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Challis-Morrison, S. (2006). Caring for a community wanderer. Kai Tiaki: Nursing New Zealand, 12(11), 20–22.
Abstract: A community based registered nurse from Waikato District Health Board's Older Persons Assessment Team (OPAT) presents her experiences of working with older people with dementia. She uses a case study approach to highlight the issue of wandering, behaviour which can be difficult to modify and can cause carer distress. She outlines a team approach to the condition which requires good communication and co-ordination. Key aspects of management included a risk assessment plan, support for caregivers, and encouraging activity.
Keywords: Case studies; Older people; Community health nursing; Dementia
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Hunt, M. (2006). Nurses can enhance the pre-operative assessment process. Kai Tiaki: Nursing New Zealand, 12(10), 20–22.
Abstract: This reports on an initiative at Whakatane Hospital, where a Nurse-Led pre-assessment (NLPA) was delivered at an outpatients clinic. NLPA involves taking a comprehensive medical history, a nursing assessment, physical examination, airway assessment, ordering appropriate investigations and carefully documenting the process and results. More valuably, it provides an opportunity for the patient to participate in planning their care. The aim of this initative was to short circuit delays and congestion in existing pre-assessment clinics, streamline the pre-assessment process and reduce the number of patient visits to hospital. Reducing cancellations of surgery (often on the day of surgery) and “did not appear” (DNA) numbers were also objectives. After a small pilot, a six-month trial was funded by the Ministry of Health. Over the six-month trial, 373 patients attended NLPA; 178 patients required anaesthetist review before surgery, and 198 could proceed directly to surgery following NLPA. An anonymous postal survey was made of patients, who indicated satisfaction with the service. Other outcomes are discussed, and the trial was deemed successful. Follow up plans have been disrupted by restructuring at the hospital and the clinic has yet to be implemented.
Keywords: Nursing specialties; Clinical assessment; Hospitals; Surgery
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McKenna, B., O'Brien, A. J., Dal Din, A., & Them, K. (2006). Responsible clinician role offers opportunities for nurses. Kai Tiaki: Nursing New Zealand, 12(11), 12–14.
Abstract: The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation.
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Wareham, P., McCallin, A., & Diesfeld, K. (2005). Advance directives: The New Zealand context. Nursing Ethics, 12(4), 349–359.
Abstract: Advance directives convey consumers' wishes about accepting or refusing future treatment if they become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may arise regarding a consumer's competence and the document's validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers' and providers' perspectives, and the medical and nursing positions in New Zealand.
Keywords: Law and legislation; Patient rights; Nursing; Ethics
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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.
Keywords: Psychiatric Nursing; Mental health; Nurse-patient relations
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Gaskin, C. J., O'Brien, A. P., & Hardy, D. J. (2003). The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. International Journal of Mental Health Nursing, 12(4), 259–270.
Abstract: This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.
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Bishop, D., & Ford-Bruins, I. (2003). Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study. International Journal of Mental Health Nursing, 12(3), 203–212.
Abstract: This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
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Palmer, S. G. (2003). Application of the cognitive therapy model to initial crisis assessment. International Journal of Mental Health Nursing, 12(1), 30–38.
Abstract: This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
Keywords: Mental health; Clinical assessment; Psychiatric Nursing
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McLeland, A., & Williams, A. (2002). An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries. Contemporary Nurse, 12(2), 185–193.
Abstract: The purpose of this qualitative study was to analyse the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalisation; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalisation. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability.
Keywords: Nursing; Education; Clinical supervision; Preceptorship
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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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White, T. (2004). Avoiding the pitfalls of long-term suprapubic catheterisation. Available online at Eastern Institute of Technology, 12(2), 4–7.
Abstract: Studies show that majority of complications experienced by patients with long term suprapubic catheters are associated with urinary tract infection and encrustation of catheters. This article will revise the pathophysiology of infection and encrustation and discuss management of suprapubic catheters based on current best practice. It is stressed that suprapubic catheters should only be considered once less invasive methods of maintaining bladder function have been exhausted as it is preferable for patients to manage incontinence with bladder training, pelvic floor exercises and continence products than to have a permanent indwelling catheter inserted.
Keywords: Nursing specialties; Long term care
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Litchfield, M. (2021). Nursing is -- and has -- a methodology: a nursing voice. Kai Tiaki Nursing Research, 12(1), 66–72.
Abstract: Argues that a nursing paradigm identifies and differentiates the nursing perspective on health, and reinterprets practical expertise. Posits that nurse researchers present their findings as practice wisdom. Suggests that the significance of nursing lies in its knowledgeable practitioners and that the nursing voice is a collective one. Emphasises the need for a distinctly nursing perspective on health in NZ.
Keywords: Nursing knowldege; Nursing voice; Nursing methodology
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Stodart, K., & Woods, H. (2021). How international databases take Kai Tiaki Nursing Research to the world. Kai Tiaki Nursing Research, 12(1), 77–78.
Abstract: Explains how the journal receives international exposure through the databases in which it is indexed: AcademicOnefile, Informit, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL). Details which articles were downloaded most frequently.
Keywords: Health databases; Nursing research
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Spence, D., & Fielding, S. (2002). Win-win-win: Collaboration advances critical care practice. Contemporary Nurse, 13(2/3), 223–228.
Abstract: This paper provides an overview of the structure and processes of an eighteen month, distance education course focused on developing advanced practice in the context of critical care nursing. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) was developed as a collaboration between Auckland University of Technology and two regional health providers. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This course is set against a background of increasing interest in education post registration. The acquisition of highly developed clinical capabilities requires a combination of nursing experience and education. This requires collaboration between clinicians and nurse educators, and approaches to address accessibility of relevant educational opportunities for nurses outside the country's main centres.
Keywords: Nursing specialties; Rural nursing; Nursing; Education; Curriculum
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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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