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Author |
McLean, J.M. |
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Title |
Pushing the boundaries: Relationships with adolescents |
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Year  |
2007 |
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 |
Psychiatric Nursing; Mental health; Adolescents; Nurse-patient relations |
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Abstract |
Therapeutic relationships are central to mental health nursing. The nurse's role in maintaining professional yet therapeutic boundaries within this relationship can be challenging. When therapeutic boundaries are breeched within the nurse adolescent relationship the adolescent's safety within this relationship is compromised. There is currently limited literature on how nurses are managing professional boundaries in relationships with adolescents in this setting. The adolescent's nature is to push boundaries; therefore the nurse needs to be acutely aware of this boundary pushing in everyday practice settings. For the safety of the adolescent and the nurse it is vital the nurse understands her role in managing the professional boundary. This thesis explores, through the use of narrative inquiry, four adolescent mental health nurses' experiences of assessing, understanding and maintaining therapeutic boundaries with adolescents in a mental health setting in New Zealand. The unique and specific implications for adolescent mental health nursing are discussed. Three key themes emerged from the analysis and findings: the importance of the nurse clarifying his/her role; the learning that occurs throughout the practice journey; and the role of the nurse in keeping the adolescent and the nurse safe. These findings highlight the importance of clinical supervision and open communication with senior nurses and mentors, which assist the nurse in monitoring practice. When nurses do not have sufficient knowledge of the fundamental principles of adolescent mental health nursing; such as knowledge and skills in both adolescent development and psychodynamic nursing, they are at risk of boundary crossings. Recommendations from this research include more emphasis on psychodynamic nursing principles in nursing education and nursing practice. There is a need for specialised education for nurses in child and adolescent mental health nursing. Nursing entry to practice programmes for new graduate nurses working in mental health, could assist in providing this. There is a call for further research into therapeutic relationships and professional boundaries in this complex nursing specialty. |
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Call Number |
NRSNZNO @ research @ 762 |
Serial |
748 |
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Author |
Prebble, K. |
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Title |
Ordinary men and uncommon women: A history of psychiatric nursing in New Zealand public mental hospitals, 1939-1972 |
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Year |
2007 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Mental health; History; Gender |
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Abstract |
This social-cultural history explores the changing context, culture, and identity of psychiatric nurses working in New Zealand public mental hospitals between 1939 and 1972. Primary documentary sources and oral history interviews provided the data for analysis. The thesis is divided into two periods: 1939 to 1959 when asylum-type conditions shaped the culture of the institutional workforce, and 1960 to 1972 when mental health reform and nursing professionalisation challenged the isolation and distinct identity of mental hospital nurses. Between 1939 and 1959 the introduction of somatic treatments did not substantially change nursing practice in mental hospitals. Overcrowding, understaffing and poor resources necessitated the continuance of custodial care. The asylum-type institutions were dependent on a male attendant workforce to ensure the safety of disturbed male patients, and the maintenance of hospital farms, gardens, and buildings. Although female nurses provided all the care and domestic work on the female side, the belief that psychiatric nursing was physically demanding, potentially dangerous, and morally questionable, characterised the work as generally unsuitable for women. Introduction of psychiatric nursing registration which was a move toward professionalisation did little to change the dominance of a male, working-class culture. From 1960 to 1972 psychiatric nurses' identity was contested. New therapeutic roles created the possibility of the nurses becoming health professionals. Their economic security and occupational power, however, was tied to an identity as unionised, male workers. As psychiatric nurses were drawn closer to the female-dominated nursing profession through health service changes and nursing education reform, both men and women acted to protect both their working conditions and their patients' welfare. To achieve these ends, they employed working-class means of industrial action. By accepting the notion that psychiatric nurses' identity was socially constructed, this thesis provides an interpretation that goes beyond the assumption that nursing is a woman's profession. Instead, it presents psychiatric nursing as a changing phenomenon shaped by contested discourses of gender, class and professionalisation. Nursing in public mental hospitals attracted ordinary men and uncommon women whose collective identity was forged from the experience of working in a stigmatised role. |
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Call Number |
NRSNZNO @ research @ 763 |
Serial |
749 |
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Author |
Lesa, R.; Dixon, D.A. |
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Title |
Physical assessment: Implications for nurse educators and nursing practice |
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Journal Article |
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Year |
2007 |
Publication |
International Nursing Review |
Abbreviated Journal |
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Volume |
54 |
Issue |
2 |
Pages |
166-172 |
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Keywords |
Advanced nursing practice; Clinical assessment; Cardiovascular diseases; Nursing; Education |
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Abstract |
In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
786 |
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Author |
Saba, W. |
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Title |
Walking in two worlds: A Kaupapa Maori research project examining the experiences of Maori nurses working in district health boards, Maori mental health services |
