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Author |
Wilson, L.J. |
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Title |
Futurist planning, not a shortage stopgap: Recruitment and retention of registered nurses in New Zealand |
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Year  |
2001 |
Publication |
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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 |
Recruitment and retention; Registered nurses; Policy; Careers in nursing |
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Abstract |
This literature review critically examines contributing factors to the current nursing shortage in New Zealand, centering on recruitment and retention of registered nurses. There is a dramatic widening between the supply of registered nurses and the demand for their services. All regions in New Zealand are reporting difficulty in hiring experienced and specialty nurses, and recruiting time is lengthening. This report suggests that the shortage is closely linked to factors in the nursing care environment. As a result of multiple factors during the centralising, cost-containing, acuity-increasing decade of the 1990s, the care environment has driven practising nurses out of acute care settings and discouraged new students from entering the profession. The availability of numerous alternative career opportunities has heightened the effect. Continuing causes to the non-selection of nursing as a profession are the influences of wage compression and limited career progression over the lifetime of the nurse, and insufficient orientation and mentoring of new nurses. Recent changes in the health care system have gone unevaluated and without oversight by nursing regulatory agencies – a situation not in the best interests of patients or nurses. A number of both literature-supported and resourceful approaches, including recommendations towards addressing the nursing shortage are proposed in this review. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1258 |
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Author |
Gilmour, J.A. |
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Title |
On the margins: Nurses and the intermittent care of people with dementia: A discourse analysis |
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Year |
2001 |
Publication |
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Abbreviated Journal |
Massey University, Palmerston North, Library |
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Issue |
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Pages |
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Keywords |
Older people; Dementia; Nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1276 |
Serial |
1261 |
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Author |
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Title |
Dementia care: A literature review |
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Journal Article |
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Year |
2001 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
7 |
Issue |
13 |
Pages |
33-36 |
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Keywords |
Dementia; Nurse-patient relations; Quality of health care; Nursing; Education |
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Abstract |
This article defines dementia, and explores recent trends in relation to why it is such a misunderstood condition in the health care setting. Within a theoretical framework of literature development, nurse client relationships, and quality of care and attitudes are analysed. Gaps, inconsistencies and consistencies are outlined, with the implications for nursing practice and education explored. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1279 |
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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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Issue |
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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 |
Robertson, G. |
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Title |
Disquiet in the development of clinical supervision for professional development in nursing practice: A literature review |
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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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Issue |
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Pages |
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Keywords |
Clinical supervision; Professional development; Nursing |
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Abstract |
Nursing literature reflects that nurses have been exploring and experiencing the process of clinical supervision for well over a decade. Nurses in the United States, United Kingdom, Scandinavia, and Australasia have written much over the past fifteen years. However, the author notes that nurses grapple with what clinical supervision is within nursing development and disquiet continues to emerge in the literature. This literature review expands on themes that surround this disquiet. These centre on continued confusion and lack of clear definition; whether psychotherapy is implemented under the guise of clinical supervision, who uses it, and the dearth of empirical evaluation of its effectiveness. The lack of significant empirical evidence of its ability to assist practitioners to deliver improved patient/client care continues despite claims of improved professional and personal development, therapeutic relationship, and occupational stress management. These claims come from both supervisees and supervisors. The manner in which clinical supervision is portrayed in nursing in that it is frequently referred to as a support system, rather than one of learning a complex set of communication skills is also highlighted. The continued debate on what model(s) best suit nurses, or whether line management should provide clinical supervision as a means to ensure quality standards and control over nursing practice and optimal patient care is discussed. Whether nursing should stop borrowing from other fields and develop their own model(s) is also raised. Two emerging stances focus on a process that is practice-based as identified by senior staff and management, or one that continues along the lines of what psychotherapy has developed with practitioner-identified developmental needs. These issues raise many questions for further development in nursing, one being are nurses developed enough in their self-awareness to understand what they are to adopt into their practice? Authentic voices from those nurses experienced in the practice of providing and receiving clinical supervision, are shaping therapeutic practice for nurses in the future, and continue to sharpen the debate. Some reference to unpublished data and local practice in the Wellington area have been included as a stimulus for further incorporation of clinical supervision in local practice development. |
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Call Number |
NRSNZNO @ research @ |
Serial |
794 |
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Author |
