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Author |
Bishop, D.; Ford-Bruins, I. |
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Title |
Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue  |
3 |
Pages |
203-212 |
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Keywords |
Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models |
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Abstract |
This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed. |
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Call Number |
NRSNZNO @ research @ 1082 |
Serial |
1067 |
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Author |
Muir-Cochrane, E.; Holmes, C.; Walton, J.A. |
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Title |
Law and policy in relation to the use of seclusion in psychiatric hospitals in Australia and New Zealand |
Type |
Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
13 |
Issue |
2/3 |
Pages |
136-145 |
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Keywords |
Psychiatric Nursing; Law and legislation; Policy; Patient rights; Cross-cultural comparison |
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Abstract |
This paper discusses legal issues associated with the seclusion of acutely disturbed patients in psychiatric hospitals in Australia and New Zealand. There continues to be great variation in opinion and operational definition as to whether seclusion is a medical treatment, nursing intervention and management tool, or merely a form of situational restraint. Reflecting this lack of clarity, mental health acts and policies concerning the regulation and practice of seclusion lack consistency and focus across geographical boundaries and jurisdictions. Australian and New Zealand legislation and institutional policy is discussed in order to shed light on the contemporary issues highlighted by this controversial nursing practice. The authors note that mental health professionals must continue to review the practice of seclusion and to actively promote the use of acceptable alternatives. In addition nurses and other mental health professionals have a responsibility to understand current legislation and policy frameworks and to influence change where this is necessary to ensure the best practice possible in their clinical area. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1074 |
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Author |
Walsh, K.; McAllister, M.; Morgan, A.; Thornhill, J. |
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Title |
Motivating change: Using motivational interviewing in practice development |
Type |
Journal Article |
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Year |
2004 |
Publication |
Practice Development in Health Care |
Abbreviated Journal |
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Volume |
3 |
Issue |
2 |
Pages |
92-100 |
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Keywords |
Psychiatric Nursing; Hospitals; Motivation; Older people |
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Abstract |
The present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self-efficacy and managing resistance to change. |
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Call Number |
NRSNZNO @ research @ |
Serial |
718 |
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Author |
Fourie, W.; McDonald, S.; Connor, J.; Bartlett, S. |
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Title |
The role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality |
Type |
Journal Article |
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Year |
2005 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
Available online from Coda: An institutional repository for the ITP sector |
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Volume |
14 |
Issue |
2 |
Pages |
134-141 |
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Keywords |
Psychiatric Nursing; Nurse-patient relations; Organisational change |
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Abstract |
This study compared the perceptions that registered psychiatric nurses have of their roles with their actual practice. Following the closure of large scale psychiatric institutions in New Zealand, there was was an increased demand for limited beds in acute inpatient facilities for acutely mentally ill patients. This change in location and downsizing of acute inpatient beds challenged traditional roles of mental health nursing, resulting in confusion over what roles mental health nurses should now perform in the new context of care. This qualitative descriptive exploratory study observed nursing practice on three selected wards and used focus group interviews to establish from registered nurses what they perceived their roles to be. A key finding of this study was that many of the nursing roles related to delivering care from a crisis management perspective, which covers aspects such as assessment, stabilisation of symptoms and discharge planning. Participants also believed that the therapeutic relationship was a fundamental role in inpatient care. Nurses used any opportunity to make it a reality such as kitchen organisation, medications, or dealing with a challenging patient. This study highlighted the complexity of the roles that nurses performed and went some way to give voice to what at times seems an invisible practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
875 |
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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 |
Type |
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 |
Rydon, S.E. |
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Title |
The attitudes, knowledge and skills needed in mental health nurses: The perspective of users of mental health services |
Type |
Journal Article |
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Year |
2005 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
78-87 |
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Keywords |
Patient satisfaction; Psychiatric Nursing; Attitude of health personnel |
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Abstract |
In this study a qualitative descriptive methodology with focus group interviews was used to explore with users of mental health services, the attitudes, knowledge and skills that they need in mental health nurses. Users of mental health services valued the therapeutic work of mental health nurses, and identified positive attitudes towards users of mental health services as essential in mental health nurses. However, they did not consistently experience a therapeutic approach in their interactions with mental health nurses. In a sociopolitical climate where the views of users of mental health services are increasingly incorporated into education and the planning and delivery of services, there is a need for more research that reflects the perspective of users. |
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Call Number |
NRSNZNO @ research @ 961 |
Serial |
945 |
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Author |
McKenna, B. |
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Title |
Bridging the theory-practice gap |
Type |
Journal Article |
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Year |
1999 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
5 |
Issue |
2 |
Pages |
14-16 |
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Keywords |
Psychiatric nursing; Nursing; Education; Teaching methods |
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Abstract |
The author presents a case study of a joint appointment between a nurse lecturer and a staff nurse in an acute forensic psychiatry unit. He explores the advantages, disadvantages and reasons for success in relation to the findings of a survey of the literature on joint appointments. This technique is seen as a means of narrowing the gap between theory and practice which resulted when nurse training was transferred from hospitals to polytechnics. He highlights the need to develop research methodology to clarify potential benefits of this approach. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1024 |
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Author |
McKenna, B.; O'Brien, A.J.; Dal Din, T.; Thom, K. |
