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Richardson, S. (2005). Coping with outbreaks of the norovirus. Kai Tiaki: Nursing New Zealand, 11(7).
Abstract: The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages.
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Flint, V. (2005). The place of ECT in mental health care.11(9), 18–20.
Abstract: The author reviews the controversial treatment of electroconvulsive therapy (ECT) which has re-emerged as a safe and effective treatment for major depressive disorders. She first addresses the popular conceptions of ECT, which are based on early misuse of the treatment when it was delivered unmodified, or forcefully and without anaesthetic. She then uses a case study to illustrate the benefits of ECT for catatonia and catatonic states. Diagnostic criteria for catatonia include motoric immobility, excessive motor activity, extreme negativism or mutism, peculiarities of voluntary movement, and echolalia or echopraxia. The treatment of a patient is detailed, and the role of the ECT nurse is outlined. The ECT nurse is a co-ordinator, an educator, liaises with other services and families, and is a point of contact about ECT within the mental health service generally and in the ECT unit in particular. The case study showed successful use of ECT. A series of eight ECT treatments were administered to the catatonic patient, after which he was discharged home with minor depression and showing signs of enjoying life once again.
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Crowe, M., & Luty, S. (2005). Recovery from depression: A discourse analysis of interpersonal psychotherapy. Nursing Inquiry, 12(1), 43–50.
Abstract: This paper describes a discourse analysis of the process of interpersonal psychotherapy (IPT) in the recovery from depression. It demonstrates how IPT is an effective treatment strategy for mental health nurses to utilise in the treatment of depression. The discourse analysis highlights how the development of more meaningful subject positions enables one woman to recover from her depression. The process of recovery is underpinned by an understanding of women's depression as promoted by contemporary social and cultural expectations for detachment and reflexivity. This paper shows how IPT provides an opportunity for recovery from depression for one woman by facilitating a reconstruction of her subject positions in relation to others. The discourse analysis revealed that the therapist facilitated this through the use of a range of techniques: seeking information, exploring beliefs/values/assumptions, exploring communication patterns, exploring affective responses and exploring alternative subject positions.
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Cobham, J. (2005). Why do nurses stay in nursing? A test of social identity, equity sensitivity and expectancy theory. Ph.D. thesis, , .
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Smart, S. (2005). Post-operative pain management knowledge and attitude of paediatric nurses: A New Zealand regional view. Ph.D. thesis, , .
Abstract: This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn't carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice. While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses.
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Holloway, K. T., & Pearson, J. R. (2005). Trailblazers: Primary health care programme evaluation. (Vol. Paper presented June 2004 at Royal New Zealand Plu).
Abstract: This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful.
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Rudd, J. (2005). From triage to treatment: An exploration of patient flow systems in emergency departments. Ph.D. thesis, , .
Abstract: To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room.
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Lewis, T. (2005). Euthanasia: A Foucauldian analysis. Ph.D. thesis, , .
Abstract: This study drew upon the theoretical insights of Michel Foucault to provide a discursive analysis of the term euthanasia, and the issues surrounding the “right-to-die”. It involved an analysis of primary texts from; nursing, general, and legal literature as well as the media between the years 2002-2004. Drawing upon data researched, the study analyses the main discourses regarding the practice of euthanasia for terminally ill individuals. The two competing discourses that emerged were what the author termed the sanctity-of life-discourse and the right-to-die discourse. The aim of the study was to uncover the discourses understanding of “truth” regarding the right-to-die. The analysis revealed that a small percentage of cancer sufferers (5%) die with their pain insufficiently treated and the right-to-die discourse claims that no individual should have to suffer needlessly, asserting the individuals right to autonomy. Directly opposing this is the sanctity-of life-discourse which states all life is sacred and nothing can justify euthanasia as an acceptable practice in society. These findings indicate the need for effective palliative care and pain management when caring for the terminally ill individual. The legal, ethical and moral implications of euthanasia are many and this study discusses the effects these may have on health professionals involved with the care of terminally ill patients. The study revealed an increasing deployment of the right-to-die discourse in the media and revealed concerns regarding the nursing profession's lack of preparation to deal with euthanasia if it becomes a legal option in end of life care.
