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Robertson, G. (2000). Disquiet in the development of clinical supervision for professional development in nursing practice: A literature review.
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 Some reference to unpublished data and local practice in the Wellington area have been included as a stimulus for further incorporation of clinical supervision in local practice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.
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McClunie-Trust, P. (2000). Body boundaries and discursive practices in life threatening illness: Narratives of the self. Ph.D. thesis, , .
Abstract: This thesis tells a story from within and between the boundaries of my professional work as a nurse and my private life as the wife of a patient with life threatening illness. The events related in the thesis are told using a technique I have called writing back to myself, where my own journals and stories of the experience of living with life threatening illness provide data for analysis. The reader is invited to participate in these representations and to consider the potential for the skilful practice of nursing which may be read in the stories, and the analysis I have developed from them. I have developed the theoretical and methodological positionings for the thesis from the work of Foucault (1975,1979,1982,1988), Deleuze (1988), Ellis (1995), Richardson (1998) and other writers who utilise genealogical or narrative approaches. The analysis of my own stories in the thesis explores the philosophical and contextual positionings of the nurse as a knowledge worker through genealogies of practice and the specific intellectual work of the nurse. Local and contextual epistemologies are considered as ways of theorising nursing practice through personal knowledge, which is surfaced through the critical analysis of contextual positionings and the process of writing as inquiry.
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Logan, C. M. (2000). Anaesthetic nursing: Focusing perioperative practice on the patient.
Abstract: The purpose of this literature review is to generate a picture of what is known and what needs to be investigated further about anaesthetic nursing in the perioperative nursing role in New Zealand, and to examine this in relation to international trends. Nurse anaesthetists in the United States are described in American nursing literature, and recognised as one of the four advanced nurse practitioner roles. In New Zealand, recent efforts to provide appropriate post-graduate education for the perioperative nurse have been challenged by other inter-professional interests, thus restricting the development of an expanded role. The author notes that this has caused concern for New Zealand's perioperative nurses who consider anaesthetic nursing is an integral part of perioperative practice. Anaesthetic nursing forms a substantial component of the basic competencies required of a registered nurse working in the operating theatres. Orientation programmes and ongoing education at all levels of professional development incorporate anaesthetic nursing competencies to provide continuity of patient care and support perioperative practice. Care of the patient undergoing anaesthesia is an area where nurses demonstrate their advanced assessment skills and clinical judgement and is included in perioperative specialist or nurse practitioner job descriptions. The Perioperative Nurses Association in New Zealand is concerned to develop postgraduate education in their area of speciality to support their application for 'College' status within the New Zealand Nurses Organisation. For this to happen in a cogent fashion, information and knowledge generated from research, are required to clarify perioperative nursing's current position and determine how practice can be shaped to best care for patients undergoing surgical interventions. Evidence from research supports nurses in the anaesthetic role by demonstrating that the preoperative visits and assessments they undertake can reduce patients' anxieties, decrease the need for pain relief and shorten hospital stays. This review includes literature sources that explore disparities between the development of New Zealand anaesthetic nursing and international models. The author suggests that information and understanding gained from conducting this review will allow future developments in anaesthetic nursing practice to be informed by previous initiatives and projects and identifies areas for further research.
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Blackie, S. A. H. (2001). Women, work, study and health: The experience of nurses engaged in paid work and further education. Ph.D. thesis, , .
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Archer, L. K. (2001). We talk what we do: An exploration of the value, role and function of storytelling in nursing from one nurse's practice perspective.
Abstract: The role of storytelling in any society fulfils multiple functions such as maintaining culture, holding history, teaching genealogical lessons, imparting wisdom, entertaining, passing on knowledge. The author suggests that nursing, historically described as a craft with an oral tradition, could be seen to be quietly moving away from the practice of storytelling. Or has it? She asked this question and began to realise that her practice and relationships with colleagues had always been based on stories and storying. To explore this phenomenon, she began to describe her day to day practice in story form, and began to position stories she had previously written. In her work of oncology palliative care nursing within a community setting in New Zealand, the stories proved crucial to her role as an educator, and companion of patients and their families. In this paper she examines how she uses story for her benefit, the patients' benefit, but mainly for the benefit of nursing. She examines from her own perspective, some underlying themes that reinforce the need to continue this ancient tradition and explore the role, value and function of storytelling within nursing.
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Peri, K., Kerse, N., Kiata, L., Wilkinson, T., Robinson, E., Parsons, J., et al. (2008). Promoting independence in residential care: Successful recruitment for a randomized controlled trial. Journal of the American Medical Directors Association, 9(4), 251–256.
