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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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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 |
Sye, J. |
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Title |
A fine balance |
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Year |
2008 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Issue |
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Pages |
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Keywords |
Paediatric nursing; Community health nursing; Nurse-patient relations; Children; Patient rights |
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Abstract |
The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates. |
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Call Number |
NRSNZNO @ research @ 911 |
Serial |
895 |
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Author |
Jarvis, B.M.; Mortimer, E.C. |
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Title |
Relevance of physical nursing assessment as seen by nurses and patients in the New Zealand setting |
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Year |
1983 |
Publication |
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Abbreviated Journal |
Otago Hospital Board, Dunedin |
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Issue |
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Abstract |
A study to identify the relevance of the Nursing assessment phase of the Nursing process to Nurses and Patients in the New Zealand setting |
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Call Number |
NRSNZNO @ research @ 91 |
Serial |
91 |
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Author |
Richardson, S.; Allen, J. |
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Title |
Casualization of the nursing workforce: A New Zealand perspective on an international phenomenon |
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Journal Article |
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Year |
2001 |
Publication |
International Journal of Nursing Practice |
Abbreviated Journal |
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Volume |
7 |
Issue |
2 |
Pages |
104-108 |
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Keywords |
Industrial relations; Organisational change; Nursing; Personnel staffing and scheduling |
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Abstract |
A discussion of the increased use of 'casual' nursing staff (those nurses employed on a casual or 'per diem' basis) is presented. Reference is made to related literature, together with consideration of the implications associated with this trend. This issue has international significance, with the increased use of casual staff being widely recognised. A New Zealand perspective is included, with the provision of nursing care at Christchurch Hospital presented to illustrate certain aspects of the discussion. The impact of changing health-care systems and increased emphasis on efficiency and accountability are identified. This change to workplace practice will inevitably affect nursing; possible future developments are considered. |
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Call Number |
NRSNZNO @ research @ 909 |
Serial |
893 |
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Author |
Mears, A. |
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Title |
The role of the clinical nurse co-ordinator |
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Journal Article |
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Year |
2003 |
Publication |
Journal of the Australasian Rehabilitation Nurses Association |
Abbreviated Journal |
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Volume |
6 |
Issue |
3 |
Pages |
24-25 |
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Keywords |
Nursing; Nursing specialties; Older people |
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Abstract |
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Call Number |
NRSNZNO @ research @ 907 |
Serial |
891 |
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Author |
Lui, D.M.K. |
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Title |
Nursing and midwifery attitudes towards withdrawal of care in a neonatal intensive care unit: Part 1. Literature review |
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Journal Article |
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Year |
2003 |
Publication |
Journal of Neonatal Nursing |
Abbreviated Journal |
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Volume |
9 |
Issue |
2 |
Pages |
45-47 |
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Keywords |
Attitude of health personnel; Neonatal nursing; Ethics; Technology |
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Abstract |
This article seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Advanced technology results in the survival of increasingly premature babies with extremely low birthweights and this has inevitably led to an increase in the ethical dilemmas faced by neonatal staff as to whether continued treatment is actually in the best interests of these infants. Part 1 reviews the literature on this subject. Part 2 describes the results of a survey carried out in a New Zealand NICU. |
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Call Number |
NRSNZNO @ research @ 906 |
Serial |
890 |
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Author |
Pirret, A.M. |
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Title |
A preoperative scoring system to identify patients requiring postoperative high dependency care |
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Journal Article |
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Year |
2003 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
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Volume |
19 |
Issue |
5 |
Pages |
267-275 |
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Keywords |
Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment |
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Abstract |
The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions. |
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Call Number |
NRSNZNO @ research @ 904 |
Serial |
888 |
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Author |
Butler, A.M. |
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Title |
On-going refinement of patient dependency scales for use in general hospitals |
Type |
Miscellaneous |
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Year |
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Publication |
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Abbreviated Journal |
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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 @ 90 |
Serial |
90 |
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Author |
Euswas, P.W. |
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Title |
Professional nurses' view of caring in nursing practice: two preliminary studies in New Zealand |
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Year |
1991 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
Massey University Library |
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Volume |
5 |
Issue |
3 |
Pages |
42 |
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Keywords |
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Abstract |
Two convenience samples of 90 NZ registered nurses responded to two structured questionnaires designed to explore nurses views of caring in nursing practice.The studies demonstrate that nurses see caring as a central concept in their practice. From the response the meaning of caring was found to be multi dimensional, consisting of six components: value, expressive, action, relationship, knowledge and purpose. The value dimension includes areas such as humanistic value and professional value. The expressive component consists of empathy, compassion, trust, concern, sharing and willingness. Action components are helping, comforting, being there, empowering, advocacy, nurturing, advising, touching and performing nursing procedures. The major relationship component is partnership. An important part of the knowledge component is clinical expertise and the purposive component of caring consists of meeting health needs and promoting healing and welfare. The meaning of caring begins to emerge from these studies. However, they do not provide full understanding of caring phenomena. A further in-depth study of actual nursing practice is still in progress |
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Call Number |
NRSNZNO @ research @ 9 |
Serial |
9 |