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Year |
2007 |
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; District Health Boards; Maori |
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Abstract |
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Call Number |
NRSNZNO @ research @ 817 |
Serial |
801 |
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Author |
Watson, S.L. |
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Title |
Attitudinal shifting: A grounded theory of health promotion in coronary care |
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Year |
2007 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Health promotion; Policy; Professional development; Cardiovascular diseases; Nursing; Nurse-patient relations; Education |
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Abstract |
Current New Zealand health policy encourages collaborative health promotion in all sectors of health service delivery. The integrated approach to the acute management of coronary heart disease in a coronary care unit, combining medical therapy and lifestyle change, supports clinical health promotion. The aim of this study was to use the grounded theory approach to discover the main concerns of nurses' promoting health in an acute coronary care setting and to explain the processes that nurses used to integrate health promotional activities into their practice. Seventeen registered nurses from three coronary care units within a large metropolitan city in New Zealand were interviewed. Data were constantly compared and analysed using Glaser's emergent approach to grounded theory.The main concern for nurses promoting health within coronary care was ritualistic practice. In this study, ritualistic practice concerns the medically-based protocols, routines, language and technology that drives nursing practice in coronary care. This concern was resolved via the socio-cultural process of attitudinal shifting that occurs over time involving three stages. The three conceptual categories, environmental pressures, practice reality and responsive action are the main components of the theory of attitudinal shifting. In environmental pressures, nurses experience a tension between specialist medically-dominated nursing practice and the generalist nursing role of promoting health. In practice reality, nurses become aware that the individual needs of patients are not being met. This causes role conflict until the nurse observes colleagues who role model possibilities for practice, working with patients to promote health. Responsive action sees the nurse engaging in self-development, also focusing on the nurse-patient relationship, thereby enabling active patient involvement in individual health-promoting decisions. The author suggests that the findings from this research have implications for nursing practice and education. With the increasing specialisation in nursing practice, these findings may be of interest to nurses working in delegated medical roles where the reality of everyday practice precludes nurses from undertaking their essential nursing role. Health care facilities also need to ensure that there are opportunities for the personal and professional development of nursing staff. The place of health promotion within nursing undergraduate curricula needs to be examined, as many nurses found that they were ill prepared for undertaking health promotional activities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
807 |
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Author |
Bigwood, S. |
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Title |
Got to be a soldier: Mental health nurses experiences of physically restraining patients |
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Year |
2007 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Workplace violence; Mental health; Stress |
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Abstract |
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Call Number |
NRSNZNO @ research @ 829 |
Serial |
813 |
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Author |
Grainger, J. |
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Title |
Mind shift: Creating change through narrative learning cycles: A qualitative interpretive study of clinical conversation as an appraisal process for sexual and reproductive health nurses |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Auckland University of Technology Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Sexual and reproductive health; Nursing; Professional development |
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Abstract |
This thesis explores the process of an annual appraisal strategy, 'clinical conversation', from the perspective of seven nurses who were assessed using this technique. The findings demonstrate that clinical conversation is a strategy which facilitates reflection, both as a solitary exercise and with others, to ensure that learning from experience is optimised. The research used a qualitative interpretive approach informed by the model of Grounded Theory espoused by Strauss and Corbin. All eight nurses who were assessed using the clinical conversation strategy were advanced practitioners working within the scope of sexual and reproductive health. Two of the actual appraisals were observed and seven of the nurses were interviewed within eight weeks of being assessed. The outcome of the clinical conversation was primarily one of learning; the acquisition of new insights into self as practitioner. The learning was facilitated through the process of narration; telling the story of clinical practice. Three distinct narrative cycles were identified, each an experiential learning episode. The experience of undertaking a variety of assessment activities created a narrative with self and triggered an internal reflective thinking process; the experience of working with a peer created an additional narrative, a mutual dialogue reflecting back on practice; the experience of sharing practice with an assessor created a further and final narrative, a learning conversation. Each narrative can be seen as a catalyst for change. Primarily, the nurses felt differently about themselves in practice, the way they saw themselves had shifted. Such a change can be described as an alteration in perspective. These alterations in perspective led all nurses to identify ways in which they would change their actual clinical practice. In this way the nurses attempted to align their espoused beliefs about practice with their actual practice. The author notes that the study shows that each nurse responded differently to each narrative learning cycle: for some the conversation with the assessor was more of a catalyst for change than for others. In this way clinical conversation may be flexible enough to respond to a variety of differing learning styles. Learning was person specific which is an imperative for the continued professional development of already highly skilled clinicians. The implication of the research is that whilst clinical conversation was designed as a tool for appraising clinical competence, its intrinsic value lies in supporting the professional development of nurses. |
