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Lynes, H. (2004). Partnership or collaboration? Exploring professional relationships between public health nurses and school staff in Otago, New Zealand. Ph.D. thesis, , .
Abstract: School staff are a conduit by which children and families can access the public health nursing service and the public health nurses can access children and their families. The author notes that, to benefit children, public health nurses need more than knowledge of health issues; they need to understand how to work well with staff from the education sector. A good professional relationship between public health nurses and school staff will therefore ultimately result in a benefit to children's health. This thesis reviews the literature using an interpretive lens to examine the position of public health nurses and schools. It argues that public health nurses need to access expertise from other sources besides nursing in order to develop and sustain the skills of relating professionally to staff from the education sector. It proposes collaboration as a model of public health nursing practice with school staff but recognises that further research on inter-sectorial collaboration is necessary.
Keywords: Public health; Nursing; Nurse-family relations; School nursing
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Crowe, M. (2006). Psychiatric diagnosis: Some implications for mental health nursing care. Journal of Advanced Nursing, 53(1), 125–131.
Abstract: This article explores some of the functions of psychiatric diagnosis and the implications this has for mental health nursing care. It critiques the psychiatric diagnosis as a categorisation process that maintains oppressive power relations within society, by establishing and enforcing normality through gender, culture and class biases. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is used to illustrate some of the inherent biases in the diagnostic process. The author argues that mental health nursing practice needs to demonstrate an awareness of the power relations inherent in any diagnostic process and make attempts to redress these at both the individual and sociopolitical levels. To create a true patient-centred partnership in mental health nursing, the nursing focus should be on the patient's experience rather than the psychiatric diagnosis with which the experience is attributed. NB this is a reprint of article first published in Journal of Advanced Nursing, 2000 Mar; 31(3), 583-9.
Keywords: Psychiatric Nursing; Diagnosis; Culture; Gender; Socioeconomic factors; Nursing models
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Walsh, K., Moss, C., Lawless, J., McKelvie, R., & Duncan, L. (2008). Puzzling practice: A strategy for working with clinical practice issues. International Journal of Law and Psychiatry, 14(2), 94–100.
Abstract: The authors share the evolution of innovative ways to explore, 'unpack' and re-frame clinical issues that exist in everyday practice. The elements of these processes, which they call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which they draw on and use in their practice development work and in research practice. This paper pays attention to a particular form of puzzling practice that they found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle; exploring the heart of out practice; formulating the puzzle question; visualising the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.
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Honey, M., Waterworth, S., Baker, H., & Lenzie-Smith, K. (2006). Reflection in the disability education of undergraduate nurses: An effective learning tool? Journal of Nursing Education, 15(11), 449–453.
Abstract: The aim of this qualitative study was to evaluate the usefulness of formal reflection in the context of undergraduate nursing education during the teaching of a disability module. Reflection is defined as examination and exploration of an issue of concern to help create or clarify meaning.Twelve reflection assignments written by second-year nursing students were analysed. The analysis indicated that students' reflection focused less on their experience of working with people with disabilities and more on their overall learning experience and coping with clinical practice. A central theme, Coping with Clinical Practice, and four sub-themes were identified. Students acknowledged reflection as beneficial to their learning and linked to their clinical practice.
Keywords: Nursing; Education; People with disabilities; Teaching methods; Evaluation
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Day, W. (2000). Relaxation: A nursing therapy to help relieve cardiac chest pain. Australian Journal of Advanced Nursing, 18(1), 40–44.
Abstract: This article discusses ways in which relaxation, when used as an adjunct to medical therapies, can be a useful nursing management tool for effectively relieving cardiac pain. The available literature suggests that although nurses place a lot of importance on cardiac patients being pain free, it is apparent this is often not achieved. Research and documented case studies suggest that relaxation can play an important role in the treatment and prevention of this distressing symptom. The author advocates for nurses to challenge nursing practice and help patients deal effectively with chest pain in a way that meets each individual's needs.
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Hylton, J. A. (2005). Relearning how to learn: Enrolled nurse transition to degree at a New Zealand rural satellite campus. Nurse Education Today, 25(7), 519–526.
