Nursing praxis in New Zealand inc最新文献

{"title":"Health professional and family perceptions of post-stroke information","authors":"Dianne Roy, S. Gasquoine, Shirrin Caldwell, D. Nash","doi":"10.36951/ngpxnz.2015.004","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.004","url":null,"abstract":"Introduction and BackgroundThe global burden of stroke is increasing. Despite a decrease over the past twenty years in stroke mortality rates there is an increase in terms of the absolute number of people affected every year (Feigin et al., 2014). There are an estimated 60,000 stroke survivors in New Zealand, many of whom live with impairment and need significant daily support (Stroke Foundation of New Zealand, 2015). Stroke can have negative consequences on the health, wellbeing and quality of life of both the stroke survivor and their extended family (Ellis, Grubaugh, & Egede, 2013; Yu, Hu, Efird, & McCoy, 2013). Care and support needs are variable, can be complex and are dependent on the severity, origin and location of the cerebral trauma, the timeperiod post-stroke, socioeconomic variables and ethnicity (Cecil, Thompson, Parahoo, & McCaughan, 2013; Harwood et al., 2012a, 2012b; Moloczij, 2009). Nurses play a pivotal role in stroke care and management across all phases of the stroke trajectory and, along with other health professionals, can help alleviate the stresses experienced by families caring for their whanau member who is a stroke survivor (Cecil et al., 2013). There is strong evidence for the efficacy of a co-ordinated multidisciplinary team (MDT) approach to stroke care (Clarke, 2013). Core members of a MDT in stroke care include nurses (often stroke nurse specialists), stroke physicians, physiotherapists (PTs), occupational therapist (OTs), speech language therapists (SLTs) and therapy assistants (trained to support PTs and OTs). Multidisciplinary teams may also include social workers, needs assessors, and community-based support workers such as the Community Stroke Advisors (CSAs) from the Stroke Foundation of New Zealand. Trained CSAs assist stroke survivors and their families with any stroke-related problems. They make hospital and home visits, support families and can advise on accessing carer-relief services and funding. Some MDTs include stroke cocoordinators (usually a nurse, PT or OT) within the team whose role is to co-ordinate in-patient rehabilitation and services for patients and their families post-stroke. At the participating DHB for this study these stroke coordinators are known as key workers.The importa nee of information and education provision, alongside the right support, for stroke survivors and their families is well documented (Cameron & Gignac, 2008; Cameron, Naglie, Silver, & Gignac, 2013; Draper & Brocklehurst, 2007; Eames, Hoffmann, Worrall, & Read, 2010; Larson et al., 2005; Temize & Gozum, 2012; Wallengren, Segesten, & Friberg, 2010; Wright et al., 2012). A recent Cochrane review (Forster et al., 2012) showed that information provision for stroke survivors and families improved their knowledge of stroke and aspects of patient satisfaction. A reduction In depression scores was also noted. Three Cochrane reviews (Forster et al., 2012; Forster et al., 2001; Smith, Forster, & Young, 2009) have concluded that","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"54 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81280942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural responsiveness and the family partnership model","authors":"Zoe Tipa, Denise Wilson, S. Neville, Jeffery Adams","doi":"10.36951/ngpxnz.2015.006","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.006","url":null,"abstract":"IntroductionCultural responsiveness is contingent on the relationships developed between nurses and clients, and is necessary for the clients' and whanau (extended family) cultural needs to be incorporated into care delivery. The health and wellbeing of Maori children and their whanau is an ongoing concern for the delivery of health and social services in New Zealand. The Royal New Zealand Plunket Society (known as Plunket) provides well child services to 90% of children and their families nationwide, and to 65% of Maori children born in 2010 (Royal New Zealand Plunket Society, 2012). Plunket is committed to the Family Partnership Model, developed in the United Kingdom (Davis, Day, & Bidmead, 2002). The Family Partnership Model is based on establishing relationships and communication for working with others, and informs a programme to develop knowledge, skills and techniques for those working with children and their families. Plunket nurses undertake a 10-session Family