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Friedel, J., & Treagust, D. F. (2005). Learning bioscience in nursing education: Perceptions of the intended and the prescribed curriculum. Learning in Health & Social Care, 4(4), 203–216.
Abstract: This study used a curriculum inquiry framework to investigate the perceptions of 184 nursing students and nurse educators in relation to bioscience in the nursing curriculum. Nursing students were found to have significantly more positive attitudes to bioscience in nursing education than nurse educators, and nurse educators were not found to have significantly better self-efficacy in bioscience than the students, although this might have been expected. The results of focus group discussions, used to investigate this in more depth, suggested that some nurse educators and clinical preceptors may not have sufficient science background or bioscience knowledge, to help nursing students apply bioscience knowledge to practice. As a result of this, it is suggested that the aims of the intended and prescribed nursing curricula are not being fulfilled in the implemented curriculum.
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Butterfield, S. L. (1982). Helplessness or self care: a study of nursing practice with depressed patients in an In care setting. Ph.D. thesis, , .
Abstract: This study was conducted to investigate the practise of Nurses when working with depressed patients in an In Care setting. A survey of the literature shows that the role commonly prescribed for nurses who work in psychiatric settings is one that emphasises a one- on -one relationship based on models of psychotherapy and focuses on individual illness, pathology, systems and psycho dynamics. It is suggested that this is not a role which most Nurses working in New Zealand psychiatric settings would be able to implement in practise. Three perspective's of Nursing practise were explored in the study. What Nurses were seen to do in practice. What they thought they should do as evidenced in results of an exercise to rank different possible interventions, and what patients said were helpful Nursing interventions. A framework was developed for the study which depicts the process of helplessness(depression) as the negative 'mirror -image' of the process of self care. Results were analysed within this framework to determine whether or not Nurses tended to support behaviours which were indicative of movement towards helplessness or encourage those which indicated progress towards self care by their interventions. There was little evidence of positive reinforcement for independent or coping behaviours with patients in the study sample. Further, the nursing practise showed little relationship to the role prescribed in the literature. The Nurses did demonstrate a warm caring friendly approach that seemed to stem from a more traditional 'succouring, mothering' view of Nurses' role
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Gordon, M. J. (1988). View of the new – a case study of the perceptions of nurse tutors support and development in the first two years of their employment. Ph.D. thesis, , .
Abstract: This study was designed to explore the perceptions of Nurse Tutors, of their first two years following appointment to teaching positions, in a small regional Polytechnic . There was particular emphasis on factors they believed enhanced or impeded their performance, in the first two years of their employment.It was hoped the project would serve as a springboard for their development of support to assist Nursing Tutors during the first two years in their employment.The purpose of the study was not to examine the formal induction process, or the role of the staff development unit. Instead it aimed to focus on the experience of the Nursing Tutors within the Nursing school, and associated practicum teaching.An essentially qualitative approach was adopted. The aim being to discover patterns in the data from the research, and explore these themes with reference to relevant literature. Case study was chosen as the design framework for the study.Participants in the study were five Nurse Tutors who had joined the Polytechnic during the last two years and volunteered to participate in the study.Data was gathered by interview based on critical incidents, identified by participants. Themes identified from interview transcripts are discussed with reference to relevant literature. These themes indicated that tutors looked forward to their new role with anticipation, but that initial teaching experience was somewhat negative, and they did not feel well prepared. An important issue was congruency between the Nursing Curriculum (with focus on care), relationships with students and staff, and institutional constraints. The tutors coped with multiple demands, the three worlds of the Polytechnic , Health Care system and home (and for some degree study!). Participants were actively seeking strategies for successful teaching and able to reflect on aspects they wished to change. Although there were common elements , each participant demonstrated individual strengths and needs.The study concludes with suggestions for future action, including appropriate preparation prior to initial teaching, attention to initial workloads, exploration of buddying, discussion of what constitutes a safe, caring, learning and teaching environment and the relationship to the Nursing curriculum. It is suggested that collaborative sessions in order to share expertise in teaching and learning and/or action research may assist in support of new tutors (and ultimately benefit all staff)
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Gregg, D. Survey of student nurse uniform.
