Aspinall, C. (2022). The impact of intersectionality on the empowerment and development of nurses into leadership roles. Doctoral thesis, University of Auckland, Auckland.
Abstract: Highlights the impact of the intersection of socially-constructed identities such as race, gender, and class, on nurses' ability to develop as leaders. Aims to learn how to create a culture of nursing leadership by explaining the impact of intersectionality on the empowerment and development of nurses into leadership roles. Designs a mixed-methods, explanatory, sequential research study in two phases, comprising an online questionnaire and 31 semi-structured interviews with nurses and managers.
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Sharma, M. (2020). An exploration of the experiences of registered nurses working in aged residential care facilities regarding interRAI: A qualitative research design. Master's thesis, University of Otago, Dunedin.
Abstract: Assesses the experiences of registered nurses (RNs)working in aged residential care facilities in Christchurch, in performing interRAI assessments using interRAI MOMENTUM software. Explores the positive and negative aspects of their experiences and the factors affecting performance of interRAI-based comprehensive health assessments. Identifies the aids and barriers faced by RNs in applying and using interRAI. Conducts focus-group interviews with 7 RNs. Highlights the need for a unified standard assessment system.
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Vuorinen, M. (2017). Registered nurses' experiences with, and feelings and attitudes towards, interRAI-LTCF in New Zealand in 2017. Master's thesis, Massey University, Albany.
Abstract: Conducts 12 interviews with Registered Nurses (RN) 18 months after the International Resident Assessment Instrument for Long-Term Care Facilities (interRAI-LTCF) became mandatory in NZ. Bases the interviews on a United Theory of Acceptance and Use of Technology (UTAUT) model. Analyses the benefits and drawbacks of InterRAI-LTCF according to RN experience, and what they feel would improve the system.
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Armstrong, S. E. (2008). Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46). [Dunedin]: Rural Health Opportunities.
Abstract: A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them.
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Higgins, A. (2008). Collaboration to improve health provision: Advancing nursing practice and interdisciplinary relationships. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 215-223). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter introduces national policies and strategies that promote interdisciplinary collaboration as a means of providing better access to health care for all communities. It identifies a role for advancing nursing practice as part of a collaborative approach to healthcare in rural areas. An increasing focus on collaboration as a concept within health practice during the last 10 years has become evident in policy documents from the Report of the Ministerial Taskforce on Nursing (Ministry of Health, 1998) to the Working Party for After Hours Primary Health Care (Ministry of Health, 2005). The emphasis would seem to be in response to political pressure to address health inequalities and an apparent assumption that interprofessional collaboration results in improved communication, fewer gaps in provision of care and more effective use of the limited health funds.
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Farrow, T. (2002). Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments. International Journal of Mental Health Nursing, 11(4), 214–219.
Abstract: 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
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Strochnetter, K. T. (2000). Influences on nurses' pain management practices within institutions: A constructivist approach. Ph.D. thesis, , .
Abstract: Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient.
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Carryer, J. B., & Boyd, M. (2003). The myth of medical liability for nursing practice. Nursing Praxis in New Zealand, 19(4-12), 4–12.
Abstract: This article explores the complex nature of liability in the case of standing orders and vicarious liability by employers, and also when nurses and doctors are in management roles. The authors address misconceptions about medico-legal responsibility for nursing practice with the advent of nurse prescribers and nurse practitioners. They refer to the submission made by the College of Nurses Aotearoa (NZ) on the Health Practitioners Competence Assurance Act (2003), and discuss practice liability and nurse-physician collaboration.
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Pullon, S., & McKinlay, E. M. (2007). Interprofessional learning: The solution to collaborative practice in primary care. The Royal New Zealand College of General Practitioners website, 34(6), 404–408.
Abstract: In this paper the authors outline the basis of interprofessional education, which occurs when members of two or more professions are engaged in learning together. They describe its relationship to primary care clinical practice, where it can lead to collaborative problem-solving approaches, mutual decision making and interdisciplinary teamwork. A New Zealand model of postgraduate interprofessional education is presented. Barriers to the implementation of interprofessional education in New Zealand are identified along with possible solutions.
