bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colonisation: the Experience of a Psychiatric Nurse Through the Lens of Reflective Autobiography
Authors:   , Ramsamy Krishnasamy 
Published: November 2021

<p>The oppression of colonization lives on in the daily lives of colonized people. It is vital for us as nurses to understand the effects of that oppression, as well as the restrictive impacts, and dislocation from one's land and culture to-day. Nurses come from both the descendants of colonisers and the colonised. This thesis is a journey and a quest for insights into the impacts and significances of colonisation by looking at historical and socio-political contexts that have bearing on the health of colonised people who remain mostly powerless and marginalized. It is prompted in response to a cultural safety model which advocates that nurses should become familiar with their own background and history in order to be culturally safe in practice. This reflective autobiographical account is a personal effort and provides the foundation for an exploration of issues during nursing practice encounters, from a colonised ethnic minority perspective. The method was informed by Moustakas research approach and Johnstone's Reflective Topical Autobiographical process. The selection of specific events are deliberate, to make visible some of the many barriers that exist within our health structures as pertinent issues for non-dominant cultures that remain on the margin of our society. Maori issues provide a contrast and became a catalyst for me as the author while working for kaupapa Maori services in Aotearoa/New Zealand. The intention of this thesis is to generate new knowledge about what it means to be a nurse from an ethnic minority working in a kaupapa Maori mental health service, and to encourage other nurses to explore these issues further. Some recommendations are made for nurses in the last chapter, as I believe that they are ideally situated to build upon the strengths indigenous people already have and contribute positively toward the improvement of poor health outcomes of the colonized people in an embracing and collective way.</p>
Advocating Practice: the Role of the Community Oncology Nurse
Authors:   , Southgate Deborah G 
Published: November 2021

<p>The oncology nurse, along with many other expert practitioners, has a vital role within the community, and due to the many changes within the health system, it will be an even more crucial role in the future. Little is written about the role of the community oncology nurse, which may endanger its very existence. Several nurse scholars as Benner (1984) Johnstone (1999) and Taylor (2000) support and encourage nurses to tell their stories and increase public awareness of their practice. The primary aim of this research was to advocate for, and make known, the role of the community oncology nurse, and to bring alive the hidden but real issues of nursing people in the community who have active cancer treatment. This study is also about my journey from novice to expert in developing the role as a community oncology nurse. The research also aimed to identify and understand practice that community oncology nurses do and often take for granted. To capture the essence of this study the method of reflective topical autobiography was utilized, which gave the opportunity to gather advanced nursing inquiry, and generate new nursing knowledge. To obtain insight into the highs and lows in everyday interaction with patients, reflective practice stories are presented. The thesis generated by this research is that care required by cancer patients at home goes beyond the scope of traditional community health. It requires nurses to be competent in technological skills as well as bringing in-depth expertise to the practical and human needs of people experiencing cancer. The role involves holistic, family-centered care; anticipating patient and family needs; educating; managing symptoms; advocating; confronting ethical issues; coordinating complex care; and monitoring progress.</p>
The Private World of Nursing Related to Incident Reporting
Authors:   , Elbe Elaine M W 
Published: November 2021

<p>During the 1990s governments, professionals and the public in general have had brought to their attention that incidents in healthcare are occurring in larger numbers than had ever been imagined and are costing tax-payers large amounts of money. Research sponsored by governments has tried to identify some objective evidence of the number of incidents and types of incidents that occur and to put forward some tools to assist with the risk management of incidents. The purpose of this project was to explore the experience of nurses related to incident reporting. The reporting of incidents is important as it identifies professional risks for nurses. A descriptive qualitative approach was the methodology used and individual interviews of five senior nurses was the method of data collection. Attention was given to finding out about the supports for and barriers against nurses in reporting incidents; the outcomes for nurses of incident reporting; and the organisational culture and scope of 'professional' behaviour of nurses around incident reporting. The findings revealed that nurses identified themselves as the major reporters of incidents. They considered there was not 'a level playing field' for all professionals around who, how and why incidents were reported, investigated and within the post incident processes. The nurses reported that they made daily decisions about what was an incident, and whether to report events as incidents. They identified aids and supports to the decisions they made such as the medium for reporting and fear of what happened when the incident form left the nurse and went to management. A number of significant implications were identified for nursing, management and organisations in this research. Nurses need to feel they work in organisations which have a culture of safety around incident reporting. Management need to clearly communicate policies, processes and organisational expectations related to incident reporting. This should include how incidents will be reported, investigated and the purposes for which management use incident reporting information. It is also important that adequate structures are in place to support nurses when an incident occurs as incidents when they occur have stressful consequences for the nurses who are involved. Professional nursing bodies need to give consideration to the development of clear guidelines on the legal and professional accountability of nurses related to incident reporting including the limitations of this accountability. When processes are clear a more effective approach can be taken to incident reporting, learning can occur and this will prevent the recurrence of some incidents.</p>
"Getting on Top of Pain": a Critical Analysis of Surgical Nurses' Talk About Their Work with Hospitalised Patients Reporting Pain
Authors:   , King Suzanne Lavinia Jane 
Published: November 2021

