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Author Woodgyer, A.R.
Title Living without the song of the tui: A nursing lecturer's experience in India facilitating a New Zealand degree programme for registered nurses Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Curriculum; Nursing; Education; Culture
Abstract This research considers the issues raised by the transfer from New Zealand to India of a degree for registered nurses. In the context of globalisation and the continuing migration of nurses, many countries are actively facilitating the transfer of educational programmes from other countries into their own. This transfer brings with it particular challenges for educators establishing and implementing programmes in a new environment and culture. Based on the experience and reflections of one educator involved in such a transfer, this research considers pedagogical issues such as addressing cultural safety in course content and delivery, expectations of teaching and learning styles, as well as the ethical issues raised by transferring a programme to another country in order to facilitate nurses' migration from it.
Call Number NRSNZNO @ research @ Serial 1141
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Author Laracy, K.
Title Exploration of the self: The journey of one pakeha cultural safety nurse educator Type
Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Cultural safety; Teaching methods; Nursing; Education; Professional development; Transcultural nursing; Maori; Identity
Abstract Cultural safety is taught in all undergraduate nursing programmes in Aotearoa/New Zealand. There is a predominance of Pakeha nurse educators in teaching this content. There is little explanation of what being Pakeha entails. This perpetuates a silence and continues the dominant hegemonic position of Pakeha in Aotearoa/New Zealand. This study suggests that as Pakeha cultural safety nurse educators we examine our dominance and critique the delivery of cultural safety education. This autobiographical study undertakes to explore the Pakeha identity of a cultural safety nurse educator. The author discusses identity in the context of a globalised world, and challenges the idea of a definitive Pakeha identity. There are multiple descriptions of Pakeha, all underdeveloped and inadequate for the purposes of cultural safety education. In this study, the author uses the heuristic process of Moustakas (1990) and Maalouf's (2000) ideas of vertical and horizontal heritage to locate and present the essence of the self. In keeping with the purpose of cultural safety education, the author considers her ethnic cultural self as described by Bloch (1983) and explores Helms' (1990) theory of White racial identity development. This thesis describes the position of one Pakeha in the context of teaching cultural safety in an undergraduate nursing degree programme in Aotearoa/New Zealand. For Pakeha cultural safety nurse educators the author argues that exploration of one's heritages and location of a personal Pakeha identity is pivotal to progressing the enactment of cultural safety in Aotearoa /New Zealand.
Call Number NRSNZNO @ research @ Serial 864
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Author Ramsden, I.
Title Cultural safety and nursing education in Aotearoa and Te Waipounamu Type
Year 2002 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Cultural safety; Maori; Nursing; Education
Abstract The research on which this thesis is based involves both a private narrative and a public narrative, with the story of cultural safety, and the history, theory and the future direction gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced cultural safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety Theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of cultural safety is undertaken. The role and application of the Treaty of Waitangi to the theory of cultural safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of cultural safety into the nursing education system and its implementation. The public and media reaction to the inclusion of cultural safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of cultural safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The author notes that the story of cultural safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, she points out that, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients.
Call Number NRSNZNO @ research @ Serial 486
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Author Ramsamy, K.
Title Colonisation: The experience of a psychiatric nurse through the lens of reflective autobiography Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Cultural safety; Colonisation; History; Nursing
Abstract The author points to the oppression of colonisation living on in the daily lives of colonised people, and goes on to say that it is vital for nurses to understand the effects of that oppression, as well as the restrictive impacts, and dislocation from one's land and culture to-day. Nurses come from both the descendants of colonisers and the colonised. This thesis is a journey and a quest for insights into the impacts and significances of colonisation by looking at historical and socio-political contexts that have bearing on the health of colonised people who remain mostly powerless and marginalised. It is prompted in response to a cultural safety model which advocates that nurses should become familiar with their own background and history in order to be culturally safe in practice. This reflective autobiographical account is a personal effort and provides the foundation for an exploration of issues during nursing practice encounters, from a colonised ethnic minority perspective. The method was informed by Moustakas research approach and Johnstone's Reflective Topical Autobiographical process. The selection of specific events are deliberate, to make visible some of the many barriers that exist within our health structures as pertinent issues for non-dominant cultures that remain on the margin of our society. Maori issues provide a contrast and became a catalyst for the author while working for kaupapa Maori services. The intention of this thesis is to generate new knowledge about what it means to be a nurse from an ethnic minority working in a kaupapa Maori mental health service, and to encourage other nurses to explore these issues further. Some recommendations are made for nurses in the last chapter.
Call Number NRSNZNO @ research @ 739 Serial 725
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Author Wilson, S.K.
