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Author  |
McKenzie-Green, B. |
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Title |
Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study |
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Year |
2003 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Older people; Registered nurses; Nurse-patient relations |
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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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Call Number |
NRSNZNO @ research @ 912 |
Serial |
896 |
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Author |
McKergow, C.R.W. |
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Title |
Preparing to care in the 21st century: A personal search for the meaning of ontological competency through an embodied journey of the soul |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
Nursing; Professional development; Breast cancer; Cancer |
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Abstract |
This thesis is a philosophical inquiry that reflects a personal search for the meaning of ontological competency undertaken by the author after developing breast cancer. The text weaves together in creative synthesis, a collection of academic and personal writing undertaken during an MA (Applied) in Nursing degree process. Using the work of Dowling Singe (1999), Watson (1999), and Wilber (1985, 1990, 1991 & 2000), the thesis seeks, through the use of reflective autobiographical inquiry (Johnstone 1999a), to explore the personal meaning-making activities engaged in during this time to throw light upon the nature of nurse / nursing being. Exploring developmental schemata drawn from personal experience and illuminated by theory, nurses and nursing are challenged to become more self-reflective and self-aware. To facilitate the personal and professional growth that underpins notions of ontological competency, various aids in the form of maps and models are provided to support a transformative journey into awareness. From this position of expanding consciousness, the nurse / nursing is encouraged to reach beyond current paradigms, metaparadigms, epistemologies, and restrictive philosophies and to yield to the evolutionary imperative that seeks to prepare for a 21st century clinical practice where caring / healing becomes embodied enactment from “the Ground of All Being”. |
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Call Number |
NRSNZNO @ research @ |
Serial |
774 |
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Author |
McKerras, R. |
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Title |
Waiting in the emergency department – it doesn't have to take all day |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Issue |
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Pages |
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Keywords |
Emergency nursing |
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Abstract |
This thesis explores the nature of the emergency department environment as it continues to challenge emergency nurses to meet the health needs of an increasingly complex emergency department population. The emergency nurse is also facing conflict and challenge with regard to workplace safety and patient rights. The author suggests that, until recently, very little debate or consideration has been given to the moral dilemmas raised in the ability of emergency department staff to deliver timely and appropriate care in an overcrowded environment. She goes on to say that, in New Zealand, there is no national consistency with regard to the waiting crisis, no national guidelines and no national consensus putting the emergency nurse at risk. This thesis argues the need to acknowledge waiting times as a significant safety issue at a national level as increasing waiting times continue to impact on patient outcomes and nursing practice. It challenges current practice, in particular the role of the emergency nurse and the potential to legitimise expansion of the role to improve the patient experience of waiting in the emergency department. |
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Call Number |
NRSNZNO @ research @ |
Serial |
512 |
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Author |
McKey, A.; Huntington, A.D. |
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Title |
Obesity in pre-school children: Issues and challenges for community based child health nurses |
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Journal Article |
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Year |
2004 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
18 |
Issue |
1-2 |
Pages |
145-151 |
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Keywords |
Obesity; Children; Community health nursing; Parents and caregivers |
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Abstract |
In this paper, literature related to childhood obesity in New Zealand and internationally is explored to identify current issues, and the implications for nurses in community based child health practice are discussed. Themes that emerged from the literature relate to the measurement of obesity, links between childhood and adult obesity and issues for families. Studies that investigated maternal perceptions of childhood obesity found that mothers identified their child as being overweight or obese only when it imposed limitations on physical activity or when the children were teased rather than by referring to individual growth graphs. The implications for nursing in the area of child health practice are discussed. Understanding of the complex and emotive issues surrounding childhood obesity is required when devising health promotion strategies. |
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Call Number |
NRSNZNO @ research @ |
Serial |
946 |
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Author |
McKillop, A.M. |
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Title |
Evaluation of the implementation of a best practice information sheet: Tracheal suctioning of adults with an artificial airway |
