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Smith, M. C. (2008). Reviewing the role of a mental health nurse practitioner. Kai Tiaki: Nursing New Zealand, 14(3), 20–22.
Abstract: The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role.
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Wilson, M. (2001). Organisational psychopaths and our health culture. Kai Tiaki: Nursing New Zealand, 7(3), 27–29.
Abstract: The author discusses recent research on organisational psychopaths, and suggests it offers an explanation for the state of the health system since managerialism was ushered in through health reforms. She identifies personality traits of organisational psychopaths and of aberrant self-promoters. The author gives her experience of changes to the structure of nursing at a North Island metropolitan public hospital over an 8-year period.
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O'Brien, A. J., & Kar, A. (2006). The role of second health professionals under New Zealand mental health legislation. Journal of Psychiatric & Mental Health Nursing, 13(3), 356–363.
Abstract: The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for the second health professional role is suggested as a way of supporting clinical practice in this area.
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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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Wilson, D. (2003). The nurse's role in improving indigenous health. Contemporary Nurse, 15(3), 232–240.
Abstract: The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people is discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups.
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Bishop, D., & Ford-Bruins, I. (2003). Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study. International Journal of Mental Health Nursing, 12(3), 203–212.
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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Kirkham, S., Smye, V., Tang, S., Anderson, J., Blue, C., Browne, A., et al. (2002). Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research. Research in Nursing & Health, 25(3), 222–232.
Abstract: The authors trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalisation and help-seeking experiences of diverse ethnocultural populations.
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Rameka, M. (2001). Perioperative nursing practice & cultural safety. Dissector, 29(3), 21–23.
Abstract: This article is from a conference paper presented to the 12th World Conference on Surgical Patient Care. It presents cultural safety, as differentiated from transcultural nursing, and investigates how it relates to perioperative nursing. Examples are presented of how nurses can adhere to medical requirements, and address the cultural needs of Maori patients.
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Banks, J., McArthur, J., & Gordon, G. (2000). Flexible monitoring in the management of patient care process: A pilot study. Lippincott's Case Management, 5(3), 94–106.
Abstract: This article describes a study conducted on the internal medicine, general surgical, and vascular wards of a large metropolitan hospital to assess the impact of a networked monitoring system and portable patient monitors. This pilot study was developed to address the needs of hospital patients who require continuous non-invasive vital signs monitoring (including heart rate, non-invasive blood pressure, pulse oximetry, cardiac waveform monitoring) with the addition of surveillance from a cardiac intensive care area. Data were collected from 114 patients over a three-month period to identify a patient group that could be managed appropriately under the new system and to determine the effect that flexible monitoring had on patient care management. Findings include identification of a specific patient group that can be managed successfully outside the cardiac intensive care area using this system. Other findings suggest a way to improve the management of patient monitoring in the general ward areas.
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Richardson, S. (1999). Increasing patient numbers: The implications for New Zealand emergency departments. Accident & Emergency Nursing, 7(3), 158–163.
Abstract: This article examines influences that impact on the work of the Emergency Departments (EDs). EDs are noticing increased attendance of patients with minor or non-urgent conditions. This increase in patient volume, together with on-going fiscal constraints and restructuring, has placed an added strain on the functioning of EDs. New Zealand nurses need to question the role currently given to EDs and identify the issues surrounding the increased use of these departments for primary health care.
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Walsh, K. (2004). Change and development of nusing practice: The challenges for the new century. Emergency Nurse New Zealand, 3(3), 10–13.
Abstract: In light of the current challenges facing the nursing workforce, the author proposes a way forward to capture and utilise the challenges to bring about positive change.
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Chenery, K. (2004). Family-centred care: Understanding our past (Vol. 20).
Abstract: Oral history accounts of the care of the hospitalised child in the context of family are used to argue that current practice paradoxes in family-centred care are historically ingrained. The article looks at the post-war period, the intervening years, and current practice, centred on the changing concept of motherhood throughout that time. The conflict between clinical expediency versus family and child needs is explored.
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Wilson, H. V. (2003). Paradoxical pursuits in child health nursing practice: Discourses of scientific mothercraft. Critical Public Health, 13(3), 281–293.
Abstract: The purpose of this paper is to examine the discourses of scientific mothercraft and their implications for the nurse-mother relationship, drawing on the author's recent research into surveillance and the exercise of power in the child health nursing context. The application of Foucauldian discourse analysis to the texts generated by interviews with five New Zealand child health nurses confirms that this paradoxical role has never been fully resolved. Plunket nurses primarily work in the community with the parents of new babies and preschool children. Their work, child health surveillance, is considered to involve routine and unproblematic practices generally carried out in the context of a relationship between the nurse and the mother. However, there are suggestions in the literature that historically the nurse's surveillance role has conflicting objectives, as she is at the same time an inspector and family friend.
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Jonsdottir, H., Litchfield, M., & Pharris, M. (). The relational core of nursing practice as partnership. Journal of Advanced Nursing, 47(3), 241–250.
Abstract: This article elaborates the meaning of partnership in practice for nurses practising in different and complementary way to nurses in specialist roles and medical practitioners. It positions partnership as the relational core of nursing practice. Partnership is presented as an evolving dialogue between nurse and patient, which is characterised by open, caring, mutually responsive and non-directive approaches. This partnership occurs within a health system that is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. It is the second of a series of articles written as a partnership between nurse scholars from Iceland, NZ and USA.
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Litchfield, M. (1998). The scope of advancing nursing practice. Nursing Praxis in New Zealand, 13(3), 13–24.
Abstract: An overview of the model of nursing practice and nurse roles derived through a programme of nursing research in the context of the changing New Zealand health system. The emphasis is on the complementary nature of the practice of family nurses taking a generic integrative service delivery hub role and the practice of other nurses advancing in specialist roles. Nursing care is presented as a professional, collective practice of registered nurses spread across all health service sectors and employment settings. Nurse roles are differentiated according to the interplay of two factors influencing the extent of practice autonomy the nurses assume (educationally supported) in responding to health need. A diagram depicts the interrelationship of competency and scope for the inclusive three different career trajectories of nurses advancing in practice. NOTE: This paper was published with an error in the title of the article (stated correctly on the journal contents page). An apology from the journal editor with an explanation of the importance of the use of the term ?advancing? and not ?advanced? was published in the subsequent issue (Nursing Praxis in NZ,14(1)).
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