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Author Evans-Murray, A.
Title Meeting the needs of grieving relatives Type Journal Article
Year 2004 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 10 Issue 9 Pages (down) 18-20
Keywords Intensive care nursing; Grief; Communication
Abstract This article examines the role of nurses working in intensive care units who may need to work with families as they face the death of a loved one. How the nurse communicates with relatives during these crucial hours prior to the death can have profound implications on their grief recovery. Universal needs for families in this situation have been identified in the literature, and include: hope; knowing that staff care about their loved one; and having honest information about their loved one's condition. A case study is used to illustrate key skills and techniques nurses can employ to help meet these universal needs. In the first stage of grief the bereaved is in shock and may feel a sense of numbness and denial. The bereaved may feel confused and will have difficulty concentrating and remembering instructions, and they may express strong emotions. Studies on families' needs show that honest answers to questions and information about their loved one are extremely important. It is often very difficult for the nurse to give honest information when the prognosis is poor. Good communication skills and techniques are discussed, in which hope is not offered at the expense of truthfulness, and the nurse facilitates the process of saying goodbye and expressing emotions. Practical techniques, such as including the family in basic care such as foot massaging and simple hygiene routines, may also be used to move the family from being bystanders to the impending death, to comforters.
Call Number NRSNZNO @ research @ 1004 Serial 988
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Author Ho, T.
Title Ethical dilemmas in neonatal care Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue 7 Pages (down) 17-19
Keywords Intensive care nursing; Paediatric nursing; Ethics; Clinical decision making
Abstract The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment.
Call Number NRSNZNO @ research @ 1035 Serial 1019
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Author Hansen, G.
Title The role of massage in the care of the critically ill Type Journal Article
Year 2002 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 8 Issue 7 Pages (down) 14-16
Keywords Nursing; Alternative therapies; Intensive care nursing
Abstract This article looks at the research on the benefits of massage for alleviating the anxiety of patients in critical care. The author draws on her own experiences with cardiac patients and affirms the lasting psychological benefit of massage. She provides advice on which parts of the body to massage on patients in critical care, which to avoid and how to know when it is contraindicated.
Call Number NRSNZNO @ research @ Serial 1010
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Author Wright, R.
Title Linking theory with practice Type Journal Article
Year 2001 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 7 Issue 2 Pages (down) 14-15
Keywords Intensive care nursing; Nurse-family relations; Nursing models
Abstract This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family.
Call Number NRSNZNO @ research @ Serial 1012
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Author Dredge, A.
Title An insider's view of professional nursing and care management of the critically ill patient Type Journal Article
Year 1999 Publication Vision: A Journal of Nursing Abbreviated Journal
Volume 5 Issue 8 Pages (down) 13-16
Keywords Intensive care nursing; Interprofessional relations; Registered nurses
Abstract This article explores the role of the registered nurse (RN) in the critical care environment. It presents the Intensive Care Unit (ICU) as a unique environment, with a specific relationship to technology, and a history that mirrors scientific development. It explores the tensions for a caring profession with a distinct culture practising in a highly medicalised, acute environment, and affirms the value of quality human care.
Call Number NRSNZNO @ research @ 1302 Serial 1287
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Author Evans, S.
Title Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes Type Journal Article
Year 2003 Publication Pediatric Intensive Care Nursing Abbreviated Journal
Volume 4 Issue 2 Pages (down) 7
Keywords Nursing specialties; Intensive care nursing; Equipment and Supplies
Abstract The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
Call Number NRSNZNO @ research @ Serial 926
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Author Blanchard, D.L.
Title Developing the place and role of family within the culture of critical care nursing: An action research approach Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages (down)
Keywords Relationships; Nurse-family relations; Intensive care nursing; Nursing research
Abstract This research examines how nurses negotiate the context of the Intensive Care Unit (ICU) while working with families. The action research described in this thesis developed through a series of meetings and conversations where the conversations supported the reflexive intent of the research. In commissioning the research, the design of the meetings and conversations were as a series of overlapping actions. Data collection and data analysis occurred in the action research by meetings, reflective conversations, ad libitum observations, and in a research journal. Conceptual maps explain the progress and findings of the research in this thesis while categories distilled from the conversations also support the findings in the research. The Family Action Research Group that was established within this project proposed a Family Assessment Form for the family to provide an assessment of themselves and the patient. Implementing this assessment tool demonstrated that clear information was needed for the family in the ICU. Findings in this research focus on developing action research and family care in ICU. Findings also focused on the role of the researcher being of and not being of the context where action research is undertaken. Recommendations include staff examining relationships for potential asymmetries and seeking ways to address these to support families and staff. Suggested strategies for developing action research in a clinical context include detailed planning, clear focusing, transparency of data, and working to explain change initiatives through the research are also included.