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Journal Article |
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Year |
2004 |
Publication |
JBI Reports |
Abbreviated Journal |
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Volume |
2 |
Issue |
9 |
Pages |
293-308 |
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Keywords |
Evidence-based medicine; Nursing; Guidelines; Evaluation |
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Abstract |
This report presents an evaluation of the implementation of a best practice information sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa, based in Auckland, conducted a systematic review of the evidence and produced the best practice information sheet. A survey of 105 nurses was conducted at three sites, in New Zealand and Australia. Using a before/after design, data were collected at the time of release of the information sheet and then approximately 12 months later. The study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and the best practice information sheet. |
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Call Number |
NRSNZNO @ research @ |
Serial |
696 |
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Author |
McKillop, A.M. |
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Title |
Native health nursing in New Zealand 1911-1930: A new work and a new profession for women |
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Year |
1998 |
Publication |
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Abbreviated Journal |
Massey University Library, Northland Polytechnic L |
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Issue |
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Pages |
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Abstract |
The focus of this thesis is the practice of the nurses employed in the Native Health Nursing Scheme in New Zealand from 1911 to 1930. These nurses were a vanguard movement for change in community nursing services as they established a new role and developed innovative ways of practicing nursing while claiming greater autonomy and accountability for nurses who worked in community settings. Consequently they contributed to an increase in status for nurses in New Zealand.The Native Health Nursing Scheme was established by the Health Department to replace the Maori Health Nursing Scheme, an initiative by Maori leaders for Maori nurses to provide nursing care for their own people. The original scheme had foundered amid under-resourcing, a lack of support from hospital boards and administrative chaos. Government policy for Maori health was openly assimilationist and the mainly non-Maori Native Health nurses carried out this policy, yet paradoxically adapting their practice in order to be culturally acceptable to Maori.Their work with the Maori people placed the Native Health nurses in a unique position to claim professional territory in a new area of practice. As they took up the opportunities for an expanded nursing role, they practiced in a manner which would develop the scope and status of nursing. The geographical isolation of their practice setting provided the nurses with the challenge of practicing in an environment of minimal administrative and professional support, while also offering them the opportunity for independence and relative autonomy. Obedience, duty and virtue, qualities highly valued in women of the day, were expected especially in nurses. These expectations were in direct contrast to the qualities necessary to perform the duties of the Native Health nurse. The conditions under which these nurses worked and lived, the decisions they were required to make, and the partnerships they needed to establish to be effective in the communities in which they worked, required courage, strength, organizational ability and commitment |
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Call Number |
NRSNZNO @ research @ 14 |
Serial |
14 |
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Author |
McKinlay, E.M. |
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Title |
Thinking beyond Care Plus: The work of primary health care nurses in chronic conditions programmes |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
34 |
Issue |
5 |
Pages |
322-327 |
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Keywords |
Primary health care; Nursing models; Chronic diseases |
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Abstract |
This paper focuses on the work of primary health care nurses on chronic conditions, through both formal chronic care management (CCM) programmes and informal work. The author overviews the key components of CCM and describes Care Plus, a funding stream accessed via PHOs. The author gives examples of nurse led clinics and programmes in the general practice environment, and outlines the structures and processes necessary. A table summarises nurse involvement in several PHOs throughout the country. The author finds that the role of PHC nurses within a framework of inter-disciplinary chronic condition care is diverse and increasing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
455 |
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Author |
McKinlay, E.M. |
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Title |
New Zealand practice nursing in the third millennium: Key issues in 2006 |
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Journal Article |
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Year |
2006 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
33 |
Issue |
3 |
Pages |
162-168 |
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Keywords |
Primary health care; Practice nurses; Careers in nursing |
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Abstract |
The author looks at the accelerated change in the role of practice nurses, due to factors such as the effects of the Primary Health Care Strategy. She reviews the current role of practice nurses, which is influenced by a population approach and new funding streams that encourage preventative, maintenance and chronic illness management activities. She highlights the positive effects of increased visibility of nursing leaders in the sector, increasing interdisciplinary education, and new career pathways which include advanced roles. She addresses some of the professional and systemic structural barriers which impact on practice nurses' ability to work effectively and equally within a general practice team. |
