Green, C. (2018). Medication simulation: enhancing nursing students' clinical environmental awareness through self-care and promotion of patient safety. Whitireia Nursing and Health Journal, (25), 37–51.
Abstract: Undertakes an evidence-based practice pilot project to examine the effectiveness of simulation-based learning in teaching nursing students to become aware of the role of stress, anxiety and distraction in medication errors. Stresses the importance of medication-error prevention at the pre-licensure level, by increasing awareness of patient safety culture. Notes the need to teach nursing students self-awareness of the distractions and stresses within the clinical environment and therefore the need for self-care to avoid medication error.
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Harun, I., Trimmer, W., & Thompson, S. R. (2019). Identifying and managing the pre-hospital presentation of psychogenic non-epileptic seizures: a literature review. Whitireia Journal of Nursing, Health and Social Services, (26), 73–80.
Abstract: Performs a review of the literature on the topic to assist paramedics to identify and manage patients with psychogenic, non-epileptic seizures (PNES). Explores current pre-hospital practice in NZ and makes recommendations to improve health-care and outcomes in such patients.
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Wiffin, L. (2006). Treating depression during pregnancy: Cognitive behavioural therapy as a treatment option. Available online from Eastern Institute of Technology, 14(1), 8–12.
Abstract: This article reviews the use of cognitive behavioural therapy (CBT) for pregnant women suffering from depressive symptoms. CBT provides a structured, short-term, collaborative process between clinician and client, using strategies and techniques to identify dysfunctional thinking and beliefs, challenge and change these beliefs, then implement new rational beliefs and behaviours. A process of engagement, assessment and conceptualisation is followed by treatment planning and implementation, and modification of dysfunctional thinking and behaviours. Use of CBT to treat depression in women during pregnancy is supported by the literature, especially where pharmacological intervention is declined or contraindicated. Pregnancy can bring stressors that combine with biological factors and core beliefs to contribute to depressive symptoms.
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Kell, A. - M., Gilmour, J., & Wissen, K. van. (2018). Nurses' experiences caring for patients surgically treated for oral cavity cancer. Nursing Praxis in New Zealand, 34(1).
Abstract: Explores nurses' experiences of caring for patients who have had surgery for oral cavity cancer in one NZ hospital, involving wound care, tracheostomy management, oral care, ongoing patient education and the provision of emotional support to patients and families. Interviews three registered nurses about the challenges involved in caring for this patient group; their moral conflict over the effects of surgery on the patients; their professional uncertainty, and the emotional effort involved in nursing oral cavity cancer patients. Suggests the need for informal debriefing, grief counselling, clinical supervision, stress management training, and continuing education in this specialised role.
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Cook, C., Brunton, M., Chapman, M. K., & Roskruge, M. (2021). Frontline nurses' sensemaking during the initial phase of the COVID19 pandemic in 2020 Aotearoa New Zealand. Nursing Praxis in Aotearoa New Zealand, 37(3).
Abstract: Identifies the impact of the pandemic on front-line nurses, based on qualitative data from a national mixed-methodology study done between October and December 2020. Conducts 29 interviews via Zoom and telephone with nurses in a range of front-line clinical roles. Highlights the place of organisational culture, communication and clinical leadership in either strengthening or weakening professional commitment.
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Jamieson, I., Andrew, C., & King, J. (2021). Keeping our borders safe: The social stigma of nursing in managed isolation and quarantine border facilities during the COVID-19 pandemic. Nursing Praxis in Aotearoa New Zealand, 37(3).
Abstract: Reports a qualitative, single-centre descriptive study of the experiences of nurses
working in managed isolation and quarantine facilities (MIQFs)in Aotearoa New Zealand. Conducts 14 semi-structured interviews, via Zoom, with registered nurses working in MIQFs, focusing on the personal and social impacts on the nurses. Identifies four themes: protecting the community while being a risk to the community; social stigma; families and social connections; being part of, but apart from, other health professionals. Underlines the importance for employers, colleagues, and the wider community of supporting nurses during a pandemic.
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Brinkman, A., & Caughley, B. (2004). Measuring on-the-job stress accurately. Kai Tiaki: Nursing New Zealand, 18(8), 12–15.
