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Author |
Dearden, G. |
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Title |
When things go wrong: The experiences of mental health nurses who have had a patient die through suicide |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
Mental health; Psychiatric Nursing; Nurse-patient relations; Case studies; Suicide |
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Abstract |
This thesis discusses the findings of a research study, informed by the work of van Manen (1997b), which explored the lived experiences of five mental health nurses who have had a patient die through suicide. Narrative was used as a method in interviews to uncover the essence of their lived experiences. Five interwoven themes uncovered in each of the interviews were: impact, support, feelings, closure and paradox. All of the nurses interviewed experienced a wide range of feelings about their patient's suicides, ranging from shock to guilt, to anger and sadness, and described their patient's suicide as having a significant impact on them. Support received by the nurses following their patient's suicide was variable, and they were often in the difficult position of trying to offer support to the patient's family. Common to all of the nurses was the lack of closure following the suicide. Paradox was found to be the overall essence of the experience of the mental health nurses interviewed. Three main paradoxical themes or statements were identified that are in many respects a summary of all of the themes that emerged. These were: unavoidable – responsible; inevitable – unprepared; duty of care – respect for patient's decision to end their life. The author suggests that the ability of the nurses interviewed to accept and reconcile the paradoxical issues that arise in relation to patient suicide, and accept the lack of closure they experience, is a fundamental element in their ability to continue to work in the mental health setting, despite the significant impact their patient's suicide has had on them. Four recommendations are made based on the insights gained from this research. These are: that every mental health service should have a suicide response policy; that undergraduate nursing education includes the impact of patient suicide; the development of policies which promote dialogue about suicide within the community; and the need for further research in this topic. |
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Call Number |
NRSNZNO @ research @ |
Serial |
602 |
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Author |
Kwai, K. |
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Title |
The value of a programme of clinical supervision for graduate nurses: An evaluative study |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
Clinical supervision; New graduate nurses; Mentoring |
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Abstract |
The function and implementation of clinical supervision in the practice setting presents a number of challenges for new graduate programmes for registered comprehensive nurses. There have been numerous reports and papers promoting its benefits as important and providing the impetus for change. Clinical supervision has been well established as part of social work, counselling, psychotherapy and psychoanalytic practice, and in mental health nursing and midwifery. Its utilisation for graduate nurses is clearly important and should be seen as integral to professional practice. This study evaluated a programme of clinical supervision as a component of a new graduate nurse programme in a secondary health care practice environment. The clinical supervision component aimed to support graduate registered nurses' transition from the role of student nurse to staff nurse in the context of professional clinical practice. This report is also intended to inform the ongoing provision of clinical supervision at Hutt Valley District Health Board. The evaluation process was guided by the work of Owen (1990) and used utilisation focussed evaluation as the framework on which to undertake the evaluation. A mix of quantitative and qualitative methodology was used to collect and analyse the data. Data were collected from nurse graduates of the new graduate programme using a postal questionnaire that covered three areas; clinical supervision, the Hutt Valley District Health Board new graduate programme and an evaluation of stakeholder roles. Twelve of the new graduates responded to the survey. Findings suggest clinical supervision provided professional support and assisted the new graduate in the identification of education needs. Difficulties associated with accessing the structured component of the new graduate programme and clinical supervision were highlighted. The recommendations made to Hutt Valley District Health Board to improve the programme include considering accessibility, consumer rights, acceptability, a comprehensive approach, the Treaty of Waitangi, efficiency and a coordinated approach. |
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Call Number |
NRSNZNO @ research @ |
Serial |
603 |
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Author |
McDonald, S. |
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Title |
Registered nurses' perceptions of their role in acute inpatient care in New Zealand: A qualitative descriptive study |
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Year |
2004 |
Publication |
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Abbreviated Journal |
University of Auckland |
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Pages |
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Keywords |
Mental health; Psychiatric Nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 620 |
Serial |
606 |
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Author |
Fraser, A.G.; Williamson, S.; Lane, M.; Hollis, B. |
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Title |
Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori |
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Journal Article |
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Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
