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Campbell, K. (2008). Experiences of rural women who have cared for their terminally ill partners. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 166-178). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter firstly offers background information in relation to palliative care and the role of women as providers of care in the home setting. Secondly, it discusses a study that evolved from a trend the author observed as a district nurse providing community palliative care in rural New Zealand and from New Zealand literature; that the majority of carers of the terminally ill in home-settings are women. The aim of this research study was to offer insights into the requirements of caring for a dying person at home and provide information to assist nurses working in the community and other women who take on the caregiver's role.
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Robertson, A. M. (2008). Rural women and maternity services. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 179-97). [Dunedin]: Rural Health Opportunities.
Abstract: The author discusses the roles that nurses undertake in response to rural communities' health needs, focusing on the provision of maternity service. The author reviews structural changes such as the 1990 Amendment to the Nurses Act 1977 which, the author suggests, introduced a climate of professional rivalry, changes in funding that cut back general practitioners in the field, and the development of Lead Maternity Carers. Despite controversial developments, New Zealand maternity services have evolved to include a unique and internationally respected model of midwifery care. However, the author highlights several areas that limit the positive contribution of rural nurses and midwives. These include workforce recruitment and retention, equity of access, and issues around maintaining competency and education.
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Maw, H. (2008). The challenge of developing primary health care nurse practitioner roles in rural New Zealand. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 201-214). [Dunedin]: Rural Health Opportunities.
Abstract: The author traces the development of the nurse practitioner role in New Zealand, which was finally introduced in 2001. It traces the key events, from early debates on the issue, the influence of the Centre for Rural Health, and a series of government investigations into nursing which noted the untapped potential of the nursing workforce and the lack of ongoing clinical career pathways. Barriers to rural nurses becoming endorsed as primary health care nurse practitioners are examined, and some of the solutions to this issue are explored. Relationships between nurse practitioners and the local general practitioners, and community resistance are areas that need management. Education is seen as a key response to many of these issues.
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Higgins, A. (2008). Collaboration to improve health provision: Advancing nursing practice and interdisciplinary relationships. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 215-223). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter introduces national policies and strategies that promote interdisciplinary collaboration as a means of providing better access to health care for all communities. It identifies a role for advancing nursing practice as part of a collaborative approach to healthcare in rural areas. An increasing focus on collaboration as a concept within health practice during the last 10 years has become evident in policy documents from the Report of the Ministerial Taskforce on Nursing (Ministry of Health, 1998) to the Working Party for After Hours Primary Health Care (Ministry of Health, 2005). The emphasis would seem to be in response to political pressure to address health inequalities and an apparent assumption that interprofessional collaboration results in improved communication, fewer gaps in provision of care and more effective use of the limited health funds.
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Armstrong, S. E. (2008). Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46). [Dunedin]: Rural Health Opportunities.
Abstract: A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them.
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Hennephof, R. (2005). Preceptorship and mentoring. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp. 27-45). Dunedin: Otago Polytechnic.
Abstract: This paper reviews international and local nursing literature on preceptorship and mentoring. This includes an exploration of ways in which these two terms are defined, a discussion of the essential qualities needed to undertake such roles, and an examination of appropriate preparation and exploration of the ways in which registered nurses can be supported when engaged in providing these roles. At the end of the chapter, discussion questions are provided by Joc Parkes.
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Manning, J. (2005). Formative assessment: Using feedback to enhance learning. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp. 47-65). Dunedin: Otago Polytechnic.
Abstract: This paper explores the literature surrounding the development, definition, process and value of formative feedback. In particular, this review considers how formative assessment can be used by a clinical educator in the practice setting. At the end of the chapter, discussion questions are provided by Rebecca Hennephof.
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Latta, L. (2005). Reflective storytelling to enhance learning from practice experience. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp.67-82).. Dunedin: Otago Polytechnic.
Abstract: The author looks at the value of using reflective storytelling as a teaching/learning tool in the hospice setting and examines constructs that provide a theoretical underpinning. She also outlines processes that support the implementation of storytelling practice and the creation of a safe space for storytelling. At the end of the chapter, discussion questions are provided by Janice McDrury.
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Bishop, J. (2005). Motivation: An essential element of learning. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp. 83-100). Dunedin: Otago Polytechnic.
Abstract: The author defines extrinsic and intrinsic motivators, describes motivational theories, and introduces Wlodkowski's Motivational Framework, which is specifically developed for adult learners. She goes on to explore the implementation of this model within a nursing education context. At the end of the chapter, discussion questions are provided by Janice McDrury.
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Wong, G., Fishman, Z., McRobbie, H., Arroll, B., Clair, S., Freeman, B., et al. (2007). Smoking and nurses in New Zealand: ASH-KAN Aotearoa: Assessment of smoking history, knowledge and attitudes of nurses in New Zealand. Auckland: ASH New Zealand.