Title Reconstructing nurse learning using computer mediated communication (CMC) technologies: An exploration of ideas Type
Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Computers; Technology; Nursing; Education
Abstract Computerised technology has become a way of life. As nurse graduates enter a computer driven health care system we have a responsibility as nurse educators to ensure that they are computer familiar as borne out by the recent discussion papers released by the Nursing Council of New Zealand (2000a), which define the requirements for the practitioner of the future. Concurrently there is a call from the discipline of nursing for practitioners who have a form of knowledge that will bring about change within the socio-political context of the discipline as an outcome of critically reflective knowledge skills. Jurgen Habermas' (1971) treatise on knowledge and human interests, which offers a multi-paradigmatic approach to three forms of knowledge culminating in the emancipatory form provides a conceptual framework for many under-graduate pre-registration nursing curricular in Aotearoa-New Zealand. This thesis explores the author's ideas about contemporary undergraduate pre-registration nursing preparation in Aotearoa-New Zealand, associated knowledge outcomes, and the consequent links with contemporary computer-mediated communication (CMC) technologies. It positions a framework for integrating CMC technologies and the action of critically reflective practice as a learning journey. The framework is hypothetical and pragmatic. It emerges from the exploration of the thesis and is posited as a way toward integrating CMC technologies within extant undergraduate pre-registration nursing curricular in Aotearoa-New Zealand. The learning journey is comprised of three dimensions, learning-for-practice, learning-from-practice and learning-with-practice and draws on four different cyber constructs: being, knowing, relating and dialoguing. Knowing, relating and dialoguing are ontological positions taken in relation to being. The learning journey sustains some derivation from Habermasian (1971) based conceptual framework. There is a need for nurse educators to consider this in relation to contemporary CMC technologies. The author hope that this framework will serve those with an interest in nurse education and who are interested in a future using CMC technologies within the realities of nursing practice and education.
Call Number NRSNZNO @ research @ Serial 904
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Author Woodbridge, M.
Title From child savers to child activists: A participatory action research project with community child health nurses Type
Year 2002 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Community health nursing; Paediatric nursing
Abstract
Call Number NRSNZNO @ research @ 1266 Serial 1251
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Author Elliott, M.M.
Title Model of care development: Moving between liaison and complex care coordination in the community health setting Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Community health nursing; Nursing models
Abstract Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services.
Call Number NRSNZNO @ research @ Serial 684
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Author Radka, I.M.
Title Handover and the consumer voice: The importance of knowing the whole, full story Type
Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Communication; Patient satisfaction; Nurse-patient relations
Abstract In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare.
Call Number NRSNZNO @ research @ 883 Serial 867
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Author Robertson, G.
Title Disquiet in the development of clinical supervision for professional development in nursing practice: A literature review Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Clinical supervision; Professional development; Nursing
Abstract Nursing literature reflects that nurses have been exploring and experiencing the process of clinical supervision for well over a decade. Nurses in the United States, United Kingdom, Scandinavia, and Australasia have written much over the past fifteen years. However, the author notes that nurses grapple with what clinical supervision is within nursing development and disquiet continues to emerge in the literature. This literature review expands on themes that surround this disquiet. These centre on continued confusion and lack of clear definition; whether psychotherapy is implemented under the guise of clinical supervision, who uses it, and the dearth of empirical evaluation of its effectiveness. The lack of significant empirical evidence of its ability to assist practitioners to deliver improved patient/client care continues despite claims of improved professional and personal development, therapeutic relationship, and occupational stress management. These claims come from both supervisees and supervisors. The manner in which clinical supervision is portrayed in nursing in that it is frequently referred to as a support system, rather than one of learning a complex set of communication skills is also highlighted. The continued debate on what model(s) best suit nurses, or whether line management should provide clinical supervision as a means to ensure quality standards and control over nursing practice and optimal patient care is discussed. Whether nursing should stop borrowing from other fields and develop their own model(s) is also raised. Two emerging stances focus on a process that is practice-based as identified by senior staff and management, or one that continues along the lines of what psychotherapy has developed with practitioner-identified developmental needs. These issues raise many questions for further development in nursing, one being are nurses developed enough in their self-awareness to understand what they are to adopt into their practice? Authentic voices from those nurses experienced in the practice of providing and receiving clinical supervision, are shaping therapeutic practice for nurses in the future, and continue to sharpen the debate. Some reference to unpublished data and local practice in the Wellington area have been included as a stimulus for further incorporation of clinical supervision in local practice development.
Call Number NRSNZNO @ research @ Serial 794
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Author Sims, D.A.
