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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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McCallum, C. (2002). Balancing technology with the art of caring. Kai Tiaki: Nursing New Zealand, 8(7), 21–23.
Abstract: The author examines the role of technology in high dependency units, which can alienate nurses from patients. The ethical issues raised by technology are reviewed, particularly the allocation of expensive interventions, and the implications of life-sustaining technology on the application of informed consent. The author highlights the challenge facing nurses to bridge the gap between medical technology and humane caring.
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O'Brien, A. J., & Kar, A. (2006). The role of second health professionals under New Zealand mental health legislation. Journal of Psychiatric & Mental Health Nursing, 13(3), 356–363.
Abstract: The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for the second health professional role is suggested as a way of supporting clinical practice in this area.
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McKenna, B., Simpson, A. I. F., & Coverdale, J. (2006). Best practice management strategies for mental health nurses during the clinical application of civil commitment: An overview. Contemporary Nurse, 21(1), 62–70.
Abstract: The aim of this article is to outline best practice management strategies for nurses during the clinical application of civil commitment of mentally ill persons. A literature search on 'coercion' and 'civil commitment' was undertaken. Published and unpublished research undertaken by the authors in New Zealand on this topic was drawn upon. This research considered the use of civil commitment during admission to acute mental health services, acute forensic mental health services and community mental health services. The experience of coercion by service users coincides with the degree of restriction associated with the service they are involved in. Socio-demographic factors, clinical factors and the experience of coercive events have little bearing on the amount of coercion experienced. Rather, it is the pattern of communication and the use of 'procedural justice' that has the potential to ameliorate the amount of perceived coercion. The authors conclude that 'Procedural justice' aligns with the emphasis placed on the therapeutic relationship in mental health nursing and is an important consideration for nurses during the clinical application of civil commitment
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Crowe, M., & Luty, S. (2005). Recovery from depression: A discourse analysis of interpersonal psychotherapy. Nursing Inquiry, 12(1), 43–50.
Abstract: This paper describes a discourse analysis of the process of interpersonal psychotherapy (IPT) in the recovery from depression. It demonstrates how IPT is an effective treatment strategy for mental health nurses to utilise in the treatment of depression. The discourse analysis highlights how the development of more meaningful subject positions enables one woman to recover from her depression. The process of recovery is underpinned by an understanding of women's depression as promoted by contemporary social and cultural expectations for detachment and reflexivity. This paper shows how IPT provides an opportunity for recovery from depression for one woman by facilitating a reconstruction of her subject positions in relation to others. The discourse analysis revealed that the therapist facilitated this through the use of a range of techniques: seeking information, exploring beliefs/values/assumptions, exploring communication patterns, exploring affective responses and exploring alternative subject positions.
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Polaschek, N. (2003). Living on dialysis: Concerns of clients in a renal setting. Journal of Advanced Nursing, 41(1), 44–52.
Abstract: This article reports a study that sought to understand the experience of a group of Caucasian men with end stage renal failure managing their own haemodialysis therapy in their homes. The study used a critical interpretive methodology. The renal setting was critically viewed as a specialised health care context constituted by several interrelated discourses. Although established by the dominant professional discourse, it also includes a number of others, in particular an obscure client discourse that is a response to the dominant discourse. Initially, participants' own interpretations of their individual experiences were outlined. These were then collectively reinterpreted by contextualising them in terms of the critical view of the renal setting, in order to discern their own views as renal clients that were obscured by the language and ideas of the dominant discourse with which they had been enculturated. From an analysis of the set of accounts derived from interviews with six participants, four concerns of the renal client discourse were identified. These concerns were: (1) suffering from continuing symptoms of end stage renal failure and dialysis; (2) limitations resulting from negotiating dialysis into their lifestyle; (3) ongoingness and uncertainty of life on dialysis; and (4) altered relationship between autonomy and dependence inherent in living on dialysis. One specific implication of this study is that the distinctive potential of the nursing role in renal settings lies beyond the performance of a range of technical tasks, in addressing the experience of people living on dialysis, described here as the concerns of the renal client discourse.
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O'Brien, A. J. (2001). The therapeutic relationship: Historical development and contemporary significance. Journal of Psychiatric & Mental Health Nursing, 8(2), 129–137.
Abstract: This article examines the therapeutic relationship, a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realised in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualisations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses.
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Spence, D. (2001). Prejudice, paradox, and possibility: Nursing people from cultures other than one's own. Journal of Transcultural Nursing, 12(2), 100–106.
