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Author |
Crowe, M.; Carlyle, D. |
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Title |
Deconstructing risk assessment and management in mental health nursing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
43 |
Issue |
1 |
Pages |
19-27 |
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Keywords |
Psychiatric Nursing; Risk management; Policy; Culture |
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Abstract  |
The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1069 |
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Author |
Crowe, M.; O'Malley, J.; Gordon, S. |
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Title |
Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand |
Type |
Journal Article |
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Year |
2001 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
35 |
Issue |
1 |
Pages |
88-96 |
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Keywords |
Community health nursing; Psychiatric Nursing; Patient satisfaction; Mental health |
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Abstract |
The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1087 |
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Author |
Kuehl, S. |
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Title |
Emergency Department re-presentations following intentional self-harm |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment |
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Abstract |
The aim of this research was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present at emergency departments with intentional self-harm. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1214 |
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Author |
Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N. |
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Title |
Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
46 |
Issue |
1 |
Pages |
95-109 |
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Keywords |
Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori |
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Abstract |
The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1060 |
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Author |
McKenna, B.; Simpson, A.I.F.; Coverdale, J. |
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Title |
Best practice management strategies for mental health nurses during the clinical application of civil commitment: An overview |
Type |
Journal Article |
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Year |
2006 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
21 |
Issue |
1 |
Pages |
62-70 |
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Keywords |
Psychiatric Nursing; Law and legislation; Nurse-patient relations; Patient satisfaction |
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Abstract |
The aim of this article is to outline best practice management strategies for nurses during the clinical application of civil commitment of mentally ill persons. A literature search on 'coercion' and 'civil commitment' was undertaken. Published and unpublished research undertaken by the authors in New Zealand on this topic was drawn upon. This research considered the use of civil commitment during admission to acute mental health services, acute forensic mental health services and community mental health services. The experience of coercion by service users coincides with the degree of restriction associated with the service they are involved in. Socio-demographic factors, clinical factors and the experience of coercive events have little bearing on the amount of coercion experienced. Rather, it is the pattern of communication and the use of 'procedural justice' that has the potential to ameliorate the amount of perceived coercion. The authors conclude that 'Procedural justice' aligns with the emphasis placed on the therapeutic relationship in mental health nursing and is an important consideration for nurses during the clinical application of civil commitment |
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Call Number |
NRSNZNO @ research @ |
Serial |
1051 |
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Author |
Green, M. |
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Title |
Psychiatric consultation liaison nurse: A model for practice |
Type |
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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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Volume |
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Issue |
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Pages |
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Keywords |
Nursing models; Psychiatric Nursing |
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Abstract |
Psychiatric consultation liaison (PCL) nursing is an evolving specialist area of mental health nursing in the USA, UK, Australia and New Zealand. The aim of this dissertation is to explore models of PCL nursing practice in order to develop and discuss a PCL nursing model applicable to the New Zealand context. The role of the PCL nurse was of particular interest to the author as a new practitioner in this specialist area. While there have been PCL nurses in practice for over 50 years, the literature does not offer much clarity about models of PCL nursing. From a review of the literature, four themes were recurrent in the work of PCL nurses. These themes represent four functions which are vital to the role of the PCL nurse: partnership, expertise of the PCL nurse, therapeutic relationship and organisational consultation. The needs of the patient are the core of this model and the primary objective is to improve the quality of care of patients in the general hospital with co-existing physical and psychological problems. It is imperative that PCL nurses evaluate their practice and embark on research to investigate clinical outcomes, cost effectiveness and the impact of PCL nurse practice on patients and staff. This PCL nursing model provides a beginning for this process. It also clarifies and articulates the role of the PCL nurse which enables the service to be promoted to colleagues. This PCL nursing model represents a critique of the author's understanding of the role of the PCL nurse. As expertise develops, the model will continue to be tested and refined. |
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Call Number |
NRSNZNO @ research @ |
Serial |
608 |
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Author |
Gillard, D. |
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Title |
