title: To explore the creation of a multi-skilled adoptable / agile perioperative Registered Nurse: A mixed methods study exploring the creation of a multi-skilled perioperative registered nurse at Waikato Hospital

authors: Ngatia, Judy Diane

subjects: ‘perioperative department’

abstract: Background:  The global nursing shortage has highlighted vulnerabilities within the Aotearoa-NZ health system.  Within large acute hospitals, the level of nursing specialisation within perioperative care (preoperative, intraoperative and postoperative) often means that nurses do not have the skillsets to operate across multiple areas and instead focus solely in one area of practice.  Issues arise when departments within perioperative services become challenged, either through increased demand or staff shortages.  Being able to relocate nurses across the service according to highest demand is important, but often not possible if specialised nurses lack the skills required of working within other areas. 

Objective:  This study aims to explore the creation of a multi-skilled, agile perioperative Registered nurse equipped with skills to work across the perioperative department in Waikato Hospital.  

Participants:  The study included two groups of participants.  The first consisted of 14 health professionals (Nurse executives, n=4; Nurse operation managers, n=1; Senior registered nurses, n=2; Intermediate registered nurses, n=2; Junior registered nurses, n=2; and Senior specialist nurses, n=3). The second group (survey) consisted of registered nurses at differing levels within the perioperative department (n=88).  

Methods:  A mixed-methods approach was employed in this study.  Qualitative data collected through semi-structured interviews with health professionals working in the perioperative department was analysed using a general inductive method of enquiry.  Online surveys were analysed statistically using qui squared and ANOVA to explore the relationship between satisfaction and ability to work across different areas in the perioperative service. 
 
Results:  Five key themes emerged from the interviews: (i) Teamwork and role understanding; (ii) The current nursing configuration versus the desirable configuration; nursing skills; (iii) Knowledge and holistic care; and (iv) Leadership; and barriers to change.  No statistically significant differences were identified between any of the variables. 

Conclusion:  The absence of well-organised training for nurses, especially those in specialised areas, poses a significant challenge to develop a flexible workforce.  To proceed further, the service should consider developing a training programme, accept cross-training as a method of career development and consider multi-skilling as an essential core part of the of the perioperative workforce.

text: To explore the creation of a multi-skilled adoptable / agile perioperative Registered Nurse: A mixed methods study exploring the creation of a multi-skilled perioperative registered nurse at Waikato Hospital Background:  The global nursing shortage has highlighted vulnerabilities within the Aotearoa-NZ health system.  Within large acute hospitals, the level of nursing specialisation within perioperative care (preoperative, intraoperative and postoperative) often means that nurses do not have the skillsets to operate across multiple areas and instead focus solely in one area of practice.  Issues arise when departments within perioperative services become challenged, either through increased demand or staff shortages.  Being able to relocate nurses across the service according to highest demand is important, but often not possible if specialised nurses lack the skills required of working within other areas. 

Objective:  This study aims to explore the creation of a multi-skilled, agile perioperative Registered nurse equipped with skills to work across the perioperative department in Waikato Hospital.  

Participants:  The study included two groups of participants.  The first consisted of 14 health professionals (Nurse executives, n=4; Nurse operation managers, n=1; Senior registered nurses, n=2; Intermediate registered nurses, n=2; Junior registered nurses, n=2; and Senior specialist nurses, n=3). The second group (survey) consisted of registered nurses at differing levels within the perioperative department (n=88).  

Methods:  A mixed-methods approach was employed in this study.  Qualitative data collected through semi-structured interviews with health professionals working in the perioperative department was analysed using a general inductive method of enquiry.  Online surveys were analysed statistically using qui squared and ANOVA to explore the relationship between satisfaction and ability to work across different areas in the perioperative service. 
 
Results:  Five key themes emerged from the interviews: (i) Teamwork and role understanding; (ii) The current nursing configuration versus the desirable configuration; nursing skills; (iii) Knowledge and holistic care; and (iv) Leadership; and barriers to change.  No statistically significant differences were identified between any of the variables. 

Conclusion:  The absence of well-organised training for nurses, especially those in specialised areas, poses a significant challenge to develop a flexible workforce.  To proceed further, the service should consider developing a training programme, accept cross-training as a method of career development and consider multi-skilling as an essential core part of the of the perioperative workforce.

year: 2025

title: Geoscientific reconnaisance of Perry Aggregates quarry, River Road, Horotiu

authors: Nelson, Campbell S.

abstract: At the request of David Jennings, Opus International Consul tan ts Ltd, Hamil ton, we visited the Perry Aggregates quarry on River Road, Horotiu, on the morning of Wednesday 23 April 1997 to comment on the geoscientific context of the quarry. Our specific remarks relate only to observations made at the pit face at the present northwestern extremity of the quarry, which nevertheless are probably appropriate for the quarry as a whole. The quarry area inspected lies on a low terrace about 8 m above present-day river level (about 15 m a.s.l.) immediately adjacent to the Waikato River and covers an area of about 180 x 250 m centred on approximate grid reference S14 029885 (1:50 000 topographic map series NZMS 260).