116 |
Issue |
1176 |
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Keywords |
Advanced nursing practice; Hospitals; Clinical assessment; Evaluation |
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Abstract |
Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive. |
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Call Number |
NRSNZNO @ research @ 625 |
Serial |
611 |
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Author |
Ardagh, M.; Wells, E.; Cooper, K.; Lyons, R.; Patterson, R.; O'Donovan, P. |
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Title |
Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial |
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Journal Article |
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Year |
2002 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
115 |
Issue |
1157 |
Pages |
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Keywords |
Emergency nursing; Time factors; Clinical assessment; Clinical decision making |
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Abstract |
The aim of this study was to test the hypothesis that triaging certain emergency department patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. During the five weeks of the RAC clinic a total of 2263 patients attended the emergency department, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the emergency department. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The researchers found that the rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources. |
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Call Number |
NRSNZNO @ research @ |
Serial |
617 |
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Author |
Topliss, J. |
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Title |
Nursing by telephone in mental health emergency settings: What underpins and informs clinical practice? |
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Miscellaneous |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Bill Robertson Library, Otago Polytechnic |
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Pages |
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Keywords |
Mental health; Emergency nursing |
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Abstract |
This dissertation is an exploration of what underpins and informs clinical nursing practice by telephone in mental health emergency settings. A critical review of the literature provides the foundation for discussion. Points of reflection explore links between the literature and the author's own experience and thoughts about clinical practice. Findings are presented within three main sections. 'Historical Context' considers the development and function of mental health emergency service telephone work. Practical aspects are discussed under `Service Provision Context.' 'Nursing Context' explores the fundamental skills involved in clinical reasoning and the preparation of staff for telephone work. Whilst 'Best practice' in the area of nursing by telephone is yet to be well defined, this work aims to provide a foundation for further inquiry, research and dialogue. |
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Call Number |
NRSNZNO @ research @ 676 |
Serial |
662 |
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Author |
Bleach, A. |
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Title |
Nurses talk the walk: An exploration of nurses' perception of advanced nursing practice on acute mental health inpatient units in New Zealand |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Mental health; Nursing; Policy; Registered nurses; Advanced nursing practice; Psychiatric Nursing |
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Abstract |
The last twenty years, particularly the early 1990s, ushered in major mental health sector reforms inclusive of deinstitutionalisation policies and subsequent development of community services. Concurrent changes to student nurses' education left registered nurses as the workforce mainstay on inpatient units. However, the author suggests, an emerging global shortage of nurses and implementation of the Employment Contracts Act (1991) negatively impacted on recruitment and retention of registered nurses. Inpatient nurses either left nursing or moved to community positions for better money and increased job status. The author suggests that, as a consequence, the 'critical mass' of experienced and skilled nurses who traditionally provided nursing leadership disappeared resulting in compromised standards of care for patients. As the manager of an inpatient unit, the author proposed the establishment of advanced nursing practice roles as one initiative to provide nursing leadership in order to attract and retain nurses. This study explored five inpatient nurses' perceptions of advanced practice and whether these roles could assist to provide leadership and improve standards of care. The research was a qualitative exploratory descriptive study using a focus group interview as the data collection method. A thematic analysis of the group discussion transcription revealed three key themes: 1) the 'makeup' of advanced nursing practice, 2) moving forwards: establishing roles, 3) moving sideways: barriers to role development. The themes are critically discussed in relation to selected literature. The thesis includes recommendations that could be used by nurses responsible for planning and implementing advanced practice roles on inpatient units. |
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Call Number |
NRSNZNO @ research @ |
Serial |
663 |
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Author |
Holbrook, P. |
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Title |
Nurse initiated analgesia in an emergency department: Can nurses safely decrease door to analgesia times by providing analgesia before medical assessment? |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Drug administration; Nursing; Pain management |
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Abstract |
