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Author |
Fitzwater, A. |
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Title |
The impact of tourism on rural nursing practice |
Type |
Book Chapter |
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Year |
2008 |
Publication  |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 137-43) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Tourism; Advanced nursing practice; Occupational health and safety |
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Abstract |
This chapter reviews some effects of the growth of tourism, including adventure tourism and the numbers of tourists over 50, on rural nursing practice. Tourism contributes to socio-cultural change within a community, and health resources that previously met the needs of the local community may not meet the expectations of growing numbers of tourists. The transient visitor includes both the tourist and the seasonal worker, and has become a feature of rural nursing. Major effects on rural nurses include the increased volume of work, the advanced scope of practice required to meet more complex needs of visitors, and challenges to personal and professional safety. |
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Call Number |
NRSNZNO @ research @ 773 |
Serial |
757 |
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Author |
Horner, C. |
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Title |
Emergency health provision and maintaining competency |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 125-136) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Professional competence; Emergency nursing |
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Abstract |
This chapter focuses on issues associated with rural nursing and the provision of emergency care for patient(s) located remotely from secondary hospital services. All emergencies have diverse characteristics, but the rural practitioner also contends with having sole practice, professional and geographical isolation, and the lack of regular experience. The chapter reviews the PRIME (Primary Response in Medical Emergency) recommendations and training, and looks in particular at the issues around the maintenance of competency for the rural nurse providing emergency on call health care that includes managing medical and accident emergencies in the absence of a medical practitioner. |
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Call Number |
NRSNZNO @ research @ |
Serial |
756 |
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Author |
Ross, J. |
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Title |
Perspectives on developing the advanced role of rural nursing in New Zealand |
Type |
Journal Article |
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Year |
2001 |
Publication |
Health Manager |
Abbreviated Journal |
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Volume |
8 |
Issue |
1 |
Pages |
19-21 |
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Keywords |
Rural nursing; Advanced nursing practice; School nursing; Professional competence |
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Abstract |
The author traces the development of rural nursing, which began as an assistant role for general practitioners, to the present role which incorporates advanced nursing practice. She reports the results of two surveys of nurses' roles and skills, from 1996 and 1999-2000. Specific rural competencies are identified, in managing isolation, professionalism in a small community, nurse/patient relationships in a small community, and independence. |
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Call Number |
NRSNZNO @ research @ 1313 |
Serial |
1297 |
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Author |
Spence, D.; Fielding, S. |
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Title |
Win-win-win: Collaboration advances critical care practice |
Type |
Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
13 |
Issue |
2/3 |
Pages |
223-228 |
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Keywords |
Nursing specialties; Rural nursing; Nursing; Education; Curriculum |
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Abstract |
This paper provides an overview of the structure and processes of an eighteen month, distance education course focused on developing advanced practice in the context of critical care nursing. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) was developed as a collaboration between Auckland University of Technology and two regional health providers. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This course is set against a background of increasing interest in education post registration. The acquisition of highly developed clinical capabilities requires a combination of nursing experience and education. This requires collaboration between clinicians and nurse educators, and approaches to address accessibility of relevant educational opportunities for nurses outside the country's main centres. |
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Call Number |
NRSNZNO @ research @ |
Serial |
878 |
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Author |
Ross, J. |
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Title |
International perspective: The development of the advanced role of rural nurses in New Zealand |
Type |
Journal Article |
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Year |
1999 |
Publication |
Australian Journal of Rural Health |
Abbreviated Journal |
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Volume |
7 |
Issue |
4 |
Pages |
253-257 |
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Keywords |
Nursing; Education; Rural nursing; Advanced nursing practice |
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Abstract |
This paper offers an insight into the development of the advanced role of rural nursing practice in New Zealand. The concept of advanced nursing practice is discussed within the context of the interdisciplinary healthcare team. It is argued that as nurses take on advanced practice, it is essential they receive appropriate clinical and theoretical skills to ensure they are in a position to provide competent and clinically safe, effective health care in an ethical, efficient manner. A description of a survey, undertaken by the author, studying rural nurses' skills provides the recommendation for the development of an appropriate postgraduate course at Masters level, designed specifically for primary rural nurses for the advanced role. |
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Call Number |
NRSNZNO @ research @ |