Abstract: This study was undertaken to ascertain the opinions of nursing students at Wellington Polytechnic (now Massey University Campus of Wellington) about their current uniform worn on clinical placements. As the NZNO National Student Unit representative at Wellington Polytechnic, it was brought to my attention by my fellow students that the current uniform was not particularly functional. As a result of these comments I concluded the best way for students to voice their opinions further was to circulate a survey. The survey questioned the students about the current uniform and what they thought the future uniform might be. The survey was available for collection by students for a two week period in July 1998. Participation was voluntary and anonymous. It was approved by the Research and Ethics Committee, School of Nursing, Health and Environmental Sciences, Wellington Polytechnic. The results were that sixty percent of students supported a change in the current uniform. Most students chose a tunic top as their preferred option. If there was to be a change, students would be prepared to spend $20-49. Consequently permission has been granted by the Head of Department – School of Nursing to investigate a change to a tunic style top. The item will be trialed by those who wish to purchase it in 1999. I believe that it is of utmost importance that student satisfaction with their clinical uniform is assessed at regular intervals to ensure that the students take a pride in their presentation and the uniform serves the purpose for which it is intended
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Kennedy, W. (2008). How do Registered Nurses utilise self assessment and performance appraisal to inform their professional practice? Ph.D. thesis, , .
Abstract: This thesis describes an exploratory study of registered nurses within a local district health board which pursued 'if' and 'how' professional practice frameworks assisted nurses in their individual professional practice. Self assessment and performance appraisal are identified as critical elements of professional development by the Nursing Council of New Zealand, and this became the focus of the author's research. A qualitative descriptive framework was utilised to explore the research question, where experiences of registered nurses employed within inpatient adult medical and surgical settings were collected through questionnaire. Analysis of the data was through general inductive thematic approach. Eight themes arose, of which, two have sub-themes. The first four themes relate to self assessment and performance appraisal and the second four themes relate to professional practice. The findings from the participant's perspective provide an understanding of how participants' utilised self assessment and performance appraisal to inform their professional practice. There are significant implications for professional practice within the findings of this study, which are presented along with recommendations for future practice, and future avenues for research.
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Dearden, G. (2004). When things go wrong: The experiences of mental health nurses who have had a patient die through suicide. Ph.D. thesis, , .
Abstract: This thesis discusses the findings of a research study, informed by the work of van Manen (1997b), which explored the lived experiences of five mental health nurses who have had a patient die through suicide. Narrative was used as a method in interviews to uncover the essence of their lived experiences. Five interwoven themes uncovered in each of the interviews were: impact, support, feelings, closure and paradox. All of the nurses interviewed experienced a wide range of feelings about their patient's suicides, ranging from shock to guilt, to anger and sadness, and described their patient's suicide as having a significant impact on them. Support received by the nurses following their patient's suicide was variable, and they were often in the difficult position of trying to offer support to the patient's family. Common to all of the nurses was the lack of closure following the suicide. Paradox was found to be the overall essence of the experience of the mental health nurses interviewed. Three main paradoxical themes or statements were identified that are in many respects a summary of all of the themes that emerged. These were: unavoidable – responsible; inevitable – unprepared; duty of care – respect for patient's decision to end their life. The author suggests that the ability of the nurses interviewed to accept and reconcile the paradoxical issues that arise in relation to patient suicide, and accept the lack of closure they experience, is a fundamental element in their ability to continue to work in the mental health setting, despite the significant impact their patient's suicide has had on them. Four recommendations are made based on the insights gained from this research. These are: that every mental health service should have a suicide response policy; that undergraduate nursing education includes the impact of patient suicide; the development of policies which promote dialogue about suicide within the community; and the need for further research in this topic.
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Wepa, D. (2003). An exploration of the experiences of cultural safety educators. Ph.D. thesis, , .
