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Tielemans, W. (2008). Encouraging young women to have regular smear tests. Kai Tiaki: Nursing New Zealand, 14(7), 16–18.
Abstract: The author presents the results of a study carried out as part of a research project with two nurse researchers from Maastricht University in the Netherlands. The aim of this study was to examine awareness among female students aged 18 to 25 about cervical cancer and to identify factors associated with their decision or intention to enter the cervical screening programme. Students aged 18-25 were recruited from four tertiary institutions in the Wellington region. A questionnaire was available online and distributed by student health centres and the researchers. Questions covered the following areas: intentions, attitude, knowledge, awareness, modelling, and support systems and efficacy. Data was analysed using descriptive statistics, multiple regression and independent t-tests. The findings are presented, and factors associated with intention and participation in cervical screening are discussed. The results indicate that the information concerning the national screening programme needs to be adjusted for the different age groups.
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Neville, S. J., & Gilmour, J. A. (2007). Differentiating between delirium and dementia. Kai Tiaki: Nursing New Zealand, 13(9), 22–25.
Abstract: Accurate nursing assessment is a critical element in the identification of health problems and treatment strategies for older adults who have delirium and/or dementia. This practice update provides information on the differentiation between these two debilitating and adverse health events, along with some useful assessment frameworks and other resources. Comments from people with delirium and dementia are interspersed throughout the article to draw attention to the impact of these conditions on people's lives and well-being. The article includes the 'A presenting concern framework', useful mnemonic devices to help nurses assess an older person who may have delirium or dementia, and a list of online resources.
Keywords: Dementia; Psychiatric Nursing; Clinical assessment; Older people
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Surtees, R. (2007). Developing a therapeutic alliance in an eating disorders unit. Kai Tiaki: Nursing New Zealand, 13(10), 14–16.
Abstract: The author presents the approach of a nursing team at Christchurch's Princess Margaret Hospital, in the regional specialist service for people with anorexia nervosa. This unit provides the only specialist inpatient unit in the country, consisting of a six or seven-bed facility that shares a unit with a mother and baby unit. A multidisciplinary team of psychiatric nurses, dietitians, occupational therapists, psychiatrists, psychologists and social workers all make significant contributions. The Christchurch unit uses a cognitive-behavioural therapy model (CBT) across the disciplines, a multidimensional approach incorporating psychotherapeutic, psychoeducational, biomedical and behaviourist paradigms. This occurs within a “lenient flexible approach”. Within the Unit, the eight nurses constitute what could be seen as an “intra”-disciplinary team within the wider “inter”-disciplinary or MDT team. They apply an evidence-based nursing approach with a commitment to partnership and advocacy with their patients. They use collaborative techniques for defining shared goals, and the careful management of the introduction of food. As one of the team members, the author envisages that the job of specialised nurses is to form a therapeutic alliance with patients, which takes account of the dynamic ways that patients may negotiate their own complex understandings of health, care, and recovery.
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Richardson, S. (2005). Coping with outbreaks of the norovirus. Kai Tiaki: Nursing New Zealand, 11(7).
Abstract: The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages.
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Dellagiacoma, T. (2007). Contracting as a career option for nurses. Kai Tiaki: Nursing New Zealand, 13(1), 20–22.
Abstract: A nurse presents research and her own experiences of contracting. Contracting, as defined in this article, refers to a nurse not employed permanently on a wage. It covers agency nursing, short and long fixed-term contracts and secondments. The author identifies the need to continue to develop professionally, which is now a mandatory requirement under the Health Practitioners Competence Assurance (HPCA) Act. Contractors have little, if any financial support to develop professionally, and time taken to do courses is not paid. Taking study leave within a contract may also not be an option. Options for managing professional development in these conditions are offered, including goal setting, investing in education or training, and considering some longer contracts. Practical financial advice and examples are given, including managing accounts and consideration of employment law. The author recommends that skilled nurses looking for interesting ways to develop their careers and to branch out in an entrepreneurial way should seriously consider taking up contract work.
