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Author Water, T. url  openurl
  Title The meaning of being in dilemma in paediatric practice: A phenomenological study Type
  Year 2008 Publication (down) Abbreviated Journal NZNO Library  
  Volume Issue Pages 259 pp  
  Keywords Psychology; Paediatric nursing; Paedetric practice; Problem solving  
  Abstract This study explores the phenomenon of dilemma in paediatric practice. Using a hermeneutic phenomenological method informed by the writings of Heidegger [1889-1976] and Gadamer [1900-2002] this study provides an understanding of the meaning of 'being in dilemma' from the perspective of predominantly paediatric health care professionals but also families in New Zealand. Study participants include four families who had a child requiring health care and fifteen health care practitioners from the disciplines of medicine, nursing, physiotherapy, play specialist and occupational therapy who work with families and children requiring health care. Participants' narratives of their experiences of 'being in dilemma' were captured via audio taped interviewing. These stories uncover the everyday realities facing health professionals and families and provide an ontological understanding for the notion of dilemma. The findings of this study suggest that experience of dilemma for health professionals reveals a world that is uncertain and questionable where they are thrown into having to make uncomfortable choices and must live with the painful consequences of their actions. The consequences of being in such dilemma are having to find ways of living with the angst, or risk becoming too sensitive or desensitizing. For families the experience of dilemma reveals a similar phenomenon most evident in circumstances where they feel totalized by the impact of heath care encounters. This study has uncovered that the perspectives that health professionals and families bring to the experience of dilemma reveal different concerns and commitments and may be hidden from each other. This thesis proposes that health professionals and families need support in living with their own personal encounters of enduring experiences of dilemma.  
  Call Number NRSNZNO @ research @ Serial 1234  
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Author Bennison, C. openurl 
  Title Emergency nurses' perceptions of the impact of postgraduate education on their practice in New Zealand Type
  Year 2008 Publication (down) Abbreviated Journal NZNO Library  
  Volume Issue Pages  
  Keywords Emergency nursing; Nursing; Education  
  Abstract ABSTRACT

BACKGROUND: Emergency nursing is a specialty concerned with the care of people of all ages, with either perceived or actual unwellness presenting to the emergency department(ED) for assessment, resuscitation, investigation, treatment and review of their illness or injury. Emergency nurses apply specialty knowledge and expertise in the provision, delivery and evaluation of emergency nursing care. Over recent decades social, political and professional changes have affected nursing care delivery and nursing education. In particular the 21st century has witnessed the development of state funded postgraduate nursing education programmes, developing nurses specialty or advanced nursing knowledge, quality patient/client care and nursing practice within the tertiary education system.

AIM: The aim of this study is to investigate emergency nurses? perceptions of the impact of postgraduate education on their practice in New Zealand (NZ).

METHODS: This study utilises critical social theory as the overarching framework, informed by the writing of Jürgen Habermas (b.1929- ). It is the three phases of

Habermas?s practical intent of critical social theory; namely enlightenment, empowerment and emancipation, that this study is concerned with. This descriptive research study employs both quantitative and qualitative methods and is therefore known as mixed-methods research. Data collection took place over 12 weeks, from August to November 2006, using a survey questionnaire obtained with permission from Ms Dianne Pelletier, Sydney, Australia. The sample included 105 emergency nurses from District Health Board (DHB) emergency departments in NZ, 10 respondents from this sample self-selected to be interviewed by telephone. Ethical approval for this study was obtained from the University of Otago Ethics Committee for research involving human participants. Data was analysed using the Statistical Package for Social Sciences (SPSS).

RESULTS: Two main themes arose from the thematic analysis; these being positive and negative, these themes were further divided into 10 sub-themes. The results indicate that postgraduate study (PGS) has increased nurses? perception of their knowledge; leadership and understanding on the quality of patient care delivered, increased their academic and research skills and increased their confidence/self-esteem and recognition by their colleagues and team. Therefore the majority of respondents perceive postgraduate education has been an instrument of liberation and a process of empowerment and emancipation. A smaller percentage of respondents perceived that PGS had no effect on various aspects of patient care and another significantly smaller percentage of respondents reported negative results from PGS. This research identified similarities between this study and that of Pelletier and colleagues? (2003; , 2005; , 1998a; , 1998b) Australian study.