Pain management practices within emergency departments require a more patient focused approach due to extended waiting times for analgesia. This dissertation questions current methods of providing timely and appropriate delivery of analgesia. Nurses represent the biggest resource in emergency departments therefore are in a position to be able to access patients in a timely fashion. A review of the literature pertaining to nurse initiated analgesia protocols has been evaluated and information relating to efficiency and safety utilised to discuss the processes for planning and implementation of a similar protocol. The author finds that the literature provides no evidence that nurse initiated analgesic practices prior to medical assessment compromises patient safety or delays diagnosis. A discussion of the benefits to patients, nurses and the institution has been included to highlight the appropriateness of extending nursing roles. |
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Call Number |
NRSNZNO @ research @ |
Serial |
664 |
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Author |
Wilson, B. |
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Title |
Maintaining equilibrium: The community mental health nurse and job satisfaction |
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Year |
2005 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Pages |
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Keywords |
Community health nursing; Mental health; Job satisfaction; Stress |
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Abstract |
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Call Number |
NRSNZNO @ research @ 681 |
Serial |
667 |
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Author |
Paterson, J.E. |
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Title |
Nurses' clinical decision-making: The journey to advancing practice |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Pages |
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Keywords |
Clinical decision making; Mentoring; Nursing; Nurse practitioners |
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Abstract |
This dissertation reports on a scholarly journey to better understand the processes of clinical decision-making by nurses. It begins by identifying the various terms used to describe a clinical decision, its components and the contexts within which clinical decisions are made. Two philosophies of decision-making are summarised. Some insight into the history of the phenomenological and the rationalist theories of decision-making is offered. The author notes that it became evident that both of these theories are applicable to all nurses and their clinical decision making competencies. Four studies that were undertaken to analyse the decision-making methods of nurse practitioners are critiqued. Of the studies two are British, one is American and one is Australian. The author has summarised the combined findings that identified that the nurses were using a blend of decision-making processes that involved rational decision making as well as the use of intuition. The studies identified that sound clinical decision-making is determined by appropriate educational and clinical preparation and supported by a formal mentoring process and the use of critical reflective practice. In conclusion, the author reflects on her knowledge of decision making prior to embarking on the dissertation and states her intent to facilitate and support advanced decision-making by her colleagues. She goes on to say that uppermost is the need for an institutional and managerial environment that encourages advanced and independent decision-making by nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
681 |
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Author |
Clarke, R. |
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Title |
New graduate nurse experiences of using health assessment skills in practice: A descriptive qualitative study |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
New graduate nurses; Clinical assessment |
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Abstract |
Use of health assessment skills is undeniably part of everyday nursing practice, guiding nursing decisions and a part of facilitating patient outcomes. Undergraduate nursing education in New Zealand includes the use of health assessment skills within the context of nursing practice. The registered nurse working in their first year of practice is required to use effective assessment skills to identify potential risks to a patient's health, while learning to adjust to the many other demands of practice, but little research has explored these experiences. The purpose of this research study was to describe the experience of using health assessment skills within the first year of practice as a registered nurse. Using a qualitative descriptive method, informed by phenomenology, interviews were conducted with six newly graduated registered nurses working within a New Zealand setting. Findings of this study revealed that graduates endeavour to incorporate the skills of health assessment taught at undergraduate level into their practice. Six main themes of health assessment philosophy; tuning in; mobilising health assessment skills; recognition; anxiety; and identification and facilitation of outcomes can be aligned with Benner's (1984) model of skill acquisition. The author suggests that these research findings are useful to inform nursing education, clinical practice and further research. An awareness of these graduate experiences provides opportunities for nurses in both clinical practice and education to facilitate and support graduate nurses' of health assessment within their nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
682 |
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Author |
Martin, H.E. |
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Title |
Marking space: A literary psychogeography of the practice of a nurse artist |
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Year |
2006 |
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 |
Psychiatric Nursing; Mental health; Nurse-patient relations |
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Abstract |