Keywords: Professional development; Nursing; Work
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Shaw, S. (2007). Constructing media images of nursing: How does the media represent nurses when reporting on nurse prescribing? Kai Tiaki: Nursing New Zealand, 13(1), 16–18.
Abstract: This research presents a discourse analysis of articles published in the New Zealand Herald between October 1999 and September 2005. The terms “nurse prescribing” and “prescribing fights” identified seven articles published which referred specifically to this issue. They were predominantly editorial comments and statements attributed to senior doctors. Examples of comments from these articles are presented and discussed in this article, and three inter-related themes are identified – competence, responsibility and competition. Discussion on competence centred on education, skill and experience level of nurses, as described by editorial comment and senior doctors. Positive international research and experience of nurse prescribing did not feature. A number of comments in the articles analysed could be seen to represent concerns about competition between medicine and nursing. One interpretation of the comments contained in these articles is to see medical practitioner groups defending their status and desire to define and control nursing practice. The media has the power to select the information conveyed and, in these instances, appears to have demonstrated a bias towards the medical community's perspective.
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Hughes, F., & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki: Nursing New Zealand, 13(4), 14–16.
Abstract: The authors review the contemporary notion of obesity and suggest that the nursing approach, with an emphasis on treatment, are shaped by a culture located within “western” views of ideal body shape. The biomedical framework regards obesity as disease and obese people as the cause of their own health problems. The authors note varying cultural interpretations of obesity, and suggest that by viewing obesity as a disease, the cultural, social or economic determinants of obesity are not acknowledged. Nursing needs to broaden the concept of the categories of difference to respond in a culturally safe way to obesity. Cultural safety asks that nurses care for people “regardful” of difference. This means nurses must reflect on the care given, so that the biomedical model is not just replicated. Nurse-led clinics offer an opportunity for practices based on nursing values of care and cultural safety. Such clinics are based on nursing's social model of health, rather than a biomedical, disease-focused model.
Keywords: Nursing models; Obesity; Cultural safety
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Challis-Morrison, S. (2006). Caring for a community wanderer. Kai Tiaki: Nursing New Zealand, 12(11), 20–22.
Abstract: A community based registered nurse from Waikato District Health Board's Older Persons Assessment Team (OPAT) presents her experiences of working with older people with dementia. She uses a case study approach to highlight the issue of wandering, behaviour which can be difficult to modify and can cause carer distress. She outlines a team approach to the condition which requires good communication and co-ordination. Key aspects of management included a risk assessment plan, support for caregivers, and encouraging activity.
Keywords: Case studies; Older people; Community health nursing; Dementia
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Manning, J. (2006). Building trust with families in neonatal intensive care units. Kai Tiaki: Nursing New Zealand, 12(6), 18–20.
Abstract: Establishing a trusting relationship is a key therapeutic intervention for nurses working with families of hospitalised children. This article is an exploration of the definition of trust. Specifically, it considers how parents come to trust (or not) nurses in neonatal intensive care unit (NICU) helps to reveal the meaning of parent-nurse trust and how this affects nursing practice. Understanding and meeting parental needs is important in developing and sustaining trust. The medical model of care often dominates in NICU. This is a deficit model that focuses on illness and treatment. However, the use of a nursing framework, such as developmentally supportive family centred care, focuses on recognising and building on the strengths of the family, by fostering trust to equip the family with the capacity to manage their infant's health care.
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Chenery, K. (2007). Building child health nurses' confidence and competence. Kai Tiaki: Nursing New Zealand, 13(5), 26–38.