Partnership Model training that aims to enhance their communication and ability to establish partnerships with families. However, it is not clear if the Family Partnership Model supports culturally responsive nursing practice. In this article we report the findings of a study investigating whether the Family Partnership Model influenced culturally responsive practice for nurses working with Maori whanau.BackgroundMaori, indigenous peoples of New Zealand, experience persistent inequities in health status and outcomes, similar to other Indigenous peoples who have histories of colonisation. They comprise 14.9% of the New Zealand population (Statistics New Zealand, 2013). Ninety percent of Maori live in households with other family members, and of these, 42.9% are couples with children, 26.5% are single adults with children and 11.5% in multi-family households (Te Puni Kokiri, 2011). Many Maori women have children at a younger age than other women living in New Zealand, are disconnected from their iwi and lack wider whanau support (Ritchie, 2007). Consequently, Maori whanau and children are often deemed at risk and vulnerable. For example, Maori children suffer health disparities and inequities at higher rates than other children living in New Zealand (Ministry of Health, 2012a, 2012b).Health inequities occur within a complex context that includes being indigenous; experiencing discrimination, poverty and unemployment; and having low levels of education. Many Maori children live in areas of high deprivation, with 41% of Maori whanau living in neighbourhoods with high deprivation (NZDep 2006 deciles 9 and 10) compared with 15% of non-Maori, while 73% of Maori live in deciles 6 to 10 neighbourhoods compared with 44% of non-Maori (Ministry of Health, 2010). There is a high likelihood that Maori children will live in poverty, an adverse experience that impacts lifelong health and social outcomes (Marie, Fergusson, & Boden, 2008; Poulton et al., 2002). The health system has a role to manag","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"197 1","pages":"35-50"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77718630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health professionals perspectives of care for seriously ill children living at home","authors":"Cynthia Ward, A. Evans, Rosemary Ford, N. Glass","doi":"10.36951/ngpxnz.2015.005","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.005","url":null,"abstract":"IntroductionGlobal advances in medical knowledge and technology have resulted in increased survival of neonates with complex illnesses. Many of these neonates now live into childhood, however their care requirements have become more complex (Elias & Murphy, 2012; Maddox & Pontin, 2013; Schuster, Chung, & Vestal, 2011). Previously these children remained in a hospital setting, however the contemporary care setting is the family home with parents the primary carers and providers of their child's technical and personal cares (Dybwik, Tollali, Nielson, & Brinchmann, 2011; Elias & Murphy, 2012; Hewitt-Taylor, 2012; Maddox & Pontin, 2013; McCann, Bull, & Winzenburg, 2012). Parents/ families are now required to learn how to safely and effectively deliver technical interventions, following instruction from community nurses. Some examples of these interventions are: oxygen and ventilation therapy, tracheotomy care, suctioning, feeding-tube care, intravenous nutrition and intravenous drug regimens (Eilas & Murphy, 2012; Maddox & Pontin, 2013; Shuster et al., 2011; Whiting, 2013).Shuster and colleagues (2011) described care provided by parents/families as a 'shadow health care' (p. 91) system upon which health care services rely. Publically funded child health care systems would be unable to function without this level of parental support (Shuster et al., 2011). Buhler-Wilkerson (2007) argued home care could be the cornerstone of a system to meet the needs of the chronically ill. However, the management of technical, physical and emotional care for children at home has a direct impact on the parent/family in terms of physical, mental health and emotional resilience. Parents often have been found to experience altered roles, financial burden, marital strain, psychological distress (Carnevale, Alexander, Davis, Rennick, & Troini, 2006; Ling, 2012; Santacroce, 2003; Schuster et al., 2011; Whiting, 2013) and low quality of life (Al-Gamal, 2013). There continues to be the question of how to deliver funded care that has the potential to reduce the physical, emotional and financial burden for parent/family carers (BuhlerWilkerson, 2007; Shuster et al., 2011).It is important that home care for seriously ill