Abstract: The authors discuss the usefulness of a generic tool to measure job stress in New Zealand workplaces, and report on a study using one such generic tool. The study involved sending questionnaires to all staff (193) who had worked at a regional women's health service for a minimum of six months. The mailed package contained the Job Stress Survey (JSS), the General Health Questionnaire (GHQ-12), demographic questions (including cultural safety), shift work questions, and a blank page for “qualitative comment”. Over 12,000 pieces of data were collected from the study but this article focuses only on the results of the JSS. The JSS can be used to determine a “job stress index” and can also be used to measure “job pressure” and “lack of organisational support”. For this study, job stress index scores were calculated and organised by occupational groupings. Midwives, nurses and doctors all cited inadequate or poor quality equipment, excessive paperwork, insufficient personal time, and frequent interruptions, as their top stressors. Three of these four stressors fall within the job pressure index. The results of the survey prompted organisational changes, including: extensive discussions; equipment being updated; management being made aware of the depth of concern felt by staff; the creation of a place for staff to have personal time; and coping intervention strategies were initiated. The authors suggest that no generic measure of job stress can fully evaluate stressors unique to a particular work setting. They support additional items being constructed and administered to assess stressors that are idiosyncratic to a particular occupational group.
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Brinkman, A. (2002). Occupational stress in hospitals: A nursing perspective. Kai Tiaki: Nursing New Zealand, 8(6), 21–23.
Abstract: This article examines the environmental stressors that cause occupational stress for many nurses, particularly the health reforms and the Employment Contracts Act (ECA). The concept of stress is reviewed and theories of occupational stress are described, including the demand-control theory and the transactional model. Nurses are advised to become aware of occupational stress in their workplaces, citing a study by the author showing high levels of stress among hospital nurses.
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Hendry, C., & East, S. (2013). Impact of the Christchurch earthquakes on clients receiving health care in their homes. Available through NZNO library, 4(1), 4–10.
Abstract: Eighteen months after the first of many large earthquakes, Christchurch-based home health care provider Nurse Maude surveyed staff to identify the impact on the well-being of their mainly elderly clients. Responses from 168 staff identified five key issues. These were: mental health, anxiety, and depression, symptoms similar to post-traumatic stress disorder (PTSD); unsafe environments; loneliness and isolation; difficulty coping with change; and poor access to services. To meet the needs of clients in this challenging environment, staff felt they needed more time to care, including listening to stories, calming clients and dealing with clients who had become slower and more cautious. Damaged and blocked roads, and the fact that many clients moved house without warning, added to the time it took to deliver care in the home. This survey has helped Nurse Maude build on its initial post-earthquake responses to better meet the needs of clients and support health-care workers in this stressful environment.
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Tabakakis, C., McAllister, M., & Bradshaw, J. (2020). Burnout in New Zealand resgistered nurses: the role of workplace factors. Kai Tiaki Nursing Research, 11(1), 9–16.
Abstract: Investigates the impact of workplace factors on burnout in NZ RNs. Conducts a cross-sectional survey among 480 RNs in which burnout, practice environment and negative acts in the workplace were self-reported by means of the Copenhagen Burnout Inventory (CBI), the Practice Environment Scale (PES), and the Negative Acts Questionnaire (NAQ).
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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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Hall, L. (2001). Burnout: Results of an empirical study of New Zealand nurses. Contemporary Nurse, 11(1), 71–83.
Abstract: This is the first New Zealand study to use the Maslach Burnout Inventory (MBI) and the Phase Model of Burnout to determine the extent and severity of burnout in a population of 1134 nurses. Burnout is conceptualised as a syndrome consisting of three components-emotional exhaustion, reduced personal accomplishment and depersonalisation of clients or patients that occurs in individuals who work in the human service professions, particularly nursing. It has been observed that nurses are at a high risk of burnout and burnout has been described as the 'professional cancer' of nursing. Results revealed an overall 'low to average' level of burnout, suggesting that New Zealand nurses, apart from those in the 41-45 age group, are doing better than expected insofar as they are managing to avoid or not progress to the advanced phases of burnout. Possible explanations and directions for future research are presented.
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Daniels, A. (2004). Listening to New Zealand nurses: A survey of intent to leave, job satisfaction, job stress, and burnout. Master's thesis, Auckland University of Technology, Auckland.
