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Howie, L. (2006). Rural nursing practice in context. Ph.D. thesis, , .
Abstract: Although it is accepted in rural nursing literature that the context shapes nursing practice there is limited opportunity to gain an understanding of how this occurs. This dissertation addresses this issue. Firstly, by employing a social geographical lens to define and examine the dynamic, evolving rural context and secondly, by considering the nursing concepts that arise from those contextual factors that relate directly to rural societal health needs. Defining 'rural' is essential when describing or debating rural nursing practice in context. However, there remains no universally accepted definition of 'rural'. Despite this and even though each location is individually specific, there are socio-cultural, occupational, ecological and health aspects that are common and bespeak rural society. These aspects have been developed into a Rural Framework Wheel as a visual reference to demonstrate the substantial influences which impact on nursing practice within the rural context. The framework encapsulates the distinctive dimensions that are hallmarks of rural nursing practice. Nurses can therefore use the framework to express concisely their individualised practice and competence by employing the two broad themes that have emerged from the literature; that of 'nursing per se' and 'partnership'. The Rural Framework Wheel is recommended as a paradigm to critique the practice of rural nurses from an educational, employment, research and political perspective. It is advocated that this framework be used by rural nurses to describe their practice and therefore to express the distinctiveness of the rural nursing identity.
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McKenna, B., O'Brien, A. J., Dal Din, A., & Them, K. (2006). Responsible clinician role offers opportunities for nurses. Kai Tiaki: Nursing New Zealand, 12(11), 12–14.
Abstract: The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation.
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McKenna, B., O'Brien, A. J., Dal Din, T., & Thom, K. (2006). Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992. International Journal of Mental Health Nursing, 15(2), 128–134.
Abstract: The objectives of this research were to determine how many registered nurses are working as 'responsible clinicians', under what phases of the legislation they are functioning, and to describe the enabling processes and barriers to nurses undertaking this statutory role. An anonymous descriptive survey was distributed to the 11 nurses who were currently responsible clinicians as well as five senior nurses selected from each of the 21 district health boards and the Auckland Regional Forensic Psychiatry Services (n=121). The response rate was 88.4% (n=107). The survey questioned respondents on statutory roles currently undertaken. Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain it. They were also asked which competencies of the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. Of the approximately 395 responsible clinicians nationally, 11 (2.8%) are nurses. Most nurses viewed the role as legitimate. However, many were unaware of competencies for the role and credentialing processes, and were somewhat ambivalent about achieving the role due to current workload, role conflict and lack of remuneration. Competency deficits were highlighted. The authors conclude that there are grounds to encourage nurses as responsible clinicians given the intent of the legislation. This will require the promulgation of appropriate mental health policy, and a concerted effort by major stakeholders in mental health service delivery.
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Honey, M., Waterworth, S., Baker, H., & Lenzie-Smith, K. (2006). Reflection in the disability education of undergraduate nurses: An effective learning tool? Journal of Nursing Education, 15(11), 449–453.
Abstract: The aim of this qualitative study was to evaluate the usefulness of formal reflection in the context of undergraduate nursing education during the teaching of a disability module. Reflection is defined as examination and exploration of an issue of concern to help create or clarify meaning.Twelve reflection assignments written by second-year nursing students were analysed. The analysis indicated that students' reflection focused less on their experience of working with people with disabilities and more on their overall learning experience and coping with clinical practice. A central theme, Coping with Clinical Practice, and four sub-themes were identified. Students acknowledged reflection as beneficial to their learning and linked to their clinical practice.
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Hughes, F. (2006). Reconnecting with policy: Requirements for survival as a mental health nurse. Journal of Psychosocial Nursing & Mental Health Services, 44(8), 30–39.
Abstract: This article discusses the disconnection between mental health nurses and policy, and the importance of reconnecting such relationships. It is suggested this will benefit consumers, provide influence in health care policies and, ultimately, contribute to strategies to improve the health of our nation. In this article, the author draws on her own experiences and applies these to a discussion of how mental health nurses can influence and strengthen their relationships with nursing policy.
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Blair, K. M. (2006). Recognising the sick patient: An emergency nurses view: A research paper.
Abstract: This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration.
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Kupa, S. (2006). Psychogeriatric nursing: A review of the literature.
