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Harris, C., Crozier, I., Smyth, J., Elliot, J., Watson, P. B., Sands, J., et al. (2007). An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI.
Abstract: This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
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Churcher, R. L., Bowden, J., Grogan, J., Grofski, H., Parker, R., & Berry, A. (2000). Trends in theatre nurse education. Ph.D. thesis, , .
Abstract: This reports the results of a national survey to ascertain what direction education of theatre nursing personnel is taking. It includes method and content preselection, orientation and in service education/ staff development phases of education. Options for the future are also addressed.
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Gardner, A., Hase, S., Gardner, G., Dunn, S., & Carryer, J. B. (2008). From competence to capability: A study of nurse practitioners in clinical practice. Author copy available 12 months after publication from QUT ePrints, 17(2), 250–258.
Abstract: This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners.
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Gifford, H., Walker, L., Clendon, J., Wilson, D., & Boulton, A. (2013). Maori nurses and smoking; Conflicted identities and motivations for smoking cessation. Available through NZNO library, 4(1), 33–38.
Abstract: This research aims to design and test the feasibility of an intervention promoting smoking cessation, and reducing smoking relapse, among Māori nurses who smoke. It is being conducted in two phases. Phase one, a national web-based survey, conducted in December 2012, explored the views of Māori nurses (smokers, ex-smokers and non-smokers) regarding smoking. This paper reports on the analysis of qualitative responses from 410 nurses and nursing students identifying as Māori who completed an online survey. Five themes were identified: beliefs about smoking; ?for our tamariki?; personal stories of quitting; dissatisfaction with current approaches; and plans for future strategies. The findings confirm that nurses who smoke may experience feelings of conflict, and regard their behaviour as inconsistent with their role as nurses and health promoters. Nurses who smoke must be supported to become, and to stay, smokefree. Tailored Māori-specific cessation initiatives are needed.
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Woodgyer, A. R. (2006). Living without the song of the tui: A nursing lecturer's experience in India facilitating a New Zealand degree programme for registered nurses. Ph.D. thesis, , .
Abstract: This research considers the issues raised by the transfer from New Zealand to India of a degree for registered nurses. In the context of globalisation and the continuing migration of nurses, many countries are actively facilitating the transfer of educational programmes from other countries into their own. This transfer brings with it particular challenges for educators establishing and implementing programmes in a new environment and culture. Based on the experience and reflections of one educator involved in such a transfer, this research considers pedagogical issues such as addressing cultural safety in course content and delivery, expectations of teaching and learning styles, as well as the ethical issues raised by transferring a programme to another country in order to facilitate nurses' migration from it.
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Blanchard, D. L. (2006). Developing the place and role of family within the culture of critical care nursing: An action research approach. Ph.D. thesis, , .
Abstract: This research examines how nurses negotiate the context of the Intensive Care Unit (ICU) while working with families. The action research described in this thesis developed through a series of meetings and conversations where the conversations supported the reflexive intent of the research. In commissioning the research, the design of the meetings and conversations were as a series of overlapping actions. Data collection and data analysis occurred in the action research by meetings, reflective conversations, ad libitum observations, and in a research journal. Conceptual maps explain the progress and findings of the research in this thesis while categories distilled from the conversations also support the findings in the research. The Family Action Research Group that was established within this project proposed a Family Assessment Form for the family to provide an assessment of themselves and the patient. Implementing this assessment tool demonstrated that clear information was needed for the family in the ICU. Findings in this research focus on developing action research and family care in ICU. Findings also focused on the role of the researcher being of and not being of the context where action research is undertaken. Recommendations include staff examining relationships for potential asymmetries and seeking ways to address these to support families and staff. Suggested strategies for developing action research in a clinical context include detailed planning, clear focusing, transparency of data, and working to explain change initiatives through the research are also included.
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van Rooyen, P., Dixon, D. A., Dixon, G., & Wells, C. C. (2006). Entry criteria as predictor of performance in an undergraduate nursing degree programme. Nurse Education Today, 27(7), 593–600.