Serial |
953 |
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Author |
Lindley, G. |
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Title |
Using frameworks to critically analyse the advancement of rural practice: One nurse's experience |
Type |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Nursing models |
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Abstract |
The process of describing her scope of practice led the author to become interested in just how she has advanced her practice and the journey that unfolded. The author was introduced to a number of models or frameworks and these frameworks have been critiqued within this dissertation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
483 |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse (PHCRN) interface with secondary care doctors |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Rural health services; Relationships |
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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 as a component of rural nursing practice and representative of the primary-secondary care interface. Crucial to patient centred care, the premise was that the quality of this interface would be variable due to multiple influences such as: the historical nurse/doctor relationship that has perpetuated medical dominance and nursing subordination; current policy direction encouraging greater inter-professional collaboration; and changing role boundaries threatening traditional professional positioning. A total of 11 nurses representing 10 separate rural areas participated in semi-structured interviews. Rural nurses typically interact with secondary care doctors for acute clinical presentations with two tiers of interaction identified. The first tier was presented as a default to secondary care doctors for assistance with managing primary care level clinical presentations in the absence of access to a general practitioner or an appropriate Standing Order enabling appropriate management. The second tier presented itself as situations where, in the professional judgement of the nurse, the client status indicated a need for secondary level expertise and/or referral to secondary care. The needs of the rural nurse in these interactions were identified as access to expertise in diagnosis, therapy and management, authorisation to act when intervention would exceed the nurse's scope of practice; the need to refer clients to secondary care; and the need for reassurance, encompassing emotional and professional issues. The quality of the interactions was found to be variable but predominantly positive. Professional outcomes of positive interactions included professional acknowledgement, support and continuing professional development. For the patient, the outcomes included appropriate, timely, safe intervention and patient centred care. The infrequent but less than ideal interactions between the participants and secondary care doctors led to professional outcomes of intraprofessional discord, a sense of invisibility for the nurse, increased professional risk and professional dissatisfaction; and for the client an increased potential for deleterious outcome and suffering. Instead of the proposition of variability arising from interprofessional discord and the current policy direction, the data suggested that variability arose from three interlinking factors; appropriate or inappropriate utilisation of secondary care doctors; familiarity among individuals with professional roles and issues of rurality; and acceptance by the primary care doctor of the sole on-call primary health care rural nurse role and the responsibility to assist with the provision of primary health care. Recommendations for improving interactions at the interface include national, regional and individual professional actions. |
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Call Number |
NRSNZNO @ research @ |
Serial |
493 |
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Author |
Dillon, D.R. |
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Title |
Islands, islandness and nursing: Advanced nursing practice in rural remote and small island areas |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Primary health care |
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Abstract |
This dissertation focuses on the concepts of island, island-ness, and isolation. It aims to further advance the national and international literature relating to the health beliefs of island people as linked to the provision of primary health care services within New Zealand. New Zealand is an island nation made up of two main islands and numerous outlying islands, relatively isolated from the rest of the world by water. This geography means going anywhere from New Zealand involves traveling either “over” or “on” the sea. All people of New Zealand since the first inhabitants, whether residents or visitors, have arrived to New Zealand either by sea or more recently by plane. The population of New Zealand is 25% rural, with most of these rural dwellers residing in the South Island, and several of the smaller off shore Islands. This builds a sense of culture of the people, or tangata whanua (the people of the land), for whom there are degrees of island-ness, and the characteristics of this can be seen amongst the people of New Zealand. A further challenge which is discussed comes in the form of the “island penalty” which encompasses high transport costs, long distances to travel to main centres, lack of specialists and trained health workers, effects of migration and tourism, and communication difficulties. The more isolated people are, the tougher the challenges become. Most rural island populations are served by lay care workers, volunteers, and rural and remote nurses. Nurses are often the main health care providers to small island populations, and they demonstrate advanced nursing practice which is acknowledged internationally as meeting Nurse Practitioner competencies. As a group these nurses possess knowledge of the extrinsic and intrinsic factors involved in the health needs and health determinants of these island communities. Researching these advanced nursing roles adds to the body of knowledge around isolated and island communities. The author suggests that studying the concepts of islands, islandness, and isolation in relation to health beliefs will bring more understanding of services for the advanced rural nurse to consider in developing appropriate, accessible, affordable and adaptable Primary Health Care which is fair and equitable. |
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Call Number |
