|
Maloney-Moni, J. (2004). Kia Mana: A synergy of wellbeing. Ph.D. thesis, , .
|
Grainger, J. (2007). Mind shift: Creating change through narrative learning cycles: A qualitative interpretive study of clinical conversation as an appraisal process for sexual and reproductive health nurses. Ph.D. thesis, , .
Abstract: This thesis explores the process of an annual appraisal strategy, 'clinical conversation', from the perspective of seven nurses who were assessed using this technique. The findings demonstrate that clinical conversation is a strategy which facilitates reflection, both as a solitary exercise and with others, to ensure that learning from experience is optimised. The research used a qualitative interpretive approach informed by the model of Grounded Theory espoused by Strauss and Corbin. All eight nurses who were assessed using the clinical conversation strategy were advanced practitioners working within the scope of sexual and reproductive health. Two of the actual appraisals were observed and seven of the nurses were interviewed within eight weeks of being assessed. The outcome of the clinical conversation was primarily one of learning; the acquisition of new insights into self as practitioner. The learning was facilitated through the process of narration; telling the story of clinical practice. Three distinct narrative cycles were identified, each an experiential learning episode. The experience of undertaking a variety of assessment activities created a narrative with self and triggered an internal reflective thinking process; the experience of working with a peer created an additional narrative, a mutual dialogue reflecting back on practice; the experience of sharing practice with an assessor created a further and final narrative, a learning conversation. Each narrative can be seen as a catalyst for change. Primarily, the nurses felt differently about themselves in practice, the way they saw themselves had shifted. Such a change can be described as an alteration in perspective. These alterations in perspective led all nurses to identify ways in which they would change their actual clinical practice. In this way the nurses attempted to align their espoused beliefs about practice with their actual practice. The author notes that the study shows that each nurse responded differently to each narrative learning cycle: for some the conversation with the assessor was more of a catalyst for change than for others. In this way clinical conversation may be flexible enough to respond to a variety of differing learning styles. Learning was person specific which is an imperative for the continued professional development of already highly skilled clinicians. The implication of the research is that whilst clinical conversation was designed as a tool for appraising clinical competence, its intrinsic value lies in supporting the professional development of nurses.
|
Bridgen, A. F. (2007). A heuristic journey of discovery: Exploring the positive influence of the natural environment on the human spirit. Ph.D. thesis, , .
Abstract: The intention of this heuristic study was to explore and discover the essence of the positive influence of the natural environment on the human spirit. The study quest was identified as a central concern that evolved from the author's personal experience of spiritual awakening in the natural environment and an interest in the concept of connectedness in nursing care and practice. The study also focused on the self of the nurse and the qualities of holistic nursing care. Guided by heuristic methodology developed by Moustakas (1990) the thesis traces a journey of discovery. Using conversational interviews, six nurses were asked to describe their experiences of their spirit being positively influenced in the natural environment. These nurses were also asked if these beneficial experiences had any flow-on effect to their nursing practice. From these interviews various commonalities of experience were identified as well as some experiences unique to the individual participants. The participant knowing was articulated using Reed's (1992) dimensions of relatedness in spirituality as a framework. Reed describes these dimensions as being able to be experienced intrapersonally, interpersonally and transpersonally. A substantive body of nursing and non-nursing literature was explored to support the participant knowing and provide strength to the discussion. The study discovered that the human spirit is positively influenced in the natural environment. The three actions of personal healing and wellbeing in the natural environment, knowing self – knowing others and sustaining self in nursing practice were valued by the participants as contributing to the quality of their nursing care. In bringing together spirituality, the natural environment and nursing, holism was discovered to be the significant and connecting constituent. The study has some implications for the discipline of nursing that are also discussed by the author.
|
|
Bigwood, S. (2007). Got to be a soldier: Mental health nurses experiences of physically restraining patients. Ph.D. thesis, , .
|
Bunn, S. (2007). An exploration of the transition of patients from intensive care to the ward environment: A ward nursing perspective. Ph.D. thesis, , .
Abstract: The transition of patients from intensive care to the ward environment is a regular occurrence in intensive care. Today patients are often transferred earlier and sicker due to the demands for intensive care beds. This results in patients with higher acuity being cared for in the wards. Here ward nurses have to meet the ongoing complex demands of caring for higher acuity patients, alongside managing high patient-to-nurse ratios, staffing concerns, and varying levels of experienced nurses. This research explored the experiences of ward nurses receiving patients transferred from intensive care. The aims were to identify any areas of concern, highlight specific problems that occur on transition and to address what information is pertinent to ward nurses when receiving patients from intensive care. A qualitative descriptive methodology using focus groups was utilised to gather information about these experiences. Three focus groups were held with ward nurses from various wards within the study setting hospital. All participants had considerable contact with intensive care and were familiar with the processes of transferring patients. Five themes emerged from the focus groups – Patients as intensive care staff say they are; Time to prepare the biggest thing; Documentation as a continuation of patient care; They forget what its like; and Families, a need to know about them. The theme Patients as intensive care staff say they are relates to reliable information sharing focused on the patient, their needs and condition. Participants expressed their concern that patients were not always in the condition that the intensive care staff stated they were on the referral. Having adequate time to prepare was considered important for the majority of ward nurses receiving patients from intensive care. Documentation was highlighted in the theme Documentation as a continuation of patient care particularly in relation to fluid balances and vital sign history. The theme They forget what its like suggests there is a perception that intensive care nurses have a lack of understanding of what the ward staff can actually manage. Decreased staffing levels during certain shift patterns and a lack of appropriately experienced staff on the wards is a common concern for ward nurses. Ward nurses also recognised that caring for families was part of their role. Patients and families may respond differently to the transfer process and their inclusion in transfer planning was seen as essential. Communication was a reoccurring element throughout all themes.The author concludes that communication is the paramount factor that impacts on a 'smooth transition' for ward nurses. A 'smooth transition' refers to the transfer of patients from intensive care to the next level of care. Subsequently, nurses' perceptions need to change, whereby transfer planning from ICU should be the focus rather than discharge planning. Transfer planning and education for all nursing staff is vital if the transfer process is to be improved. Consequently, transitional care within the context of ICU aims to ensure minimal disruption and optimal continuity of care for the patient. The knowledge gained from this research may provide better understanding of the multifaceted issues linked with transitional care that may be adapted for a wider range of patients in various clinical environments.