CONCLUSION: This study adds to the existing literature on postgraduate studies undertaken by nurses. No known study has previously investigated solely emergency nurses?perceptions of the effects of PGS, either nationally or internationally. The results of this study offer enlightening information regarding emergency nurses? perceptions of their PGS within NZ and offers a platform from which other studies may be undertaken. It also has the potential to inform nurses contemplating PGS and educators facilitating these programmes,as well as provide implications for policy development by the Nursing Council of NZ, NZ Universities, DHBs and the Ministry of Health.
 
  Call Number NRSNZNO @ research @ Serial 1291  
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Author Spackman, N. E. openurl 
  Title Nurses' early experiences with patient death Type
  Year 2008 Publication (down) Abbreviated Journal NZNO Library  
  Volume Issue Pages 156 pp  
  Keywords New graduate nurses; Terminal care  
  Abstract Chronic stress and 'burnout' have been extensively researched in nursing populations, but very little is known about the impact of specific acutely stressful or significant events. A novice nurse's first encounter with patient death may pose considerable cognitive, emotional and clinical challenges. Using a mixed methods design, this study explored the clinical circumstances, impact and challenges and rewards of nurses' early experiences with patient death.  
  Call Number NRSNZNO @ research @ Serial 1292  
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Author Brinkman, A.; Wilson-Salt, R.; Walker, L. openurl 
  Title Education survey report: Implications for practice Type Report
  Year 2008 Publication (down) Abbreviated Journal http://www.nzno.org.nz  
  Volume Issue Pages  
  Keywords Professional development; Professional Competence; Nursing  
  Abstract Professional development is an ongoing requirement of nurses as a result of the Health Practitioners Competence Assurance Act. The Act?s principal purpose is to protect the health and safety of the public by ensuring health practitioners are fit and competent to practise. This survey was designed to explore the avenues nurses have taken, and would prefer to take, for their professional development. The questionnaire was sent to a random sample of the New Zealand Nurses Organisation's registered and enrolled nurse members. Nurses overwhelmingly favoured professional development in the workplace. More than half the respondents reported a conflict with other time commitments, while a number of respondents wrote of their desire for work-life balance. The cost of fees, ability to take time off work, and time and travelling distance were all hurdles to professional development. Nurses cited information technology, conflict resolution, managing challenging behaviour, and dealing with rostered & rotating shifts as aspects of their current work for which their nursing education (pre and post) had not adequately prepared them. Nurses also indicated that their pre-registration education in health systems and political processes was inadequate for their current work. As nurses aged, their interest in professional development increased, though many still preferred workplace options. The authors conclude that, in order for professional development opportunities to be accessible and relevant, resources and time must be made available. This is vital to achieve ongoing education of nurses and improved patient outcomes. Management support, combined with effective assessment of learning needs guiding professional development opportunities, are fundamental to ensuring nurse competence.  
  Call Number NZNO @ research @ Serial 1329  
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Author Brinkman, A. openurl 
  Title Collating for collaboration: Tertiary education funding structures Type Report
  Year 2008 Publication (down) Abbreviated Journal Available from http://www.nzno.org.nz  
  Volume Issue Pages  
  Keywords Nursing; Education; Policy  
  Abstract The nursing education environment is complex and varied, and is affected by both the education and health systems. This report backgrounds the funding systems that underwrite the Tertiary Education Commission (TEC) processes. The two primary objectives that have guided this collation are: to stimulate awareness and discussion of the issues around funding nursing education in New Zealand; and to promote understanding of the complex funding structures currently in place in New Zealand by students, nurses, nurse educators and nurse managers.  
  Call Number NZNO @ research @ Serial 1330  
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Author Dawson, A.L. openurl 