When I am nursing |
Type |
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Year |
2002 |
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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Volume |
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Issue |
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Pages |
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Keywords |
Nursing models; Mental health; Adolescents; Psychiatric nursing |
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Abstract |
Over the last century the nursing profession has drawn from numerous theories and disciplines to construct its own theoretical foundations. While this diversity and flexibility may be one of the nursing profession's strengths it may have contributed to nurses' difficulty in explaining the complexities of their every day clinical work. This is a particular challenge for the domain of mental health nursing. This dissertation discusses how nursing models that have credibility at a clinical level can contribute to informing and advancing nursing practice. Models can achieve this by assisting nurses to conceptualise and articulate what it is they do that makes a difference to patient outcomes. Through this process nurses can maintain a distinct professional identity and establish themselves as effective members of multidisciplinary health team. Specifically, the application and limitations of Godkin's (2001) proposed model of a 'healing presence' to the author's own practice in a one-to-one nurse-adolescent client relationship in the mental health nursing is examined. It is claimed that a 'healing presence' provides a meaningful way to understanding the author's own practice. The proposed model of a 'healing presence' embraces the diversity of her background, and allows the author to maintain a nursing identity by providing a nursing framework to critique her practice, furthering her understanding of what it is that 'expert' nurses do and how this impacts on patient outcomes. Also suggested is that a 'healing presence' can contribute to the author's own and other nurses advanced nursing practice by making nursing visible to the multidisciplinary health team and to articulate “what it is that I do 'when I am nursing'”. Through presenting this dissertation, the author wishes to inspire other nurses to examine and understand their own practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
914 |
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Author |
Rydon, S.E. |
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Title |
The attitudes, knowledge and skills needed in mental health nurses: The perspective of users of mental health services |
Type |
Journal Article |
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Year |
2005 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
78-87 |
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Keywords |
Patient satisfaction; Psychiatric Nursing; Attitude of health personnel |
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Abstract |
In this study a qualitative descriptive methodology with focus group interviews was used to explore with users of mental health services, the attitudes, knowledge and skills that they need in mental health nurses. Users of mental health services valued the therapeutic work of mental health nurses, and identified positive attitudes towards users of mental health services as essential in mental health nurses. However, they did not consistently experience a therapeutic approach in their interactions with mental health nurses. In a sociopolitical climate where the views of users of mental health services are increasingly incorporated into education and the planning and delivery of services, there is a need for more research that reflects the perspective of users. |
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Call Number |
NRSNZNO @ research @ 961 |
Serial |
945 |
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Author |
Matheson, S. |
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Title |
Psychiatric/mental health nursing: Positioning undergraduate education |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; History of nursing; Nursing; Education |
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Abstract |
In this paper, the critique of the mental health component of comprehensive nursing education and the questions that it raises are explored from historical, structural and ideological perspectives. In order to locate the past and highlight its significance to where psychiatric/mental health nurses find themselves today some of the history of the asylum system and the development of psychiatric nursing in New Zealand within these structures are presented. Ideological changes to the way mental health was thought about, and responded to, have had considerable impact on where psychiatric nurses practiced, how they practised and what they were named. This created the need for a different kind of nurse and has led to changes in the education of nurses. The structural influences on the training and education of nurses are identified through relevant reports and their recommendations and significance in relation to psychiatric/mental health nursing are examined. Issues deriving from the critique of undergraduate psychiatric/mental health nursing education highlight the urgent nature of the crisis and draw out the multiple and competing discourses that inform the education of nurses. In acknowledging that the crisis can be viewed from multiple perspectives the need for responses from multiple levels involving the Nursing Council of New Zealand, the Ministry of Health, the Mental Health Commission and nurses in education and practice are recommended. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1146 |
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Author |
Maxwell-Crawford, K. |
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Title |
Huarahi whakatu: Maori mental health nursing career pathway |
Type |
Report |
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Year |
2004 |
Publication |
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Abbreviated Journal |
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Volume |
(Trm/04/15) |
Issue |
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Pages |
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Keywords |
Professional development; Careers in nursing; Maori; Psychiatric nursing; Mental Health |
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Abstract |