Abstract: This study aims to identify work related factors contributing to New Zealand nurses' intent to leave the job. Two hundred and seventy five surveys (response rate = 68.8%) from a random sample of 400 nurses employed in one district health board were used to explore intent to leave the job. Three research questions directed the description of levels of job satisfaction, job stress, and burnout found in nurse participants, correlations between the three variables, and the identification of variables predicting intent to leave the job through regression analyses. The survey found levels of job satisfaction were high, job stress was low, and burnout was average. Specifically, lack of opportunity to participate in organisational decision making, control over work conditions, control over what goes on in the work setting (key Magnet Hospital characteristics) were not evident, and with pay rates, were the main sources of job dissatisfaction. Workload was the most frequently experienced source of stress by nurse participants. Twenty-five per cent of nurse participants reported high levels of intent to leave the job. Correlations suggested that reductions in job satisfaction influenced increases in job stress and burnout. Job stress was associated with increases in emotional exhaustion. Emotional exhaustion was influenced by eight job satisfaction, job stress, and burnout subscales. Five subscales (professional opportunities, praise and recognition, interaction opportunities, extrinsic rewards, lack of support) explained 26.2% of the variance in nurse participant's intent to leave. The author concludes that issues of power and control were associated with job dissatisfaction, job stress and burnout in nursing practice. However, predictors of intent to leave the job suggest a growing realisation by nurse participants that postgraduate education and nursing research may provide the tools to create positive change in the health care environment and make nursing visible, valued and appropriately rewarded.
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Brinkman, A. (2000). A study into the causes and effects of occupational stress in a regional women's health service. Ph.D. thesis, , .
Abstract: Hospital-based health systems have the potential to be high stress environments, as staff work towards meetings the many and varied demands of the patients and their families / whanau in a situation of limited resources and unpredictable workloads. Dealing with physical and emotional trauma, and the 'normal' exigencies of daily life in what may be a far from normal workplace may compound the stresses facing health workers. Nurses, who are often at the interface between patients and other health professionals, may be caught in a cross-fire of transferred stress while also coping with stressors associated with their jobs. As well as being likely to have a negative effect on their well-being and job satisfaction, any such compounding impact of stress and stressors could have adverse impacts on patients and their supporters. The primary focus of this study has been to identify stress levels among nurses in a woman's health service, and to establish the causes of elevated stress. All staff were surveyed (with a 68% response rate). Midwives made up the largest portion, followed by nurses, doctors, therapies, support and clerical groups. The Job Stress Survey (JSS) and the General Health Questionnaire – 12 (GHQ-12) were used to help detect emergent stressors, and stress effects that staff were experiencing at the time. Aggregate data was used, focusing on the six occupational groupings and the nine areas within the health service. Findings from the JSS confirm that the staff had experienced a number of stressors, while indications of deleterious mental health effects in some staff emerged from the GHQ-12 scores. Occupational stress is a subset of general stress, making it difficult to separate one from the other as spheres of our lives overlap and interact. The stressors that were identified should contribute to the discussions and policies that might abet the reduction of stress. On the other hand, it is not possible to attribute the effects describes by the GHQ-12 as being derived primarily from occupational stress. A stressed staff member, no matter what the source of their stress might be, still needs support in order to cope. The author notes that the negative outcomes of occupational stress manifests themselves in many ways such as; mistakes, absenteeism, horizontal violence, burnout and turnover. These all affect the quality of the patient care delivered, leading to decreased patient satisfaction and and need to be addressed for these reasons.
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Falleni, P. M. (2007). The implications of stress and the effect it has on Maori who have type 2 diabetes in Aotearoa/New Zealand. Ph.D. thesis, , .
Abstract: In this review, the author illustrates the connection between diabetes, stress and barriers to care, and the impact these have on Maori who have type 2 diabetes. A literature review, which focused mainly on indigenous peoples, and more specifically on Maori was undertaken. The connections between all the factors involved are explored, and combined with reflections from the author's own clinical practice experience. She argues that stress, diet, exercise and barriers to care place a heavy burden on the lives of Maori who live in Aotearoa/New Zealand, suffering from the disease of diabetes. By empowering them to face their situation and see this from a wellness rather than an illness perspective, they can take control of their diabetes and so will live a healthy, longer life, ensuring quality time with their mokopuna/grandchildren.
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