<p>This thesis investigates the relationship between language, 'discourse' and professional knowledge and power in a specific context; that of surgical nurses' "talk" about their work managing pain in hospitalised patients. This thesis argues that the work of 'caring for' hospitalised surgical patients who report pain is influenced by discourses which are predicated on different readings/understandings of the body/patient, and from which different knowledge is constructed. Of interest to this thesis are the discourses of biomedicine and nursing, and their role in constructing a particular reality/ies which determine the ways in which surgical nurses talk about their work managing pain. Using the method of critical discourse analysis, the "texts" of transcribed audio-taped conversations with four registered nurses working in surgical specialties were analysed to uncover 'discourses of pain management'. The results of the analysis indicate that the biomedical construction of pain, and approaches to pain management, remain the dominant influence over surgical nurses' practice. There was evidence of nursing discourses with an emphasis on nurse-patient relationships also playing a role. These discourses were critically examined for what they reveal about relations of professional knowledge and power in this specific context of the nurses' practice. The implications for nursing and nursing research are considered significant because the study critically (re)presents a different perspective on, and reality for surgical nurses' pain management practices. In so doing, it elucidates an explanation for, and understanding of, why surgical nurses take care of patients reporting pain in particular ways.</p>
The Benefits and Challenges of One New Zealand Nursing Undergraduate Clinical Education Model: a Case Study
Authors:   , Sims Deborah 
Published: November 2021

<p>This research project has utilised a case study approach to give ward managers a voice in the literature, by exploring and describing from their perspective the benefits and challenges of one particular nursing undergraduate clinical education model. The Tertiary Education Provider contracts the Health Provider to provide Clinical Nurse Educators (CNEs) to support second and third year undergraduate nursing students during their clinical experiences. The CNEs are seconded from their respective wards to meet the organisation’s contractual obligations. Data were gathered from two ward manager’s using semi-structured interviews. A thematic analysis using the ‘colour coding’ method as described by Roberts and Taylor (1999) was used to analyse the interview data. The findings elucidate the role of the undergraduate CNE, highlighting benefits such as the CNE being supernumerary to ward rosters and having time to teach, not only supervise students. CNEs are student-focused and easily accessible as they are based on site. The CNE was the one person who was ‘there’ for a student as a student’s preceptor can change shift-by-shift and day-by-day. One significant challenge which emerged was the replacement of ward staff, not only of senior nurses who can leave their wards for up to 12 weeks to undertake the CNE role but also that of the student’s preceptor if the student’s preceptor was on annual, sick or study leave. Other challenges such as the inability of ward managers to pre-book casual staff; preceptor work-loads; skill-mix issues and fluctuating fulltime equivalents (FTEs) are also discussed.</p>
An Exploration of the Experience of Critical Incident Stress Debriefing on Firefighters Within a Region of the New Zealand Fire Service
Authors:   , Maher Julie Mary 
Published: November 2021