  Title Same person different nurse : A study of the relationship between nurse and patient based on the experience of shifting from secondary care to home based nursing Type
  Year 2008 Publication (down) Abbreviated Journal Held by Lakes DHB Library (ROM)  
  Volume Issue Pages  
  Keywords  
  Abstract A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Nursing.  
  Call Number NZNO @ research @ Serial 1370  
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Author Atkin, Rachel url  openurl
  Title Discourses of deficiency: An analysis of the critical care outreach literature Type
  Year 2008 Publication (down) Abbreviated Journal http://researcharchive.wintec.ac.nz/1/  
  Volume Issue Pages  
  Keywords  
  Abstract Critical care outreach is part of a new approach to manage all critically ill patients, regardless of where they are located in the hospital. It is the complete process of care that focuses on individual patients needs rather than on beds and buildings. There has been a proliferation of research literature since critical care outreach teams were introduced and subsequently required to provide robust evidence in the form of research to prove the effectiveness of their service. The research conducted by nurses has largely focused on phenomenological inquiry and has utilised methodologies such as questionnaires and interviews.  
  Call Number NZNO @ research @ Serial 1376  
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Author Kennedy, Wendy Lynette url  openurl
  Title How do Registered Nurses utilise self assessment and performance appraisal to inform their professional practice? Type Book Whole
  Year 2008 Publication (down) Abbreviated Journal  
  Volume Issue Pages 97 p.  
  Keywords Registered Nurses; Self-assessment; Performance appraisal; Surveys  
  Abstract Describes an exploratory study of Registered Nurses (RNs) within a local District Health Board which pursued the question of 'if' and 'how' professional practice frameworks assisted nurses in their individual professional practice, specifically self-assessment and performance appraisal. Utilises a qualitative descriptive framework to explore the experiences of RNs in inpatient settings, via questionnaire. Identifies 8 themes related to self-assessment, performance appraisal, and professional practice.  
  Call Number NZNO @ research @ Serial 1703  
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Author Cumming, Glynis url  openurl
  Title From a generic to a gynaecological oncology Clinical Nurse Specialist: an evolving role Type Book Whole
  Year 2008 Publication (down) Abbreviated Journal  
  Volume Issue Pages 106 p.  
  Keywords Clinical Nurse Specialist; Nursing role; Patient outcomes; Patient satisfaction; Gynaecology nursing; Oncology nursing  
  Abstract Explores the role of the generic clinical nurse specialist (CNS) in order to provide clarity and guidance for an evolving Gynaecological Oncology CNS. Undertakes an integrative literature review to identify the generic components of a CNS role, the factors that impact on role development, and to establish what current literature states regarding the impact of the CNS role on patient outcomes. Highlights clinical expert, educator, consultant, researcher and care coordinator as generic components of a CNS role, with relational practice key to improved patient outcomes and satisfaction.  
  Call Number NZNO @ research @ Serial 1704  
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Author Butters, Katheryn Janine url  openurl
  Title A qualitative study of the ethical practice of newly-graduated nurses working in mental health Type Book Whole
  Year 2008 Publication (down) Abbreviated Journal  
  Volume Issue Pages 184 p.  
  Keywords Newly-graduated nurses; Nursing ethics; Mental health nurses; Surveys  
  Abstract Presents a qualitative exploration of factors that influence eight newly-graduated nurses as they endeavour to practice ethical mental health nursing. Gathers data from in-depth interviews with the participants, analysed using a thematic analysis method. Considers aspects of the social and political context within which the participants are situated.  
  Call Number NZNO @ research @ Serial 1861  
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Author Kidd, J.D. url  openurl
  Title Aroha mai: Nurses, nursing and mental illness Type
  Year 2008 Publication (down) Abbreviated Journal University of Auckland Library  
  Volume Issue Pages  
  Keywords Mental health; Nursing; Culture  
  Abstract This research takes an autoethnographical approach to exploring the connections between being a nurse, doing nursing work, and experiencing a mental illness. Data is comprised of autoethnographical stories from 18 nurses. Drawing on Lyotard's (1988) postmodern philosophy of 'regimes of phrases' and 'genres of discourse,' the nurses' stories yielded three motifs: Nursing, Tangata Whaiora (people seeking wellness) and Bullying. Interpretation of the motifs was undertaken by identifying and exploring connected or dissenting aspects within and between the motifs.  
