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Clayton, J. R. (2008). Exploring transitions: Working in “the space between the no longer and the not yet”. Ph.D. thesis, , .
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.
Keywords: Communication; Nurse-patient relations; Case studies
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Sheward, K. A. (2005). Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying.
Abstract: The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.
Keywords: Palliative care; Hospitals; Communication; Nurse-patient relations
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Carryer, J. B. (2001). Embodied largeness: A significant women's health issue. Nursing Inquiry, 8(2), 90–97.
Abstract: This paper describes a three-year long research project in which nine large-bodied women have engaged in a prolonged dialogue with the researcher about the experience of being 'obese'. The study involved an extensive review of the multidisciplinary literature that informs our understandings of body size. The literature review was shared with participants in order to support their critical understanding of their experience. The experience of participants raised questions as to how nursing could best provide health-care for large women. An examination of a wide range of literature pertinent to the area of study reveals widespread acceptance of the notion that to be thin is to be healthy and virtuous, and to be fat is to be unhealthy and morally deficient. According to the literature review, nurses have perpetuated an unhelpful and reductionist approach to their care of large women, in direct contradiction to nursing's supposed allegiance to a holistic approach to health-care. This paper suggests strategies for an improved response to women who are concerned about their large body size.
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Cavanagh, C. (2004). Dignity and palliative care: A search to discover the true meaning of the concept of “dying with dignity”.
Abstract: This paper presents an exploration of a foundational goal of palliative care nursing which is to help patients die with dignity. The paper presents this practice exploration as a journey to gain understanding of the concept of dignity; the author notes that it does not avoid the difficulties encountered in practice situations because dying with dignity is unique and curiously also invisible and different for everyone. Much of human life is conducted through stories and much of nursing involves telling and listening to stories. Many of our social institutions are comprised almost entirely of opportunities for telling and retelling stories. Nurses are constantly listening to patients telling them what is going on in their lives and because of this the stories related here are written bold and raw. The three stories explore and reveal in-depth details of nursing practice that evolved and changed after reflection. The paper also reveals and explores the untold and often painful stories that challenge nurses' capacity to offer dignified care. To deepen the exploration towards discovering ways to articulate the complexity of dignity, the author reflected on the nature of the practice changes documented in the stories and then used a range of diverse literature and her love of the paintings and philosophy of a New Zealander, Ralph Hotere, to support her ideas that dignity is indeed a complex phenomenon.
Keywords: Palliative care; Nursing; Case studies; Nurse-patient relations; Terminal care
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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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Mortensen, A. (2000). Destigmatisation: A grounded theory of the work of sexual health nurses. Ph.D. thesis, , .
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(2001). Dementia care: A literature review. Vision: A Journal of Nursing, 7(13), 33–36.
Abstract: This article defines dementia, and explores recent trends in relation to why it is such a misunderstood condition in the health care setting. Within a theoretical framework of literature development, nurse client relationships, and quality of care and attitudes are analysed. Gaps, inconsistencies and consistencies are outlined, with the implications for nursing practice and education explored.
Keywords: Dementia; Nurse-patient relations; Quality of health care; Nursing; Education
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Tipa, Z., Wilson, D., Neville, S., & Adams, J. (2015). Cultural Responsiveness and the Family Partnership Model. Nursing Praxis in New Zealand, 31(2).
Abstract: Investigates the bicultural nature of the Family Partnership Model for working with Maori whanau in the context of well-child care services. Reports a mixed-methods study in 2 phases: an online survey of 23 nurses trained in the Family Partnership Model and 23 not trained in the model; observation of nurses' practice and interviews with 10 matched nurse-Maori client pairs. Identifies 3 aspects of the findings: respectful relationships, allowing clients to lead, and lack of skills.
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Connor, M. (2004). Courage and complexity in chronic illness: Reflective practice in nursing. Wellington: Daphne Brasell & Whitireia Publishing.
Abstract: This book presents the reflective account of an actual nursing practice situation (a woman living with chronic asthma).The author provides a descriptive narrative and then delves deeper into the narrative to obtain greater understanding of what she calls “strife” in chronic illness and the best nursing practice to assist its resolution.