Sadler, D. |
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Title |
Stigma, discrimination and a model for psychiatric mental health nursing practice |
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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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Issue |
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Pages |
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Keywords |
Mental health; Psychiatric Nursing; Psychology |
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Abstract |
This paper seeks to understand the aetiology of stigma. The word stigma comes from the Greek language and refers to a brand, a mark of shame. Society has used this phenomenon to mark those who do not fit with the stereotypical virtual identity expected by a group. Stigma has persisted throughout the ages to enforce norms and sanction rules. Stigma is a term used to broadly define an attitude to negative attributes. It is a way of treating people that indicates to the individual, they are different from the norm. Research indicates the general population has discriminatory attitudes to those who have experienced mental illness. This discrimination impacts on the lives of those people. Their stories tell of shame, sadness and anguish. Families too, feel the ongoing effects of stigma. Psychiatric mental health professionals are said to perpetuate the discrimination arising from the stigma of mental illness. This is shown in the literature to persist through labelling and disempowering practices. The attitude of nurses in particular is critical to promoting healing environments. It is thought that a humanistic altruistic approach to nursing practice will help to eliminate discriminatory practice by nurses. It is hoped that this approach will create collaborative care that gives the individual the respect, response, choice and support they need to assist in recovering from mental illness. |
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Call Number |
NRSNZNO @ research @ 815 |
Serial |
799 |
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Author |
Holloway, K. T. |
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Title |
The future for nursing education: UKCC review has relevance for New Zealand |
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Journal Article |
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Year |
2000 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
16 |
Issue |
2 |
Pages |
17-24 |
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Keywords |
Nursing; Education; Recruitment and retention; Clinical assessment; Policy |
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Abstract |
The author reviews the report 'Fitness for Practice' by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) noting many areas of relevance for New Zealand educators in outlining possible strategies for nursing education. Discussion of some of the recommendations is put in the context of a strategic review of undergraduate nursing education recently commissioned by the Nursing Council of New Zealand. Issues such as recruitment and access to education; retention; clinical assessment and placements; clinical skill acquisition and partnership are valid concerns for educators here also. Internationally, the author suggests, the commonalties in issues of concern lend validity to the concept of the global village and the necessity for a global perspective in health care workforce planning, including educational preparation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
848 |
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Author |
O'Brien, A.J. |
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Title |
The therapeutic relationship: Perceptions of mental health nurses |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Massey University 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; Nurse-patient relations |
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Abstract |
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Call Number |
NRSNZNO @ research @ 914 |
Serial |
898 |
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Author |
Strochnetter, K.T. |
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Title |
Influences on nurses' pain management practices within institutions: A constructivist approach |
Type |
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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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Issue |
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Pages |
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Keywords |
Interprofessional relations; Pain management; Nursing |
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Abstract |
Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient. |
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Call Number |
NRSNZNO @ research @ |
Serial |
909 |
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Author |
Casey, H. |
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Title |
Empowerment: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area |
Type |
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Year |
2000 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Policy; Leadership; Careers in nursing; Mental health; Psychiatric nursing |
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Abstract |
For nurses to have control over their practice they need to have input into policy development. Nurses having control over their practice has been linked to nursing empowerment. Therefore the question explored in this research project is: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area? The literature reviewed for this project includes empowerment, power, the history of nursing in relation to women's role in society, oppression and resistance, and literature on Critical Social Theory as the underlying theoretical and philosophical position which informs the research process. In order to answer the research question a single focus group was used to gather data from a group of registered nurses practising in mental health. Focus groups as a data collection method produce data and insights that would be less accessible without the interaction found in the group. The key themes to emerge from the data analysis were: power is an important component of empowerment and power relationships; and at a systems level, professional, organisational, and political influences impact on feelings of empowerment and/or disempowerment. These key themes are discussed in relation to the literature and the broader social and cultural context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations for nurse leaders who aim to provide an empowering environment for nurses practising in mental health. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1145 |
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Author |
Thompson, R.; Farrow, T. |
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Title |
The Workbook Portfolio: Facilitating undergraduate student learning in the mental health clinical area |
Type |
Journal Article |