text: Geoscientific reconnaisance of Perry Aggregates quarry, River Road, Horotiu At the request of David Jennings, Opus International Consul tan ts Ltd, Hamil ton, we visited the Perry Aggregates quarry on River Road, Horotiu, on the morning of Wednesday 23 April 1997 to comment on the geoscientific context of the quarry. Our specific remarks relate only to observations made at the pit face at the present northwestern extremity of the quarry, which nevertheless are probably appropriate for the quarry as a whole. The quarry area inspected lies on a low terrace about 8 m above present-day river level (about 15 m a.s.l.) immediately adjacent to the Waikato River and covers an area of about 180 x 250 m centred on approximate grid reference S14 029885 (1:50 000 topographic map series NZMS 260).

year: 1997

title: Te kiri ka tōkia e te anu: Ko ētahi āhuatanga ki ngā kāinga o Hiruhārama me Te Horo

authors: Parata, Patricia Hekia

subjects: Tangihanga

abstract: He mea waihanga e ahau, tēnei tuhituhinga, i runga i tēnei whakaaro, kia tirohia te hanga, me te āhua o te tangihanga, ki ōku marae e rua, o roto o Ngāti Porou, kei Hiruhārama me Te Horo. Kāore i whāia he wāhanga ki ngā pūtakenga mai o ngā tikanga. Engari, he mea tātaki haere noa iho ko ngā kaupapa tauira o ēnei tikanga. 
He mea raranga anō ngā kōrero nei, kia whiri ai i roto i ngā tauira kōrero nei, te tūpāpaku, te marae, ngā tāngata me ngā tikanga, e pā ana ki a rātau katoa. 
Ahakoa te nui, te huhua noa iho, o ngā tuhituhinga mō te āhua ki tēnei mea, ki te marae, te whaikōrero, te tangihanga, ēnei mea katoa, kore rawa anō nei, tētahi paku tuhituhi kua whakatakotoria i tēnei hanga nei. Ehara hoki tēnei i te tuhituhinga e whai ana i te āhua o ērā o mua atu. 
He mea kohikohi ēnei kōrero, nā ētahi kuia, me ētahi kaumātua, me ngā mea pakeke o tōku nei rohe, ā, he aronga nui nāku ki ngā mea i kite ai au i ngā wā i ahau i te kāinga, me ngā hui i tae ai au mai anō i tōku tamarikitanga. Nō reira, he whakapūteatanga ēnei mea katoa, nō ngā mea katoa i runga ake nei. 
Kua wehewehengia ēnei kōrero kia takoto pēnei ana nā: ko te wāhanga tuatahi, ko te takenga mai o Ngāti Porou, me ngā wehewehenga mai o ngā hapū; ko te wāhanga tuarua, e pā ana ki ngā whakamārama o ngā kupu, arā, te kirimate, te paemate, me te wharemate; tuatoru, ko te whakahoki o te tūpāpaku; tuawhā, kei ngā mahi ki runga i te marae; tuarima, ngā tikanga o te rā nehu; tuaono, ngā mahi whakatutuki. 
Hei whakamutu ake, kua whakarārangitia e ahau, ngā roherohenga mahi, me ngā tūranga e rite ana mō tēnā, mō tēnā, mō tēnā.

text: Te kiri ka tōkia e te anu: Ko ētahi āhuatanga ki ngā kāinga o Hiruhārama me Te Horo He mea waihanga e ahau, tēnei tuhituhinga, i runga i tēnei whakaaro, kia tirohia te hanga, me te āhua o te tangihanga, ki ōku marae e rua, o roto o Ngāti Porou, kei Hiruhārama me Te Horo. Kāore i whāia he wāhanga ki ngā pūtakenga mai o ngā tikanga. Engari, he mea tātaki haere noa iho ko ngā kaupapa tauira o ēnei tikanga. 
He mea raranga anō ngā kōrero nei, kia whiri ai i roto i ngā tauira kōrero nei, te tūpāpaku, te marae, ngā tāngata me ngā tikanga, e pā ana ki a rātau katoa. 
Ahakoa te nui, te huhua noa iho, o ngā tuhituhinga mō te āhua ki tēnei mea, ki te marae, te whaikōrero, te tangihanga, ēnei mea katoa, kore rawa anō nei, tētahi paku tuhituhi kua whakatakotoria i tēnei hanga nei. Ehara hoki tēnei i te tuhituhinga e whai ana i te āhua o ērā o mua atu. 
He mea kohikohi ēnei kōrero, nā ētahi kuia, me ētahi kaumātua, me ngā mea pakeke o tōku nei rohe, ā, he aronga nui nāku ki ngā mea i kite ai au i ngā wā i ahau i te kāinga, me ngā hui i tae ai au mai anō i tōku tamarikitanga. Nō reira, he whakapūteatanga ēnei mea katoa, nō ngā mea katoa i runga ake nei. 
Kua wehewehengia ēnei kōrero kia takoto pēnei ana nā: ko te wāhanga tuatahi, ko te takenga mai o Ngāti Porou, me ngā wehewehenga mai o ngā hapū; ko te wāhanga tuarua, e pā ana ki ngā whakamārama o ngā kupu, arā, te kirimate, te paemate, me te wharemate; tuatoru, ko te whakahoki o te tūpāpaku; tuawhā, kei ngā mahi ki runga i te marae; tuarima, ngā tikanga o te rā nehu; tuaono, ngā mahi whakatutuki. 
Hei whakamutu ake, kua whakarārangitia e ahau, ngā roherohenga mahi, me ngā tūranga e rite ana mō tēnā, mō tēnā, mō tēnā.

year: 1983