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Giddings, D. L. S. (2005). A theoretical model of social consciousness. Advances in Nursing Science, 28(3), 224–239.
Abstract: The article presents a theoretical model of social consciousness developed from nurses' life histories. A 3-position dialectical framework (acquired, awakened, and expanded social consciousness) makes visible the way people respond to social injustice in their lives and in the lives of others. The positions coexist, are not hierarchical, and are contextually situated. A person's location influences her or his availability for social action. Nurses who could most contribute to challenging social injustices that underpin health disparities are relegated to the margins of mainstream nursing by internal processes of discrimination. The author suggests that more inclusive definitions of “a nurse” would open up possibilities for social change.
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Gasquoine, S. E. (2005). Mothering a hospitalized child: It's the 'little things' that matter. coda, An Institutional Repository for the New Zealand ITP Sector, 9(3), 186–195.
Abstract: This article reports one aspect of a phenomenological study that described the lived experience of mothering a child hospitalised with acute illness or injury. The significance for mothers that nurses do the 'little things' emerged in considering the implications of this study's findings for nurses in practice. Seven mothers whose child had been hospitalised in the 12 months prior to the first interview agreed to share their stories. The resulting data were analysed and interpreted using van Manen's interpretation of phenomenology. This description of mothering in a context of crisis is useful in the potential contribution it makes to nurses' understanding of mothers' experience of the hospitalisation of their children. It supports the philosophy of family-centred care and highlights the ability of individual nurses to make a positive difference to a very stressful experience by acknowledging and doing 'little things', because it is the little things that matter to the mothers of children in hospital.
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Hughes, M., & Farrow, T. (2005). Invisible borders: Sexual misconduct in nursing. Nursing Praxis in New Zealand, 21(2), 15–25.
Abstract: This paper identifies the issue of sexual misconduct by nurses in New Zealand. There is evidence that some nurses have been involved in sexual misconduct, resulting in disciplinary proceedings against them. Despite this, there is an absence of guidelines and discussion for New Zealand nurses to prevent such occurrences. This article identifies difficulties in naming and defining sexual misconduct, and discusses sexual misconduct as an abuse of power by nurses. New Zealand and international literature about sexual misconduct by nurses and other health professionals is described, as are guidelines designed to prevent sexual misconduct. Finally, the authors make recommendations for actions needed to facilitate New Zealand nurses in identifying and avoiding sexual misconduct in practice.
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Lyford, S., & Cook, P. (2005). The Whanaungatanga model of care. Nursing Praxis in New Zealand, 21(2), 26–36.
Abstract: The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme.
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Roud, D., Giddings, D. L. S., & Koziol-McLain, J. (2005). A longitudinal survey of nurses' self-reported performance during an entry-to-practice programme. Nursing Praxis in New Zealand, 21(2), 37–46.
Abstract: The researchers conducted a study to compare self-reported changes in both frequency and quality of performance of nursing behaviours in a cohort of recently graduated nurses undertaking a one year entry to practice programme. Thirty-three nurses were surveyed, seven weeks after beginning the programme and again seven months later, using a modified version of Schwirian's (1978) Six-Dimension Scale of Nursing Performance (6-DSNP). Over the study period participants reported significant increases in frequency of performance for the domains of leadership, critical care, teaching/collaboration, and planning/evaluation. Significant increases in the quality of nurse behaviours in the domains of critical care, planning/evaluation and interpersonal relations/communication were also reported. The modified Schwirian 6-DSNP was found to be a useful instrument for measuring nurses' self reporting of performance during periods of transition.
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Fourie, W., McDonald, S., Connor, J., & Bartlett, S. (2005). The role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality. Available online from Coda: An institutional repository for the ITP sector, 14(2), 134–141.
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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Rydon, S. E. (2005). The attitudes, knowledge and skills needed in mental health nurses: The perspective of users of mental health services. International Journal of Mental Health Nursing, 14(2), 78–87.
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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McKinney, C., Cassels-Brown, K., Marston, A., & Spence, D. (2005). Linking cultural safety to practice: Issues for student nurses and their teachers. Vision: A Journal of Nursing, (13(1)).
Abstract: Student nurses rely on their teachers, both academic and clinical, to assist them to develop their capacity to practice safely. Yet, in relation to cultural safety, relatively little has been written to assist the integration of theoretical knowledge to the world of practice. This article presents the findings of a small project undertaken by lecturers whose experiences supporting students' learning during clinical placements in Auckland stimulated interest in the students' attempts to use their classroom learning to begin their journey towards culturally safe nursing practice. A qualitative descriptive approach was used to explore the experience of nursing clients from cultures other than one's own and to describe culturally safe practice from the perspective of third year students.
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Kiata, L., Kerse, N., & Dixon, R. (2005). Residential care workers and residents: The New Zealand story. Access is free to articles older than 6 months, and abstracts., 118(1214).
