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Spence, D., & Smythe, E. (2007). Courage as integral to advancing nursing practice. Nursing Praxis in New Zealand, 23(2), 43–55.
Abstract: This paper focuses on the illumination of courage in nursing. The authors suggest it is a fundamental component of nursing, yet it is seldom mentioned or recognised in the literature, or supported in practice. Data from a hermeneutic analysis of nurses' practice stories is integrated with literature to assist deeper understanding of the meaning of courage in contemporary nursing practice. The purpose is to make visible a phenomenon that needs to be actively fostered if nursing is to effectively contribute to an improved health service.
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Spence, D., & Anderson, M. (2007). Implementing a prescribing practicum within a Master's degree in advanced nursing practice. Nursing Praxis in New Zealand, 23(2), 27–42.
Abstract: This article reports the implementation of a collaborative project undertaken to monitor and improve the effectiveness of the prescribing practicum papers delivered within two Master's degree programmes in advanced nursing practice. The recent introduction of Nurse Practitioner registration in New Zealand has resulted in the development of a number of Master's degree programmes in which students can complete a Nursing Council of New Zealand approved programme for prescribing. For the study, a developmental action research approach was used. Data were collected through interviews with practicum students, their medical supervisors and academic staff. Formative findings were progressively used to refine delivery of the practicum papers and a thematic analysis of summative findings identified areas for further improvement. The findings suggest that the processes being implemented are developing well. The researchers recommend that further education is required to clearly differentiate medical and advanced nursing roles. They recommend that greater attention needs to be paid to the preparation of medical supervisors and, most significantly, revision of funding is required to more equitably support the ongoing development of nurses for advanced practice roles.
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Carryer, J. B., & Russell, L. (2007). Nurses' understandings of the Professional Development Recognition Programme. Nursing Praxis in New Zealand, 23(2), 5–13.
Abstract: Professional Development and Recognition Programmes (PDRP) for nurses have developed out of the Clinical Career Pathways (CCP) of the 1990s. The Health Practitioners Competence Assurance Act (2003) has now required all health professionals to provide evidence that their practice meets criteria set by the individual regulatory body, which, for nursing, is the Nursing Council of New Zealand. In 2002 a tool was developed to measure knowledge and attitudes of the then CCP which was tested with 239 nurses. This paper is a report on the second application of the tool in the same hospital in New Zealand. Results show that knowledge and attitudes of the PDRP are similar to those found in the previous study. It also suggests that greater understanding of the PDRP and the implementation process increases the likelihood of a positive response to the programme.
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Lesa, R., & Dixon, D. A. (2007). Physical assessment: Implications for nurse educators and nursing practice. International Nursing Review, 54(2), 166–172.
Abstract: In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing.
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O'Shea, M., & Reddy, L. (2007). Action change in New Zealand mental health nursing: One team's perspective. Practice Development in Health Care, 6(2), 137–142.
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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Polaschek, L., & Polaschek, N. (2007). Solution-focused conversations: A new therapeutic strategy in Well Child health nursing telephone consultations. Journal of Advanced Nursing, 59(2), 111–119.
Abstract: This paper reports a study to explore Well Child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of Well Child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognise the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of Well Child telenurses.
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Lawless, J., & Moss, C. (2007). Exploring the value of dignity in the work-life of nurses. Contemporary Nurse, 23(2), 225–236.
Abstract: In this paper the authors draw attention to the value and understandings of nurse dignity in the work-life of nurses. A review of nursing literature and a theoretical lens on worker dignity derived from recent work by Hodson (2001) was used to explore these questions. In the context of current and international workforce issues associated with recruitment and retention, analysis of the construct of worker dignity within the profession takes on a strong imperative. Findings of this inquiry reveal that while there is a degree of coherence between the nursing research and elements of Hodson's (2001) research on worker dignity, the dignity of nurses, as a specific construct and as an intrinsic human and worker right has received little explicit attention. Reasons for this may lie partly in approaches that privilege patient dignity over nurse dignity and which rely on the altruism and self-sacrifice of nurses to sustain patient care in environments dominated by cost-control agendas. The value of dignity in the work-life of nurses has been under-explored and there is a critical need for further theoretical work and research. This agenda goes beyond acceptance of dignity in the workplace as a human right towards the recognition that worker dignity may be a critical factor in sustaining development of healthy workplaces and healthy workforces. Directing explicit attention to nurse dignity may benefit the attainment of both nurse and organisational goals. Hodson's (2001) framework offers a new perspective on dignity in the workplace.
