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Chadwick, A., & Hope, A. (2000). In pursuit of the named nurse. Australasian Journal of Neuroscience, 13(4), 6–9.
Abstract: This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required.
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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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Evans, S. (2003). Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes. Pediatric Intensive Care Nursing, 4(2), 7.
Abstract: The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
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DeSouza, R. (2008). Wellness for all: The possibilities of cultural safety and cultural competence in New Zealand. Journal of Research in Nursing, 13(2), 125–135.
Abstract: The author contends that responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prevent marginalised groups from utilising universal health services. A combination of approaches is suggested in this paper to meet these two imperatives. Cultural safety is one indigenous New Zealand nursing approach derived in response to inequalities for Maori, whereas cultural competence is an imported paradigm derived from a multicultural context. Furthermore, research and dialogue are required to examine points of complementarity and tension. This paper offers a beginning for this process.
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Koorey, R. (2008). Is there a place for clinical supervision in perioperative nursing? Dissector, 35(4), 15–17.
Abstract: This article explores the concept of clinical supervision and outlines a brief history of implications for nursing practice. Models of clinical supervision are outlined and examples of how they may be applicable to the clinical setting of perioperative nursing are provided.
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Gardner, A., Hase, S., Gardner, G., Dunn, S., & Carryer, J. B. (2008). From competence to capability: A study of nurse practitioners in clinical practice. Author copy available 12 months after publication from QUT ePrints, 17(2), 250–258.
Abstract: This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners.
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Gage, J., & Hornblow, A. R. (2007). Development of the New Zealand nursing workforce: Historical themes and current challenges. Nursing Inquiry, 14(4), 330–334.
Abstract: This article reviews the development of the New Zealand nursing workforce, which has been shaped by social, political, scientific and interprofessional forces. The unregulated, independent and often untrained nurses of the early colonial period were succeeded in the early 1900s by registered nurses, with hospital-based training, working in a subordinate role to medical practitioners. In the mid/late 1900s, greater specialisation within an expanding workforce, restructuring of nursing education, health sector reform, and changing social and political expectations again reshaped nursing practice. Nursing now has areas of increasing autonomy, expanding opportunities for postgraduate education and leadership roles, and a relationship with medicine, which is more collaborative than in the past. Three current challenges are identified for nursing in New Zealand's rapidly evolving health sector; development of a nursing-focused knowledge culture, strengthening of research capacity, and dissemination of new nursing knowledge.
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Gallagher, P. (2007). Preconceptions and learning to be a nurse. Nurse Education Today, 27(8), 878–884.
Abstract: This article discusses the important role that preconceptions play in the process by which students learn to be nurses. The importance of preconceptions emerged from the analysis of data in a grounded theory study that sought to gain a greater understanding of how undergraduate student nurses in New Zealand experienced and responded to differences they perceived between the theory and the practice of nursing. It became clear that the preconceptions each student nurse held about the nature of nurses and nursing care were the standards against which the worth of the formal, practical and personal theories to which students were exposed during their nursing degree was evaluated. It was clear that preconceptions functioned as the mediator between the intentions of nursing education and the learning that eventuated for each student from practicum experiences. The implications for nursing education, for which preconceptions are not generally highly valued as a basis for learning about professional nursing, are that the individual experience and personal characteristics of each student receive significant focus when a nursing programme is planned. This means that the orthodox principles that underpin the design of nursing curricula should be reviewed and an overtly constructivist perspective adopted for nursing education for which the prior experiences of the student are the starting point.
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Carryer, J. B., Gardner, G., Dunn, S., & Gardner, A. (2007). The core role of the nurse practitioner: Practice, professionalism and clinical leadership. Journal of Clinical Nursing, 16(10), 1818–1825.
Abstract: This article draws on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. A study jointly commissioned by both countries' Regulatory Boards developed information of the newly created nurse practitioner role, to develop shared competency and educational standards. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner programme curricula and interviews with 15 nurse practitioners from the two countries. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care.
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Pirret, A. M. (2007). The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making. Intensive & Critical Care Nursing, 23(3), 145–155.
Abstract: The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved.
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Wilkinson, A. (2007). New age informatics & the management of perioperative nursing documentation. Dissector, 35(1), 20–23.
Abstract: Investigates the requirements for documentation by nurses. Research by Millar & Araquiza (1999) suggests that nurses spend an estimated 30% of their time documenting patient care.
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Fisher, M. (2007). Resuscitation guidelines: Managing change in practice. Pediatric Intensive Care Nursing, 8(1), 7–10.
Abstract: This article describes the effect of an education programme for Paediatric Intensive Care Unit (PICU) staff, developed as part of the roll out of revised clinical guidelines. In 2005, the International Liaison Committee on Resuscitation released advisory statements and a revised universal algorithm for Infant, Child and Adult Cardiopulmonary Resuscitation (CPR). Subsequently the New Zealand Resuscitation Council developed and disseminated revised guidelines for use within the New Zealand Healthcare System. Within the PICU the challenge of integrating new practice standards whilst ensuring compliance with CPR guidelines, was how to disseminate information to over 80 staff nurses working 12 hour shifts. Following implementation of an education programme, a survey completed by 20 staff members demonstrated that staff felt well supported with the introduction of the new CPR guidelines (90%) and confident that they understood the changes to the resuscitation guidelines (90%). Staff identified that the poster display (95%) and the mail sleeve “flyer” (80%) helped them understand the changes to CPR.
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Simon, V. N. (2006). Characterising Maori nursing practice. Contemporary Nurse, 22(2), 203–213.
Abstract: This paper summarises research which addresses the question What might constitute Maori nursing practice? The research design adopted was influenced by kaupapa Maori methodology and used a semi-structured, qualitative, in-depth interview process. It was found that by understanding the current experiences of Maori registered nurses, their reflections on their preparation for practice, and their current practice, it is possible to identify the present and future training and practice needs of Maori nurses. Maori nursing practice can be characterised as having five features: the promotion of cultural affirmation including cultural awareness and identity; the support of, and access to Maori networks; the adoption of Maori models of health; the enabling of visibility and pro-activity as Maori nurses; and, the validation of Maori nurses as effective health professionals. Three recommendations for promoting Maori nursing practice are made in relation to staff in the workplace and in nurse education programmes: all nursing staff need to be alert to: 1. the impact of western scientific models on Maori healthcare; 2. the (often passive) non-acceptance of Maori within mainstream institutions; and iii) the benefits of valuing indigenous nursing programmes.
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Horsburgh, M., Perkins, R., Coyle, B., & Degeling, P. (2006). The professional subcultures of students entering medicine, nursing and pharmacy programmes. Journal of Interprofessional Care, 20(4), 425–431.
Abstract: This study sought to determine the attitudes, beliefs and values towards clinical work organisation of students entering undergraduate medicine, nursing and pharmacy programmes in order to frame questions for a wider study. University of Auckland students entering medicine, nursing and pharmacy programmes completed a questionnaire based on that used by Degeling et al. in studies of the professional subcultures working in the health system in Australia, New Zealand, England and elsewhere. Findings indicate that before students commence their education and training medical, nursing and pharmacy students as groups or sub-cultures differ in how they believe clinical work should be organised. Medical students believe that clinical work should be the responsibility of individuals in contrast to nursing students who have a collective view and believe that work should be systemised. Pharmacy students are at a mid-point in this continuum. There are many challenges for undergraduate programmes preparing graduates for modern healthcare practice where the emphasis is on systemised work and team based approaches. These include issues of professional socialisation which begins before students enter programmes, selection of students, attitudinal shifts and interprofessional education.
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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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