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McNab, M. (2005). The nursing roles in respect of tuberculosis in New Zealand from 1928 to 1966. Ph.D. thesis, , .
Abstract: In this thesis the nursing roles in respect of tuberculosis in New Zealand from 1928 to 1966 are identified, and then examined by contextualising them in relation to the changing social, political, demographic, scientific and technological environments in which the treatment and prevention of tuberculosis took place. The history of the various institutions is described in order to show some of the circumstances that led to the evolution of the roles of dispensary nurse, district nurse, school nurse, public health nurse, sanatorium nurse, and hospital nurse. 1928 to 1966 covers a sufficiently long period of intensive activity and change in the detection, treatment and research of pulmonary tuberculosis in New Zealand, to enable comparisons between nursing roles to be made. It was found that nurses had an individualised approach to their work. This was defined by the physical environments within which they worked, whether it was a hospital, sanatorium, dispensary, school or in a patient's home. Also, the medical treatments advocated and implemented by the medical practitioners, the rules and regulations which governed the various work areas, and the availability of staff, funds, facilities and resources all had an impact upon how nurses were able to work and how their respective roles developed. In addition, some of the factors which contributed to nurses getting tuberculosis and the initiatives to improve the nurse's conditions of work are examined, because these had an impact on the performance of the nurse's work and evolution of her role. Apart from practical nursing care, nurses also had a role in the on-going inspection, monitoring, notification, emotional support of patients and families, morale boosting and education. Each role had these components. The differences were in the time and emphasis given to each.
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McLoughlin, N. (2007). Dying to know: Advancing palliative care nursing competence with education in elderly health settings. Ph.D. thesis, , .
Abstract: This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities.
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McLeland, A., & Williams, A. (2002). An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries. Contemporary Nurse, 12(2), 185–193.
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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McLean, J. M. (2007). Pushing the boundaries: Relationships with adolescents. Ph.D. thesis, , .
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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McLaughlin, K. (2004). Nephrology nursing: Early intervention in chronic kidney disease. Ph.D. thesis, , .
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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McLauchlan, M. F. (2006). Mobile computing in a New Zealand Bachelor of nursing programme. In Consumer-Centered Computer-Supported Care for Healthy People. Studies in health technology and informatics, 122 (pp. 605-608). IOS Press.
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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McKinney, C., Cassels-Brown, K., Marston, A., & Spence, D. (2005). Linking cultural safety to practice: Issues for student nurses and their teachers. Vision: A Journal of Nursing, (13(1)).
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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McKinlay, E. M. (2007). Thinking beyond Care Plus: The work of primary health care nurses in chronic conditions programmes. New Zealand Family Physician, 34(5), 322–327.
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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McKinlay, E. M. (2006). New Zealand practice nursing in the third millennium: Key issues in 2006. New Zealand Family Physician, 33(3), 162–168.
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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McKillop, A. M. (2004). Evaluation of the implementation of a best practice information sheet: Tracheal suctioning of adults with an artificial airway. JBI Reports, 2(9), 293–308.
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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McKey, A., & Huntington, A. D. (2004). Obesity in pre-school children: Issues and challenges for community based child health nurses. Contemporary Nurse, 18(1-2), 145–151.
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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McKerras, R. (2005). Waiting in the emergency department – it doesn't have to take all day. Ph.D. thesis, , .
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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McKergow, C. R. W. (2002). Preparing to care in the 21st century: A personal search for the meaning of ontological competency through an embodied journey of the soul.
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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McKenna, B., Thom, K., & O'Brien, A. J. (2008). Return to nursing programmes: Justifications for a mental health specific course. Intensive & Critical Care Nursing, 5(1), 1–16.
Abstract: This paper presents the findings from research that investigated the feasibility of developing a specialty return to mental health nursing programme in New Zealand. This was achieved through a scoping of existing return to nursing programmes; a survey of non-active nurses; and stakeholder consultation via interviews or focus groups. Existing generic programmes fail to attract non-active nurses wishing to focus on mental health nursing. The non-active nurses survey found 142 nurses who presently would or might possibly return to mental health nursing and participate in a programme. Most stakeholders supported the idea of implementing such a programme. The findings from this research indicate both feasibility and enthusiasm for the introduction of return to mental health nursing programmes. It is recommended that all aspects of this course mirror the service user focused 'recovery paradigm' that is a central tenet in contemporary mental health service delivery.
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McKenna, B., Simpson, A. I. F., & Coverdale, J. (2006). Best practice management strategies for mental health nurses during the clinical application of civil commitment: An overview. Contemporary Nurse, 21(1), 62–70.
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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