  Call Number NRSNZNO @ research @ 478 Serial 465  
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Author Sye, J. url  openurl
  Title A fine balance Type
  Year 2008 Publication (down) Abbreviated Journal AUT University Library  
  Volume Issue Pages  
  Keywords Paediatric nursing; Community health nursing; Nurse-patient relations; Children; Patient rights  
  Abstract The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates.  
  Call Number NRSNZNO @ research @ 911 Serial 895  
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Author Davies, B. url  openurl
  Title Same person different nurse: A study of the relationship between nurse and patient based on the experience of shifting from secondary care to home-based nursing Type
  Year 2008 Publication (down) Abbreviated Journal Research Archive at Wintec  
  Volume Issue Pages  
  Keywords Nurse-patient relations; Communication; Hospitals; Home care  
  Abstract This study focuses on power themes in the nurse-patient relationship. The study is a critical reflection of the author's practice using a humanistic perspective from Hartrick Doane and Varcoe's (2005) model of relational family practice. It reviews the literature relating to power relationships in communication between nurses and patients and compares the ability to provide relational care in the home with hospital care. Practice examples demonstrate the shift in power relationships that the author had noticed since changing roles from hospital based to home care nursing. This is related to cultural, socio-environmental, historical and traditional influences on power in communication. The study is based on her reflection of the paradigm shift in her practice. Her practice moved from a problem solving approach to an empowerment, strengths based approach within partnership. The ethical challenges of discussing her practice in relation to clients has been managed by scrambling patient data so that it is not related to a single person and is focused on the author's nursing practice.  
  Call Number NRSNZNO @ research @ 1195 Serial 1180  
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Author Tustin-Payne, W. url  openurl
  Title Self esteem, competence assessment and nurses ability to write reflectively: Is there any connection? Type
  Year 2008 Publication (down) Abbreviated Journal Wintec Research Archive  
  Volume Issue Pages  
  Keywords Professional competence; Nursing; Psychology; Quality of health care; Feminist critique  
  Abstract The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection.  
  Call Number NRSNZNO @ research @ 1198 Serial 1183  
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Author Clayton, J.R. url  openurl
  Title Exploring transitions: Working in “the space between the no longer and the not yet” Type
  Year 2008 Publication (down) Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue Pages  
  Keywords Communication; Nurse-patient relations; Case studies  
  Abstract This thesis uncovers a personal journey of reflective practice, focusing on the author's emerging role as a nurse facilitating transitions using a dialectical approach in the context of a private nursing practice. Transitions encompass: life changes, loss, and adjustment to changes in function. Dialectical nurse facilitation of transition (DNFT) is a way of exploring self in the transitional space between “the no longer and the not yet”. In this facilitated process people potentially discover paradoxes, tensions, and creative energy, as they search for a way forward. The research design details a dialectical heuristic quest through journaling and reflecting on practice supervision and peer review, over a two year period. Exemplars written after reflecting on case notes reveal the lived experiences of participants. These case reviews show the complexity of patterns for people undergoing transitions and nurse facilitation. A relational pattern for DNFT encompasses compassionate engagement, catalytic mirroring, and interconnectedness. An exploration of literature encompasses nursing theories, facilitation, dialogue, loss, grief, spirituality and transition. This thesis provides a basis for evaluative research on the effectiveness of DNFT in health care settings in the future. Discussions regarding the expansion of these reflective and praxis genres are included which may be of interest to nursing education and practice contexts.  
  Call Number NRSNZNO @ research @ 1203 Serial 1188  
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