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Author |
O'Shea, M.; Reddy, L. |
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Title |
Action change in New Zealand mental health nursing: One team's perspective |
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Journal Article |
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Year |
2007 |
Publication |
Practice Development in Health Care |
Abbreviated Journal |
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Volume |
6 |
Issue |
2 |
Pages |
137-142 |
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Keywords |
Experiential learning; Psychiatric Nursing; Communication; Community health nursing |
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Abstract |
This paper describes an attempt at effecting change with specific relevance to the discharge planning of clients from a New Zealand inpatient mental health unit to a community setting. It explores how a team of community mental health nurses, practising in an urban/rural area, used the concepts of practice development to endeavour to bring about change while still retaining a client-centred focus. It describes how, in their enthusiasm, they embarked on the road to practice change without undertaking some of the essential ground work, Although they did not achieve all they set out to achieve, much was learnt in the process. In this paper, the authors outline their key learning points concerning the importance of engagement, communication, consistency and cooperation to the process and outcomes of practice change. |
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Call Number |
NRSNZNO @ research @ 897 |
Serial |
881 |
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Author |
Connor, M. |
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Title |
The practical discourse in philosophy and nursing: An exploration of linkages and shifts in the evolution of praxis |
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Journal Article |
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Year |
2004 |
Publication |
Nursing Philosophy |
Abbreviated Journal |
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Volume |
5 |
Issue |
1 |
Pages |
54-66 |
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Keywords |
Nursing philosophy; Ethics; Nursing |
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Abstract |
This paper, firstly, examines the linkages and shifts in the evolution of of praxis. The concept of praxis, also known as the practical discourse in philosophy, has been expressed in different ways in different eras. However, the linkages from one era to another and from one paradigm to another are not well explicated in the nursing literature. Blurring of the linkages occurred from the popular association of praxis within the emancipatory paradigm. Integral to the concept of praxis, since the time of Aristotle, is the notion of phronesis: a process of moral reasoning enacted to establish the 'good' of a particular situation, often referred to as practical wisdom. Secondly, the paper, promotes and affirms the importance of praxiological knowledge development in the discipline. Furthermore, increased appreciation of the concept of praxis provides an important vehicle for the advancement of nursing as a moral endeavour and the nurse as moral agent. |
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Call Number |
NRSNZNO @ research @ 890 |
Serial |
874 |
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Author |
Farrell, E. |
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Title |
A lamp to light the way: Public health nurses' perceptions and experiences of professional/clinical supervision |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Auckland University of Technology |
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Volume |
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Issue |
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Pages |
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Keywords |
Public health; Nursing; Clinical supervision; Professional competence |
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Abstract |
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Call Number |
NRSNZNO @ research @ 887 |
Serial |
871 |
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Author |
Van der Harst, J. |
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Title |
Inside knowledge: A qualitative descriptive study of prison nursing in New Zealand |
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Year |
2003 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing specialties |
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Abstract |
Analysis of the research literature on prison nursing revealed a paucity of research, both in New Zealand and internationally. The aim of this research was to describe the working life of the nurse in a New Zealand prison and provide an understanding of and documentation on prison nursing in New Zealand. A qualitative descriptive study was undertaken to determine what it is like to nurse in a New Zealand prison. Ten nurses working at two public prisons and one private prison took part in the study. Data was collected by the use of semi-structured interviews and analysed thematically into four main themes. The participants' descriptions of their working lives as prison nurses expose the multifaceted nature of this work and the inherent relational dynamics. These dynamics determine the nurse's ability to practise effectively in the prison setting. Findings highlighted many paradoxical situations for nurses when working in this environment. The very aspects of the work that participants described as negative were also identified, in some instances, as challenging and satisfying. |
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Call Number |
NRSNZNO @ research @ 886 |
Serial |
870 |
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Author |
Stuart, J. |
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Title |
How can nurses address generalist/specialist/nursing requirements of the urban/rural population of Southland |
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Year |
2003 |
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 |
Nursing specialties; Policy; Technology; Scope of practice; Community health nursing |
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Abstract |
This study, which is undertaken in the Southland area, explores the effect of the increasing specialisation of nursing services in what is a rural/urban environment. It is indicated in the literature that systemic changes in health, such as the health reforms, and the increase in the use of technology have meant that nurses are required to function in disease oriented roles rather than according to their more traditional generalist roots. A significant event, which also affected nursing scope of practice, was the transfer of nurse education to the tertiary education institutions environment from the hospitals in the mid 1970s. The traditional nursing hierarchy and its nurse leadership role disappeared and the adoption of specialist nurse titles increased, and identified with a disease or disorder, for example 'diabetes' nurse. The increase in specialist categories for patients contributed to the nurse shortage by reducing the available numbers of nurses in the generalist nursing pool. The nurses in this rural/urban environment require generalist nurse skills to deliver their nursing services because of the geographical vastness of the area being a barrier to specialist nurses. Workforce planning for nurses in the rural/urban then must focus on how to reshape the nursing scope of practice to utilise the existing resources. This study explores how key areas of health services could be enhanced by reclaiming the nurse role in its holistic approach, in mental health, public health, geriatric services and psychiatric services. |
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Call Number |
NRSNZNO @ research @ 885 |
Serial |
869 |
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Author |
Radka, I.M. |
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Title |
Handover and the consumer voice: The importance of knowing the whole, full story |
Type |
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Year |
2003 |
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 |
Communication; Patient satisfaction; Nurse-patient relations |
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Abstract |
In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare. |
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Call Number |
NRSNZNO @ research @ 883 |
Serial |
867 |
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