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Call Number |
NRSNZNO @ research @ 833 |
Serial |
817 |
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Author |
Barber, M. |
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Title |
Nursing and living in rural New Zealand communities: An interpretive descriptive study |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Rural nursing; Rural health services; Recruitment and retention |
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Abstract |
This study used an interpretive descriptive method to gain insight into and explore key issues for rural nurses working and living in the same community. Four Rural Nurse Specialists were recruited as participants. The nurses had lived and nursed in the same rural community for a minimum of 12 months. Participants were interviewed face to face and their transcribed interviews underwent thematic analysis. The meta-theme was: the distinctive nature of rural nursing. The themes identified were: interwoven professional and personal roles; complex role of rural nurses and relationships with the community. A conceptual model was developed to capture the relationship between the meta-theme and the themes. A definition for rural nursing was developed from the findings. This research identified some points of difference in this group of rural nurses from the available rural nursing literature. It also provides a better understanding of the supports Rural Nurse Specialists need to be successful in their roles, particularly around the recruitment and retention of the rural nursing workforce. |
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Call Number |
NRSNZNO @ research @ |
Serial |
820 |
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Author |
Spence, D.; Wood, E.E. |
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Title |
Registered nurse participation in performance appraisal interviews |
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Journal Article |
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Year |
2007 |
Publication |
Journal of Professional Nursing |
Abbreviated Journal |
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Volume |
23 |
Issue |
1 |
Pages |
55-59 |
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Keywords |
Registered nurses; Management; Professional development; Attitude of health personnel |
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Abstract |
This article presents the findings of an interpretive study that explored and documented the meaning and impact of nurse participation in performance appraisal interviews. Data gleaned from nine New Zealand registered nurses employed by a single district health board provide evidence that nurses are often disappointed by the process of performance appraisal. Although they believe in the potential value of performance appraisal interviews, they seldom experience the feedback, direction, and encouragement necessary for an effective appraisal process. It is suggested that changes to the current professional development program and its accompanying performance appraisal will require skilled commitment on the part of nurses, managers, and the employing organisation to improve and develop the assessment and promotion of nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
840 |
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Author |
Gosnell, M. |
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Title |
Postoperative pain assessment: A retrospective review of nursing documentation |
Type |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Pain management; Nursing |
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Abstract |
An essential part of nursing practice for the nurse on the surgical floor is to relieve the discomfort of post operative pain for patients in their care. Post operative pain management encompasses a series of processes from assessing pain, providing relief, assessment of measures used to relieve pain through to documentation in the patient record. Yet literature, both internationally and from Australia and New Zealand, suggests that post operative pain continues to be poorly managed despite having the means to provide more than adequate relief. Events leading up to the commencement of this study indicated that locally, post operative pain assessment, including documentation in the patient record may be substandard. The objective of this study was to develop and test an audit tool; undertake a retrospective audit of nursing records, including nursing notes and the nursing care plan, in respect of what postoperative pain assessments nurses document in the patient record; evaluate data and make recommendations for practice. Methodology: A five part, 23 question Likert scale audit tool, designed specifically for this study was used to collect data over a period of two months. In total 40 patient records that met the inclusion criteria were audited.The results indicate that local practice reflects poor documentation standards found in other studies. The most complete recordings were those entered on specifically designed charts such as the Patient Controlled Analgesia and Epidural charts (N 28) but this did not carry over into the patient record. Despite that fact that the patient's self reports of pain is said to be the single most reliable indicator of pain, there was only four occasions when the patient's verbal response to pain was recorded. None of those responses were according to any type of pain rating scale. Evidence of evaluation following measures used to relieve pain was more likely to be recorded if pain was poorly controlled or when side effects such as nausea were experienced by the patient. The author concludes that overall the audit has highlighted many gaps in what is or is not recorded in the patient record in respect of post operative pain assessment and has highlighted the need to develop standards of practice that will improve post operative pain management practices. |
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Call Number |
NRSNZNO @ research @ |
Serial |
915 |
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Author |
Allan, J. |
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Title |
What is it like for older women to live with depression? |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Older people |
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Abstract |