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Title |
Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992 |
Type |
Journal Article |
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Year |
2006 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
15 |
Issue |
2 |
Pages |
128-134 |
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Keywords |
Advanced nursing practice; Psychiatric Nursing; Law and legislation |
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Abstract |
The objectives of this research were to determine how many registered nurses are working as 'responsible clinicians', under what phases of the legislation they are functioning, and to describe the enabling processes and barriers to nurses undertaking this statutory role. An anonymous descriptive survey was distributed to the 11 nurses who were currently responsible clinicians as well as five senior nurses selected from each of the 21 district health boards and the Auckland Regional Forensic Psychiatry Services (n=121). The response rate was 88.4% (n=107). The survey questioned respondents on statutory roles currently undertaken. Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain it. They were also asked which competencies of the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. Of the approximately 395 responsible clinicians nationally, 11 (2.8%) are nurses. Most nurses viewed the role as legitimate. However, many were unaware of competencies for the role and credentialing processes, and were somewhat ambivalent about achieving the role due to current workload, role conflict and lack of remuneration. Competency deficits were highlighted. The authors conclude that there are grounds to encourage nurses as responsible clinicians given the intent of the legislation. This will require the promulgation of appropriate mental health policy, and a concerted effort by major stakeholders in mental health service delivery. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1044 |
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Author |
O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J. |
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Title |
Clinical indicators as measures of mental health nursing standards of practice in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
2 |
Pages |
778-788 |
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Keywords |
Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth |
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Abstract |
This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1059 |
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Author |
Crowe, M. |
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Title |
Reflexivity and detachment: A discursive approach to women's depression |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
9 |
Issue |
2 |
Pages |
126-132 |
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Keywords |
Gender; Mental health; Psychiatric Nursing; Culture |
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Abstract |
This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1077 |
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Author |
O'Brien, A.J. |
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Title |
The therapeutic relationship: Historical development and contemporary significance |
Type |
Journal Article |
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Year |
2001 |
Publication |
Journal of Psychiatric & Mental Health Nursing |
Abbreviated Journal |
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Volume |
8 |
Issue |
2 |
Pages |
129-137 |
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Keywords |
Psychiatric Nursing; Nursing models; History of nursing; Nurse-patient relations |
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Abstract |
This article examines the therapeutic relationship, a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realised in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualisations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1088 |
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Author |
McKenna, B.; O'Brien, A.J.; Dal Din, A.; Them, K. |
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Title |
Responsible clinician role offers opportunities for nurses |
Type |
Journal Article |
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Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
11 |
Pages |
12-14 |
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Keywords |
Psychiatric Nursing; Advanced nursing practice; Law and legislation; Mental health |
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Abstract |
The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
992 |
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Author |
Surtees, R. |
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Title |
Developing a therapeutic alliance in an eating disorders unit |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
10 |
Pages |
14-16 |
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Keywords |
Nursing specialties; Multidisciplinary care teams; Psychiatric Nursing; Nurse-patient relations; Anorexia nervosa |
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Abstract |
The author presents the approach of a nursing team at Christchurch's Princess Margaret Hospital, in the regional specialist service for people with anorexia nervosa. This unit provides the only specialist inpatient unit in the country, consisting of a six or seven-bed facility that shares a unit with a mother and baby unit. A multidisciplinary team of psychiatric nurses, dietitians, occupational therapists, psychiatrists, psychologists and social workers all make significant contributions. The Christchurch unit uses a cognitive-behavioural therapy model (CBT) across the disciplines, a multidimensional approach incorporating psychotherapeutic, psychoeducational, biomedical and behaviourist paradigms. This occurs within a “lenient flexible approach”. Within the Unit, the eight nurses constitute what could be seen as an “intra”-disciplinary team within the wider “inter”-disciplinary or MDT team. They apply an evidence-based nursing approach with a commitment to partnership and advocacy with their patients. They use collaborative techniques for defining shared goals, and the careful management of the introduction of food. As one of the team members, the author envisages that the job of specialised nurses is to form a therapeutic alliance with patients, which takes account of the dynamic ways that patients may negotiate their own complex understandings of health, care, and recovery. |
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Call Number |
NRSNZNO @ research @ |
Serial |
982 |
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Author |
McKenna, B. |
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Title |
Risk assessment of violence to others: Time for action |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
18 |
Issue |
1 |
Pages |
36-43 |
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Keywords |
Mental health; Workplace violence; Risk management; Nursing; Nurse-patient relations; Psychiatric nursing |
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Abstract |
The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings. |
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Call Number |
NRSNZNO @ research @ |
Serial |
621 |
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Author |
McKenna, B.; Poole, S.; Smith, N.A.; Coverdale, J.; Gale, C. |
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Title |
A survey of threats and violent behaviour by patients against registered nurses in their first year of practice |
Type |
Miscellaneous |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
56-63 |
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Keywords |
New graduate nurses; Workplace violence; Occupational health and safety; Training; Mental health; Psychiatric nursing |
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Abstract |
For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes. |
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Call Number |
NRSNZNO @ research @ |
Serial |
649 |
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