The author suggests that the thesis as a production of disciplined work presented in a creative style is congruent with performance and presentation best practice in community arts. As a practising nurse artist the author describes creating spaces of alternate ordering within the mental health field environment. “I also inhabit the marginal space of the artist working in hospital environments. This Other Place neither condones nor denies the existence of the mental health field environment as it is revealed. Yet, it seeks to find an alternative to the power and subjectivity of the [social] control of people with an experience of mental illness that inhabit this place both voluntarily and involuntarily. I have used a variety of texts to explore the experience and concept of Otherness. The poems are intended to take you, as a reader where you could not perhaps emotionally and physically go, or might have never envisaged going. They also allow me as the author to more fully describe the Otherness of place that is neither the consumer story nor the nurse's notation, but somewhere alternately ordered to these two spaces. Drawing on the heuristic research approaches of Moustakas and literary psychogeography , particularly the work of Guy Debord, this thesis creates the space to explore the possibilities of resistance and change and the emergence of the identity of the nurse artist within the mental health field environment”. |
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Call Number |
NRSNZNO @ research @ |
Serial |
685 |
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Author |
Goulding, M.T. |
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Title |
The influence of work-related stress on nurses' smoking: A comparison of perceived stress levels in smokers and non-smokers in a sample of mental health nurses |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Smoking; Psychiatric Nursing; Stress; Mental health |
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Abstract |
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Call Number |
NRSNZNO @ research @ 701 |
Serial |
687 |
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Author |
Macfarlane, K. |
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Title |
Communicating changes in a patient's condition: A critical incident approach |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Communication; Clinical assessment; Physicians; Nursing; Relationships |
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Abstract |
This study explores how registered nurses working within the acute surgical ward environment of a New Zealand hospital communicate changes in a patient's condition. The purpose of this research study was to examine the processes, communication techniques and behaviours that nurses use, in order to determine the critical requirements for registered nurses to effectively communicate changes in patients' conditions to doctors. The critical incident technique developed by Flanagan (1954) was adapted and used to explore incidents that occurred when six registered nurses working in acute surgical wards communicated a change in a patient's condition to a doctor. Communication is an integral part of everyday activity. This study has shown an assessment process occurs before communication can take place. A nurse's concern for a patient's condition initiates the assessment process. A judgement is formed from the nurse's concern that a patient's condition has changed. Judgements take into account multiple ways of knowing including pattern recognition, empirical knowing and intuition. Institutional protocols also affect judgements and the ability of a nurse to ensure support is received for the patient's well being. The communication process is initiated for two reasons, to support the patient, and to support the nurse in providing care for the patient. Significant in determining the need for support is the action required that might be outside the nurse's scope of practice. The response should address the nurse's concern and take into account the importance of the relationship, trust between all parties, respect of each other's positions and knowing team members and their capabilities. Understanding these aspects of the communication process should enhance nurses and doctors abilities to effectively communicate regarding a change in a patient's condition. |
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Call Number |
NRSNZNO @ research @ |
Serial |
724 |
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Author |
Dal Din, A. |
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Title |
Accepting the challenge: Registered nurses' experiences of undertaking the statutory role of Responsible Clinician in New Zealand |
Type |
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Year |
2006 |
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 |
Mental health; Registered nurses; Nursing specialties; Scope of practice |
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Abstract |
This aim of this thesis was to explore and describe registered nurses' experiences of undertaking the statutory role of Responsible Clinician under the Mental Health (Compulsory Assessment and Treatment) Act 1992. The role of Responsible Clinician has been available to nurses since 1992 yet to date there has been little research into nurses' experiences of undertaking this role. An exploratory descriptive approach was therefore used in this study. A convenience sample of four nurses who had been undertaking the role of Responsible Clinician was recruited. Their experiences were elicited through in-depth interviews. Analysis of the interview material revealed the themes of legitimacy, relationships, expanding practice, responsibility and accountability, approaches to care, nurses' responsiveness to the role and support of the role. The author points to this research being important to nurses who are working in the psychiatric mental health area so that they can understand the role more fully. In this way, more nurses may choose to undertake the role of Responsible Clinician. |
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Call Number |
NRSNZNO @ research @ 745 |
Serial |
731 |
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