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Lynch, T. M. (2005). A qualitative descriptive study of youth with Crohn's disease. Ph.D. thesis, , .
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Roberts, F. (1999). The people the programme & the place: Nurses' perceptions of the Lakeland Health Professional Development Programme. Ph.D. thesis, , .
Abstract: This thesis concerns the Professional Development Programme at Lakeland Health. In New Zealand, such programmes were introduced as a mechanism to openly recognise the clinical expertise of nurses. Clinical Career Pathways were introduced to nursing in North America in the 1970's at a time of nursing shortage. Prior to their inception, nurses wishing to develop their careers had to move to administration, management or education. The programmes recognised and rewarded expertise in practice. A qualitative, descriptive approach (using focus groups) was used with Registered Nurses to gather their perceptions of what helps nurses enroll in the Professional Development Programme. The ideas and insights of nine Registered Nurses were clustered around three main categories: The People (fear; being struck; motivation; feedback; peer support; ways of learning); the Programme (relevance; flexibility; Bachelor's Degrees; implementation; supporting information; fairness); the Place (time; regular and accessible; support from nurse leaders; management). These perceptions are discussed in more detail in the context of nursing at Lakeland Health and of Clinical Career Pathways in New Zealand. The findings are helpful for the evaluation and future development of the Professional Development at Lakeland Health. The research contributes to our understanding of what helps nurses enroll in a Clinical Career Pathway, and emphasises the importance of the People, the Programme and the Place.
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Schumacher, A. T. (2001). More than meets the eye: Explicating the essence of gerontology nursing. Ph.D. thesis, , .
Abstract: The purpose of this hermeneutic phenomenological was to unveil a deeper meaning and understanding of gerontology nursing, thus contributing to its value and worth as a speciality area of nursing. Conversations with four gerontology nurses were taped, transcribed and then analysed using van Manen's (1990) approach to researching lived experience. From the analysis, four cardinal elements emerged: true acceptance, personal knowing, being present, and being alive. Those four cardinal elements were reworked and further analysed to reveal three central aspects or essences of gerontology nursing. These essences were the centrality of temporality, the interconnectedness of human relationships, and the significance of the lived body. Temporality is demonstrated by nursing application of objective, or clock time, as well as subjectively in regards to the lived time of the clients. Interconnectedness is the lived human relationship between nurse and client and is represented by commitment, presencing/giving of self, connecting, and knowing the client holistically. The third essence is corporeality, which is portrayed by the gerontology nurses' distinguishing characteristics and their perception of the lived body of the nursed. The final analysis unveiled caring for the body, the act of seeing, and the joy of care as emergent essences of gerontology nursing. Language of nursing in relationship to 'basic nursing care' is critiqued for its potential to devalue gerontology nursing and, by association, old people.
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Andrews, C. M. (2001). Developing a nursing speciality: Plunket Nursing 1905 – 1920. Ph.D. thesis, , .
Abstract: This paper focuses on the history of Plunket nursing and Truby King's ideology and other dominant ideologies, during the years 1905 – 1920. To provide a context, the paper explores the development of a new nursing speciality – Plunket nursing, that became part of the backbone of a fledgling health system and the New Zealand nursing profession. Correspondingly, Truby King presented the country with a vision for improving infant welfare underpinned by his eugenics view of the world and his experimentation with infant feeding. The author argues that nurses were drawn to the work of the newly created Plunket Society and that the Society had lasting influence on the development of nursing in New Zealand.
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Cullens, V. (2001). Not just a shortage of girls: The shortage of nurses in post World War 2 New Zealand 1945-1955. Ph.D. thesis, , .
Abstract: This thesis explores the shortage of general hospital nurses in post World War II New Zealand between 1945 and 1955. Historical inquiry is used to identify the causes of the shortage and the response to the shortage by the Health Department, hospital boards and nurse leaders. Christchurch Hospital, administered by the North Canterbury Hospital Board, is used to illustrate the situation at one large, public, general hospital. Primary sources provided the majority of material which informed this thesis. Two themes emerge regarding the causes of the shortage of nurses: those that were readily acknowledged by nurse leaders and other health professionals at the time, and those which were less widely discussed, but which contributed to the nature of nursing work appearing less attractive to potential recruits. In response to the shortage the Health Department, hospital boards and the New Zealand Registered Nurses Association mounted several recruitment campaigns throughout the decade. As the shortage showed no sign of abatement the focus turned from recruitment to retention of nurses. While salaries, conditions and training were improved, nurse leaders also gave attention to establishing what nurses' work was and what it was not. Nurse leaders and others promoted nursing as a profession that could provide young women with a satisfying lifelong career. Due to these efforts, by 1955, this episode in the cycle of demand and supply of nurses had begun to improve.
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MacDonald, L. M. (2003). Nurse talk: Features of effective verbal communication used by expert district nurses. Ph.D. thesis, , .
Abstract: This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development.
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Litchfield, M. (2004). Achieving health in a rural community: A case study of nurse – community partnership. Wellington: Litchfield Healthcare Associates.
Abstract: This study describes rural, nurse-led health services provided by the Takapau Health Centre (Central Hawkes Bay) and its outreach, Norsewood & District Health Centre. The study looks at its model of service delivery through to 2002. It examines the establishment, development, funding and management of the service, along with the nursing practice and the healthcare people received. The book is a snapshot of nursing initiative and survival through a decade of change in health policy and service funding and delivery. The information was subsequently used to move the health centre service into the new paradigm of primary health care launched in the New Zealand Health Strategy.