Abstract: This paper reports a study that examined the factors that assisted or hindered the transition of a group of enrolled nurses to registration/degree programmes, via a flexible course developed by a North Island tertiary institution. The study follows ten enrolled nurses, primarily Maori and working in rural settings, as they continued to work while studying at a small satellite campus. The study was exploratory and descriptive, and utilised focus group interviews. Two major categories emerged from comparative analysis of the data. One category entitled 'relearning how to learn', demonstrated the cognitive and behavioural adaptations made and is the focus of this paper. The other category 'barriers and catapults', demonstrated the physical and environmental factors that influenced the students' transition but is outside the scope of this paper. Recent changes in New Zealand nursing education have witnessed the clarification of scopes of nursing practice and the controversial development of a new Certificate in Health Science (Nurse Assistant). Currently enrolled nurses are again facing threats to employment and it is envisaged that many will be seeking to undertake transition to registered nurse in the near future.
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Clear, G. M., & Carryer, J. B. (2001). Shadow dancing in the wings: Lesbian women talk about health care. Nursing Praxis in New Zealand, 17(3), 27–39.
Abstract: A participatory approach, grounded in both critical social and feminist research, was used in this study of seven women who claim being lesbian as part of their identity. With the objective of providing information to enhance safe care provision for this marginalised group, the study explored factors which hindered or facilitated these women's sense of safety related to health care. The findings indicate that barriers to receiving health care exist for these women. As there is little local or international research on lesbians and healthcare, this work offers a starting place for future New Zealand nursing research involving lesbians. The authors encourage other nurses to explore previously ignored sections of our society in order to strive for safety for all those whom nursing serves.
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Giddings, D. L. S., & Smith, M. C. (2001). Stories of lesbian in/visibility in nursing. Nursing Outlook, 49(1), 14–19.
Abstract: A study of the life histories of five self-identified lesbian women in nursing is reported. A metastory of “In/Visibility” captured the essence of lesbians being the focus of intense scrutiny while at the same time feeling the pressure to keep their lifestyle and identity hidden from others. Seven story themes were elaborated: closeting of lesbianism in nursing, isolating and hiding from self and others, living a double-life, self-loathing and shame, experiencing discrimination from others, keeping safe, and threatening others who are closeted.
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MacGeorge, J. M., & Nelson, K. (2003). The experience of the nurse at triage influences the timing of CPAP intervention. Accident & Emergency Nursing, 11(4), 234–238.
Abstract: This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.
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Holloway, K. T. (2000). The future for nursing education: UKCC review has relevance for New Zealand. Nursing Praxis in New Zealand, 16(2), 17–24.
Abstract: The author reviews the report 'Fitness for Practice' by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) noting many areas of relevance for New Zealand educators in outlining possible strategies for nursing education. Discussion of some of the recommendations is put in the context of a strategic review of undergraduate nursing education recently commissioned by the Nursing Council of New Zealand. Issues such as recruitment and access to education; retention; clinical assessment and placements; clinical skill acquisition and partnership are valid concerns for educators here also. Internationally, the author suggests, the commonalties in issues of concern lend validity to the concept of the global village and the necessity for a global perspective in health care workforce planning, including educational preparation.
Keywords: Nursing; Education; Recruitment and retention; Clinical assessment; Policy
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Baur, P. (2004). Patients who present to the emergency department but do not wait: An exploratory study. Ph.D. thesis, , .
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Ritchie, M. S. (2004). Process evaluation of an emergency department family violence intervention programme. Ph.D. thesis, , .