Huarahi whakatu describes a pathway for recognising the expertise of nurses working in kaupapa Maori mental health services and recommends a professional development programme that can lead to advancement along the pathway. An emphasis on dual competencies – cultural and clinical – underlies the rationale for regarding kaupapa Maori mental health nursing as a sub-specialty. Eight levels of cultural competencies and twelve levels of clinical competencies are used to differentiate career stages and it is recommended that movement from one level to another should be matched by increased remuneration. The report also contains a recommended professional development programme to support the operationalisation of the career pathway. |
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Call Number |
NRSNZNO @ research @ |
Serial |
824 |
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Author |
Gingell, M.E. |
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Title |
Home based treatment nursing in Aotearoa New Zealand: Factors influencing the successful delivery of care |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Home care; Psychiatric Nursing |
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Abstract |
Home Based Treatment in acute mental health care is a relatively new phenomenon in New Zealand, although it has been utilised successfully overseas for many years. This paper considers factors that are integral elements of its successful implementation, specifically considering the relationship of nursing care to crisis intervention methodology. It describes how Home Based Treatment fits with contemporary crisis services and how the adherence to crisis intervention models can enable nurses to create a clearly defined recovery perspective in their practice. The author notes that service users in New Zealand and overseas have openly voiced their concerns around the discrepancies between how services have traditionally been delivered and how they wish services to be. He suggests that, as an alternative to inpatient care, Home Based Treatment is an option that promotes recovery and self determination. It is also an arena in which nurses can deconstruct the traditional power relationships between themselves and clients to create a new and invigorating way of practicing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
589 |
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Author |
McKenna, B.; Poole, S. |
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Title |
Debating forensic mental health nursing [corrected] |
Type |
Miscellaneous |
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Year |
2001 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
7 |
Issue |
6 |
Pages |
18-20 |
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Keywords |
Psychiatric Nursing; Law and legislation; Cross-cultural comparison; History of nursing |
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Abstract |
Forensic mental health nursing roles have developed along different lines in the United States and the United Kingdom. The authors suggest that New Zealand nurses consider the evolution of such roles here. |
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Call Number |
NRSNZNO @ research @ 1043 |
Serial |
1027 |
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Author |
McKenna, B.; Poole, S.; Smith, N.A.; Coverdale, J.; Gale, C. |
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Title |
A survey of threats and violent behaviour by patients against registered nurses in their first year of practice |
Type |
Miscellaneous |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
56-63 |
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Keywords |
New graduate nurses; Workplace violence; Occupational health and safety; Training; Mental health; Psychiatric nursing |
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Abstract |
For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes. |
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Call Number |
NRSNZNO @ research @ |
Serial |
649 |
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Author |
Casey, H. |
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Title |
Empowerment: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Policy; Leadership; Careers in nursing; Mental health; Psychiatric nursing |
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Abstract |
For nurses to have control over their practice they need to have input into policy development. Nurses having control over their practice has been linked to nursing empowerment. Therefore the question explored in this research project is: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area? The literature reviewed for this project includes empowerment, power, the history of nursing in relation to women's role in society, oppression and resistance, and literature on Critical Social Theory as the underlying theoretical and philosophical position which informs the research process. In order to answer the research question a single focus group was used to gather data from a group of registered nurses practising in mental health. Focus groups as a data collection method produce data and insights that would be less accessible without the interaction found in the group. The key themes to emerge from the data analysis were: power is an important component of empowerment and power relationships; and at a systems level, professional, organisational, and political influences impact on feelings of empowerment and/or disempowerment. These key themes are discussed in relation to the literature and the broader social and cultural context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations for nurse leaders who aim to provide an empowering environment for nurses practising in mental health. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1145 |
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Author |
Morrison-Ngatai, E. |
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Title |
Mai i muri ka haere whakahaere: Maori woman in mental health nursing |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Maori; Female; Psychiatric Nursing |
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Abstract |
Contents: Chapter 1 Kupu whakataki – introduction; Chapter 2 Raranga mohiotanga – literature review; Chapter 3 To te wahine mana tuku iho – theoretical framework; Chapter 4 Tahuri ki te rangahau – research methodology; Chapter 5 Whakaaturanga whakaoho – beginnings; Chapter 6 Kia pakari – positioning and contesting; Chapter 7 E ara ki runga wahine toa – standing and enduring; Chapter 8 Kua takoto te whariki. |
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Call Number |
NRSNZNO @ research @ |
Serial |
828 |
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