NRSNZNO @ research @ |
Serial |
507 |
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Author |
Robertson, A.M. |
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Title |
Meeting the maternity needs of rural women: Negotiating the reality of remote rural nursing and midwifery practice |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Midwifery |
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Abstract |
Recent changes to the way that health services are provided and issues related to the rural health workforce are creating an international crisis in the availability of rural maternity care. International trends show a workforce decline in rural general practitioner obstetric specialists and rural midwives, as well as a decline in rural births. The aim of this study is to highlight the maternity needs of rural New Zealand women. Further, it discusses how the changes to maternity services in New Zealand, over the last sixteen years, have impacted on the rural nurse and midwife role and therefore on service provision. This information is intended to identify issues that could be used as the basis for development of a uniquely rural model of maternity care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
510 |
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Author |
Boyd, M.E. |
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Title |
Advancing nursing knowledge: The experience of a nurse working with dying people in a highly remote rural area |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Terminal care; Rural nursing; Rural health services |
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Abstract |
By describing and gaining insight into one rural nurse's experience working with dying people in a highly, remote rural area, this project seeks to advance nursing practice. Key findings indicate that, through community partnership and teamwork, nurses can act to assist rural people by: increasing public awareness of health resources; exposing barriers to access; and identifying different health service needs. The author makes a case that some rural nurses may feel insufficiently prepared for rural nursing. To understand death and dying, key ideas from Kuebler-Ross's (1969) framework for dying are examined: denial, fear of dying, spirituality, hope, depression and how to die well. Nurses require a blend of end-of-life and rural nursing postgraduate education and skills, to manage well. Key findings imply that dying people can be helped by: improving function and independence to promote autonomy; encouraging faith, hope, and love within the person's personal concept of spirituality; listening to dying people, to oneself, to one's own reactions, and knowing oneself. Parse's theory (1981) indicates nurses can help rural dying people by the following key factors: encouraging the person to live life to the full while dying; accepting humans cannot be separated from their perspectives, circumstances or environments; focusing on quality of life from the person's perspective: encouraging the person to live life fully while dying; and offering new possibilities. The author goes on to say that Parse's human-universe-health process aids nurses to live their beliefs indicating Parse's theory could guide and advance nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
573 |
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Author |
Thompson, R. |
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Title |
Red Band nursing: From swannies to stethoscopes |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Community health nursing; Public health |
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Abstract |
The author notes that many registered nurses undertake a role in the community which may or may not be recognised for what it really is – one of these roles may be that of the unpaid health care provider. The nurse may be called on by family, friends, neighbours, or the wider community to provide a voluntary health service at any time of the day or night according to the need of the person wanting the information or assistance. This is the story of one such nurse. Four themes have been uncovered from a nursing practice that has spanned three decades of providing an on-call basic first aid service to a community of about two hundred households in a rural community. These experiences are used to shape the stories within the story of this voluntary role, and provide a framework to discuss the implications for the future of voluntary practice.The themes are: Maintaining personal and professional boundaries; Maintaining values and a high standard of care; Commitment to ongoing education; Accepting accountability for one's actions. The confidence and competence that such practice demands is explained from a personal perspective, along with an attempt to answer a question that is often asked – “Who will or indeed does anyone want to replace me when I retire or shift away from the district?” This question is addressed in the context that this story is written, the changes that the healthcare system is experiencing at present, and the impact that these changes may have for the future. |
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Call Number |
NRSNZNO @ research @ |
Serial |
607 |
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Author |
Fitzwater, A. |
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Title |
The impact of tourism on a rural nursing practice |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Rural nursing; Tourism |
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Abstract |
Rural nursing in the remote context of South Westland is shaped by factors common to rural nursing practice world-wide including geographical and professional isolation, living and working in a small community, providing health care to rural people and the broad, generalist and advanced scope of nursing practice. Tourism is a major industry in the townships in the proximity of the two accessible glaciers in South Westland. The practice of the nurses in these areas is significantly affected by tourists seeking health care and by providing a health service for the large number of migrant seasonal workers who service the tourist industry. Tourists seek health care from the nurses across the full spectrum of health problems and their expectations of the health care required may exceed the service that can be provided. The nurses are challenged to advance their practice to find the personal and professional resources to provide a safe service. This includes the challenge of cultural safety and personal safety. The tourist industry brings significant numbers of young people as seasonal/temporary workers to the glacier areas. This imposes a youth culture onto the existing rural culture. Nursing practice has expanded to include the specialist practice of youth health care that includes the problems of alcohol and drug misuse, sexual and reproductive health, and youth mental health. This work is drawn from the experience of the nurses working in the glacier communities. The impact of the tourism industry on their rural nursing practice includes the increasing volume of work that challenges the viability of the service, the advanced scope of practice required to meet the health needs of tourists and the seasonal tourist industry workers, and challenges to personal and professional safety. |
