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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.
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Hinvest, K. (2020). The meaning of nurses' caring for clinically-deteriorating patients. Master's thesis, Auckland University of Technology, Auckland. Retrieved June 30, 2024, from http://hdl.handle.net/10292/13140
Abstract: Reveals and explores the stories of ten Registered Nurses working in Acute Assessment Units caring for clinically-deteriorating patients. Uses the perspectives of hermeneutic phenomenology to explore the meaning of nurses caring for such patients. Conducts semi-structured interviews with the RNs identifying three main themes.
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McGinty, M., Poot, B., & Clarke, J. (2020). Registered nurse prescribing: A descriptive survey of prescribing practices in a single district health board in Aotearoa New Zealand. Nursing Praxis in New Zealand, 36(3). Retrieved June 30, 2024, from http://dx.doi.org/https://doi.org/10.36951/27034542.2020.014
Abstract: Surveys 11 RN prescribers working in cardiology, respiratory health, diabetes and primary care working in one DHB, about the medicines they prescribe for their areas of practice. Reveals the importance of regular updates to the list of medications available for RN prescribers.
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Hylton, A. (2019). Nurses' knowledge and attitudes regarding pain. Master's thesis, University of Otago, Dunedin. Retrieved June 30, 2024, from http://hdl.handle.net/10523/9447
Abstract: Surveys the knowledge and attitudes of registered nurses (RNs) regarding pain management in the care of the post-operative patient, across five District Health Boards (DHBs). Collects data using a modified version of the Knowledge and Attitudes Survey Regarding Pain (KASRP) tool (Ferrell & McCaffery, 2014), in a cross-sectional descriptive non-experimental design.
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Floyd, S., & Meyer, A. (2007). Intramuscular injections: What's best practice? Kai Tiaki: Nursing New Zealand, 13(6), 20–22.
Abstract: The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
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Budge, C., Carryer, J. B., & Wood, S. (2003). Health correlates of autonomy, control and professional relationships in the nursing work environment. Journal of Advanced Nursing, 42(3), 260–268.
Abstract: The aim of this study was to examine nursing in New Zealand and to see whether aspects of the work environment are associated with health status. A total of 225 registered nurses in a general hospital completed the Revised Nursing Work Index (NWI-R) and Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36). Ratings indicated that the New Zealand hospital environment was characterized by less autonomy and control and better nurse-physician relations than in USA hospitals. Results of correlations demonstrated that more positive ratings of the three workplace attributes were associated with better health status amongst the nurses. The results of regression analyses were indicative either of a confounding relationship or of a mediating relationship such that nurses' relations with physicians, administration and other departments mediate the associations between autonomy, control and health status.
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Jamieson, I. (2012). What are the views of Generation Y New Zealand Registered Nurses towards nursing, work and career?: A descriptive exploratory study. Ph.D. thesis, University of Canterbury, Christchurch.
Abstract: The author has taken a broad approach to this research to explore the views of Generation Y New Zealand Registered Nurses towards the nursing profession, the work itself and their career plans. This study arose out of the author?s interest in health care workforce planning for nursing and in particular the retention of young nurses given the current national and global shortage of nurses. Because of the broad and descriptive nature of the research, a wide variety of topics are included in the literature reviewed.
Chapter one provides background to the study and an overview of generational cohorts.
Chapter two explores selected literature relevant to the concept of work and the characteristics of the Generation Y workforce.
Other topics included in this chapter include Herzberg?s work motivation hygiene/maintenance theory and a selection of literature about key workforce recruitment and retention issues.
A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Health Sciences
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Mearns, G. (2005). Developing autonomous ownership: A grounded theory study of how registered nurses working in aged care are advancing their nursing practice. Ph.D. thesis, , .
