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Author |
Ramsden, I. |
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Title |
Cultural safety and nursing education in Aotearoa and Te Waipounamu |
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Year |
2002 |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
Cultural safety; Maori; Nursing; Education |
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Abstract |
The research on which this thesis is based involves both a private narrative and a public narrative, with the story of cultural safety, and the history, theory and the future direction gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced cultural safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety Theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of cultural safety is undertaken. The role and application of the Treaty of Waitangi to the theory of cultural safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of cultural safety into the nursing education system and its implementation. The public and media reaction to the inclusion of cultural safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of cultural safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The author notes that the story of cultural safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, she points out that, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients. |
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Call Number |
NRSNZNO @ research @ |
Serial |
486 |
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Author |
Mitchell, D.F. |
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Title |
Is it possible to care for the “difficult” male? A study exploring the interface between gender issues, nursing practice and men's health |
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Year |
1999 |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
Male; Nurse-patient relations; Gender |
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Abstract |
This thesis is about caring for males, especially those males who could be considered “difficult” to care for through their use of behaviours such as silence, anger or defensive humour. This thesis is positioned in the view that these behaviours are often expressions of distress, which typically distance males from those who attempt to care for them. The author suggests that the word “distress” more accurately reflects the theme of the thesis, and it is used throughout the work. This thesis explores the interface between gender issues, nursing practice and caring for males. It is informed by a review of relevant literature and data gathered from a focus group of nine registered nurses. The analysis is framed by questions that are developed from a series of reflections on my personal and professional life. Critical social theory, with its emphases on dominant dialogue, power and emancipation is used to inform and guide this analysis. What is most obvious is the contrast between themes arising from the literature and those arising from the focus group. It appears that the literature, in the main, is critical of males in regard to concepts of masculinity, issues related to gender, and men's health. Males are portrayed as arbitrators of their own misfortune, as deliberately choosing a lifestyle that reflects poorly on their health, their self-expression, and communication with others. Concepts such as power and control over others, both at a societal and individual level, often feature. Conversely, the literature is noticeably lacking in regard to information about the health related experiences of males and about caring for males. In contrast, the participants of the focus group frame their discussion in the positive. For example, they suggest that males are interested in their health but require an environment that supports this expression of interest. They support this by identifying a range of behaviours they believe are effective in caring for males. The participants also suggest that it is the registered nurse rather than the male who manages issues to do with power and control. The thesis concludes that creating and sustaining an environment supportive of, and sensitive to the needs of males, is an activity that requires considerable thought, skill and experience. These areas are not adequately addressed in academic dialogue, research activity, or in the education of registered nurses. The thesis suggests that this situation is inconsistent with an ethic of care and that nursing should make a priority of broadening its research and knowledge base to better understand and care for males. |
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Call Number |
NRSNZNO @ research @ 503 |
Serial |
489 |
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Author |
Rolls, S. |
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Title |
An exploration of workplace violence in the emergency department: Are emergency nurses safe? |
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Year |
2006 |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
Workplace violence; Emergency nursing; Guidelines |
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Abstract |
This thesis arises from the author's experience of several years of working in the emergency department and being exposed to workplace violence from patients and their families. Emergency nurses in New Zealand experience workplace violence every day. Registered nurses and the institutions in which they work manage workplace violence to varying degrees and in an ad hoc manner. The author notes that New Zealand has no national guidelines, or consensus on the management of workplace violence in the health sector. This research explores emergency nurses' encounters during their work when they have experienced workplace violence. The purpose of this study is to demonstrate the experience and the consequences when nurses are confronted with episodes of violence while working in the emergency department. The essence of this research is gaining an understanding of how registered nurses have managed workplace violence and the impact of that violence on themselves, their colleagues, and the patients in the emergency department. Recommendations are made regarding nationally consistent guidelines, education on the management of workplace violence, improved security, and emergency department design. The discussion concludes with suggestions for further research on workplace violence in the health sector |
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Call Number |
NRSNZNO @ research @ |
Serial |
492 |
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Author |
Skally, M.H. |
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Title |
An exploration of the preparation of New Zealand nurse educators for their role in teaching postgraduate clinical nursing courses |
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Year |
2007 |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Issue |
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Pages |
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Keywords |
Education; Nursing |
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Abstract |