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Call Number |
NRSNZNO @ research @ |
Serial |
659 |
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Author |
Horner, C. |
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Title |
Maintaining rural nurses' competency in emergency situations |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Nurse practitioners; Rural nursing; Education |
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Abstract |
On call emergency health services are becoming routinely provided by some rural nurses, predominantly within the South Island. Rural nurses have been advancing their practice to accommodate the limited availability of general practitioners in rural communities. Although this is becoming routine practice, the author has been providing a service such as this for the past 12 years. This dissertation describes this practice in relationship to the present social-political context, advancing nurse competencies and her experience of rural nursing in a rural town within the South Island. Particular significance for the rural nurse is the required independent practice and overall responsibility when remote from traditional medical oversight. Providing on call emergency care with the possibility of a broad spectrum of emergency situations while maintaining competence for the unpredictable frequency (or lack of frequency) of the rural emergency is the focus of this dissertation. The professional and personal risks are high for rural nurses when placed in situations they are not prepared for or unable to remain competent to manage. Implications resulting from the critique of the health service literature on this subject are identified. Firstly, rural nurses need to be insightful of their own emergency on call expertise and limitations. Secondly, rural nurses require ongoing education and thirdly that appropriate education is available and accessible to rural nurses. Lastly, rural nurses require maintenance of competency so these emergency skills are not lost. This dissertation and the resulting recommendations embrace Nursing Council of New Zealand Nurse Practitioner Competencies. The resulting outcomes fulfilling the rural nurse's need for maintenance of competency for emergency on call care, the community's need for safe appropriate emergency care and national legislation requirements. |
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Call Number |
NRSNZNO @ research @ |
Serial |
666 |
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Author |
Pepers, M.G. |
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Title |
A grey zone: The experience of violence in remote nursing practice |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Workplace violence; Rural health services; Rural nursing |
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Abstract |
This dissertation explores the issues affecting the exposure of isolated rural nurses working in New Zealand to violence from members of the local community, including the visiting public. Discussion on the collaborative role with the New Zealand Police is thematic in the issues presented. Challenges presented include the unique community dynamics of the Stewart Island nursing practice on the Island, with scope of practice, isolation and practice issues included. Role definition, present-day health-care delivery, the potential for violence including causation and reporting are presented. Incident management and risk strategies, including de-escalation are rationalised and described. Evidence for the nurse-police inter-service relationship along with issues including confidentiality and legislation are reviewed. Recommendations and conclusion are provided. The thread and theme of the dissertation is to encourage discussion within nursing circles on the provision of satisfactory safety standards for nurses working in remote isolated parts of New Zealand. |
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Call Number |
NRSNZNO @ research @ |
Serial |
688 |
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Author |
Roulston, E. |
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Title |
Storytelling: The story of my advancing rural nursing journey |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing |
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Abstract |
The author tells a story to describe her advancing practice as a registered nurse practising in the rural context. Storytelling is a way to add to the growing knowledge of rural nursing practice in New Zealand. By sharing her rural nursing story through a storytelling framework, she suggests that other nurses may be in a position to utilise this framework and tell their own stories. She has adapted a formalised storytelling framework from McDrury and Alterio (2002). Concepts of the storytelling framework, including reflection, critical reflection and critiquing, can lead to new knowledge and understanding of nursing practice. Past experience is a component of this framework as are the concepts of surface and deep learning. In this way, nursing practice can be deconstructed then reconstructed for new knowledge to be obtained. The innermost thoughts and feelings of the nurse are an integral part of this whole process and need to be acknowledged. The author wanted to answer questions she asked of herself, namely, “how do I practise and how can I improve my practice for the benefit of my patients?” The rural context is expanded upon in her nursing story as this is where she practises as a registered nurse. Her various nursing roles, including advanced practice as a district nurse and rural nurse specialist, are described in depth as are the two areas where she has lived and worked as a rural nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
737 |
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