Abstract: The introduction of nurse practitioner registration into New Zealand in 2001 was heralded as a move that would open up a wealth of opportunities for registered nurses to extend their practice into more independent roles and to provide a client-centred health service. It was also seen as a way to retain experienced registered nurses in the clinical practice area by providing a credible clinical career pathway. If nurse practitioner's are to meet these expectations, then, the author suggests, it is important to understand the processes that encourage or discourage nurses from advancing their practice. One of the early scopes of practice to be introduced was nurse practitioner with an endorsement in aged care scope of practice. Grounded theory was the method used to generate an explanation of how registered nurses working in aged care were preparing for the introduction of nurse practitioner roles. An analysis of early data highlighted codes around registered nurses in aged care extending and advancing their practice rather than preparing specifically for the nurse practitioner role. The research question for this study was: 'How are registered nurses in aged care advancing their nursing practice?' Semi-structured interviews were used to collect data from ten experienced registered nurses working in aged care clinical practice settings ranging from secondary hospital facilities, to community settings and residential care villages. Dimensional analysis of the data eventually generated three major conceptual categories: 'ownership of nursing', 'extending practice', and 'moving out of a comfort zone'. Of these, 'ownership of nursing' was identified as the core construct that linked the other categories together. The substantive theory that explains how registered nurses in aged care advance their clinical practice is 'developing autonomous ownership'. Nurses who develop autonomous ownership of nursing are more likely than other nurses to move out of a current comfort zone and advance their practice into more independent roles that suit their autonomous ownership of nursing. This study identified important contextual factors and conditions that support the development of an autonomous ownership of nursing and that subsequently facilitate advancing nursing practice. These include creating supportive environments, organisational commitment to advanced nursing practice roles, visible nursing leadership, congruence between organisational and nursing philosophies, interdisciplinary collaboration and participating in postgraduate education. The author suggests that the significance of this study is that it generated a theory about the processes that encourage or discourage nurses from preparing for, and progressing into, advanced nursing practice roles such as nurse practitioner.
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Bleach, A. (2005). Nurses talk the walk: An exploration of nurses' perception of advanced nursing practice on acute mental health inpatient units in New Zealand. Ph.D. thesis, , .
Abstract: The last twenty years, particularly the early 1990s, ushered in major mental health sector reforms inclusive of deinstitutionalisation policies and subsequent development of community services. Concurrent changes to student nurses' education left registered nurses as the workforce mainstay on inpatient units. However, the author suggests, an emerging global shortage of nurses and implementation of the Employment Contracts Act (1991) negatively impacted on recruitment and retention of registered nurses. Inpatient nurses either left nursing or moved to community positions for better money and increased job status. The author suggests that, as a consequence, the 'critical mass' of experienced and skilled nurses who traditionally provided nursing leadership disappeared resulting in compromised standards of care for patients. As the manager of an inpatient unit, the author proposed the establishment of advanced nursing practice roles as one initiative to provide nursing leadership in order to attract and retain nurses. This study explored five inpatient nurses' perceptions of advanced practice and whether these roles could assist to provide leadership and improve standards of care. The research was a qualitative exploratory descriptive study using a focus group interview as the data collection method. A thematic analysis of the group discussion transcription revealed three key themes: 1) the 'makeup' of advanced nursing practice, 2) moving forwards: establishing roles, 3) moving sideways: barriers to role development. The themes are critically discussed in relation to selected literature. The thesis includes recommendations that could be used by nurses responsible for planning and implementing advanced practice roles on inpatient units.
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Lyall, C. (2003). Therapeutic relationships: What are inpatient registered nurses perceptions of the factors which influence therapeutic relationship development? Ph.D. thesis, , .
Abstract: The question explored in this research project is: What are inpatient registered nurses' perceptions of the factors which influence therapeutic relationship development? The literature reviewed for this project includes the history of interpersonal relationships in nursing; therapeutic relationships; what constitutes these relationships. Also discussed is literature about phenomenology as the underlying theoretical and philosophical position that informs the research method. To answer the research question a single focus group was used to gather data from a group of registered nurses practising in inpatient mental health units. Focus groups as a data collection method produce data and insights that would not be accessible without the group interaction. The key themes to emerge from the data analysis were; time, environment, knowing / self-awareness, compassion and power imbalance / empowerment. These key themes are discussed in relation to the literature and the wider context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations to nurses, nurse leaders and managers who aim to provide therapeutic mental health unit environments.
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Dal Din, A. (2006). Accepting the challenge: Registered nurses' experiences of undertaking the statutory role of Responsible Clinician in New Zealand. Ph.D. thesis, , .