Abstract: This paper is a literature review of the psychogeriatric specialty and describes the clinical role, practice and knowledge of the psychogeriatric nurse. Literature reviews provide a useful means for evaluating what is currently known and understood in a particular area of interest to help nurses' build current opinion into practice. Psychogeriatric nursing is a specialised field of practice that focuses on the mental health needs of people over the age of 65 (including younger people who have acquired needs that are similar in 'like' and age and 'interest'). The literature asserts the urgent need to develop the role and practice of the psychogeriatric nurse in order to address the complex needs of our ageing population in areas such as home care, hospitals, primary health, and long term care institutions. The findings highlight aspects of nursing care that are essential to the role and practice of the psychogeriatric nurse. Knowledge that is necessary for best practice in psychogeriatric nursing care is drawn mainly from the field of general psychiatry and gerontology but also from general medicine, psychology, neurology, and disability. Nurses' working with older adults affected by psychogeriatric conditions must possess a broad knowledge of physical and mental health issues that affect the elderly, including also knowledge and understanding of psychosocial risk factors that can also have an impact on the health and behaviour of older people and their carers. Despite these literal assertions however there appears to be a dearth of literature available to support the requirements for developing the psychogeriatric nursing specialty in clinical practice, research, and education. The author notes that authorities in this specialised field of practice generally agree that with an increasing aging population looming in the future more research in the field of “old age psychiatry” will be critical.
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Crowe, M. (2006). Psychiatric diagnosis: Some implications for mental health nursing care. Journal of Advanced Nursing, 53(1), 125–131.
Abstract: This article explores some of the functions of psychiatric diagnosis and the implications this has for mental health nursing care. It critiques the psychiatric diagnosis as a categorisation process that maintains oppressive power relations within society, by establishing and enforcing normality through gender, culture and class biases. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is used to illustrate some of the inherent biases in the diagnostic process. The author argues that mental health nursing practice needs to demonstrate an awareness of the power relations inherent in any diagnostic process and make attempts to redress these at both the individual and sociopolitical levels. To create a true patient-centred partnership in mental health nursing, the nursing focus should be on the patient's experience rather than the psychiatric diagnosis with which the experience is attributed. NB this is a reprint of article first published in Journal of Advanced Nursing, 2000 Mar; 31(3), 583-9.
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Thompson, L. E. (2006). Profession and place: Contesting professional boundaries at the margins. Ph.D. thesis, , .
Abstract: Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural.
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Morgan, F. A. (2006). Primary health care nurses supporting families parenting pre-term infants. Ph.D. thesis, , .
Abstract: This thesis reviews the role of primary health care nurses, who have an opportunity to play a unique role in teaching, touching and empowering families with newly discharged pre-term babies. Birth of a baby earlier than 37 weeks gestation ushers in a period of uncertainty and stress for parents. Uncertainties may centre on whether their infant will survive and what ongoing growth and developmental issues their infant will face.
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Medlin, E. (2006). Practice nursing: An autoethnography: Changes, developments and influences. Ph.D. thesis, , .
Abstract: Practice nurses work in general practice providing an increasingly autonomous service to consumers of primary health care. Autoethnography is a biographical method of research that describes personal experience in terms of society and culture and is the theoretical foundation of personal narratives and storytelling. Throughout history, stories have been used as a means of communicating and learning which with reflection, allows new meanings to develop for all participants. This autoethnography is the author's story of practice nursing and it discusses her experience of being a practice nurse over the past 12 years. It is autobiographical and reflexive and charts the changes that she has found in her practice during this time. Some of these changes have arisen from influences personal to her practice, others because of influences on practice nursing in general, but all are intertwined. Education and professional development, leadership and government policies are identified as the major influences on her practice. A discussion of these influences enables recognition of the changes, advancement and expansion of services thereby allowing others to share the experience and find meaning within it.
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Davies, D. C. (2006). Practice nurses' perceptions of their contribution to the care of individuals with chronic health conditions. Ph.D. thesis, , .
Abstract: Table of Contents: 1. Background and overview; 2. Research design and method; 3. Literature review; 4. Preparation of the individual for an appointment at the general practice; 5. Care provided by the practice nurse at the general practice; 6. The giving of information; 7. A discussion of the dualities of the contribution of practice nurses to the care of individuals with chronic conditions; 8. Study summary and conclusions.
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Weidenbohm, K. (2006). Pioneering rural nursing practice: An impact evaluation of a preventive home visiting service for older people. Ph.D. thesis, , .
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Neville, S. J., & Henderson, H. M. (2006). Perceptions of lesbian, gay and bisexual people of primary healthcare services. Journal of Advanced Nursing, 55(4), 407–415.
Abstract: This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.
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Dewes, C. A. (2006). Perceptions and expectations of a kaiawhina role. Ph.D. thesis, , .
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