Abstract: This thesis is a study of the experiences of four cultural safety lecturers in nursing education in Aotearoa / New Zealand. A review of literature reveals the recent and turbulent evolution of cultural safety. The media which documented this journey in a negative light in the 1990s prompted ministerial inquiries and the publication of the Nursing Council of New Zealand's guidelines for cultural safety in nursing and midwifery education (1996). Action research methods enabled 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 every day stressors of teaching but they were also required to formulate knowledge of cultural safety. For the Maori participants their stress was confounded with recruiting and retaining Maori students and macro issues such as commitments to iwi. Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that it was organisational in nature and out of their immediate control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations have been made which focus on supporting cultural safety educators to dialogue on a regular basis through attendance at related hui; the introduction of nurse educator programmes; paid leave provisions for cultural safety 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 burn out.
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Mitchell, D. F. (1999). Is it possible to care for the “difficult” male? A study exploring the interface between gender issues, nursing practice and men's health. Ph.D. thesis, , .
Abstract: This thesis is about caring for males, especially those males who could be considered “difficult” to care for through their use of behaviours such as silence, anger or defensive humour. This thesis is positioned in the view that these behaviours are often expressions of distress, which typically distance males from those who attempt to care for them. The author suggests that the word “distress” more accurately reflects the theme of the thesis, and it is used throughout the work. This thesis explores the interface between gender issues, nursing practice and caring for males. It is informed by a review of relevant literature and data gathered from a focus group of nine registered nurses. The analysis is framed by questions that are developed from a series of reflections on my personal and professional life. Critical social theory, with its emphases on dominant dialogue, power and emancipation is used to inform and guide this analysis. What is most obvious is the contrast between themes arising from the literature and those arising from the focus group. It appears that the literature, in the main, is critical of males in regard to concepts of masculinity, issues related to gender, and men's health. Males are portrayed as arbitrators of their own misfortune, as deliberately choosing a lifestyle that reflects poorly on their health, their self-expression, and communication with others. Concepts such as power and control over others, both at a societal and individual level, often feature. Conversely, the literature is noticeably lacking in regard to information about the health related experiences of males and about caring for males. In contrast, the participants of the focus group frame their discussion in the positive. For example, they suggest that males are interested in their health but require an environment that supports this expression of interest. They support this by identifying a range of behaviours they believe are effective in caring for males. The participants also suggest that it is the registered nurse rather than the male who manages issues to do with power and control. The thesis concludes that creating and sustaining an environment supportive of, and sensitive to the needs of males, is an activity that requires considerable thought, skill and experience. These areas are not adequately addressed in academic dialogue, research activity, or in the education of registered nurses. The thesis suggests that this situation is inconsistent with an ethic of care and that nursing should make a priority of broadening its research and knowledge base to better understand and care for males.
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MacDonald, S. (1999). Having attitude: nurses' perceptions of the qualities and skills needed to successfully nurse the 10 -24 year old client. Ph.D. thesis, , .
Abstract: This thesis presents a grounded theory study following Glaser's methodological stance. It explores nursing of the 10-24 year old client through interviews with thirteen registered nurses. The participants worked in a variety of clinical settings including community, hospital and specific adolescent services. From the analysis of the data emerged the complexity of the nurses work with the chosen age group. The study identifies that the quality of the nurse/client encounter may enable the young person to feel accepted and to be empowered to make their own health choices.This thesis identifies how Having Attitude is seen by the nurse participants as critical in the care of the young person. Having Attitude is about the nurse balancing the dependence/independence needs of the young person with their family and peers, and about being acceptable to the client. This results from the work of the nurse which is characterised by the nurse being competent' and 'being supportive whilst taking into account all of the socio-political factors that effect the nurses working situation. The socio-political context impacts upon the young persons life in terms of the types of health issues they have, and the availability and affordability of appropriate health services. It also impacts on the environment in which the nurse works, in terms of the complexity of the concerns with which young people present, current health reforms and funding issues. The nurse needs to have a broad knowledge base and ability to work within a complex situation. Nurses believe they can make a difference to the young persons health experience when they are supportive, competent and have attitude
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Boyle, S. D. (1994). Nursing education in New Zealand: a case study of experiential learning. Ph.D. thesis, , .
