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Gallagher, P. (2007). Preconceptions and learning to be a nurse. Nurse Education Today, 27(8), 878–884.
Abstract: This article discusses the important role that preconceptions play in the process by which students learn to be nurses. The importance of preconceptions emerged from the analysis of data in a grounded theory study that sought to gain a greater understanding of how undergraduate student nurses in New Zealand experienced and responded to differences they perceived between the theory and the practice of nursing. It became clear that the preconceptions each student nurse held about the nature of nurses and nursing care were the standards against which the worth of the formal, practical and personal theories to which students were exposed during their nursing degree was evaluated. It was clear that preconceptions functioned as the mediator between the intentions of nursing education and the learning that eventuated for each student from practicum experiences. The implications for nursing education, for which preconceptions are not generally highly valued as a basis for learning about professional nursing, are that the individual experience and personal characteristics of each student receive significant focus when a nursing programme is planned. This means that the orthodox principles that underpin the design of nursing curricula should be reviewed and an overtly constructivist perspective adopted for nursing education for which the prior experiences of the student are the starting point.
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Hughes, F. (2006). Reconnecting with policy: Requirements for survival as a mental health nurse. Journal of Psychosocial Nursing & Mental Health Services, 44(8), 30–39.
Abstract: This article discusses the disconnection between mental health nurses and policy, and the importance of reconnecting such relationships. It is suggested this will benefit consumers, provide influence in health care policies and, ultimately, contribute to strategies to improve the health of our nation. In this article, the author draws on her own experiences and applies these to a discussion of how mental health nurses can influence and strengthen their relationships with nursing policy.
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Egan, M. (1999). The nursing and midwifery practice structure at Healthcare Hawkes Bay: An evaluation and improvement process. Vision: A Journal of Nursing, 5(8), 27–29.
Abstract: This article describes the Nursing and Midwifery Practice Structure, which has been in place at Healthcare Hawkes Bay since 1996. It was developed to provide nurses and midwives in clinical positions with a professional development structure, and uses a framework to recognise and reward competence. It encourages clinical progression and was developed to link nursing competence with remuneration. The Practice Structure, based on the work of Patricia Benner (Benner, 1984), is made up of 4 levels: Beginner/Advance Beginner Practitioner, Competent Practitioner, Proficient Practitioner, Expert Practitioner. The Structure was reviewed in 1998, and a Steering Group was formed to collect feedback from nurses and midwives, identify areas of concern, and make recommendations for improvements. At the time of writing, these recommendations are being implemented and systems are being developed to ensure the Nursing and Midwifery Practice Structure continues to develop.
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O'Brien, A. P., O'Brien, A. J., Hardy, D. J., Morrison-Ngatai, E., Gaskin, C. J., Boddy, J. M., et al. (2003). The New Zealand development and trial of mental health nursing clinical indicators: A bicultural study. International Journal of Nursing Studies, 40(8), 853–861.
Abstract: This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5-89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.
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Rose, L., Nelson, S., Johnston, L., & Presneill, J. J. (2008). Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units. Journal of Clinical Nursing, 17(8), 1035–1043.
Abstract: The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU.
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Chang, E. M., Bidewell, J. W., Huntington, A. D., Daly, J., Johnson, A., Wilson, H., et al. (2008). A survey of role stress, coping and health in Australian and New Zealand hospital nurses. Intensive & Critical Care Nursing, 44(8), 1354–1362.
Abstract: The aim of this study was to examine and compare Australian and New Zealand nurses' experience of workplace stress, coping strategies and health status. A postal survey was administered to 328 New South Wales (Australia) and 190 New Zealand volunteer acute care hospital nurses (response rate 41%) from randomly sampled nurses. The survey consisted of a demographic questionnaire, the Nursing Stress Scale, the WAYS of Coping Questionnaire and the SF-36 Health Survey Version 2. More frequent workplace stress predicted lower physical and mental health. Problem-focused coping was associated with better mental health. Emotion-focused coping was associated with reduced mental health. Coping styles did not predict physical health. New South Wales and New Zealand scored effectively the same on sources of workplace stress, stress coping methods, and physical and mental health when controlling for relevant variables. Results suggest mental health benefits for nurses who use problem-solving to cope with stress by addressing the external source of the stress, rather than emotion-focused coping in which nurses try to control or manage their internal response to stress. Cultural similarities and similar hospital environments could account for equivalent findings for New South Wales and New Zealand.