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Year |
1999 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
21-30 |
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Keywords |
Mental health; Teaching methods; Critical thinking |
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Abstract |
This article describes the use of a model that has been developed to assist students in tackling the complex issues surrounding mental health nursing. The Workbook Portfolio has identifiable components that encourage the development of reflective and analytical skills, which allow nurses to practice within an environment that is influenced and determined by a complex, and sometimes contradictory, range of external influences. The article explains the workings of this model so it can be used by educators to for students in the mental health setting. |
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Call Number |
NRSNZNO @ research @ |
Serial |
637 |
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Author |
Egan, M. |
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Title |
The nursing and midwifery practice structure at Healthcare Hawkes Bay: An evaluation and improvement process |
Type |
Journal Article |
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Year |
1999 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
5 |
Issue |
8 |
Pages |
27-29 |
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Keywords |
Professional development; Nursing; Midwifery |
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Abstract |
This article describes the Nursing and Midwifery Practice Structure, which has been in place at Healthcare Hawkes Bay since 1996. It was developed to provide nurses and midwives in clinical positions with a professional development structure, and uses a framework to recognise and reward competence. It encourages clinical progression and was developed to link nursing competence with remuneration. The Practice Structure, based on the work of Patricia Benner (Benner, 1984), is made up of 4 levels: Beginner/Advance Beginner Practitioner, Competent Practitioner, Proficient Practitioner, Expert Practitioner. The Structure was reviewed in 1998, and a Steering Group was formed to collect feedback from nurses and midwives, identify areas of concern, and make recommendations for improvements. At the time of writing, these recommendations are being implemented and systems are being developed to ensure the Nursing and Midwifery Practice Structure continues to develop. |
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Call Number |
NRSNZNO @ research @ 971 |
Serial |
955 |
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Author |
Lewer, D. |
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Title |
Analysing the Mental Health Act |
Type |
Journal Article |
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Year |
1999 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
5 |
Issue |
8 |
Pages |
14-16 |
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Keywords |
Psychiatric Nursing; Mental health; Law and legislation; Ethics |
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Abstract |
Changes brought by the Mental Health Act (MHA) to clinical practice, and some of the problems it has created for nurses, are examined in this article. Compulsory assessment and treatment orders (CATO) and the role of Duly Authorised Officers (DAO), and moral dilemmas that can arise as a consequence of CATOs used by DAOs are examined. The requirement for DAOs to act as patient advocates and to safeguard cultural beliefs are highlighted. The MHA promotes self responsibility and a treatment philosophy rather than detention of the mentally ill. |
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Call Number |
NRSNZNO @ research @ 1039 |
Serial |
1023 |
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Author |
Roberts, F. |
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Title |
The people the programme & the place: Nurses' perceptions of the Lakeland Health Professional Development Programme |
Type |
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Year |
1999 |
Publication |
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Abbreviated Journal |
NZNO Library, 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 |
Careers in nursing; Professional development; Registered nurses |
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Abstract |
This thesis concerns the Professional Development Programme at Lakeland Health. In New Zealand, such programmes were introduced as a mechanism to openly recognise the clinical expertise of nurses. Clinical Career Pathways were introduced to nursing in North America in the 1970's at a time of nursing shortage. Prior to their inception, nurses wishing to develop their careers had to move to administration, management or education. The programmes recognised and rewarded expertise in practice. A qualitative, descriptive approach (using focus groups) was used with Registered Nurses to gather their perceptions of what helps nurses enroll in the Professional Development Programme. The ideas and insights of nine Registered Nurses were clustered around three main categories: The People (fear; being struck; motivation; feedback; peer support; ways of learning); the Programme (relevance; flexibility; Bachelor's Degrees; implementation; supporting information; fairness); the Place (time; regular and accessible; support from nurse leaders; management). These perceptions are discussed in more detail in the context of nursing at Lakeland Health and of Clinical Career Pathways in New Zealand. The findings are helpful for the evaluation and future development of the Professional Development at Lakeland Health. The research contributes to our understanding of what helps nurses enroll in a Clinical Career Pathway, and emphasises the importance of the People, the Programme and the Place. |
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Call Number |
NRSNZNO @ research @ 1150 |
Serial |
1135 |
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Author |
Peach, J. |
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Title |
The Professional Development Programme: Achievements and outcomes |
Type |
Journal Article |
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Year |
1999 |
Publication |
Professional Leader |
Abbreviated Journal |
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Volume |
5 |
Issue |
1 |
Pages |
6-9 |
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Keywords |
Professional development; Evaluation; Nursing |
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Abstract |
This article backgrounds the professional development programme instigated at Auckland Hospital in 1988, and reviews the achievements of the past 10 years. It describes PDP and distinguishes it from a clinical career pathway. Specific indicators were used to assess the achievement of the programme, and these are presented. Overall the programme achieved it's outcomes and at a reasonable cost. |
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Call Number |
NRSNZNO @ research @ 1289 |
Serial |
1274 |
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