Little is known about the preparation of New Zealand nurse educators teaching clinically focused postgraduate programmes. This research gives an insight into their world and the preparation they had in order to fulfil their roles. A review of the literature on nurse educator preparation revealed a dichotomy of preparation nationally and internationally. This study was carried out to inform the New Zealand nursing profession on the preparedness of its educators teaching clinical nursing postgraduate programmes. It was the author's assumption that nurse educator preparation lacked strategic direction and was not nationally uniform. The research expected to answer how and to what extent New Zealand nurse educators teaching clinical nursing postgraduate courses at NQF Level 8 are prepared and supported for their teaching role. This research used an exploratory descriptive survey methodology and was underpinned by a conceptual framework. The conceptual framework, referred to as the critical elements of nurse educator preparation (CENEP), contained four key concepts, support, educational preparation, personal attitudes and experience. These concepts informed the design and construct of a questionnaire to determine the level of preparation of New Zealand nurse educators teaching clinical postgraduate programmes. A total of 89 postal questionnaires were administered resulting in a response rate of 46% (N=41), however, four questionnaires were excluded leaving a sample size of 37. Results of this research reveal a culture where nurse educator preparation lacks uniformity and consistency. Individually, New Zealand nurse educators were found to be highly qualified for their positions and motivated and enthusiastic about their roles. However, 40% of respondents did not hold a teaching qualification. Results from this research revealed a pattern of clinical training for postgraduate nurses that was immersed in the world of the academic institution. This research study is limited and cannot be generalised to the entire population of nurse educators teaching clinical postgraduate programmes. However, some valuable insights have been gained into a previously unexplored area, and recommendations have been made for the future direction of preparation for nurse educators teaching clinical postgraduate programmes in New Zealand. |
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NRSNZNO @ research @ |
Serial |
500 |
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Author |
Conroy, E. |
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Title |
Nursing informatics in New Zealand: Evolving towards extinction? |
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Year |
2000 |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Pages |
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Keywords |
Informatics; Technology; Education; Nursing |
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Abstract |
This project undertakes a critique and review of a decade (1990-2000) of available New Zealand literature to reveal the current state of nursing informatics utilisation in nursing practice. Since the early 1990s, nurses from diploma and baccalaureate nursing programs have been graduating with knowledge and skills in nursing informatics. Yet, when scrutinising the two main nursing publications for New Zealand, the author found scant publication of articles that pertain to this topic area of nursing. Competencies as product of the 1989 Guidelines for Teaching Nursing Informatics are a key consideration in this discussion, including ways in which the articles may reflect the content or intent of the Nursing Informatics curriculum as prescribed in these guidelines. This commentary discusses how nursing informatics has evolved in New Zealand nursing practice, situating its growth, or lack of, in the context of concurrent sociopolitical influences as well as conditions created by national and international nursing trends. Several recommendations are discussed to guide the future direction of nursing informatics for nursing education and practice in New Zealand. |
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Call Number |
NRSNZNO @ research @ |
Serial |
501 |
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Author |
Voice, D.M. |
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Title |
Everyday district nurses' experiences revealed through distillation: Palliative care in the community |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Keywords |
District nursing; Palliative care; Community health nursing; Nursing |
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Abstract |
This modified action research inquiry focused on the everyday, palliative care practice experiences of a group of district nurses. The intent was to develop an understanding of common issues of concern for this group of district nurses when providing palliative home care in a specific community context and to implement practical, achievable strategies in response to these local issues. Five district nurses identified four broad areas for action through four praxis group meetings and comprising one full cycle. These four areas have been named as methods of enhancing support for people and families, possibilities for creatively managing workloads, mechanisms to enrich working partnership with other palliative care providers and possible vehicles for supporting nurses' self care. Implementation of action from this action research project focused on enhancing care and outcomes for people and family served by this group of district nurses in their local community. This study illuminates everyday essences of the district nurse role and the elements articulated by this group in supporting their practice in one New Zealand community. This study also reveals some of the tensions and messiness when employing an action research methodology with nurses in the workplace. The author notes that this research focused on a little known area (palliative care delivered by district nurses in New Zealand) in a local community (a culturally vibrant and ethnically diverse yet with poor health and socioeconomic statistics). She goes on to say that it has resonance with other nurses, particularly those working in community settings who may experience similar issues and concerns. This research also offers important insights for nurses working in any practice setting. |
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Call Number |
NRSNZNO @ research @ 520 |
Serial |
506 |
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Author |
Baker, K.O. |
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Title |
A journey: Experienced respiratory nurses working with patients with chronic breathlessness |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing specialties; Nurse-patient relations |
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Abstract |