The author's interest in this study came from working as a mental health nurse with mainly older women with depression and developed from her concern that depression for older people is frequently misdiagnosed, not recognised or is under-treated. To date, research has rarely paid attention to the voices of people who have actually experienced depression and even less is known from the perspective of older women. This hermeneutic phenomenological study, informed by Martin Heidegger and Max van Manen, describes what it is like for four older women to live with depression. Multiple interviews were conducted with the participants. Heidegger's philosophical concepts of Being-in-the-world and Being-with-others structured the analysis. Depression was found to have a significant effect on the participants' Being-in-the-world. The themes that emerged were: something is wrong; the search for reasons; self-loathing; being overwhelmed by the feelings; hiding from the world; loss of self; loss of meaning; the struggle of everyday life; and living circumspectly. Being-with-others was difficult for the participants and the themes that emerged were: maintaining relationships when well; Being-alone; misinterpreting self and other people; the stigma of mental illness – society and self; and seeking understanding from other people. The author suggests that the findings have implications for nurses and other health professionals. |
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Call Number |
NRSNZNO @ research @ |
Serial |
917 |
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Author |
King, S.L.J.; Walsh, K. |
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Title |
'I think PCA is great, but . . .'- Surgical nurses' perceptions of patient-controlled analgesia |
Type |
Journal Article |
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Year |
2007 |
Publication |
International Journal of Nursing Practice |
Abbreviated Journal |
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Volume |
13 |
Issue |
5 |
Pages |
276-283 |
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Keywords |
Nurse-patient relations; Drug administration; Pain management |
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Abstract |
This qualitative study investigated surgical nurses' perceptions of patient-controlled analgesia as a strategy for managing acute pain in a tertiary care hospital. Patient-controlled analgesia is commonly used and nurses play an essential role in caring for patients prescribed it. The study was divided into two parts. First, audiotaped semi-structured interviews were conducted with 10 nurses. The interviews were followed by a postal questionnaire to 336 nurses with 171 returned. Thematic analysis was the chosen methodology. The audiotaped transcripts and questionnaires surfaced five themes, with the dominant one being `I think PCA is great, but . . .'. The paper outlines and explores these themes and addresses the implications arising from the research for both clinical practice and education. |
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Call Number |
NRSNZNO @ research @ |
Serial |
972 |
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Author |
Dellagiacoma, T. |
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Title |
Contracting as a career option for nurses |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
1 |
Pages |
20-22 |
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Keywords |
Professional development; Nursing; Work |
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Abstract |
A nurse presents research and her own experiences of contracting. Contracting, as defined in this article, refers to a nurse not employed permanently on a wage. It covers agency nursing, short and long fixed-term contracts and secondments. The author identifies the need to continue to develop professionally, which is now a mandatory requirement under the Health Practitioners Competence Assurance (HPCA) Act. Contractors have little, if any financial support to develop professionally, and time taken to do courses is not paid. Taking study leave within a contract may also not be an option. Options for managing professional development in these conditions are offered, including goal setting, investing in education or training, and considering some longer contracts. Practical financial advice and examples are given, including managing accounts and consideration of employment law. The author recommends that skilled nurses looking for interesting ways to develop their careers and to branch out in an entrepreneurial way should seriously consider taking up contract work. |
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Call Number |
NRSNZNO @ research @ 996 |
Serial |
980 |
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Author |
Neville, S.J.; Gilmour, J.A. |
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Title |
Differentiating between delirium and dementia |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
9 |
Pages |
22-25 |
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Keywords |
Dementia; Psychiatric Nursing; Clinical assessment; Older people |
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Abstract |
Accurate nursing assessment is a critical element in the identification of health problems and treatment strategies for older adults who have delirium and/or dementia. This practice update provides information on the differentiation between these two debilitating and adverse health events, along with some useful assessment frameworks and other resources. Comments from people with delirium and dementia are interspersed throughout the article to draw attention to the impact of these conditions on people's lives and well-being. The article includes the 'A presenting concern framework', useful mnemonic devices to help nurses assess an older person who may have delirium or dementia, and a list of online resources. |
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Call Number |
NRSNZNO @ research @ |
Serial |
983 |
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Author |
Mackay, B. |
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Title |
Leadership strategies for role development in primary health care nursing |
Type |
Journal Article |
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Year |
2007 |
Publication |
Nursing Journal Northland Polytechnic |
Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
11 |
Issue |
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Pages |
31-39 |
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Keywords |
Primary health care; Leadership; Professional development |
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Abstract |
This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support. |
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Call Number |
NRSNZNO @ research @ 1049 |
Serial |
1033 |
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