Abstract: Family violence is common and there are significant long-term negative health effects from victimisation. Health professionals are now recognised as key providers of family violence intervention. The Hawke's Bay District Health Board HBDHB) launched a Family Violence Intervention Programme in the emergency department in 2002, in accordance with national directives. The Family Violence Intervention Programme includes routine questioning for partner abuse within social history assessments for all women 16 years and over who seek healthcare services. Nurses assumed responsibility for implementing this programme into emergency department practice. Establishing partner abuse screening in practice requires an organisational and attitudinal change. Achieving and sustaining this change can be difficult. Evaluation was considered an essential aspect of the systems approach adopted within the HBDHB Family Violence Intervention Programme to support change. The aim of this study was to identify the enablers and barriers to routine questioning in the emergency department one year after the programme was launched and the strategies to address these barriers. The staff who have responsibility for routinely questioning women were considered well placed to provide this information. The methodology selected was evaluation research using semi-structured interviews. The design included member checking and triangulation of the findings. Eleven emergency department staff members participated in five (two group and three single) interviews. The interviews revealed that routine questioning for partner abuse is difficult in the emergency department setting. Barriers to questioning exist and enablers can eliminate or minimise these. Enablers such as policy and training support routine questioning. Barriers identified included the lack of privacy and time. Participants suggested strategies to overcome these. These barriers, enablers and solutions were either personal or organisational in origin and all had a common theme of safety. An outcome of the study was the development of a model of barriers and enablers to ensure safety when routinely questioning women for partner abuse. This evaluation has utility within the HBDHB as it informs programme progression. However, the evaluation has wider implications. The experiences of the emergency department staff led to the emergence of key themes that may inform the development of comparable programmes. Introducing routine questioning requires a practice change; a multifaceted approach focusing on safety can assist staff to achieve that change.
Keywords: Emergency nursing; Evaluation
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Clayton, J. R. (2004). The recovery of hope: A personal journey through paradigms toward emancipatory practice. Ph.D. thesis, , .
Abstract: This study traces the author's transition from being a mental health nurse to becoming a facilitator of an education programme, the Health and Wellbeing course, for those in recovery from mental illnesses. Within this transition, she describes a journey from disease-focused paradigms toward emancipatory paradigms, evidenced by her application of the recovery approach to her teaching. The 'recovery approach' proposed by the Mental Health Commission in November 1998, and other models of health, are explored using the methodology of descriptive/interpretive philosophical inquiry, autobiographical narrative and a dialectical research design. The author draws from the philosophies of phenomenology and existentialism to present excerpts from her journals, exemplars, poetry and artwork which illuminate epiphanies occurring as she integrates health paradigms in the design of the Health and Wellbeing course. Within this process the recovery approach is revealed as being consistent with the teaching principles of the Health and Wellbeing course. The author goes on to say that the dialectical research design reveals paradoxes and transformations in nursing, medical, psychological, and humanistic paradigms within the New Zealand socio-political context from the 1970s to 2003. The way these are integrated into her practice as an educator, becomes evident in the dialectical research cycles of being, thinking, developing a project, the encounter of teaching, making sense and communication. These cycles reveal her being in the roles of nurse and educator and the thinking through of paradigms that lead to the design and philosophy of a Health and Wellbeing course, the encounter of teaching, and the communication of insights gained. The author's main objective is to show the importance of nurses and educators developing a reflective consciousness when working with sufferers of mental illness. This reflective consciousness involves three levels: The primary level, or raw experience; the social level, or our socio-political contexts and social values, and, the realised level, insights gained about knowledge and experience.
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Shelah, G. E. (2003). Enabling pedagogy: An enquiry into New Zealand students' experience of bioscience in pre-registration nursing education. Ph.D. thesis, , .
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Smillie, A. (2003). The end of tranquillity? An exploration of some organisational and societal factors that generated discord upon the introduction of trained nurses into New Zealand hospitals, 1885-1914.
Abstract: This historical research study examines some of the factors that caused problems for early New Zealand trained nurses upon their introduction into New Zealand hospitals, between 1885 and 1914. Eight incidents in the professional lives of nurses of the period are used as illustrations of the strains and discord that were apparent in this time of change. Analysis of these incidents attempts to answer the question as to whether the introduction of trained nurses into the New Zealand hospital system did add new considerations to problems encountered by nurses in their professional life. The conclusion is that there was a new dimension of difference added to the system with the introduction of the trained nurse. This developed from the evidence that these nurses, particularly if they were also matrons, had to fit into the existing power structures, which were not really ready to accept them, either through choice or lack of foresight. Enmeshed within these considerations is the influence of Florence Nightingale; her effect on nursing itself, and the consequent public and official perception, or misperception, of who nurses should be.
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