Abstract: This article describes the development of the Generic Orientation Programme, Child Health Nursing and its perceived impact on practice after ten months, through two simultaneous evaluation surveys, seeking the views of programme participants and their nurse managers. The programme aims to equip the newly appointed RN in the child health cluster or the nurse working in a non-designated children's area with the knowledge and skills to safely care for children. These include basic anatomical and physiological differences; fluid and electrolyte management; safe administration of medication; pain management; recognition of the seriously ill child; and building partnerships with children and their families. A survey instrument eliciting qualitative and quantitative responses was used. The majority of nurse respondents believed they had gained new knowledge and described how they were incorporating it into everyday practice. Similarly, several nurse managers observed that nurses' clinical knowledge and skills had improved since attending the programme. In particular, responses from those working in non-designated children's areas suggested the programme had provided them with greater insight into the care of children.
Keywords: Paediatric nursing; Nursing; Education; Evaluation
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Macfie, B. (2006). Assessing health needs and identifying risk factors. Kai Tiaki: Nursing New Zealand, 12(6), 16–18.
Abstract: In 2004, Plunket nurses from eight areas around New Zealand participated in collecting data for a research project on health needs assessment practices. This project aimed to examine risk factors identified by Plunket nurses, what areas of health need considered to be priorities; grading of health needs; and how closely the results of health need assessment aligned with the individual clients' deprivation score. The researchers examine the assessment of health needs against the use of the Deprivation Index, which indicates a specific population in a specific area, as a funding model. This study appeared to show there are two distinct groups of clients assessed as high needs: those with risk factors such as family violence and severe parental mental illness, and who may live in an area of 1-7 deprivation; and those with multiple risk factors which include poverty, low education, and/or reluctance to access services and support, and who usually live in dep 8-10 areas. This research supports the anecdotal evidence that significant health needs exist outside the lower deprivation areas.
Keywords: Infants; Parents and caregivers; Clinical assessment; Risk factors; Plunket
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Polaschek, L., & Polaschek, N. (2007). Solution-focused conversations: A new therapeutic strategy in Well Child health nursing telephone consultations. Journal of Advanced Nursing, 59(2), 111–119.
Abstract: This paper reports a study to explore Well Child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of Well Child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognise the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of Well Child telenurses.
Keywords: Telenursing; Communication; Evaluation
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King, S. L. J., & Walsh, K. (2007). 'I think PCA is great, but . . .'- Surgical nurses' perceptions of patient-controlled analgesia. International Journal of Nursing Practice, 13(5), 276–283.
Abstract: This qualitative study investigated surgical nurses' perceptions of patient-controlled analgesia as a strategy for managing acute pain in a tertiary care hospital. Patient-controlled analgesia is commonly used and nurses play an essential role in caring for patients prescribed it. The study was divided into two parts. First, audiotaped semi-structured interviews were conducted with 10 nurses. The interviews were followed by a postal questionnaire to 336 nurses with 171 returned. Thematic analysis was the chosen methodology. The audiotaped transcripts and questionnaires surfaced five themes, with the dominant one being `I think PCA is great, but . . .'. The paper outlines and explores these themes and addresses the implications arising from the research for both clinical practice and education.
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Currie, J., Edwards, L., Colligan, M., & Crouch, R. (2007). A time for international standards? Comparing the Emergency Nurse Practitioner role in the UK, Australia and New Zealand. Accident & Emergency Nursing, 15(4), 210–216.
Abstract: The aim of this paper is to compare the Emergency Nurse Practitioner role in the UK, Australia and New Zealand. Whilst geographically distant, the role of the Emergency Nurse Practitioner within these three countries shares fundamental similarities, causing the researchers to question, is this a time to implement international standards for the role? The Emergency Nurse Practitioner role in all three countries is gradually establishing itself, yet there are shared concerns over how the role is regulated and deficits in standardisation of scope of practice and educational level. Together these issues generate confusion over what the role embodies. The authors suggest that one method of demystifying the Emergency Nurse Practitioner role would be to progress towards international standards for regulation, education and core components of practice.
Keywords: Emergency nursing; Cross-cultural comparison; Nursing; Education
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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.
Keywords: Stress; Psychology; Cross-cultural comparison; Nursing
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