Abstract: This article provides a brief overview of the findings of a hermeneutic study that explored the experience of nursing people from cultures other than one's own. The notions prejudice, paradox, and possibility are argued to describe this phenomenon. Nurses in New Zealand are being challenged to recognise and address racism in their practice. Yet, the implementation of cultural safety in nursing education has created tension within the profession and between nursing and the wider community. As nurses negotiate the conflicts essential for ongoing development of their practice, the play of prejudice, paradox, and possibility is evident at intrapersonal and interpersonal levels as well as in relation to professional and other discourses. Nurses are challenged to continue their efforts to understand and move beyond the prejudices that otherwise preclude the exploration of new possibilities.
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Jonsdottir, H., Litchfield, M., & Pharris, M. (2003). Partnership in practice. Research & Theory for Nursing Practice, 17(1), 51–63.
Abstract: This article presents a reconsideration of partnership between nurse and client as the core of the nursing discipline. It points to the significance of the relational nature of partnership, differentiating its features and form from the prevalent understanding associated with prescriptive interventions to achieve predetermined goals and outcomes. The meaning of partnership is presented within the nursing process where the caring presence of the nurse becomes integral to the health experience of the client as the potential for action. Exemplars provide illustration of this emerging view in practice and research. This is the first of a series of articles written as a partnership between nurse scholars from Iceland, New Zealand and the USA. The series draws on research projects that explored the philosophical, theoretical, ethical and practical nature of nursing practice and its significance for health and healthcare in a world of changing need.
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Jonsdottir, H., Litchfield, M., & Pharris, M. (). The relational core of nursing practice as partnership. Journal of Advanced Nursing, 47(3), 241–250.
Abstract: This article elaborates the meaning of partnership in practice for nurses practising in different and complementary way to nurses in specialist roles and medical practitioners. It positions partnership as the relational core of nursing practice. Partnership is presented as an evolving dialogue between nurse and patient, which is characterised by open, caring, mutually responsive and non-directive approaches. This partnership occurs within a health system that is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. It is the second of a series of articles written as a partnership between nurse scholars from Iceland, NZ and USA.
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Polaschek, N. (2003). Negotiated care: A model for nursing work in the renal setting. Journal of Advanced Nursing, 42(4), 355–363.
Abstract: This article outlines a model for the nursing role in the chronic health care context of renal replacement therapy. Materials from several streams of literature are used to conceptualise the potential for nursing work in the renal setting as negotiated care. In order to present the role of the renal nurse in this way it is contextualised by viewing the renal setting as a specialised social context constituted by a dominant professional discourse and a contrasting client discourse. While performing specific therapeutic activities in accord with the dominant discourse, renal nurses can develop a relationship with the person living on dialysis, based on responsiveness to their subjective experience reflecting the renal client discourse. In contrast to the language of noncompliance prevalent in the renal setting, nurses can, through their relationship with renal clients, facilitate their attempts to negotiate the requirements of the therapeutic regime into their own personal life situation. Nurses can mediate between the dominant and client discourses for the person living on dialysis. Care describes the quality that nurses actively seek to create in their relationships with clients, through negotiation, in order to support them to live as fully as possible while using renal replacement therapy. The author concludes that within chronic health care contexts, shaped by the acute curative paradigm of biomedicine, the model of nursing work as negotiated care has the potential to humanise contemporary medical technologies by responding to clients' experiences of illness and therapy.
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Peach, J., & Hall, B. (1999). Professional boundaries: Being in relationship 'with' yet remaining separate. Professional Leader, 5(1), 16–18.
Abstract: This article describes the management of the therapeutic relationship, that is set up between nurses or midwives and those in their care. It reviews the responsibilities of the health practitioner, and looks at issues around boundaries, confidentiality and accountability. It also looks at the role senior colleagues can play in ensuring this intentional relationship is managed professionally.
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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.
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Blockley, C., & Alterio, M. (2008). Patients' experiences of interpersonal relationships during first time acute hospitalisation. Nursing Praxis in New Zealand, 24(2 (Jul)), p16–26.
Abstract: Examines the role of interpersonal relationships on patients' experiences during first time acute hospitalisation. Involving 12 first time acute medical and surgical admission patients, it was developed from a wider study exploring patients' overall experiences. Using a qualitative methodology with data collected by means of personal stories and semi-structured interviews findings suggest that patient vulnerability is reduced through supportive interpersonal relationships and that it is nurses who play a key role in developing and maintaining these relationships with patients.
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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). Retrieved June 30, 2024, from http://www.nursingpraxis.org
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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