism, which in turn contributes to improved practice and client outcomes. The methodology of this research was qualitative evaluation. The themes which emerged related to personal support, managing stress and alleviating feelings of isolation, reflection, enhancing practice, improved communication skills and the concept of clinical supervision as a safety net. Participants also revealed that one-on-one supervision appeared more helpful than group supervision, and that phone supervision facilitated in-depth dialogue. These findings are important, as they demonstrate it is feasible to simultaneously offer a number of formats of clinical supervision within one organisation, allowing for the organisation to provide what works best for different workers. They also show that clinical supervision is a valuable and useful support tool for home care co-ordinators in order to facilitate empowerment, reflection and growth in practice. Further research is needed to provide evidence of the benefits of supervision on improving client outcomes. |
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Call Number |
NRSNZNO @ research @ 593 |
Serial |
579 |
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Author |
Adams, Sue |
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Title |
Nurse practitioners in rural primary health care in New Zealand : an institutional ethnography |
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Book Whole |
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Year |
2017 |
Publication |
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Abbreviated Journal |
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Pages |
372 p. |
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Keywords |
Nurse practitioners; Rural primary health care; Rural health; Institutional ethnography; Surveys |
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Abstract |
Critically examines the work required to establish nurse practitioner (NP) services in rural primary health care in NZ, using the institutional ethnography approach to the inquiry. Explores the work and experiences that nurses undertook to become NPs delivering rural primary health care services. Considers how these were institutionally-shaped and coordinated. Conducts interviews with a total of 13 NPs and four NP candidates. |
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Call Number |
NZNO @ research @ |
Serial |
1810 |
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Author |
Boyd, M.E. |
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Title |
Advancing nursing knowledge: The experience of a nurse working with dying people in a highly remote rural area |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Terminal care; Rural nursing; Rural health services |
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Abstract |
By describing and gaining insight into one rural nurse's experience working with dying people in a highly, remote rural area, this project seeks to advance nursing practice. Key findings indicate that, through community partnership and teamwork, nurses can act to assist rural people by: increasing public awareness of health resources; exposing barriers to access; and identifying different health service needs. The author makes a case that some rural nurses may feel insufficiently prepared for rural nursing. To understand death and dying, key ideas from Kuebler-Ross's (1969) framework for dying are examined: denial, fear of dying, spirituality, hope, depression and how to die well. Nurses require a blend of end-of-life and rural nursing postgraduate education and skills, to manage well. Key findings imply that dying people can be helped by: improving function and independence to promote autonomy; encouraging faith, hope, and love within the person's personal concept of spirituality; listening to dying people, to oneself, to one's own reactions, and knowing oneself. Parse's theory (1981) indicates nurses can help rural dying people by the following key factors: encouraging the person to live life to the full while dying; accepting humans cannot be separated from their perspectives, circumstances or environments; focusing on quality of life from the person's perspective: encouraging the person to live life fully while dying; and offering new possibilities. The author goes on to say that Parse's human-universe-health process aids nurses to live their beliefs indicating Parse's theory could guide and advance nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
573 |
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Author |
Thompson, L.E. |
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Title |
Profession and place: Contesting professional boundaries at the margins |
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Year |
2006 |
Publication |
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Abbreviated Journal |
UC Research Repository |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Primary health care; Identity; Interprofessional relations |
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Abstract |
Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural. |
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Call Number |
NRSNZNO @ research @ 1177 |
Serial |
1162 |
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Author |
Litchfield, M. |
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Title |
The successful design and delivery of rural health services: The meaning of success |
Type |
Report |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Accessible from www.moh.govt.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Management; Primary health care |
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Abstract |
A report on the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of ?successful design and delivery of rural health services? as a step towards a measurement tool. Participants were grouped as general practitioners (GPs), nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health. |
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Call Number |
NZNO @ research @ |
Serial |
1328 |
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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 |
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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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Author |
Weidenbohm, K. |
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Title |
Pioneering rural nursing practice: An impact evaluation of a preventive home visiting service for older people |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Community health nursing; Rural health services; Older people; Home care; Preventive health services |
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Abstract |
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Call Number |
NRSNZNO @ research @ 579 |
Serial |
565 |
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