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Kennedy, W. (2007). Professional supervision to enhance nursing practice. Available online from Eastern Institute of Technology, 14(2), 3–6.
Abstract: This article examines the concept of clinical supervision as “professional supervision”. Professional supervision contains many elements, is structured and not without effort. Fundamentally it is about being safe and professional. 'Reflective learning' and 'Live/tutorial' models are reviewed in different contexts for assisting nurses work through everyday issues, conflicts and problems of their role. The author concludes that regardless of which model is used there are benefits for safety and professionalism.
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Vernon, R. A., Jacobs, S., & Papps, E. (2007). An innovative initiative for advanced nursing practice roles. Available online from Eastern Institute of Technology, 14(2), 16–17.
Abstract: This paper reports an initiative which is an example of partnership between education and health organisations resulting in the implementation of a jointly funded advanced nursing practice role. The model is for community based Nurse Practitioner-managed health care for primary health and disease management. The key partners in this project are the Eastern Institute of Technology, Hawke's Bay District Health Board, and a Primary Health Organisation (Tu Meke – First Choice). This article summarises the objectives, implementation, evaluation and benefits of the programme.
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Truscott, J. M., Townsend, J. M., & Arnold, E. P. (2007). A successful nurse-led model in the elective orthopaedic admissions process. NZ Medical Association website. Access free to articles older than 6 months., 120(1265).
Abstract: This paper documents a successful nurse-led admissions process for same day orthopaedic surgery, on relatively fit patients under 70 years of age. During the 6-month study, 31 patients with a median age of 38 years were categorised into 3 streams. 252 patients (76%) underwent a nursing-admission process without the need for further consultation with a junior medical officer or an anaesthetist. The remaining patients not included in the study were admitted and clerked by a house officer. No safety issues arose and the surgeons and anaesthetists were satisfied with the process. The junior medical officers described improved job satisfaction by being able to attend theatre, other educational opportunities, and working more closely with the consultant. The process has now been incorporated into elective orthopaedic admissions at Burwood Hospital.
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Carryer, J. B., Gardner, G., Dunn, S., & Gardner, A. (2007). The core role of the nurse practitioner: Practice, professionalism and clinical leadership. Journal of Clinical Nursing, 16(10), 1818–1825.
Abstract: This article draws on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. A study jointly commissioned by both countries' Regulatory Boards developed information of the newly created nurse practitioner role, to develop shared competency and educational standards. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner programme curricula and interviews with 15 nurse practitioners from the two countries. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care.
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Surtees, R. (2007). Developing a therapeutic alliance in an eating disorders unit. Kai Tiaki: Nursing New Zealand, 13(10), 14–16.
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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Barber, M. (2007). Exploring the complex nature of rural nursing. Kai Tiaki: Nursing New Zealand, 13(10), 22–23.
Abstract: This article reports the results of a research study undertaken to examine how nurses manage their professional and personal selves while working in small rural communities. The participants were a small group of rural nurses on the West Coast. The rationale for the study was the long-term sustainability and viability of the service to this remote area. The research showed that the rural nurse specialists' role is a complex and challenging one, performed within the communities in which nurses live.
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Finlayson, M., & Aitken, L. H. (2007). New Zealand nurses' reports on hospital care: An international comparison. Nursing Praxis in New Zealand, 23(1), 17–28.
Abstract: The authors present the results of a 2001 New Zealand survey on nurses' perception of staffing, work organisation and outcomes, comparing this with the 2001 International Hospital Outcomes Study (US, Canada, England, Scotland and Germany). The report describes the findings for job dissatisfaction, burnout and the intent to leave, the work climate in hospitals, workforce management, the structure of nurses' work, and quality of care. The authors discuss these findings and their implications for nursing in New Zealand.
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Rodgers, V., & Neville, S. J. (2007). Personal autonomy for older people living in residential care: An overview. Nursing Praxis in New Zealand, 23(1), 29–36.
Abstract: This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how individual autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted.
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