Respiratory nursing has, as a core clinical concern, the alleviation of distress and suffering associated with respiratory disease. This research describes the ways in which experienced New Zealand respiratory nurses understand, assess, manage and support patients suffering from chronic breathlessness. It reviews the professional context in which these nurses practice, and examines the experiences and beliefs that have lead them to, and maintain them in, this area of practice. This study has been stimulated by the realisation that the skills, understandings and practice wisdom exhibited by experienced Respiratory Nurses is poorly described in the published research literature. This qualitative, grounded theory research is based upon data gathered from in-depth interviews with six experienced New Zealand respiratory nurses. A constructivist research position is adopted. Analysis of these interviews revealed distinct phases of developing respiratory nurse practice including preparing and entering respiratory nursing practice, comprehension of the phenomena of chronic breathlessness and the effect upon the patient and the seeking of possibilities which may alleviate and modify the debilitating effects of chronic breathlessness. Consistent values and beliefs are identified, which are captured in the concepts of professional caring and the movement towards developing expertise in practice. The unifying concept of journeying is employed to draw together these conceptual elements and develop a substantive model describing the work of experienced respiratory nurses with patients with chronic breathlessness. Implications for practice and the health system, and suggestions for further research, are discussed. |
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Call Number |
NRSNZNO @ research @ |
Serial |
508 |
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Author |
Cleaver, H. |
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Title |
Reflections on knowing, not knowing and being in palliative care nursing |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Palliative care; Nursing; Terminal care; Nurse-family relations; Nurse-patient relations |
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Abstract |
The author notes that responses to questions from dying people and their families are as individual as each nurse, patient, family member, or situation. This is well recognised and an unspoken truth in palliative care practice. This paper explores the subjective nature of knowledge in palliative care generated through capturing moments of practice and subsequent reflections. This demonstrates how the author uses her model of care to open a space that enables the person and their family to find meaning from their experience and articulate what they need at the time. The author identifies her interest in the paradoxical reality of knowing and not knowing and describes how that paradox contributes to her role in supporting individuals' needs within their realities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
511 |
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Author |
McKerras, R. |
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Title |
Waiting in the emergency department – it doesn't have to take all day |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing |
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Abstract |
This thesis explores the nature of the emergency department environment as it continues to challenge emergency nurses to meet the health needs of an increasingly complex emergency department population. The emergency nurse is also facing conflict and challenge with regard to workplace safety and patient rights. The author suggests that, until recently, very little debate or consideration has been given to the moral dilemmas raised in the ability of emergency department staff to deliver timely and appropriate care in an overcrowded environment. She goes on to say that, in New Zealand, there is no national consistency with regard to the waiting crisis, no national guidelines and no national consensus putting the emergency nurse at risk. This thesis argues the need to acknowledge waiting times as a significant safety issue at a national level as increasing waiting times continue to impact on patient outcomes and nursing practice. It challenges current practice, in particular the role of the emergency nurse and the potential to legitimise expansion of the role to improve the patient experience of waiting in the emergency department. |
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Call Number |
NRSNZNO @ research @ |
Serial |
512 |
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Author |
McArtney, M. |
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Title |
Nursing development units: Between a rock and a hard place |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Pages |
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Keywords |
Professional development; Nursing |
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Abstract |
Practice development, situated at the nurse-patient interface, is a crucial aspect of professional development as a whole. The Nursing Development Unit (NDU) is one model of structured clinical practice development. NDU have their origin in a desire to provide the best possible care for patient through the support and development of autonomous therapeutic nurses. All possible sources of NDU-related literature from 1983-1999 were reviewed to determine the effectiveness of the NDU model. The purpose of the research was to establish the role of the parent organisation in supporting the ongoing viability of NDU; to describe the key processes and activities of NDU that are instrumental in the development of nursing practice; to clarify the role of the NDU in contributing to improved patient outcome; and finally to identify the critical indicator of successful NDUs for their application in the New Zealand context. The study found that British nursing journals have played a large part in promoting the NDU model. The pioneering units were given positive coverage and this has by and large continued. Accreditation systems have been important in maintaining standards and providing a generic framework for implementation. The trend is now towards internal funding from the parent organisation. The review identified a number of key features for the successful establishment of NDUs. NDUs appear to have under emphasised the development of socio-political acumen in the nursing staff. However, the NDU does offer a model for the development of confident, assertive, autonomous professionals. The NDU model values nursing as professional practice. The author concludes that the NDU model has stood the test of time, and demonstrated the ability to be at the vanguard of contemporary practice development. The model is flexible and its potential is maximised when it is tailored to meet the need of the parent organisation. The model has been successfully established in Australia, and has the potential to be adapted and refined for the New Zealand context. |
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Call Number |
NRSNZNO @ research @ |
Serial |
561 |
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Author |
Morrison, M. |
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Title |
Posthuman pathology: A postmodern art project located in critical care |
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Year |
2003 |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Nursing philosophy; Culture; Technology |
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Abstract |
The author's art project “Posthuman Pathology” is a postmodern examination of the resolutely modernist culture of critical care medicine. She uses conceptual art practices in conjunction with the techniques of anti-aesthetics in order to dismantle, open out and critique ideas which are foundational to the culture of critical care. |
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Call Number |
NRSNZNO @ research @ 580 |
Serial |
566 |
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Author |
Ross, J. |
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Title |
Role identification: An impediment to effective core primary health care teamwork |