<p>This study originates from my practice experience working for the New Zealand Fire Service back in the late 1980's and early 1990's as an Occupational Health Nurse where I piloted a Critical Incident Stress Peer Support programme in the No.4 Region. My interest in the area began after attending a seminar on Critical Incident Stress Debriefing based on Mitchell's model of debriefing (1983). I had begun to recognise in my practice what I believed to be work-related stress but was a little uncertain about where this stress originated. After attending the seminar I began to understand that some of this stress was related to Critical Incident Stress (CIS) from firefighters exposure to critical incidents. This study explores four firefighters experience of Critical Incident Stress Debriefing (CISD) within a Region of the New Zealand Fire Service. It explores the application of CISD as one component of Critical Incident Stress Management (CISM), and the Nurse Researcher's philosophy of Clinical Nurse practice in relation to the application of CISD. The knowledge gained from the analysis of the data has the potential to influence professionals understanding of their experience and affect future practice and that of others working in the field of CISM. The aim of the study was to gain a greater indepth understanding of firefighters experience specifically in relation to their participation in a Critical Incident Stress Debriefing (CISD) following their exposure to a critical incident. Much of the literature that supported CISD appeared to offer a rather superficial understanding of the firefighters experience in relation to CISD. I chose to use narratives as the methodology, utilising four individual case studies as a method of social inquiry in order to explore the experience of CISD. The narratives were able to creatively capture the complexity and the dynamic practice of CISD. An overall pattern of the formalised process was uncovered through the participants' narratives. Eight dominant themes were highlighted from the narratives which included safe environment; ventilating the stress reaction; similar feelings; getting the whole picture; peer support; bonding and resolution. While these themes were common to all the participants, each participant had a particular theme/s which was unique to their experience. As a Nurse Researcher with dual practice interests in the area of nursing education and Critical Incident Stress Management (CISM), I am in a position to inform practice and service development. It is my belief that the knowledge gained from this study has the potential to be transferred to others working in the field of CISM. The study results are timely, practical and informative at a time of major change in the New Zealand Fire Service.</p>
The Illusion of Separateness, a Philosophical Study of Nursing and Naturopathic Practice: Healing Connections Between People
Authors:   , Kingsbury Katherine Margaret 
Published: November 2021

<p>This thesis describes the journey of a practicing Independent Nurse Practitioner and Naturopath towards the understanding of the illusion of separateness and what this could mean in terms of health and healing generally and specifically through the stories of five clients. The study reveals through these stories how the practice developed over time in relation to this idea. As a result of personal experience, clinical practice and my quest for knowledge I have come to a consideration that what stops or blocks us realizing that we all have an innate potential for self-healing is the illusion of separateness; that is, believing we are beings separate from each other and separate from the rest of nature. The thesis is presented as a narrative and begins with an account of the events in the practitioner's life that lead to the specific study of natural therapies and the development of a cohesive practice using holistic health practices from a nursing perspective. The text essentially describes the process of establishing a private practice combining two disciplines of Nursing and Naturopathy in New Zealand. The study reveals how a nurse and naturopath's practice is based on the premise that it is crucial to recognise that the personal life and professional life of the nurse inform and influence each other and are always part of the process of care in such a practice. Three healing modalities that are central to the practice are described in detail. The description is informed by theory and research from nursing, the social sciences and the natural sciences. The study reveals the practical value of postmodern nurse theorists, Jean Watson and Margaret Newman to this practice. This study also briefly discusses the concepts from quantum theory, evolutionary theory and psychoneuroirnmunology that are used in the practice. The thesis reveals one nurse's journey of practice development using contemplation and reflection that records an important aspect that has already benefited clients and the community where the practice occurs.</p>
Seclusion Management in an Acute In-Patient Unit
Authors:   , Mosley Barbara Joy 
Published: November 2021

<p>Trends in modern day mental health facilities have been towards the least restrictive environment with emphasis on patients’ rights, but these rights have to be balanced against the safety of both the patients themselves and anyone else in the immediate environment. One way of restricting a person’s movement is through the use of seclusion, a means of isolating a person in a locked room with minimal stimulus and from where that person cannot freely exit. This study was developed to explore the use of seclusion in an acute in-patient unit for people with mental illnesses. Investigation into this issue was considered important due to an identified large increase in seclusion use over the previous two years. The study used a qualitative research methodology with a descriptive and interpretive approach. Data collection included a retrospective file audit of patients who had been secluded over the past seven years, and one-to-one staff interviews. I also included some personal reflections of seclusion events. The principle reason for using seclusion was violence and aggression in the context of mental illness. It was also used for people who were at risk of, or who had previously absconded from the unit. A recovery approach and the use of the strengths model was fundamental to nurses’ way of working with patients in the unit. Nurses believed that the strengths process should be adapted to the person’s level of acuity and to their ability to engage in this approach in a real and tangible way. Seclusion continues to be a clinical management option in the unit that is the subject of this study. It is used when a person is so unwell that they cannot be managed in any other identified way. However, in many circumstances there are other options that could be explored so that the utmost consideration is given to the dignity, privacy and safety of that person.</p>
Shared Status and Advocating Practices: Nurses Who Work with Clients Who Have a Co-existing Intellectual Disability and Mental Health Problem
Authors:   , Dorofaeff Michael John 
Published: November 2021