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Litchfield, M. (2005). The nursing praxis of family health. In Picard, C & Jones, D., Giving voice to what we know (pp.73-82). Boston, Massachusetts, USA: Jones & Bartlett.
Abstract: The chapter explores the process of nursing practice and how it contributes to health, derived from research undertaken in New Zealand. It presents the nature of nursing research as if practice – the researcher as if practitioner – establishing a foundation for the development of nursing knowledge that would make a distinct contribution to health and health care. It includes the philosophy and practicalities of nursing through the use of a case study of nursing a family with complex health circumstances.
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Smart, S. (2005). Post-operative pain management knowledge and attitude of paediatric nurses: A New Zealand regional view. Ph.D. thesis, , .
Abstract: This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn't carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice. While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses.
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Tustin-Payne, W. (2008). Self esteem, competence assessment and nurses ability to write reflectively: Is there any connection? Ph.D. thesis, , .
Abstract: The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection.
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Maher, J. M. (1999). An exploration of the experience of Critical Incident Stress Debriefing on firefighters within a region of the New Zealand Fire Service. Ph.D. thesis, , .
Abstract: This study originates from the author's practice experience working for the New Zealand Fire Service back in the late 1980's and early 1990's as an Occupational Health Nurse where she piloted a Critical Incident Stress Peer Support programme in the No.4 Region. The author identified work-related stress and related it to Critical Incident Stress (CIS) from firefighters exposure to critical incidents. This study explores four firefighters experience of Critical Incident Stress Debriefing (CISD) within a Region of the New Zealand Fire Service. It explores the application of CISD as one component of Critical Incident Stress Management (CISM), and the Nurse Researcher's philosophy of Clinical Nurse practice in relation to the application of CISD. The knowledge gained from the analysis of the data has the potential to influence professionals understanding of their experience and affect future practice and that of others working in the field of CISM. Much of the literature that supported CISD appeared to offer a rather superficial understanding of the firefighters experience in relation to CISD. A narrative approache was chosed as the methodology, utilising four individual case studies as a method of social inquiry in order to explore the experience of CISD. The narratives were able to creatively capture the complexity and the dynamic practice of CISD. An overall pattern of the formalised process was uncovered through the participants' narratives. Eight dominant themes were highlighted from the narratives which included safe environment; ventilating the stress reaction; similar feelings; getting the whole picture; peer support; bonding and resolution. While these themes were common to all the participants, each participant had a particular theme/s which was unique to their experience.
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Buisman, B. (2006). Nursing 2020: How will 'Magnet' hospitals fit in? Nursing Journal Northland Polytechnic, 10, 33–41.
Abstract: Nursing shortages, technology, advances in genetics and the knowledge explosion are trends that have an influence on the nursing profession in the future. This article will examine these trends and give an overview of what it may be like to nurse in an acute-care hospital in the year 2020. The impact of leadership, management and political influences will also be discussed. The American concept of 'Magnet' hospitals will be described as one possible solution to the issues that affect the nursing profession in New Zealand.
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Phillips, B. N. (2004). An interpretation of four men's experiences of suicidality. Ph.D. thesis, , .
Abstract: This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of the author's own particular horizon of meaning as researcher and mental health nurse. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, he explores the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. Recovering was a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change.
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Hall, K. A. (2003). Soothing sounds: An investigation into the value of music in palliative care. Ph.D. thesis, , .
Abstract: This qualitative study focuses on van Manen's theory of the 'lived experience' in relation to two families and asks the first thesis question. What is the value of music in the care of someone who is dying? Over the course of their loved one's illness these families provided music in the patients home as part of their care. The study also captures the experiences of two nurses who work in the palliative setting, and their use of music in providing holistic care to their patients. Their experiences relate to the second question. How can nurses be assisted in introducing music into their planned care of patients? The results demonstrate the effectiveness of using taped music for someone who is dying, and the reduction in symptoms, such as anxiety, and pain. It also highlights the importance of the individual's choice, and the special moments that can be achieved for both patient and families when music is used in a caring, supportive environment. This encourages communication, especially in the sharing of emotions. This study may be the first qualitative study in New Zealand, that addresses the value of music in palliative care, therefore there is a need for continued research into this therapy as a treatment modality as part of planned care in palliative nursing.
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Stojanovic, J. E. E. (2002). Leaving your dignity at the door: Maternity in Wellington 1950 – 1970. Ph.D. thesis, , .
Abstract: This thesis describes the maternity system in Wellington between 1950 and 1970 particularly from the perspectives of consumers and midwives. Four women consumers who experienced maternity in Wellington and two midwives who worked in Wellington's maternity hospitals during this period provided their oral testimonies as the main primary sources for this study. The author's experience of being a student nurse and a consumer in Wellington and other primary and secondary sources are used to substantiate, explore and explain the topic. The study traces the socio-political changes in New Zealand maternity from 1900 to 1970 creating a backdrop against which Wellington's maternity system, including the women, the hospitals, the workforce, maternity practices and the childbearing process are illuminated using the insights of women and midwives who experienced them. The oral testimonies of the six participants described positive and negative aspects of their maternity experiences, but the three strong themes that arose from their accounts included 'being alone', 'lack of autonomy' and 'uncaring attitudes'.
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