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Year |
2001 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Multidisciplinary care teams; Teamwork; Primary health care |
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Abstract |
This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners and the understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future. |
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Call Number |
NRSNZNO @ research @ |
Serial |
571 |
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Author |
Yarker-Hitchcock, V. |
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Title |
Clinical supervision in a home care context |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Clinical supervision; Home care; Rural nursing; Rural health services |
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Abstract |
Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in relation to its effect on clinical practice. It is not clear whether supervision actually produces a change in clinician behaviour, or whether it produces benefits in terms of client outcomes. This thesis evaluates the impact of clinical supervision on five co-ordinators in a rural home care setting. It looks at the impact clinical supervision has on their practice and professional growth. The nurses all belong to one organisation, Access Homehealth Ltd. The study builds on the findings of a clinical supervision pilot, which was trialed within the organisation in 2002. The pilot examined which model of supervision was most beneficial for Access Homehealth staff. Clinical Supervision is defined as a designated interaction between two or more practitioners within a supportive environment, that enhances reflective practice and professionalism, which in turn contributes to improved practice and client outcomes. The methodology of this research was qualitative evaluation. The themes which emerged related to personal support, managing stress and alleviating feelings of isolation, reflection, enhancing practice, improved communication skills and the concept of clinical supervision as a safety net. Participants also revealed that one-on-one supervision appeared more helpful than group supervision, and that phone supervision facilitated in-depth dialogue. These findings are important, as they demonstrate it is feasible to simultaneously offer a number of formats of clinical supervision within one organisation, allowing for the organisation to provide what works best for different workers. They also show that clinical supervision is a valuable and useful support tool for home care co-ordinators in order to facilitate empowerment, reflection and growth in practice. Further research is needed to provide evidence of the benefits of supervision on improving client outcomes. |
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Call Number |
NRSNZNO @ research @ 593 |
Serial |
579 |
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Author |
Sims, D.A. |
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Title |
The benefits and challenges of one New Zealand nursing undergraduate clinical education model: A case study |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Clinical supervision; Preceptorship; Education; Students; Nursing |
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Abstract |
This research project utilised a case study approach to give ward managers a voice in the literature, by exploring and describing from their perspective the benefits and challenges of one particular nursing undergraduate clinical education model. The tertiary education provider contracts the health provider to provide Clinical Nurse Educators (CNEs) to support second and third year undergraduate nursing students during their clinical experiences. The CNEs are seconded from their respective wards to meet the organisation's contractual obligations. Data were gathered from two ward managers using semi-structured interviews. The findings elucidate the role of the undergraduate CNE, highlighting benefits such as the CNE being supernumerary to ward rosters and having time to teach, not only supervise students. CNEs are student-focused and easily accessible as they are based on site. The CNE was the one person who was 'there' for a student as a student's preceptor can change shift-by-shift and day-by-day. One significant challenge which emerged was the replacement of ward staff, not only of senior nurses who can leave their wards for up to 12 weeks to undertake the CNE role but also that of the student's preceptor if the student's preceptor was on annual, sick or study leave. Other challenges such as the inability of ward managers to pre-book casual staff; preceptor work-loads; skill-mix issues and fluctuating fulltime equivalents are also discussed. |
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Call Number |
NRSNZNO @ research @ |
Serial |
598 |
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Author |
Dearden, G. |
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Title |
When things go wrong: The experiences of mental health nurses who have had a patient die through suicide |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Psychiatric Nursing; Nurse-patient relations; Case studies; Suicide |
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Abstract |
This thesis discusses the findings of a research study, informed by the work of van Manen (1997b), which explored the lived experiences of five mental health nurses who have had a patient die through suicide. Narrative was used as a method in interviews to uncover the essence of their lived experiences. Five interwoven themes uncovered in each of the interviews were: impact, support, feelings, closure and paradox. All of the nurses interviewed experienced a wide range of feelings about their patient's suicides, ranging from shock to guilt, to anger and sadness, and described their patient's suicide as having a significant impact on them. Support received by the nurses following their patient's suicide was variable, and they were often in the difficult position of trying to offer support to the patient's family. Common to all of the nurses was the lack of closure following the suicide. Paradox was found to be the overall essence of the experience of the mental health nurses interviewed. Three main paradoxical themes or statements were identified that are in many respects a summary of all of the themes that emerged. These were: unavoidable – responsible; inevitable – unprepared; duty of care – respect for patient's decision to end their life. The author suggests that the ability of the nurses interviewed to accept and reconcile the paradoxical issues that arise in relation to patient suicide, and accept the lack of closure they experience, is a fundamental element in their ability to continue to work in the mental health setting, despite the significant impact their patient's suicide has had on them. Four recommendations are made based on the insights gained from this research. These are: that every mental health service should have a suicide response policy; that undergraduate nursing education includes the impact of patient suicide; the development of policies which promote dialogue about suicide within the community; and the need for further research in this topic. |
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Call Number |
NRSNZNO @ research @ |
Serial |
602 |
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