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Budge, C., Carryer, J. B., & Wood, S. (2003). Health correlates of autonomy, control and professional relationships in the nursing work environment. Journal of Advanced Nursing, 42(3), 260–268.
Abstract: The aim of this study was to examine nursing in New Zealand and to see whether aspects of the work environment are associated with health status. A total of 225 registered nurses in a general hospital completed the Revised Nursing Work Index (NWI-R) and Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36). Ratings indicated that the New Zealand hospital environment was characterized by less autonomy and control and better nurse-physician relations than in USA hospitals. Results of correlations demonstrated that more positive ratings of the three workplace attributes were associated with better health status amongst the nurses. The results of regression analyses were indicative either of a confounding relationship or of a mediating relationship such that nurses' relations with physicians, administration and other departments mediate the associations between autonomy, control and health status.
Keywords: Workplace; Occupational health and safety; Registered nurses
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Rydon, S. E., Rolleston, A., & Mackie, J. (2008). Graduates and initial employment. Nurse Education Today, 28(5), 610–619.
Abstract: This research project was undertaken to inform nurse educators in the Department of Nursing and Health Studies of Manukau Institute of Technology of the employment opportunities for new graduate nurses emerging from the three year degree and registration programme. Graduates from the programme for the previous three years were surveyed for their experiences in gaining employment. 89.8% of graduates were successful in gaining employment in the first three months post registration. The number of graduates employed within a district health board declined across the three years but there were no significant differences between cohorts. Overall, 73% of graduates were employed into new graduate positions. The majority of graduates felt that their nursing education prepared them well for their role as a registered nurse. The findings of the qualitative data identified a strong need for science throughout the degree; longer clinical blocks; increased hands on experience; more practice with skills and less theory in relation to practical experience.
Keywords: New graduate nurses; Curriculum; Work
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Pepers, M. G. (2006). A grey zone: The experience of violence in remote nursing practice. Ph.D. thesis, , .
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.
Keywords: Workplace violence; Rural health services; Rural nursing
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McKenna, B., Poole, S., Smith, N. A., Coverdale, J., & Gale, C. (2003). A survey of threats and violent behaviour by patients against registered nurses in their first year of practice (Vol. 12).
Abstract: For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes.
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McKenna, B. (2002). Risk assessment of violence to others: Time for action. Nursing Praxis in New Zealand, 18(1), 36–43.
Abstract: The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings.
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Lauder, G. C. (2004). Health in the workplace: An exploration of healthy options for an aged care setting.
Abstract: People working in aged care settings in New Zealand spend approximately 30% of their lives in their workplace. There is a challenge for workplaces to support people to maintain and improve their health status. This project investigated the question: How can workplaces support staff to maintain health in an aged care environment? The project concerned two considerations: primarily what people can do for themselves and how the organisation can assist their interest and maintain their investment in health based activities and secondly what workplaces can do to make the organisations more healthy. The philosophy and the realities of the workplace were reviewed and the project addressed the strategies that could be adopted by the workplace. The study identifies a series of practical activities and outcomes that aged care facilities can undertake for nurses/caregivers or other members of staff working in the workplace. The findings lead to recommendations about healthy outcomes and managing health and creating a positive climate for health within the workplace.
Keywords: Geriatric nursing; Health behaviour; Workplace
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Ross, J. (2001). Role identification: An impediment to effective core primary health care teamwork. Ph.D. thesis, , .
Abstract: This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners and the understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.
Keywords: Multidisciplinary care teams; Teamwork; Primary health care
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Tan, S. T., Wright, A., Hemphill, A., Ashton, K., & Evans, J. H. (2003). Correction of deformational auricular anomalies by moulding: Results of a fast-track service. Access is free to articles older than 6 months, and abstracts., 116(1181).
Abstract: This paper reports the result of a fast-track referral service in treating deformational auricular anomalies using moulding therapy, by employing nurses who were familiar with the indications and technique, working in close liaison with plastic surgeons. The type and severity of the auricular anomaly were documented both clinically and photographically before and three months following cessation of treatment. Assessment of the results was made by comparing the pre- and post-treatment photographs and by a postal questionnaire, which was dispatched to the parents of the patients three months after treatment was discontinued. All parents of the 30 infants felt that auricular moulding was worthwhile. The authors conclude that this is an effective treatment strategy that will largely negate the need for surgical correction of deformational auricular anomalies.
Keywords: Infants; Neonatal nursing; Teamwork
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Murrell-McMillan, K. A. (2006). Why nurses in New Zealand stay working in rural areas. New Zealand Family Physician, 33(3), 173–175.
Abstract: The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues.
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Morton, J., Williams, Y., & Philpott, M. (2006). New Zealand's Christchurch Hospital at night: An audit of medical activity from 2230 to 0800 hours. New Zealand Medical Journal, 119(1231).
Abstract: The authors conduct an audit of medical activity at Christchurch Hospital, a 650 bed tertiary centre, between 2230 and 0800 hours. They measured the volumes of tasks requiring completion overnight and identified the competencies required for this as well as the level of teamwork that existed. They found several organisational areas of concern, that indicate new approaches are required to staff the “hospital at night,” and an Out of Hours Multidisciplinary Team is recommended. Specific issues included the lack of teamwork from the Resident Medical Officers (RMOs), with some overextended while others were inactive. House officer tasks were largely generic rather than specialty specific; there was no formal handover from the afternoon or day shifts and the level of hospital medical staffing did not reflect the activity levels over the time period studied. The researchers also recommend an urgent review of the beep policy. A third of the admissions were to General Medicine, and basic medical activities (including admitting, reviewing, and prescribing drugs and fluids) for patients admitted under all specialties represented the majority of the night workload. Medical registrars had reduced some of the traditional multiple clerking by admitting patients themselves.
Keywords: Hospitals; Teamwork; Administration; Shiftwork; Organisational culture
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Rolls, S. (2006). An exploration of workplace violence in the emergency department: Are emergency nurses safe? Ph.D. thesis, , .
Abstract: This thesis arises from the author's experience of several years of working in the emergency department and being exposed to workplace violence from patients and their families. Emergency nurses in New Zealand experience workplace violence every day. Registered nurses and the institutions in which they work manage workplace violence to varying degrees and in an ad hoc manner. The author notes that New Zealand has no national guidelines, or consensus on the management of workplace violence in the health sector. This research explores emergency nurses' encounters during their work when they have experienced workplace violence. The purpose of this study is to demonstrate the experience and the consequences when nurses are confronted with episodes of violence while working in the emergency department. The essence of this research is gaining an understanding of how registered nurses have managed workplace violence and the impact of that violence on themselves, their colleagues, and the patients in the emergency department. Recommendations are made regarding nationally consistent guidelines, education on the management of workplace violence, improved security, and emergency department design. The discussion concludes with suggestions for further research on workplace violence in the health sector
Keywords: Workplace violence; Emergency nursing; Guidelines
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Finlayson, M., & Aitken, L. H. (2007). New Zealand nurses' reports on hospital care: An international comparison. Nursing Praxis in New Zealand, 23(1), 17–28.
Abstract: The authors present the results of a 2001 New Zealand survey on nurses' perception of staffing, work organisation and outcomes, comparing this with the 2001 International Hospital Outcomes Study (US, Canada, England, Scotland and Germany). The report describes the findings for job dissatisfaction, burnout and the intent to leave, the work climate in hospitals, workforce management, the structure of nurses' work, and quality of care. The authors discuss these findings and their implications for nursing in New Zealand.
Keywords: Job satisfaction; Cross-cultural comparison; Workplace
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