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Fahey, M. (2003). Family centred care in the newborn intensive care unit: Creating a supportive environment. Ph.D. thesis, , .
Abstract: The environment of the Newborn Intensive Care Unit (NICU) is a stressful one for families and is often designed to provide technical care for the infant rather than facilities that would enable and support parental and family participation in infant care. Furthermore, the author notes that the environment of the NICU emerged in literature as an obstacle to meaningful family involvement in care. However, she goes on to say that a philosophy of Family Centred Care in the NICU can offer a framework of care that supports family involvement in the infant's care and family presence in the NICU. It also promotes parental participation in decision-making for the infant and gives recognition to the importance of perspectives provided by the family. This dissertation explores the difficulties associated with the practice of Family Centred Care in the environment of the NICU. It offers recommendations for features of unit design that can promote Family Centred Care by supporting and sustaining the presence of families in the NICU and therefore facilitating their involvement in the care of their infant.
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Nicol, M. J. (2003). Genetics and nursing: Preparing for future health care development. Nursing Praxis in New Zealand, 19(2), 27–40.
Abstract: The author discusses the impact of 'new genetic knowledge' on society and how molecular and clinical genetics are having an increasing influence on routine health care. Increasingly, nurses will be exposed to this new genetic knowledge and challenged to integrate it into their clinical practice in order to ensure that patients and families receive the best health care available. The paper reports the percentage of undergraduate nursing curricula devoted to teaching about genetics and considers how the fundamental principles of molecular genetics and the clinically relevant areas of genetics can be incorporated into pre- or post-registration education.
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Carryer, J. B., & Boyd, M. (2003). The myth of medical liability for nursing practice. Nursing Praxis in New Zealand, 19(4-12), 4–12.
Abstract: This article explores the complex nature of liability in the case of standing orders and vicarious liability by employers, and also when nurses and doctors are in management roles. The authors address misconceptions about medico-legal responsibility for nursing practice with the advent of nurse prescribers and nurse practitioners. They refer to the submission made by the College of Nurses Aotearoa (NZ) on the Health Practitioners Competence Assurance Act (2003), and discuss practice liability and nurse-physician collaboration.
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Fraser, A. G., Williamson, S., Lane, M., & Hollis, B. (2003). Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori. Access is free to articles older than 6 months, and abstracts., 116(1176).
Abstract: Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive.
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Mortensen, A., & White, G. E. (2003). The process of destigmatisation: The work of sexual health nurses. Nursing Praxis in New Zealand, 19(1), 32–39.
Abstract: The focus of this article is on the findings of a grounded theory study of sexual health nursing in New Zealand. Nurses' experiences of providing sexual health care are described and theoretical explanations generated. The emphasis in this article is on countering stigma which emerged as a recurrent problem for nurses in the study. A comparative analysis of the nurses' counter reactions with Gilmore and Somerville's (1994) model of stigmatised reactions towards people with sexually transmitted diseases was done. The model describes the processes of disidentification, depersonalisation, scapegoating, and discrimination, which characterise stigmatised reactions. Nurses' understandings of the impact of socioeconomic conditions and gender/power relations in society have an important role to play in how nurses manage care. The concept of destigmatisation, which seeks to counteract negative social attitudes, is discussed. The study showed that as a consequence of their work nurses in this study encountered professional stigma and marginalisation.
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McKenna, B., Poole, S., Smith, N. A., Coverdale, J., & Gale, C. (2003). A survey of threats and violent behaviour by patients against registered nurses in their first year of practice (Vol. 12).
Abstract: For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes.
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Cowan, L. M., Deering, D., Crowe, M., Sellman, D., Futterman-Collier, A., & Adamson, S. (2003). Alcohol and drug treatment for women: Clinicians' beliefs and practice. International Journal of Mental Health Nursing, 12(1), 48–55.
Abstract: The present paper reports on the results of a telephone survey of 217 alcohol and drug treatment clinicians on their beliefs and practice, in relation to service provision for women. Nurses comprised the second largest professional group surveyed. Seventy-eight percent of clinicians believed that women's treatment needs differed from men's and 74% reported a range of approaches and interventions, such as assisting with parenting issues and referral to women-only programmes. Several differences emerged in relation to approaches and interventions used, depending on clinician gender, work setting and proportion of women on clinicians' caseload. Implications for mental health nursing include the need to more systematically incorporate gender-based treatment needs into practice and undergraduate and postgraduate education and training programmes.
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Fielden, J. (2003). Grief as a transformative experience: Weaving through different lifeworlds after a loved one has completed suicide. International Journal of Mental Health Nursing, 12(1), 74–85.
Abstract: This research is an exploration and interpretation of the lived experiences of family members since they lost a close family member to suicidal death. The findings have implications for nurses and counsellors working in the area of suicide bereavement. Heidegger's hermeneutic phenomenology was utilised and informed by van Manen's and Benner's work. Data from in-depth interviews with six participants, the researcher's journal entries and published literature were analysed. Findings gave rise to a grief model where suicide survivors moved through four modes of being-in-the-world characterized by 13 lifeworlds or themes. Surviving suicide was a transformative process that in time enabled survivors to discover new ways of understanding and relating to the world.