Call Number NRSNZNO @ research @ 494 Serial 480
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Author Roberts, C.
Title The influence of nursing culture on family visiting in adult intensive care units Type
Year 2007 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages (down)
Keywords Intensive care nursing; Nurse-family relations; Culture; Nursing
Abstract This dissertation considers the implications of the relationship between nurses and the patient's family, when family members visit intensive care units (ICUs) following the acute admission of a relative there. In particular it explores the issues of power and control, nurses might have in this setting, the culture that supports that, and the implications this has for practice in the New Zealand context. A comprehensive literature review on the perspective of nurses in relation to relatives visiting adult intensive care units was conducted. The author concludes that nurses modify policies related to visiting access for family members to suit themselves, and the needs of their patient. Nurses use a variety of tactics to maintain a position of power and control by looking out for themselves first, their patient second, and relatives third. The need of the patient and their families is not well understood by nurses, and nurses feel they have inadequate skills to cope with the needs and stresses of visiting relatives. The author suggests that for nurses to provide family focused care in ICU they must develop a therapeutic relationship with all concerned. ICU nursing culture affects nurses ability to focus on caring for their patients and their families. Nurses in ICU appear to need to maintain power and control over their environment but further research is needed to identify the current situation in New Zealand ICUs.
Call Number NRSNZNO @ research @ Serial 502
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Author Patel, R.
Title Evaluation and assessment of the online postgraduate intensive care nursing course Type
Year 2006 Publication Abbreviated Journal University of Otago Library
Volume Issue Pages (down)
Keywords Education; Intensive care nursing; Nursing specialties
Abstract
Call Number NRSNZNO @ research @ 519 Serial 505
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Author Fielding, S.
Title Learning to do, learning to be: The transition to competence in critical care nursing Type
Year 2006 Publication Abbreviated Journal Auckland University of Technology Library
Volume Issue Pages (down)
Keywords Intensive care nursing; Preceptorship; Nursing specialties
Abstract Making the transition to an area of specialist nursing practice is challenging for both the learner and staff who are responsible for education and skill development. This study uses grounded theory methodology to explore the question: “How do nurses learn critical care nursing?” The eight registered nurses who participated in this study were recruited from a range of intensive care settings. The criteria for inclusion in the study included the participant having attained competency within the critical care setting. Data was collected from individual interviews. This study found that nurses focus on two main areas during their orientation and induction into critical care nursing practice. These are learning to do (skill acquisition) and learning to be (professional socialisation). The process of transition involves two stages: that of learning to do the tasks related to critical care nursing practice, and the ongoing development of competence and confidence in practice ability. The relationship of the learner with the critical care team is a vital part of the transition to competency within the specialist area. This study identifies factors that influence the learner during transition and also provides an understanding of the strategies used by the learners to attain competency. These findings are applicable to educators and leaders responsible for the education and ongoing learning of nurses within critical care practice. The use of strategies such as simulated learning and repetition are significant in skill acquisition. However attention must also be paid to issues that influence the professional socialisation process, such as the quality of preceptor input during orientation and the use of ongoing mentoring of the learner.
Call Number NRSNZNO @ research @ Serial 509
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Author Morrison, M.
Title Posthuman pathology: A postmodern art project located in critical care Type
Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages (down)
Keywords Intensive care nursing; Nursing philosophy; Culture; Technology
Abstract The author's art project “Posthuman Pathology” is a postmodern examination of the resolutely modernist culture of critical care medicine. She uses conceptual art practices in conjunction with the techniques of anti-aesthetics in order to dismantle, open out and critique ideas which are foundational to the culture of critical care.
Call Number NRSNZNO @ research @ 580 Serial 566
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Author Fogarty, K.