Title The benefits and challenges of one New Zealand nursing undergraduate clinical education model: A case study Type
Year 2004 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Clinical supervision; Preceptorship; Education; Students; Nursing
Abstract This research project utilised a case study approach to give ward managers a voice in the literature, by exploring and describing from their perspective the benefits and challenges of one particular nursing undergraduate clinical education model. The tertiary education provider contracts the health provider to provide Clinical Nurse Educators (CNEs) to support second and third year undergraduate nursing students during their clinical experiences. The CNEs are seconded from their respective wards to meet the organisation's contractual obligations. Data were gathered from two ward managers using semi-structured interviews. The findings elucidate the role of the undergraduate CNE, highlighting benefits such as the CNE being supernumerary to ward rosters and having time to teach, not only supervise students. CNEs are student-focused and easily accessible as they are based on site. The CNE was the one person who was 'there' for a student as a student's preceptor can change shift-by-shift and day-by-day. One significant challenge which emerged was the replacement of ward staff, not only of senior nurses who can leave their wards for up to 12 weeks to undertake the CNE role but also that of the student's preceptor if the student's preceptor was on annual, sick or study leave. Other challenges such as the inability of ward managers to pre-book casual staff; preceptor work-loads; skill-mix issues and fluctuating fulltime equivalents are also discussed.
Call Number NRSNZNO @ research @ Serial 598
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Author Kwai, K.
Title The value of a programme of clinical supervision for graduate nurses: An evaluative study Type
Year 2004 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Clinical supervision; New graduate nurses; Mentoring
Abstract The function and implementation of clinical supervision in the practice setting presents a number of challenges for new graduate programmes for registered comprehensive nurses. There have been numerous reports and papers promoting its benefits as important and providing the impetus for change. Clinical supervision has been well established as part of social work, counselling, psychotherapy and psychoanalytic practice, and in mental health nursing and midwifery. Its utilisation for graduate nurses is clearly important and should be seen as integral to professional practice. This study evaluated a programme of clinical supervision as a component of a new graduate nurse programme in a secondary health care practice environment. The clinical supervision component aimed to support graduate registered nurses' transition from the role of student nurse to staff nurse in the context of professional clinical practice. This report is also intended to inform the ongoing provision of clinical supervision at Hutt Valley District Health Board. The evaluation process was guided by the work of Owen (1990) and used utilisation focussed evaluation as the framework on which to undertake the evaluation. A mix of quantitative and qualitative methodology was used to collect and analyse the data. Data were collected from nurse graduates of the new graduate programme using a postal questionnaire that covered three areas; clinical supervision, the Hutt Valley District Health Board new graduate programme and an evaluation of stakeholder roles. Twelve of the new graduates responded to the survey. Findings suggest clinical supervision provided professional support and assisted the new graduate in the identification of education needs. Difficulties associated with accessing the structured component of the new graduate programme and clinical supervision were highlighted. The recommendations made to Hutt Valley District Health Board to improve the programme include considering accessibility, consumer rights, acceptability, a comprehensive approach, the Treaty of Waitangi, efficiency and a coordinated approach.
Call Number NRSNZNO @ research @ Serial 603
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Author Yarker-Hitchcock, V.
Title Clinical supervision in a home care context Type
Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Clinical supervision; Home care; Rural nursing; Rural health services
Abstract Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in relation to its effect on clinical practice. It is not clear whether supervision actually produces a change in clinician behaviour, or whether it produces benefits in terms of client outcomes. This thesis evaluates the impact of clinical supervision on five co-ordinators in a rural home care setting. It looks at the impact clinical supervision has on their practice and professional growth. The nurses all belong to one organisation, Access Homehealth Ltd. The study builds on the findings of a clinical supervision pilot, which was trialed within the organisation in 2002. The pilot examined which model of supervision was most beneficial for Access Homehealth staff. Clinical Supervision is defined as a designated interaction between two or more practitioners within a supportive environment, that enhances reflective practice and professionalism, which in turn contributes to improved practice and client outcomes. The methodology of this research was qualitative evaluation. The themes which emerged related to personal support, managing stress and alleviating feelings of isolation, reflection, enhancing practice, improved communication skills and the concept of clinical supervision as a safety net. Participants also revealed that one-on-one supervision appeared more helpful than group supervision, and that phone supervision facilitated in-depth dialogue. These findings are important, as they demonstrate it is feasible to simultaneously offer a number of formats of clinical supervision within one organisation, allowing for the organisation to provide what works best for different workers. They also show that clinical supervision is a valuable and useful support tool for home care co-ordinators in order to facilitate empowerment, reflection and growth in practice. Further research is needed to provide evidence of the benefits of supervision on improving client outcomes.
Call Number NRSNZNO @ research @ 593 Serial 579
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Author Bunn, S.