Abstract: This aim of this thesis was to explore and describe registered nurses' experiences of undertaking the statutory role of Responsible Clinician under the Mental Health (Compulsory Assessment and Treatment) Act 1992. The role of Responsible Clinician has been available to nurses since 1992 yet to date there has been little research into nurses' experiences of undertaking this role. An exploratory descriptive approach was therefore used in this study. A convenience sample of four nurses who had been undertaking the role of Responsible Clinician was recruited. Their experiences were elicited through in-depth interviews. Analysis of the interview material revealed the themes of legitimacy, relationships, expanding practice, responsibility and accountability, approaches to care, nurses' responsiveness to the role and support of the role. The author points to this research being important to nurses who are working in the psychiatric mental health area so that they can understand the role more fully. In this way, more nurses may choose to undertake the role of Responsible Clinician.
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Dredge, A. (1999). An insider's view of professional nursing and care management of the critically ill patient. Vision: A Journal of Nursing, 5(8), 13–16.
Abstract: This article explores the role of the registered nurse (RN) in the critical care environment. It presents the Intensive Care Unit (ICU) as a unique environment, with a specific relationship to technology, and a history that mirrors scientific development. It explores the tensions for a caring profession with a distinct culture practising in a highly medicalised, acute environment, and affirms the value of quality human care.
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Spence, D., & Wood, E. E. (2007). Registered nurse participation in performance appraisal interviews. Journal of Professional Nursing, 23(1), 55–59.
Abstract: This article presents the findings of an interpretive study that explored and documented the meaning and impact of nurse participation in performance appraisal interviews. Data gleaned from nine New Zealand registered nurses employed by a single district health board provide evidence that nurses are often disappointed by the process of performance appraisal. Although they believe in the potential value of performance appraisal interviews, they seldom experience the feedback, direction, and encouragement necessary for an effective appraisal process. It is suggested that changes to the current professional development program and its accompanying performance appraisal will require skilled commitment on the part of nurses, managers, and the employing organisation to improve and develop the assessment and promotion of nursing practice.
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Wassner, A. (1999). Labour of love: Childbirth at Dunedin Hospital, 1862-1972. Dunedin: A Wassner.
Abstract: This book covers obstetrical care from a nursing perspective at the Dunedin Hospital's Maternity Units. The researcher found little information on the two lying-in (maternity) wards of the first two Dunedin Hospitals. The book presents historical records outlining obstetric nursing procedures and maternity culture at the Dunedin Hospitals, The Benevolent Institution, The Batchelor Maternity Hospital, and Queen Mary Hospital. It covers cultural, social and legislative changes over the period, and examines conditions and pay for nursing staff across this time. A chapter on the evolution of baby care looks at changes in acceptable practices around nursery care, breast and bottle feeding, and medical procedures. The book has an extensive list of appendices, including staff lists, training notes for staff, duty lists, and interviews with staff and patients.
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Wilson, L. J. (2001). Futurist planning, not a shortage stopgap: Recruitment and retention of registered nurses in New Zealand. Ph.D. thesis, , .
Abstract: This literature review critically examines contributing factors to the current nursing shortage in New Zealand, centering on recruitment and retention of registered nurses. There is a dramatic widening between the supply of registered nurses and the demand for their services. All regions in New Zealand are reporting difficulty in hiring experienced and specialty nurses, and recruiting time is lengthening. This report suggests that the shortage is closely linked to factors in the nursing care environment. As a result of multiple factors during the centralising, cost-containing, acuity-increasing decade of the 1990s, the care environment has driven practising nurses out of acute care settings and discouraged new students from entering the profession. The availability of numerous alternative career opportunities has heightened the effect. Continuing causes to the non-selection of nursing as a profession are the influences of wage compression and limited career progression over the lifetime of the nurse, and insufficient orientation and mentoring of new nurses. Recent changes in the health care system have gone unevaluated and without oversight by nursing regulatory agencies – a situation not in the best interests of patients or nurses. A number of both literature-supported and resourceful approaches, including recommendations towards addressing the nursing shortage are proposed in this review.
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