Title The assessment of competence in the novice nurse in the adult intensive care unit Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages (down)
Keywords Intensive care nursing; Nursing specialties; Clinical assessment
Abstract This dissertation explores the assessment of nurses' clinical competence in the adult ICU setting. Specifically, methods for the assessment of competence are critiqued for their practical application to the novice nurse with less than six months experience in ICU. The assessment methods considered are continuous clinical assessment, self-assessment, peer review, objective structured clinical examination (OSCE), portfolio and computer assisted assessment. Several criteria are applied to the methods including the ability of each method to assess skills, knowledge and attitudes or values. Each method is critiqued for its implications in terms of cost and staffing resource, benefits and barriers to implementation. In addition, reliability and validity issues are considered for each method. The outcome of this exploration is the recommendation of a combination of methods; namely, portfolio and OSCE, for the assessment of competence in the ICU novice. The author concludes that this finding enhances current understanding within the ICU specialty of the multidimensional nature of competence assessment.
Call Number NRSNZNO @ research @ Serial 574
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Author Fahey, M.
Title Family centred care in the newborn intensive care unit: Creating a supportive environment Type
Year 2003 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages (down)
Keywords Intensive care nursing; Infants; Nurse-family relations
Abstract The environment of the Newborn Intensive Care Unit (NICU) is a stressful one for families and is often designed to provide technical care for the infant rather than facilities that would enable and support parental and family participation in infant care. Furthermore, the author notes that the environment of the NICU emerged in literature as an obstacle to meaningful family involvement in care. However, she goes on to say that a philosophy of Family Centred Care in the NICU can offer a framework of care that supports family involvement in the infant's care and family presence in the NICU. It also promotes parental participation in decision-making for the infant and gives recognition to the importance of perspectives provided by the family. This dissertation explores the difficulties associated with the practice of Family Centred Care in the environment of the NICU. It offers recommendations for features of unit design that can promote Family Centred Care by supporting and sustaining the presence of families in the NICU and therefore facilitating their involvement in the care of their infant.
Call Number NRSNZNO @ research @ Serial 592
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Author Hall, J.
Title Building trust to work with a grounded theory study of paediatric acute care nurses work Type
Year 2004 Publication Abbreviated Journal Auckland University of Technology Library
Volume Issue Pages (down)
Keywords Nurse-family relations; Nurse-patient relations; Children; Paediatric nursing; Intensive care nursing
Abstract Grounded theory methodology has guided the grounded theory methods used to explore the acute care paediatric nurses' perspective of what they do when a child has had a severe accident. The research was initiated from the experience of nursing children in the context of a rehabilitation centre and wondering how acute care nurses promoted a child's recovery after a severe unintentional injury. Many avenues were used to search international and New Zealand literature but the scarcity of literature related to what acute care paediatric nurses do was evident. Nursing children in the acute care ward after a severe accident is complex. It encompasses nursing the family when they are experiencing a crisis. It is critical that the acute care nurse monitors and ensures the child's physiological needs are met, and the nurse “works with” the child to maintain and advance medical stability. Nursing interactions are an important part of “working with”, communication is the essence of nursing. This research has focussed on the nurses' social processes whilst caring for the physical needs of the child and interacting with the family and multidisciplinary team when appropriate. An effective working-relationship with a nurse and family is founded on trust. Grounded theory methods supported the process of exploring the social processes of “building trust” whilst “working with” families in a vulnerable position. Nurses rely on rapport to be invited into a family's space to “work with” and support the re-establishment of the parenting role. The “stepping in and out” of an effective working-relationship with a family is reliant on trust. Nurses build trust by spending time to “be with”, using chat to get to know each other, involving and supporting the family to parent a “different” child and reassuring and giving realistic hope to help the child and parents cope with their changed future. A substantive theory of the concept of “building trust to work with” has been developed using grounded theory methods. The theory has been conceptualised using the perspective of seven registered nurses working in paediatric acute care wards that admit children who have had a severe traumatic accident.
Call Number NRSNZNO @ research @ Serial 597
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Author Pirret, A.M.
Title The use of knowledge of respiratory physiology in critical care nurses' clinical decision-making Type
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue Pages (down)
Keywords Intensive care nursing; Clinical decision making
Abstract
Call Number NRSNZNO @ research @ 686 Serial 672
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