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Call Number |
NRSNZNO @ research @ 541 |
Serial |
527 |
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Author |
McKinlay, E.M. |
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Title |
Within the circle of care: the patient's lived experience of receiving palliative care |
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Year |
1998 |
Publication |
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Abbreviated Journal |
Mary Potter Hospice Library, Wellington |
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Issue |
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Pages |
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Keywords |
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Abstract |
The objective of this research was to determine aspects of hospice based palliative care which patients described as being important and valued. This research is to be the basis of future work on the development of consumer generated quality indicators. Palliative care managers could use these to evaluate hospice based care, and provide output measures for health providers. The methodology used by the researcher was qualitative descriptive informed by phenomenology. Six recently discharged hospice patients who had at least two episodes of palliative care were interviewed about their experience of care. The resulting data, after reflection, formed a representation; the circle of care. This included aspects of valued care generated by actions of the interdisciplinary staff, and other aspects of care generated within the palliative care environment which the patient perceived as being meaningful and important. In conclusion, the reality of people receiving palliative care is characterised by a number of supportive traditional and non-traditional aspects of caring. Although some characteristics have been described within general health and the palliative care literature, some appear to have been generated by these particular participants as part their reality. The researcher believes that the resulting representation of care requires further research in other palliative care settings. The process of interviewing terminally ill people although not without concern to the interviewer, and inherently difficult for the patients, appeared to allow the patient to tell the story of both their illness and care |
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Call Number |
NRSNZNO @ research @ 211 |
Serial |
211 |
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Author |
McKinney, C.; Cassels-Brown, K.; Marston, A.; Spence, D. |
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Title |
Linking cultural safety to practice: Issues for student nurses and their teachers |
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Journal Article |
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Year |
2005 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
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Issue |
13(1) |
Pages |
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Keywords |
Students; Cultural safety; Teaching methods; Nursing; Education |
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Abstract |
Student nurses rely on their teachers, both academic and clinical, to assist them to develop their capacity to practice safely. Yet, in relation to cultural safety, relatively little has been written to assist the integration of theoretical knowledge to the world of practice. This article presents the findings of a small project undertaken by lecturers whose experiences supporting students' learning during clinical placements in Auckland stimulated interest in the students' attempts to use their classroom learning to begin their journey towards culturally safe nursing practice. A qualitative descriptive approach was used to explore the experience of nursing clients from cultures other than one's own and to describe culturally safe practice from the perspective of third year students. |
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Call Number |
NRSNZNO @ research @ |
Serial |
862 |
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Author |
McLauchlan, M.F. |
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Title |
Mobile computing in a New Zealand Bachelor of nursing programme |
Type |
Book Chapter |
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Year |
2006 |
Publication |
Consumer-Centered Computer-Supported Care for Healthy People. Studies in health technology and informatics, 122 (pp. 605-608) |
Abbreviated Journal |
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Volume |
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Issue |
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Pages |
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Keywords |
Technology; Curriculum; Nursing; Education; Professional competence |
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Abstract |
Mobile computing is rapidly becoming a reality in New Zealand health care settings. Personal Digital Assistants (PDAs) are the most frequently used of these mobile technologies, giving nurses access to clinical learning resources, including drug references, medical encyclopaedias and diagnostic information. The implementation of mobile computing at Waikato Institute of Technology (Wintec) will ensure graduates of our Bachelor of Nursing Programme are able to meet health care service demands for knowledge in contemporary information technologies as well as the information technology requirements defined by the Nursing Council of New Zealand and the Health Practitioners Competency Assurance Act 2003 for registration as a nurse in New Zealand. This paper presents strategies for the implementation of mobile computing as a core element of the curriculum for the Bachelor of Nursing Programme at Wintec in Hamilton. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1192 |