Abstract: This research explored the relationship between entry criteria and academic performance in the first and second year bioscience papers at Otago Polytechnic School of Nursing. The School's inclusion of a bioscience requirement varies from the Nursing Council criteria for acceptance into undergraduate nursing programmes. Six hundred and nineteen academic records of 1994-2002 graduates were sampled. Chi-square and correlational analyses found a relationship between entry qualifications and students' academic performance in the two papers. The entry criteria had a stronger relationship with the students' performance in the first year bioscience paper than the second year paper. Performance in the first year was predicative of second year performance. Age was also found to be a useful predictor of grades. These findings support the School's Bioscience entry criteria and provide important information for admission committees.
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Boyd, L. (2001). “It could have just as easily been me”: Nurses working in mental health services who have experienced mental illness. Ph.D. thesis, , .
Abstract: This research explores the issues and experiences of mental health nurses who experience or have experienced mental illness. This project was prompted by the author's concern for colleagues and friends in this situation. The research topic was approached using a mix of critical ethnography and action research principles. Five mental health nurses who all work for the same district health board were interviewed about their experiences of being mental health professionals with mental illness and the issues that arose from this. The themes that emerged from this research are: the reactions of nurse colleagues, the effects on participants' own mental health treatment, employer responses, professional experiences and issues and strategies for coping. Discussion and recommendations focus on the need for improvements to the responses that mental health nurses with experience of mental illness encounter in their workplace. Recommendations from this research encompass suggestions for both individual and organisational education, action and change.
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McEldowney, R. A. (2002). Shape-shifting: Stories of teaching for social change in nursing. Ph.D. thesis, , .
Abstract: This research explores why and how nurse educators teach for social change. Critical feminist educators provide a useful framework for theorising about teaching for change that addresses issues of hegemony, agency, praxis, individual voice, difference, justice and equity. Six women Pakeha/Tauiwi nurse educators from throughout New Zealand volunteered to participate in this research and share their lived experiences of teaching for social change. In-depth conversations over two years unfolded new and rich material about how and why these six women continue to teach the evaded subjects, like mental health, women's health, community development and cultural safety. All teach in counter-hegemonic ways, opening students' eyes to the unseen and unspoken. Among the significant things to emerge during the research was the metaphorical construct of shape-shifting as an active process in teaching for social change. It revealed the connectedness and integrity between life as lived and the moral imperative that motivates the participants to teach for difference. Shape-shifting was also reflected in other key findings of the study. As change agents, the participants have had significant shape-shifting experiences in their lives; they live and work as shape-shifters within complex social and political structures and processes to achieve social justice; and, they deal with areas of health practice where clients are socially and politically displaced. The research also generated new methods for gathering life-stories and new processes for analysis and interpretation of life-stories. It is hoped that this research will open pathways for other nurse educators to become shape-shifters teaching for social change.
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Wepa, D. (2003). An exploration of the experiences of cultural safety educators in New Zealand: An action research approach. Journal of Transcultural Nursing, 14(4), 339–348.
Abstract: This research is a study of the experiences of four cultural safety educators in nursing education in Aotearoa, New Zealand. Action research methods assisted the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action, and reflecting. The findings of the research revealed that the participants not only coped with everyday stressors of teaching but were also required to formulate knowledge for cultural safety. For the Maori participants, their stress was confounded with recruiting and retaining Maori students and macro issues such as commitment to their iwi (tribe). Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that many issues were organisational in nature and out of their control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations include the following: support for cultural safety educators to have a dialogue on a regular basis, the introduction of nurse educator programmes, paid leave provisions for educators to conduct and publish research so that a body of knowledge can be developed, and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burnout.
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Fielden, J. (2003). Grief as a transformative experience: Weaving through different lifeworlds after a loved one has completed suicide. International Journal of Mental Health Nursing, 12(1), 74–85.
Abstract: This research is an exploration and interpretation of the lived experiences of family members since they lost a close family member to suicidal death. The findings have implications for nurses and counsellors working in the area of suicide bereavement. Heidegger's hermeneutic phenomenology was utilised and informed by van Manen's and Benner's work. Data from in-depth interviews with six participants, the researcher's journal entries and published literature were analysed. Findings gave rise to a grief model where suicide survivors moved through four modes of being-in-the-world characterized by 13 lifeworlds or themes. Surviving suicide was a transformative process that in time enabled survivors to discover new ways of understanding and relating to the world.
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Dorofaeff, M. J. (2007). Shared status and advocating practices: Nurses who work with clients who have a co-existing intellectual disability and mental health problem. Ph.D. thesis, , .