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Crowe, M., O'Malley, J., & Bigwood, S. (2002). Nursing mental health consumers in the community. Kai Tiaki: Nursing New Zealand, 8(8), 14–15.
Abstract: The purpose of this research was to describe the characteristics of community mental health nursing care in the community. Twenty six nurses were enrolled in a study consisting of semi-structured interviews about the nature of their care. Responses were analysed to identify categories of skills. These were characterised as: establishing connectedness; promoting individual and family resilience, promoting citizenship; and addressing structural issues. Responses from the nurses are used to illustrate these categories.
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French, P. (2001). Nursing registration: A time to celebrate? Kai Tiaki: Nursing New Zealand, 7(8), 17–19.
Abstract: This article examines the knowledge and power relationships between the medical profession and nurses during the first half of the twentieth century. It argues that the 1901 Nurses' Registration Act allowed doctors to exert control over the nursing profession and that the hierarchal structure of the profession contributes to the culture of control and surveillance.
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Lewer, D. (1999). Analysing the Mental Health Act. Kai Tiaki: Nursing New Zealand, 5(8), 14–16.
Abstract: Changes brought by the Mental Health Act (MHA) to clinical practice, and some of the problems it has created for nurses, are examined in this article. Compulsory assessment and treatment orders (CATO) and the role of Duly Authorised Officers (DAO), and moral dilemmas that can arise as a consequence of CATOs used by DAOs are examined. The requirement for DAOs to act as patient advocates and to safeguard cultural beliefs are highlighted. The MHA promotes self responsibility and a treatment philosophy rather than detention of the mentally ill.
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Falleni, P. M. (2004). Whakaata ikei runga manaaki: Reflection on caring. International Journal of Palliative Nursing, 10(8), 390–392.
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Dredge, A. (1999). An insider's view of professional nursing and care management of the critically ill patient. Vision: A Journal of Nursing, 5(8), 13–16.
Abstract: This article explores the role of the registered nurse (RN) in the critical care environment. It presents the Intensive Care Unit (ICU) as a unique environment, with a specific relationship to technology, and a history that mirrors scientific development. It explores the tensions for a caring profession with a distinct culture practising in a highly medicalised, acute environment, and affirms the value of quality human care.
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Bee, S. (1999). Post traumatic stress disorder: The role of critical incident stress management. Vision: A Journal of Nursing, 5(8), 20–23.
Abstract: The author defines and describes PTSD, and looks at how it may apply to nurses. Primarily affected by delayed PTSD, nurses may experience it as burn-out, after exposure to trauma over time. The Critical Incident Stress Management programme instigated at Healthcare Hawkes Bay is outlined.
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Litchfield, M. (1993). Priorities for research. kai Tiaki: Nursing New Zealand, 1(8), 28–30.
Abstract: An article adapted from the author's contribution as an invited member of the International Panel of Nurse Researchers leading the Special Research Seminar of the 1993 International Council of Nurses Quadrennial Congress, Madrid, Spain. The priorities of nursing research in New Zealand were derived from the findings of a semi-structured survey of the opinions of nurses in academic settings.
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McKillop, A. M. (2004). Evaluation of the implementation of a best practice information sheet: Tracheal suctioning of adults with an artificial airway. JBI Reports, 2(9), 293–308.
Abstract: This report presents an evaluation of the implementation of a best practice information sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa, based in Auckland, conducted a systematic review of the evidence and produced the best practice information sheet. A survey of 105 nurses was conducted at three sites, in New Zealand and Australia. Using a before/after design, data were collected at the time of release of the information sheet and then approximately 12 months later. The study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and the best practice information sheet.
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Spence, D. (2005). Hermeneutic notions augment cultural safety education. Journal of Nursing Education, 44(9), 409–414.
Abstract: In this article, the author integrates literature pertaining to the implementation of kawa whakaruruhau, or cultural safety, with the findings of a hermeneutic project that described the experience of nursing people from cultures other than one's own. It is argued that the Gadamerian notions of “horizon,” “prejudice,” and “play” can be used to facilitate understanding of the tensions and contradictions inherent in cross-cultural practice. Strategies are recommended that enable students to explore the prejudices, paradoxes, and possibilities experienced personally and professionally.
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