Abstract: The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success.
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Lesa, R., & Dixon, D. A. (2007). Physical assessment: Implications for nurse educators and nursing practice. International Nursing Review, 54(2), 166–172.
Abstract: In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing.
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Farrow, T. (2002). Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments. International Journal of Mental Health Nursing, 11(4), 214–219.
Abstract: 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
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McBride-Henry, K., & Foureur, M. (2006). Organisational culture, medication administration and the role of nurses. Practice Development in Health Care, 5(2), 208–222.
Abstract: This research study was designed to identify ways of enhancing patient safety during the administration of medications within the New Zealand context. The researchers employed a multi-method approach that included a survey using the Safety Climate Survey tool, focus groups and three clinical practice development groups. The authors conclude that the outcomes of this study indicate that practice development initiatives, such as the ones outlined in this project, can have a positive effect on nurses' perceptions of organisational safety, which in turn has been demonstrated to have a positive impact on patient safety.
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Wilson, D., & Neville, S. J. (2008). Nursing their way not our way: Working with vulnerable and marginalised populations. Contemporary Nurse, 27(2), 165–176.
Abstract: This paper uses the findings of two studies to explore the nature of nurses' practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. The first study was with the elderly with delirium and used a critical gerontological methodology informed by postmodernism and Foucault's understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory informed by a Maori-centred methodology. The findings show that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to people's lives outside of the health care environment is ignored. Consequently, the foundations of nursing practice, that of holism, is found to be merely a rhetorical construct.
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Spence, D. (2003). Nursing people from cultures other than one's own: A perspective from New Zealand. Contemporary Nurse, 15(3), 222–231.
Abstract: This paper provides an overview of the evolving meaning of 'culture' in New Zealand nursing. Then, drawing upon the findings of research that used hermeneutic phenomenology to explore the experience of nursing people from cultures other than one's own, a description of the constituent parts is of this phenomenon is briefly outlined and followed by an exemplar that describes the coalescent and contradictory nature of the phenomenon as a whole. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, interplay of the notions of prejudice, paradox and possibility is evident at intrapersonal and interpersonal levels as well as in relation to professional and other discourses.
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Phillips, B. N. (2007). Nursing care and understanding the experiences of others: A Gadamerian perspective. Nursing Inquiry, 14(1), 89–94.
Abstract: This article investigates the process where nurses attempt to understand the experience of patients. The author argues that this transcends particular models of ill-health. Gadamerian hermeneutics, which has been used in nursing research to articulate the process of understanding, is elaborated on. Gadamer's exposition of understanding shows that practitioners need to be aware that understanding of other people is developed through a fusion of one's own history, language and culture with that of the other person. This occurs through a hermeneutic question-answer dialogue in which practitioners put their ideas at risk of being modified or rejected in the process. Understanding then, is a perceptual and conceptual process. In this way, the experience of nurses seeking to understanding those they nurse increases self-awareness, as well as enhancing their ability to further understand others.
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Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing Review, 53(2), 94–101.
Abstract: This paper explores the concept of innovation in nursing, the inherent set of characteristics that need to be present in order for innovations to succeed, and the barriers that impede innovation from occurring. Successful innovations developed and implemented by nurses are featured, and organisational factors necessary to support innovation are described. This paper is based on a presentation given by the author at the 23rd Quadrennial ICN Congress and 7th International Regulation Congress in Taipei in May 2005.
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Farrow, T. (2003). 'No suicide contracts' in community crisis situations: A conceptual analysis. Journal of Psychiatric & Mental Health Nursing, 10(2), 199–202.
Abstract: 'No suicide contracts' take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable for the person concerned. They are commonly used in community crisis situations with suicidal people in New Zealand. This article describes and analyses the use of 'no suicide contracts' in these settings. It is argued that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation.
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Harding, T. S. (2006). New strategies in evidence based practice. Klinisk sygepleje, 20(3), 4–11.
Abstract: This article considers wider organisational issues that impact on the implementation of evidence based practice. It describes the strategies adopted by the Auckland Area Health Board and Unitec New Zealand to implement the principles of evidence based practice in New Zealand. This has resulted in a collaboration with Auckland University and the Joanna Briggs Institute for Evidence Based Nursing and Midwifery to form the Centre for Evidence Based Nursing – Aotearoa. Evidence based nursing is a vital part of nursing education. Unitec New Zealand has developed and incorporated evidence based nursing into all courses in their undergraduate programme. Central to this is the use of evidence based practice in patient care and the integration of technology with evidence based nursing in clinical practice.
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