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MacDonald, R. (2005). Mammography screening for breast cancer: Does it reduce the mortality rate? Available online from Eastern Institute of Technology, , 8–12.
Abstract: This paper critically examines the literature on mammography as a breast cancer screening modality. It looks at what the New Zealand consumer is being told about the scientific uncertainties about the effectiveness of mammography and the substantial risks involved with it. This literature review raises concerns about the lack of information available for healthy women to make a fully informed decision about mammography screening.
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Scrymgeour, G. (2005). Using diagnostic reasoning in nursing practice: Ectopic pregnancy: A case study approach. Available online at Eastern Institute of Technology, 13(1), 13–17.
Abstract: This paper explores, through the use of a case study, an evidence-based diagnostic reasoning process utilising the framework followed by Dains, Baumann and Scheibel (1998). This framework, as described by these authors, involves an inductive process of reasoning, which leads to formulation of a hypothesis that is then analysed using an evidence-based approach. From this analysis, a likely diagnosis can be made and appropriate therapeutic intervention initiated. This research demonstrates that although an evidence-based approach is the ideal, sometimes clinical intuition is equally important to the clinical outcome.
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Moore, J. (2005). Breaking down barriers in child healthcare (0-5) years. Margaret May Blackwell Travelling Fellowship 2005. Margaret May Blackwell Travel Study Fellowship Reports. Christchurch: Nursing Education and Research Foundation (NERF).
Abstract: Travels to Australia, Canada, the US and the UK to investigate various methods of procedural sedation for 0-5-year-olds in paediatric Emergency Departments. Describes the types of sedation used and the recovery periods. Transcribes the interviews he conducted with Emergency Department staff in each country. Part of the Margaret May Blackwell Scholarship Reports series.
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Spence, D. (2004). Advanced nursing practice through postgraduate education, part one. Nursing Praxis in New Zealand, 20(2), 46–55.
Abstract: In New Zealand the clinically focused postgraduate papers and programmes, available through universities and polytechnics, are evaluated from an educational perspective but little evaluation of the implications for practice has been undertaken. This paper is Part One of a report on a study that sought to illuminate the impact of clinically focused postgraduate education on advancing nursing practice. Hermeneutic methodology provided a framework for analysing both the perspectives of nurses who had undergone such education and those who had directly employed and worked alongside these nurses. Emerging themes are described here. In a second article the findings will be discussed in relation to literature. Constraining factors will be identified and strategies designed to maximise the benefits of education for advancing nursing practice will be recommended.
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Spence, D. (2004). Advancing nursing practice through postgraduate education, part two. Nursing Praxis in New Zealand, 20(3), 21–30.
Abstract: This paper continues presentation of the findings of a North Island based research project that explored the impact of clinically focused postgraduate education on advancing nursing practice. Like their international counterparts, increasing numbers of New Zealand nurses are enrolling in advanced practice programmes. Yet, despite international evidence supporting the usefulness of Masters level preparation for advancing clinical practice, questions about the need for such development persist. This paper argues that postgraduate education contributes to the development of courage and that this, in turn, is essential to overcoming the barriers that currently constrain the advancement of nursing practice.
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Mortensen, A., & Young, N. (2004). Caring for refugees in emergency departments in New Zealand. Nursing Praxis in New Zealand, 20(2), 24–35.
Abstract: This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours.
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Drake, M., & Stokes, G. (2004). Managing pre-registration student risk: A professional and legislative minefield. Nursing Praxis in New Zealand, 20(1), 15–27.
Abstract: This article reports data from 15 schools of nursing, surveyed to identify difficulties experienced by nurse educators with respect to entry, progression and programme completion of undergraduate nursing students. Risk assessment, along with a lack of clear policy and procedures were found to be the main problem areas. Difficulties were exacerbated for educators when there were challenges to their professional judgement, either from the Nursing Council of New Zealand or from within their own institution. The authors argue for more recognition of the dual role of nurse educators, and greater clarification of the Nursing Council of New Zealand role in regulating the student's programme entry and progression, and ultimate admission to the Register. It is suggested that the recently passed Health Practitioners Competence Assurance Act (2003) provides nursing with an opportunity to address some of these issues.
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