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Farrow, T. (2003). 'No suicide contracts' in community crisis situations: A conceptual analysis. Journal of Psychiatric & Mental Health Nursing, 10(2), 199–202.
Abstract: 'No suicide contracts' take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable for the person concerned. They are commonly used in community crisis situations with suicidal people in New Zealand. This article describes and analyses the use of 'no suicide contracts' in these settings. It is argued that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation.
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Spence, D. (2003). Nursing people from cultures other than one's own: A perspective from New Zealand. Contemporary Nurse, 15(3), 222–231.
Abstract: This paper provides an overview of the evolving meaning of 'culture' in New Zealand nursing. Then, drawing upon the findings of research that used hermeneutic phenomenology to explore the experience of nursing people from cultures other than one's own, a description of the constituent parts is of this phenomenon is briefly outlined and followed by an exemplar that describes the coalescent and contradictory nature of the phenomenon as a whole. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, interplay of the notions of prejudice, paradox and possibility is evident at intrapersonal and interpersonal levels as well as in relation to professional and other discourses.
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Moko Business Associates,. (2003). Career pathways and core competencies in Maori mental health nursing (Vol. Trm/03/04). Palmerston North: Te Rau Matatini.
Abstract: This report reviews relevant literature pertaining to clinical career pathways and associated core competencies for nursing in New Zealand. The review identifies and analyses existing clinical career pathways for nurses and mental health workers in New Zealand, paying particular attention to the content, structure, strengths, criticisms and applicability to the development of a clinical career pathway for Maori registered nurses to work in Maori mental health (NGO organisations). This report is part of Te Rau Matatini's current work on the development of a career pathway for Maori registered nurses with mental health work experience to work in NGO, community settings. It is a preliminary report, based on existing literature. A subsequent report was planned detailing the career pathway developed by Te Rau Matatini, with strong guidance and input from Maori mental health nurses and the wider Maori mental health sector.
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MacGeorge, J. M., & Nelson, K. (2003). The experience of the nurse at triage influences the timing of CPAP intervention. Accident & Emergency Nursing, 11(4), 234–238.
Abstract: This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.
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Shelah, G. E. (2003). Enabling pedagogy: An enquiry into New Zealand students' experience of bioscience in pre-registration nursing education. Ph.D. thesis, , .
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Smillie, A. (2003). The end of tranquillity? An exploration of some organisational and societal factors that generated discord upon the introduction of trained nurses into New Zealand hospitals, 1885-1914.
Abstract: This historical research study examines some of the factors that caused problems for early New Zealand trained nurses upon their introduction into New Zealand hospitals, between 1885 and 1914. Eight incidents in the professional lives of nurses of the period are used as illustrations of the strains and discord that were apparent in this time of change. Analysis of these incidents attempts to answer the question as to whether the introduction of trained nurses into the New Zealand hospital system did add new considerations to problems encountered by nurses in their professional life. The conclusion is that there was a new dimension of difference added to the system with the introduction of the trained nurse. This developed from the evidence that these nurses, particularly if they were also matrons, had to fit into the existing power structures, which were not really ready to accept them, either through choice or lack of foresight. Enmeshed within these considerations is the influence of Florence Nightingale; her effect on nursing itself, and the consequent public and official perception, or misperception, of who nurses should be.
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Bresaz, D. M. (2003). Environmental influences on inpatient assaultive behaviour. Ph.D. thesis, , .
Abstract: This retrospective quasi-experimental study reviewed assaults in two adult mental health inpatient rehabilitation units. The majority of clients in this area experience enduring mental health illnesses and have complex physical health issues. The service comprises of an intensive rehabilitation unit and a secure extended rehabilitation unit. Between May and August 2001 the service moved to purpose built facilities. The opportunity was taken to review clients' assaultive behaviour in the new environment and to compare the incidents with those in the old environment to see if there had been any significant changes. Data on assault incidents including time of assault, place of assault, who was involved and what preventative actions were suggested were collected from the Incident and Accident Hazard Reports (IAHR) dating from 1 April 2000 until 31 May 2002. Staff were expected to complete IAHR reports on all assault incidents. The research examined whether the change in environmental conditions impacted on clients' wellbeing in relation to assaultive behaviour. Trends within the IAHR reports were also examined in order to compare these to similar studies completed in other parts of the world. There were 141 IAHR reports of assault incidents. Fifty of these occurred in the pre move period, 38 in the transition phase and 53 in the post move. There was no significant difference in the rate of assaults in the pre-move to post move period. Completion of the IAHR forms was seen to be very problematic, especially in relation to legal status of perpetrators and documentation of prevention strategies. An urgent audit of existing practice is now required to establish if problems found with the quality and completion of the IAHR forms continues to be evident in the rehabilitation service and if present staff education is needed to improve the standard of documentation. Research is also needed to establish the extent to which staff implement strategies to prevent assaults, and to reduce recidivism.
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