Abstract: Because nurses work in a wide range of settings they are well-placed to provide support for smokefree environments. The aim of this research was: to assess the knowledge of cessation, attitudes towards smoking, the provision of smoking cessation advice and treatment, and attitudes to and management of smokefree workplaces in a sample of nurses with practising certificates in New Zealand; and to describe the prevalence of smoking in nurses using the 2006 New Zealand census. One thousand questionnaires were posted to a random sample of 1000 nurses (500 community-based nurses, and 500 hospital-based) from the New Zealand Nursing Council register of nurses with current practising certificates. Statistics New Zealand provided results from the New Zealand Census of Population and Dwellings, 2006, for nurses by gender, practice area and cigarette smoking status. Responses were received from 371 (37%) of the nurses. They were enthusiastic about and committed to including smoking cessation in their practice, and to learning more about helping clients who smoke. Nine out of ten felt that it was part of their responsibility to advise clients to stop smoking. Nearly nine out of ten said they would be happy to spend an extra five minutes with each patient who smoked if they could effectively intervene. Over half had not received training for effective evidence-based smoking cessation interventions but three quarters were interested in learning more about how to help people stop smoking. The respondents' knowledge of the health effects of smoking was high, but there were gaps in knowledge of effective smoking treatments and a wide misunderstanding that nicotine causes cancer and heart disease. These gaps may limit nurses' ability to intervene effectively. Nurses supported their smokefree work policies although a fifth did not report support with enforcing these. Results from the 2006 census showed that smoking prevalence among nurses has declined from 18% in 1996 to 14% in 2006. Smoking rates in mental health nurses (29%) remain higher than the New Zealand general population (21%, census data).
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Ratnasabapathy, P. (2005). Silent suffering: The 'lived experience' of women who have experienced early pregnancy loss and used the health services for their care. Ph.D. thesis, , .
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Lee, S. V. (2005). The advanced practitioners' guide to integrating physical and mental health: Introducing the role of the mental health consultation liaison nurse.
Abstract: Evidence within the literature highlights that staff within the general hospital wards are not necessarily equipped to assess and meet the needs of patients with mental health or behavioural problems. The author notes that this is cause for concern as a number of people requiring admission to the general wards often have a complex, interrelated combination of physical and mental health problems. Within New Zealand there have also been a number of changes to health care policies that have increased general nurses contact with mental health patients over the last decade. The Mental Health Consultation Liaison Nurse is an advanced nurse specialist who can meet this need. Having reviewed the literature and communicated with Mental Health Consultation Liaison Nurses in New Zealand and Australia, the author says it is clear that the availability of a mental health nurse within the district health board general wards would be advantageous to all. The role has been shown to positively influence the care of patients and benefit other health care professionals. It provides an improved system of care that is co-ordinated, integrated and responsive to the needs of patients and health care staff. The implementation of the Mental Health Consultation Liaison Nurse role has the potential to cut costs in relation to decreasing length of stay with untreated mental health issues, and reduce the cost of continued use of 'specialling' unnecessarily. Also of importance is the fact that such a position would assist the district health board to comply with the standards of health care provision as directed by the Mental Health Commission and the Ministry of Health. The author suggests that the introduction of the Mental Health Consultation Liaison Nurse role represents a change in traditional ways of providing general nursing and consequently there are a number of issues that may hinder its success. This dissertation aims to increase the visibility of mental health nursing and provide a resource for others debating the development and implementation of the Mental Health Consultation Liaison Nurse role.
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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.
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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.
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McKergow, C. R. W. (2002). Preparing to care in the 21st century: A personal search for the meaning of ontological competency through an embodied journey of the soul.
Abstract: This thesis is a philosophical inquiry that reflects a personal search for the meaning of ontological competency undertaken by the author after developing breast cancer. The text weaves together in creative synthesis, a collection of academic and personal writing undertaken during an MA (Applied) in Nursing degree process. Using the work of Dowling Singe (1999), Watson (1999), and Wilber (1985, 1990, 1991 & 2000), the thesis seeks, through the use of reflective autobiographical inquiry (Johnstone 1999a), to explore the personal meaning-making activities engaged in during this time to throw light upon the nature of nurse / nursing being. Exploring developmental schemata drawn from personal experience and illuminated by theory, nurses and nursing are challenged to become more self-reflective and self-aware. To facilitate the personal and professional growth that underpins notions of ontological competency, various aids in the form of maps and models are provided to support a transformative journey into awareness. From this position of expanding consciousness, the nurse / nursing is encouraged to reach beyond current paradigms, metaparadigms, epistemologies, and restrictive philosophies and to yield to the evolutionary imperative that seeks to prepare for a 21st century clinical practice where caring / healing becomes embodied enactment from “the Ground of All Being”.
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