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Horsburgh, M., Perkins, R., Coyle, B., & Degeling, P. (2006). The professional subcultures of students entering medicine, nursing and pharmacy programmes. Journal of Interprofessional Care, 20(4), 425–431.
Abstract: This study sought to determine the attitudes, beliefs and values towards clinical work organisation of students entering undergraduate medicine, nursing and pharmacy programmes in order to frame questions for a wider study. University of Auckland students entering medicine, nursing and pharmacy programmes completed a questionnaire based on that used by Degeling et al. in studies of the professional subcultures working in the health system in Australia, New Zealand, England and elsewhere. Findings indicate that before students commence their education and training medical, nursing and pharmacy students as groups or sub-cultures differ in how they believe clinical work should be organised. Medical students believe that clinical work should be the responsibility of individuals in contrast to nursing students who have a collective view and believe that work should be systemised. Pharmacy students are at a mid-point in this continuum. There are many challenges for undergraduate programmes preparing graduates for modern healthcare practice where the emphasis is on systemised work and team based approaches. These include issues of professional socialisation which begins before students enter programmes, selection of students, attitudinal shifts and interprofessional education.
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Meeks, M., Miligan, K., Seaton, P., & Josland, H. (2023). Interprofessional education: let's listen to the students. Nursing Praxis in Aotearoa New Zealand, 39(2). Retrieved July 6, 2024, from http://dx.doi.org/https://doi.org/10.36951/001c.87828
Abstract: Invites pre-registration nursing and medical students to write down questions to ask of students in the other discipline. Provides these questions for discussion in a facilitated interprofessional group session. Uses descriptive thematic analysis to inductively analyse the written data, from which three themes emerged: lack of knowledge about each profession, misperceptions about the other profession, and the desire to develop interprofessional relationships.
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Mowatt, R., & Haar, J. (2018). Sacrifices, benefits and surprises of internationally-qualified nurses migrating to New Zealand from India and the Philippines. Nursing Praxis in New Zealand, 34(3).
Abstract: Examines the experiences of internationally-qualified nurses from the
Philippines and India upon migration to NZ. Employs an explanatory sequential mixed-methods study to survey the migrant nurses and to identify dominant themes.
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Crick, S., Page, M., Perry, J., Pillai, N. M., & Burry, R. D. (2019). 'This building looks like a mansion but feels like a prison': personal and professional pratice prespectives on recruiting and retaining internationally-educated nurses. Whitireia Journal of Nursing, Health and Social Services, (26), 18–27.
Abstract: Presents the experience of an internationally-educated nurse (IEN) who immigrated to the UK from India. Shares insights about the social and professional challenges faced by IENs, with perspectives from the nursing literature. Examines the tensions between the needs of recruiting organisations and the needs of IENs working in new countries.
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Wraight, J. (2019). Assessing English language skills of internationally-qualified nurses in New Zealand. Kai Tiaki Nursing Research, 10(1), 59–60.
Abstract: Introduces the Clinical Communication Assessment Framework (CCAF), adapted by Nelson Marlborough Institute of Technology from communication assessment guidelines developed in Australia to assess nursing students' English language proficiency. Uses this framework to assess nurses, before the competency assessment programme (CAP) four-week clinical nursing placement, for the first time in NZ.
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Harvey, G. (2022). 'Thank you for telling our story...': An exploration of the needs of migrant nurses undergoing competence assessment for New Zealand registration. Master's thesis, Otago Polytechnic, Dunedin.
Abstract: Seeks to give voice to migrant nurses, using case-study methodology to highlight their experience of the competence assessment process. Distributes a questionnaire to a group of 22 newly-arrived IQNs, and conducts interviews with 10 IQNs who had been working in NZ for several years. Uncovers the motivations among the first group and reflections on the Competence Assessment Programme (CAP) among the second. Makes recommendations for CAP training based on the results of the study.
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