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Casey, G. (2000). Conditional expertise in chronic illness. Ph.D. thesis, , .
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Maries, V. J. (2004). Chosen moments: A reflective journey illustrating terminally ill patients choosing the moment to die.
Abstract: In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result. The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars. This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time.
Keywords: Terminal care; Palliative care; Nurse-patient relations
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Ward, C. R. (2005). Children matter: What is important to the child living with a life-threatening illness.
Abstract: When a child lives with a life-threatening illness there is a range of emotions that affect the child, family and people close to the child. This study utilises a narrative approach to explore what the child puts emphasis on in what is important to them as they live with serious illness. The study incorporates the nurse as narrator with the 'narratives' of the children integrated into her reflections to gain a broader understanding. The focus is on listening intently to the spoken needs of children, their story and the meaning they make of their situation when they live with their illness. 'Children' in this study are between the ages of six years to 15 years. The aim of this research is to provide a clear understanding of the lived experience, which may illuminate the needs of the child and what is required throughout the time of illness; therefore informing health professionals of a culture of care that may support these needs. A broader understanding and deeper insight into the complexity of children living with life-threatening illnesses provides a basis for the development of sensitive, humanistic quality nursing care for both the child and his/her family, this then enhances the potential for best practice for children living with a life-threatening illness.
Keywords: Children; Nurse-patient relations; Nursing; Chronically ill
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Mitchell, K. (2001). Childbirth: A momentous occasion. Muslim women's childbirth experiences. Ph.D. thesis, , .
Abstract: This thesis explores three Muslim women's experience of childbirth, in a setting surrounded by health professionals who largely have little understanding of their culture. Various forms of narrative such as a letter, excerpts from conversations, and interviews, have been used in presenting this research. The women's stories reveal that giving birth in a cross-cultural setting is stressful. The women had to adjust to an environment which challenged their beliefs and values, in one case with no extended family or cultural support. This stress is long lasting as evidenced in the women's stories. Given the opportunity to tell their story, all the women highlighted both the positive and negative aspects of their birth experiences. This thesis identifies situations that heightened the vulnerability of the women, and highlights the uniqueness of each woman. It concludes by identifying recommendations and reading material for nurses and midwives in education or practice.
Keywords: Childbirth; Cultural safety; Nurse-patient relations
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Powell, J. (2002). Caring for patients after an ICU admission. Kai Tiaki: Nursing New Zealand, 8(7), 24–25.
Abstract: The author presents research on nursing strategies that reduce the psychological effects of critical illness and prevent the intensive care unit (ICU) atmosphere from adversely affecting the nurse-patient relationship. Post-traumatic stress disorder and other phobic anxiety syndromes are noted as a risk among former ICU patients. Four interventions to put in place for discharge are presented: patient-centred nursing, communication, multidisciplinary care, and patient/family education.
Keywords: Intensive care nursing; Nurse-patient relations; Trauma; Communication
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Cleary, H. (2001). Caring and bioethics: Perspectives, predicaments and possibilities. Ph.D. thesis, , .
Abstract: This thesis presents an explorative study of the place of caring in bioethics. Through the examination of various sources of literature from the disciplines of nursing, feminist theory and ethics, and bioethics, a case is developed that argues for a valid respected place for caring, as an ethic of care in bioethical decision-making. The case is built by providing evidence to support the fundamental importance of caring to human life, health, relationships, and survival at the broad societal level. This is presented from the feminist and nursing perspectives, along with a critique of the negative aspects of caring practices. The next stage of the case presents a layout of the discipline of bioethics, using an historical perspective to illuminate the influences of bioethics' deep past, as it still affects the discipline in the present. The development of contemporary bioethics' current status is presented along with critiques from bioethicists themselves, and nursing and feminist theory and ethics. In the case at this point, from a bioethical perspective, two major predicaments appear to prevent an ethic of care obtaining a valid place in ethical decision-making in bioethics. These are the justice/care duality, and the conflict between different conceptions of care and autonomy. The bioethical objections and arguments put forward regarding these predicaments are examined and refuted, and the author suggests a case is established for the inclusion of an ethic of care in bioethical decision-making.
Keywords: Ethics; Feminist critique; Nurse-patient relations
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