Abstract: This research is informed by the interpretive phenomenology of van Manen, and explores the lived experience of nursing from the perspective of nurses who provide care for people with a co-existing intellectual disability and mental health problem. Although nursing research is commonly informed by phenomenology, there is a dearth of literature of any description written from the perspective of nurses who provide care for people with intellectual disabilities and mental health problems. As a result of the closure of many large institutions in New Zealand there are not many nurses who work with people who have intellectual disabilities and co-existing mental health problems. The study participants were four nurses purposefully selected because they provided care for people with intellectual disabilities and mental health problems. Data was collected using semi-structured interviews, and the researcher identified and wrote about the recurring themes in the transcribed interview data, which best captured the lived experience of the participants. The themes were: criticism of services, holistic caring, working with the client, issues of status, need for specialist knowledge, enduring relationships, diagnostic issues, advocating, modelling good practice; and working alongside. After further analysis the themes were encompassed within the larger interrelated themes of “Status and positioning” and “Advocating practices”, and finally within a single theme of: “The status and positioning of the nurse and the client leads to advocating practices.” These themes were found to be consistent with the nursing literature and with the researcher's own lived experience as a nurse who works in a specialist mental health intellectual disability service. The findings of this research have implications for a number of groups in New Zealand. Among the author's conclusions are that input is required from the Nursing Council of New Zealand, the nursing profession, nurse educators and the government to raise the status of clients with co-existing intellectual disabilities and mental health problems and the nurses who work with this client group. In addition, the roles for nurses who work with this client group are emerging and are likely to be diverse and there is a need for further research to capture the different experiences of these nurses.
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Valette, D. (2002). Nursing an adolescent in an adult inpatient mental health unit. Ph.D. thesis, , .
Abstract: This research paper reports on an exploration of the key elements nurses need to be aware of to effectively nurse adolescents in an adult inpatient unit. It describes the developmental needs and significant influences that affect this age-group, that when incorporated into nursing care, nurses can gain a therapeutic relationship with the adolescent. By means of a literature review, sharing the author's experience in nursing adolescents, and through vignettes of practice, an illustration of some common situations that may occur during the adolescent's inpatient stay are described. These situations are explored and a perspective is offered on how nurses may be effective in their nursing of an adolescent patient from the point of admission through to discharge. More research is needed on adolescent mental health nursing, however the author anticipates that nurses will be able to use this report as a helpful resource in their current practice.
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Woods, M. (1992). The ethical preparation and practice of nurses: a pilot research project. Ph.D. thesis, , .
Abstract: This research project studied the ways in which nurses are educationally prepared for, and responded to, ethical problems in practice. The study involved both descriptive and analytical-interpretive methods that provided information and insights on the given aims of the research. The research findings indicated that nurses were educationally ill prepared in the area of nursing ethics. It also maintained that nurses that nurses were quite able to correctly identify ethical issues in their practice, but felt restrained about their freedom to act autonomously in response to these issues
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Sims, D. A. (2004). The benefits and challenges of one New Zealand nursing undergraduate clinical education model: A case study. Ph.D. thesis, , .
Abstract: This research project utilised a case study approach to give ward managers a voice in the literature, by exploring and describing from their perspective the benefits and challenges of one particular nursing undergraduate clinical education model. The tertiary education provider contracts the health provider to provide Clinical Nurse Educators (CNEs) to support second and third year undergraduate nursing students during their clinical experiences. The CNEs are seconded from their respective wards to meet the organisation's contractual obligations. Data were gathered from two ward managers using semi-structured interviews. The findings elucidate the role of the undergraduate CNE, highlighting benefits such as the CNE being supernumerary to ward rosters and having time to teach, not only supervise students. CNEs are student-focused and easily accessible as they are based on site. The CNE was the one person who was 'there' for a student as a student's preceptor can change shift-by-shift and day-by-day. One significant challenge which emerged was the replacement of ward staff, not only of senior nurses who can leave their wards for up to 12 weeks to undertake the CNE role but also that of the student's preceptor if the student's preceptor was on annual, sick or study leave. Other challenges such as the inability of ward managers to pre-book casual staff; preceptor work-loads; skill-mix issues and fluctuating fulltime equivalents are also discussed.
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