Title An exploration of the transition of patients from intensive care to the ward environment: A ward nursing perspective Type
Year 2007 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Clinical decision making; Nursing; Communication
Abstract The transition of patients from intensive care to the ward environment is a regular occurrence in intensive care. Today patients are often transferred earlier and sicker due to the demands for intensive care beds. This results in patients with higher acuity being cared for in the wards. Here ward nurses have to meet the ongoing complex demands of caring for higher acuity patients, alongside managing high patient-to-nurse ratios, staffing concerns, and varying levels of experienced nurses. This research explored the experiences of ward nurses receiving patients transferred from intensive care. The aims were to identify any areas of concern, highlight specific problems that occur on transition and to address what information is pertinent to ward nurses when receiving patients from intensive care. A qualitative descriptive methodology using focus groups was utilised to gather information about these experiences. Three focus groups were held with ward nurses from various wards within the study setting hospital. All participants had considerable contact with intensive care and were familiar with the processes of transferring patients. Five themes emerged from the focus groups – Patients as intensive care staff say they are; Time to prepare the biggest thing; Documentation as a continuation of patient care; They forget what its like; and Families, a need to know about them. The theme Patients as intensive care staff say they are relates to reliable information sharing focused on the patient, their needs and condition. Participants expressed their concern that patients were not always in the condition that the intensive care staff stated they were on the referral. Having adequate time to prepare was considered important for the majority of ward nurses receiving patients from intensive care. Documentation was highlighted in the theme Documentation as a continuation of patient care particularly in relation to fluid balances and vital sign history. The theme They forget what its like suggests there is a perception that intensive care nurses have a lack of understanding of what the ward staff can actually manage. Decreased staffing levels during certain shift patterns and a lack of appropriately experienced staff on the wards is a common concern for ward nurses. Ward nurses also recognised that caring for families was part of their role. Patients and families may respond differently to the transfer process and their inclusion in transfer planning was seen as essential. Communication was a reoccurring element throughout all themes.The author concludes that communication is the paramount factor that impacts on a 'smooth transition' for ward nurses. A 'smooth transition' refers to the transfer of patients from intensive care to the next level of care. Subsequently, nurses' perceptions need to change, whereby transfer planning from ICU should be the focus rather than discharge planning. Transfer planning and education for all nursing staff is vital if the transfer process is to be improved. Consequently, transitional care within the context of ICU aims to ensure minimal disruption and optimal continuity of care for the patient. The knowledge gained from this research may provide better understanding of the multifaceted issues linked with transitional care that may be adapted for a wider range of patients in various clinical environments.
Call Number NRSNZNO @ research @ 827 Serial 811
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Author Lake, S.E.
Title Nursing prioritisation of the patient need for care: Tacit knowledge of clinical decision making in nursing Type
Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Clinical decision making; Nursing
Abstract Effective nursing prioritisation of the patient need for care is integral to daily nursing practice but there is no formal acknowledgement or study of this concept. Utilising the retroductive research strategy of critical realism, this thesis explores the nursing literature for the tacit knowledge of the discipline about nursing prioritisation and proposes a 'fit' for nursing prioritisation of the patient need for care within the bigger picture of nurse clinical decision-making. The tacit knowledge discerned within the literature indicates that nurses use discretionary judgment and ongoing assessment to determine the relative importance of the many aspects of individual patient situations as they unfold. Such nursing prioritisation takes place concurrently between the competing or even conflicting needs of the several individual patient presentations within the nurse's caseload. Varied frames of reference within different practice settings create specific imperatives on this dynamic and non-sequential process. Starting with an initial set of studies in the 1960s, study of clinical decision-making in nursing has created a significant body of knowledge encompassing a range of approaches. Nursing prioritisation of the patient need for care is most readily discerned in the interpretive perspective and in the plain language descriptions of nurse decision-making. Within the selected literature it is apparent that nursing prioritisation of the patient need for care is an advanced skill of nursing that is developed in practice and honed through experiential learning.
Call Number NRSNZNO @ research @ Serial 661
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Author Rose, A.
Title Is case management an efficient and effective model of care for complex patients in an acute medical setting? Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (down) Clinical decision making; Culture; Nursing; Quality assurance
Abstract This thesis looks at the prospect of developing and implementing case management as a model of care for complex patients in an acute medical setting. An extensive literature review was conducted to explore the concept of case management and to identify the role of the case manager, including the qualities and qualifications required for the position. Clinical pathways are a tool used in case management so these are also included in the literature review. As the author had been involved in the development of the first clinical pathway for Hutt Valley Health, this is used as an example to clarify how case management and clinical pathways can be used in conjunction. A discussion chapter examines the advantages and disadvantages of case management which shows that it can be an effective and efficient model of care through the development of clinical pathways. The ethical implications of case management are also considered. The thesis concludes with recommendations for the continued development of case management as a model of care to improve the quality of care for both patients and the organisation. During the course of the thesis, other areas that are worth further investigation have also been identified, such as the relevance of case management to different cultures. The thesis suggests that a proposal for case management for complex patients in the acute care setting is developed along with a job description for the role of the case manager.
Call Number NRSNZNO @ research @ Serial 908
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