|
Jefferson, F. E. (2007). An exploration of the competencies for advanced nursing practice in the perioperative setting.
Abstract: A clinical research practicum.
|
|
Bell, J. (2007). Blood glucose control using insulin therapy in critically ill adult patients with stress hyperglycaemia: A systematic review.
|
|
Sutton, D. M. (2007). An analysis of the application of Christensen's Nursing Partnership Model in vascular nursing: A case study approach. Ph.D. thesis, , .
|
|
Rydon, S. E. (2001). Attitudes, skills and knowledge of mental health nurses: The perception of users of mental health services. Ph.D. thesis, , .
|
|
Saba, W. (2007). Walking in two worlds: A Kaupapa Maori research project examining the experiences of Maori nurses working in district health boards, Maori mental health services. Ph.D. thesis, , .
|
Sadler, D. (2000). Stigma, discrimination and a model for psychiatric mental health nursing practice.
Abstract: This paper seeks to understand the aetiology of stigma. The word stigma comes from the Greek language and refers to a brand, a mark of shame. Society has used this phenomenon to mark those who do not fit with the stereotypical virtual identity expected by a group. Stigma has persisted throughout the ages to enforce norms and sanction rules. Stigma is a term used to broadly define an attitude to negative attributes. It is a way of treating people that indicates to the individual, they are different from the norm. Research indicates the general population has discriminatory attitudes to those who have experienced mental illness. This discrimination impacts on the lives of those people. Their stories tell of shame, sadness and anguish. Families too, feel the ongoing effects of stigma. Psychiatric mental health professionals are said to perpetuate the discrimination arising from the stigma of mental illness. This is shown in the literature to persist through labelling and disempowering practices. The attitude of nurses in particular is critical to promoting healing environments. It is thought that a humanistic altruistic approach to nursing practice will help to eliminate discriminatory practice by nurses. It is hoped that this approach will create collaborative care that gives the individual the respect, response, choice and support they need to assist in recovering from mental illness.
|
Thompson, S. A. (2000). Getting it right: An exploration of compulsive caregiving and helping profession syndrome. Ph.D. thesis, , .
Abstract: This thesis is a theoretical exploration of the concepts of 'Compulsive caregiving' and 'helping profession syndrome' in relation to the choice of nursing as a career. These concepts are derived from Bowlby's attachment theory and psychodynamic psychotherapy. Both have evolved from psychoanalytic theory. The thesis explains Bowlby's development of compulsive caregiving in health professionals. The author notes that her life history and experience as a nurse educator and as a nurse practicing psychotherapy support this theoretical explanation. An argument is developed that the propensity towards compulsive caregiving is a strength in nurses. Nursing places high value on caring and many of the traits exhibited by compulsive caregivers are desirable in nurses. Nursing as a caring interpersonal process is explored with reference to the literature. However, nursing has been identified as a stressful occupation. Support strategies such as professional supervision and reflective practice are discussed. Thesis concludes with a suggestion for further research on compulsive caregiving and helping profession syndrome.
|
Peri, K., Kerse, N., Kiata, L., Wilkinson, T., Robinson, E., Parsons, J., et al. (2008). Promoting independence in residential care: Successful recruitment for a randomized controlled trial. Journal of the American Medical Directors Association, 9(4), 251–256.
Abstract: The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success.
|
Wilson, D., & Neville, S. J. (2008). Nursing their way not our way: Working with vulnerable and marginalised populations. Contemporary Nurse, 27(2), 165–176.
Abstract: This paper uses the findings of two studies to explore the nature of nurses' practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. The first study was with the elderly with delirium and used a critical gerontological methodology informed by postmodernism and Foucault's understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory informed by a Maori-centred methodology. The findings show that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to people's lives outside of the health care environment is ignored. Consequently, the foundations of nursing practice, that of holism, is found to be merely a rhetorical construct.
|
Spence, D. (2003). Nursing people from cultures other than one's own: A perspective from New Zealand. Contemporary Nurse, 15(3), 222–231.
Abstract: This paper provides an overview of the evolving meaning of 'culture' in New Zealand nursing. Then, drawing upon the findings of research that used hermeneutic phenomenology to explore the experience of nursing people from cultures other than one's own, a description of the constituent parts is of this phenomenon is briefly outlined and followed by an exemplar that describes the coalescent and contradictory nature of the phenomenon as a whole. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, interplay of the notions of prejudice, paradox and possibility is evident at intrapersonal and interpersonal levels as well as in relation to professional and other discourses.
|