<p>This research is informed by the interpretive phenomenology of van Manen, and explores the lived experience of nursing fiom the perspective of nurses who provide care for people with a co-existing intellectual disability and mental health problem. Although nursing research is commonly informed by phenomenology, there is a dearth of literature of any description written fiom the perspective of nurses who provide care for people with intellectual disabilities and mental health problems. As a result of the closure of many large institutions in New Zealand there are not many nurses who work with people who have intellectual disabilities and co-existing mental health problems. The study participants were four nurses purposefully selected because they provided care for people with intellectual disabilities and mental health problems. Data was collected using semi-structured interviews, and the researcher identified and wrote about the recurring themes in the transcribed interview data, which best captured the lived experience of the participants. The themes were: criticism of services, holistic caring, working with the client, issues of status, need for specialist knowledge, enduring relationships, diagnostic issues, advocating, modelling good practice; and working alongside. After further analysis the themes were encompassed within the larger interrelated themes of "Status and positioning" and "Advocating practices", and fmally within a single theme of: "The status and positioning of the nurse and the client leads to advocating practices." These themes were found to be consistent with the nursing literature and with the researchers own lived experience as a nurse who works in a specialist mental health intellectual disability service. The fmdings of this research have implications for a number of groups in New Zealand. Input is required fiom the Nursing Council ofNew Zealand, the nursing profession, nurse educators and the New Zealand Government to raise the status of clients with co-existing intellectual disabilities and mental health problems and the nurses who work with this client group. The roles for nurses who work with this client group are emerging and are likely to be diverse and there is a need for further research to capture the different experiences of these nurses.</p>
Novel Predators and Naïve Prey: How Introduced Mammals Shape Behaviours and Populations of New Zealand Lizards
Authors:   , Hoare Joanne Marie 
Published: November 2021

<p>Biotas that evolved in isolation from mammalian predators are susceptible to degradation due to recent human-mediated introductions of mammals. However, behavioural, morphological and life historical adaptations of prey to novel mammalian predators can allow prey to persist in mammal-invaded areas. Lizards in New Zealand are an ideal group for exploring the effects of invasive mammals on vertebrate prey because: (1) the ca. 80 endemic species evolved without mammals as a major influence for 80 my, (2) mammalian introductions during the past 2000 y have differentially affected lizard species, and (3) some species coexist with mammals on the mainland as well as occurring on mammal-free offshore islands. I tested three hypotheses: (1) lizard populations that have persisted on New Zealand’s mainland are no longer declining in the presence of introduced mammalian predators, (2) introduced mammals induce behavioural shifts in native lizards, and (3) lizard behavioural patterns and chemosensory predator detection abilities vary according to exposure to introduced mammals. Trends in capture rates of five sympatric native lizard populations over a 23 year (1984-2006) period demonstrate that not all lizard populations that have persisted thus far on New Zealand’s mainland have stabilised in numbers. Large, nocturnal and terrestrial species remain highly vulnerable at mainland sites. Introduced kiore, Rattus exulans, induce behavioural changes in Duvaucel’s geckos, Hoplodactylus duvaucelii. A radio telemetric study demonstrated that geckos start reverting to natural use of habitats within six months of kiore eradication. Activity patterns of common geckos, H. maculatus, and common skinks, Oligosoma nigriplantare polychroma, in laboratory trials are also correlated with their exposure to mammalian predators. Lizard activity (time spent moving) increases relative to freeze behaviour with greater exposure to mammals. However, specific antipredator behaviours are not elicited by chemical cues of either native (tuatara, Sphenodon spp) or introduced (ship rat, R. rattus) predators. Lizard populations may persist by changing their behaviours in the presence of invasive mammals. However, the continued declines of particularly vulnerable mainland lizard taxa suggest that mammal-induced behavioural shifts may only slow population declines rather than enabling long-term survival. Eradicating pest mammals from offshore islands has proven effective at restoring both populations and behaviours of native lizards, but lizard populations on the mainland also deserve conservation priority. Research directed at understanding the synergistic effects of invasive species that are causing continued lizard population declines and mammal-proof fencing to protect the most vulnerable mainland populations from extinction are both urgently required.</p>