Abstract: The aim of this study was to describe the nature and size of long-term residential care homes in New Zealand; funding of facilities; and the ethnic and gender composition of residents and residential care workers nationwide. A postal, fax, and email survey of all long-term residential care homes in New Zealand was undertaken, with completed surveys received from an eligible 845 facilities (response rate: 55%). The majority of these (54%) facilities housed less than 30 residents. Of the 438 (94%) facilities completing the questions about residents' ethnicity, 432 (99%) housed residents from New Zealand European (Pakeha) descent, 156 (33%) housed at least 1 Maori resident, 71 (15%) at least 1 Pacific (Islands) resident, and 61 (13%) housed at least 1 Asian resident. Facilities employed a range of ethnically diverse staff, with 66% reporting Maori staff. Less than half of all facilities employed Pacific staff (43%) and Asian staff (33%). Registered nursing staff were mainly between 46 and 60 years (47%), and healthcare assistant staff were mostly between 25 and 45 years old (52%). Wide regional variation in the ethnic make up of staff was reported. About half of all staff were reported to have moved within the previous 2 years. The authors conclude that the age and turnover of the residential care workforce suggests the industry continues to be under threat from staffing shortages. While few ethnic minority residents live in long-term care facilities, staff come from diverse backgrounds, especially in certain regions.
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King, A., & Parsons, M. (2005). An evaluation of two respite models for older people and their informal caregivers. Access is free to articles older than 6 months, and abstracts., 118(1214).
Abstract: The researchers evaluate two case-management models of respite relief care at Waitemata District Health Board. The evaluation consisted of semi-structured interviews and postal surveys for clients utilising respite care and staff members involved in both the North/West and Rodney models of respite care in Auckland. Across the two regions, a total of 2 older people and their informal caregivers, 2 respite coordinators, and the Needs Assessment Service Coordination (NASC) Manager were interviewed. In addition, postal surveys were received from 21 older people, 36 informal caregivers, 11 NASC workers, and 3 allied health professionals. Findings revealed there was generally high satisfaction with both the respite models. Caregivers believed the respite service did give them a break, although it was insufficient. Caregivers reported concerns regarding how respite facilities could improve and the older person's deterioration post respite. Staff identified improvements for each of the models.
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McCloskey, B. A., & Diers, D. (2005). Effects of New Zealand's health reengineering on nursing and patient outcomes. Medical Care, 43(11), 1140–1146.
Abstract: This study sought to examine the effects that hospital re-engineering may have on adverse patient outcomes and the nursing workforce. In 1993, New Zealand implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. All medical and surgical discharges from New Zealand's public hospitals (n=3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n=65,221 nurse responses) from 1993 through 2000 were examined. Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. The authors conclude that in the chaotic environment created by re-engineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organisational change plays in patient outcomes, the unintended consequences of health care re-engineering and market approaches in health care, and nursing's unique contribution to quality of care.
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Wilson, D., McBride-Henry, K., & Huntington, A. D. (2005). Family violence: Walking the tight rope between maternal alienation and child safety. Contemporary Nurse, 18(1-2), 85–96.
Abstract: This paper discusses the complexity of family violence for nurses negotiating the 'tight rope' between the prime concern for the safety of children and further contributing to maternal alienation, within a New Zealand context. The premise that restoration of the mother-child relationship is paramount for the long-term wellbeing of both the children and the mother provides the basis for discussing implications for nursing practice. Evidence shows that when mothers are supported and have the necessary resources there is a reduction in the violence and abuse she and her children experience; this occurs even in situations where the mother is the primary abuser of her children. The family-centred care philosophy, which is widely accepted as the best approach to nursing care for children and their families, creates tension for nurses caring for children who are the victims of abuse as this care generally occurs away from the context of the family.
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Phillips, B. N. (2005). A survey of mental health nurses' opinion of barriers and supports for research. Nursing Praxis in New Zealand, 21(1), 24–32.
Abstract: This paper reports the findings of a preliminary survey of two district health boards, which shows that high workloads and lack of relief staffing appear as the greatest hurdles to mental health nurses participating in practice-based nursing research. A further constraint on their participation is lack of research expertise and experience. Consultative discussions with senior mental health nurses support these conclusions. In this paper, mentoring and flexible research designs are promoted as possible ways of overcoming these barriers.
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North, N., Rasmussen, E., Hughes, F., & Finlayson, M. (2005). Turnover amongst nurses in New Zealand's district health boards: A national survey of nursing turnover and turnover costs. New Zealand Journal of Employment Relations, 30(1), 49–62.
Abstract: This article reports on the New Zealand part of an international study, using agreed study design and instruments, to determine the direct and indirect costs of nursing turnover. These costs also include the systemic costs, estimated by determining the impacts of turnover on patient and nurse outcomes. It presents the findings from the pilot study conducted in six countries to test the availability of costs and suitability of the instrument. Reports the results from a survey of directors of nursing in 20 of the 21 district health boards on turnover and workplace practices.
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Richardson, S. (2005). Incorporation of research into clinical practice: The development of a clinical nurse researcher position. Nursing Praxis in New Zealand, 21(1), 33–42.
Abstract: The author backgrounds the development of the role of an innovative Nurse Researcher (Emergency Medicine) role at Christchurch Hospital. She describes the emergency department and the factors leading to the creation of the role. Specific nursing research projects are reviewed, and the nature of nursing in relation to research is discussed. The author argues that the nurse researcher is integral to the expansion of evidence-based nursing, and that the role of Clinical Nurse Researcher in the emergency department has resulted in a higher profile for research, and the gradual integration of research as a clinical skill with direct practical relevance.
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