Abstract: This thesis presents a study of a nursing 'practicum' from the perspectives of nursing students and staff 'buddies'. A grounded theory approach was used to interview six nursing students during their transition placement, the final practicum of their Diploma in Nursing programme. Five staff nurse buddies selected by the students were also interviewed. An informal, conversational interview was used and data was analysed from an experiential learning perspective.This study differs from others because it focuses on the clinical experience component of nursing education, 'practicum', and includess practitioners viewpoints. At present there is a re-evaluing of experience within nursing education with a new emphasis on practice-based learning. Experience-based learning is becoming increasingly acceptable within academia as a 'seamless' education system evolves.I identified three learning stages which students' experience during practicum – initiation, exploration and consolidation. The key stage for learning through experience was exploration. Learning during this stage was predominantly buddy-directed which contradicted the self-directed curriculum design. Students and staff nurses however agreed that communication between them during this stage enabled the development of 'competence'.The learning /teaching approach used by the students and staff nurses made it difficult for students to translate their 'all-round' competencies during practicum. It is argued that it is the useof such competencies during practicum which enable nursing students to become autonomous in the attitudinal and epistemological sense. The predominantly 'technical training' approach adopted was understood by students and staff nurses to be reinforced by 'silence' from tutors.Restructuring gives the opportunity for nursing to develop an ';investigative', enquiry-based approach in practice. There will increasingly be an emphasis on practice-based research as a result of the implementation of degree and post-graduate programmes in nursing. This study highlights some aspects of nursing education and it's relationship with practice which can assist the development of such an approach
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Woods, M. (1997). Maintaining the nursing ethic: a grounded theory of the moral practice of experienced nurses. Ph.D. thesis, , .
Abstract: This thesis presents a study of the every-day moral decision making of experienced nurses. Eight experienced registered nurses participated in the completed research that is based on data gathered through interviews, document audit and literature review. A grounded theory approach was used to analyse the extensive data gathered for the study. This methodology generated a theoretical description involving the antecedents, processes and consequences of nursing moral decision making.Nursing practice has moral content, if not an entirely moral purpose, and moral decision making is the central component of this practice, yet the ethical aspects of nursing practice remain a comparatively recent field of study. It is therefore essential to nurses and their patients that this process is adequately studied and theorised. To date, very few studies have been undertaken in this area in New Zealand. This study aims to at least partially redress this situation by offering insights through conceptualisation and theoretical description of nursing moral decision making.The findings of the study reveal that antecedents such as personal moral development, upbringing and social experiences, contribute to a 'nursing ethic' in the moral decision making of experienced nurses. Furthermore, the study shows that the context and individual and shared perceptions of moral events influence the degree of nursing involvement in ethical situations. Finally, the study maintains that an intrinsic and persistent nursing ethic guides ethical decision making in nursing. This ethic is an undeniable phenomenon of considerable significance to nursing practice and education
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Whitehead, N. (2007). Quality and staffing: Is there a relationship in aged residential care. Master's thesis, , .
Abstract: This thesis reports a mixed methods study, longitudinal in nature, of consenting Age Related Residential Care (ARRC) hospitals in the upper half of the North Island, which was conducted to examine several factors, including AARC hospital efficiency at producing adverse event free days for residents. An interpretativist approach examined what best practice strategies were implemented by the ARRC hospitals that were identified to be most successful at producing adverse event free days for the residents.
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MacDonald, L. M. (2003). Nurse talk: Features of effective verbal communication used by expert district nurses. Ph.D. thesis, , .
Abstract: This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development.
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West, S. R., Harris, B. J., Warren, A., Wood, H., Montgomery, B., & Belsham, V. L. (1986). A retrospective study of patients with cancer in their terminal year. New Zealand Medical Journal, 99(798), 197–200.
Abstract: This was a retrospective study of 100 Auckland people suffering from cancer in their terminal year. It aimed firstly to report the development of limitations in daily living activities and of dependence on help, and secondly to develop a method of assessing the functions of both patients and those who cared for them in such a way that support services could be matched to needs. The observations showed problems of progressive disability and dependence, which varied with the age of the patient and the type of malignancy. They showed clearly the long lasting emotional problems of the careers after the patients' death
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Rudd, J. (2005). From triage to treatment: An exploration of patient flow systems in emergency departments. Ph.D. thesis, , .
Abstract: To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room.
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