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Author |
McLauchlan, M.F. |
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Title |
Women's place: an exploration of current discourses of childbirth |
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Year |
1997 |
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 |
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Abstract |
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Call Number |
NRSNZNO @ research @ 345 |
Serial |
345 |
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Author |
McLaughlin, K. |
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Title |
Nephrology nursing: Early intervention in chronic kidney disease |
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Year |
2004 |
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 |
Nursing specialties; Diseases; Advanced nursing practice; Kidney disease |
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Abstract |
This study explored the potential for extending the contribution nurses make in managing patients with chronic kidney disease as they progress to end stage kidney failure. In the context of a shortage of nephrologists and an escalating patient population suffering from kidney disease, the potential to include advanced nephrology nursing in early disease management was postulated. The literature was reviewed with regard to initiatives to reduce the progression of kidney failure and the prevention of associated complications. Local and international literature on advanced nursing practice and the nurse practitioner role was examined in relation to the management of chronic kidney disease. The introduction of the nurse practitioner in New Zealand could provide an ideal framework for independent nephrology nursing. Well-established nursing practice in dialysis, transplantation and pre-dialysis provide distinct scopes of practice in these areas for independent nursing in the future. It seems likely that these sub-specialties in nephrology nursing will be the first to experience the value of the nurse practitioner. The creation of early interventionalist nurse practitioners in nephrology health care would allow nurses to step outside these well-established sub-specialties, and provide new resources to help manage chronic kidney disease. A model of care was proposed that outlines how a nephrology nurse practitioner could work collaboratively with community health providers and the local nephrology health care team to manage the early stages of kidney disease. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1150 |
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Author |
McLean, J.M. |
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Title |
Pushing the boundaries: Relationships with adolescents |
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Year |
2007 |
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 |
Psychiatric Nursing; Mental health; Adolescents; Nurse-patient relations |
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Abstract |
Therapeutic relationships are central to mental health nursing. The nurse's role in maintaining professional yet therapeutic boundaries within this relationship can be challenging. When therapeutic boundaries are breeched within the nurse adolescent relationship the adolescent's safety within this relationship is compromised. There is currently limited literature on how nurses are managing professional boundaries in relationships with adolescents in this setting. The adolescent's nature is to push boundaries; therefore the nurse needs to be acutely aware of this boundary pushing in everyday practice settings. For the safety of the adolescent and the nurse it is vital the nurse understands her role in managing the professional boundary. This thesis explores, through the use of narrative inquiry, four adolescent mental health nurses' experiences of assessing, understanding and maintaining therapeutic boundaries with adolescents in a mental health setting in New Zealand. The unique and specific implications for adolescent mental health nursing are discussed. Three key themes emerged from the analysis and findings: the importance of the nurse clarifying his/her role; the learning that occurs throughout the practice journey; and the role of the nurse in keeping the adolescent and the nurse safe. These findings highlight the importance of clinical supervision and open communication with senior nurses and mentors, which assist the nurse in monitoring practice. When nurses do not have sufficient knowledge of the fundamental principles of adolescent mental health nursing; such as knowledge and skills in both adolescent development and psychodynamic nursing, they are at risk of boundary crossings. Recommendations from this research include more emphasis on psychodynamic nursing principles in nursing education and nursing practice. There is a need for specialised education for nurses in child and adolescent mental health nursing. Nursing entry to practice programmes for new graduate nurses working in mental health, could assist in providing this. There is a call for further research into therapeutic relationships and professional boundaries in this complex nursing specialty. |
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Call Number |
NRSNZNO @ research @ 762 |
Serial |
748 |
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Author |
McLeland, A.; Williams, A. |
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Title |
An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries |
Type |
Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
12 |
Issue |
2 |
Pages |
185-193 |
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Keywords |
Nursing; Education; Clinical supervision; Preceptorship |
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Abstract |
The purpose of this qualitative study was to analyse the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalisation; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalisation. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1081 |
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