children with complex medical needs is provided in the context of a child health model of care that is family-centred and that a partnership forms between the child, family and health professionals. Fowler et al. (2012) highlight that nurse partnership activities are not new to nurses who work with parents. Fowler and colleagues (2012) argue that partnership requires nurses to skilfully create the conditions for an effective relationship to emerge. This then provides opportunity for optimal collaboration and coordination to enhance better outcomes in care (Barnes & Rowe, 2008; Denboba, McPhearson, Kenney, Strickland, & Newacheck, 2006; Fowler et al., 2012; Kenny, Denboba, Strickland, & Newacheck, 2011; Price & McNeilly, 2009; Simkiss, 2011; Yarwood, 2008).The re","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"70 1","pages":"25-35"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76258072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncology nurses' perception of cancer pain: A qualitative exploratory study","authors":"Alicia García, D. Whitehead, H. Winter","doi":"10.36951/ngpxnz.2015.003","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.003","url":null,"abstract":"IntroductionPain is one of the most distressing symptoms experienced by patients with cancer undergoing active treatment (Stark, Tofthagen, Visovsky, & McMillan, 2012). Despite advances in understanding the aetiology of cancer pain, pharmacological developments, pain assessment tools and management guidelines, pain often remains poorly managed. Many patients with cancer continue to experience severe and unrelieved pain resulting in unnecessary suffering (Dulko, Hertz, Julien, Beck, & Money, 2010; Fairchild, 2010; Huntoon, 2009). Acute pain can be triggered by surgery and diagnostic procedures such as bone marrow aspirations and repeated intravenous cannulations for chemotherapy drugs (Chapman, 2011). Treatment effects such as chemotherapy-induced neuropathy may also contribute to reported pain (De Grandis, 2007; Lavoie Smith, Cohen, Pett, & Beck, 2010).Barriers to effective pain management are commonly reported throughout health care systems and may relate to the system, health professionals, and patients themselves (Bennett, Flemming, & Closs, 2011). With regard to nursing oncology practice, a lack of knowledge surrounding opioid delivery and its effects contribute to pain prevalence (Voshall, Dunn, & Shelestak, 2013). Yildirim, Cicek, and Uyar (2008) found that oncology nurses possessed inaccurate knowledge about commonly used analgesics and consequently exaggerated anxiety about the potential for psychological dependence occurring. Furthermore, patients themselves are often reluctant to report pain related to concerns about the impact of subsequent treatment decisions, personal cost, and their own fears of addiction and dependence (Simone, Vapiwala, Hampshire, & Metz, 2012).Oncology nurses are noted as being at the frontline of cancer pain management (Aycock & Boyle, 2009). Nurses perform and evaluate many interventions for pain management and have an essential role in deciding when changes in plans are required (Bernardi, Catania, Lambert, Tridello, & Luzzani, 2007; Chapman, 2011). This study explored how oncology nurses perceive, experience and assess cancer pain in their patients and, subsequently highlighted factors affecting the delivery of effective pain management strategies.MethodsA qualitative descriptive exploratory study was conducted using semi-structured interviews in order to achieve a detailed exploration of oncology nurses' perceptions of cancer pain in patients were receiving chemotherapy. A purposive sampling method was used to include experienced participants who had knowledge of the phenomenon in question (Berg, 2009; Sandelowski, 2010). The participants were five second-level chemotherapy-certified oncology nurses. The age of participants ranged from 32 to 55 years, with an average time of ten years working in the oncology field. All the available participants were female.Data were collected using one-to-one semi-structured interviews. Interviews are commonly used to gather in-depth exploration of nurse's perceptions, view","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"39 1","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80076899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Institutional Ethnography: An Emerging Approach for Health and Nursing Research","authors":"S. Adams, J. Carryer, J. Wilkinson","doi":"10.36951/ngpxnz.2015.002","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.002","url":null,"abstract":"IntroductionInstitutional ethnography (IE) is a critical form of social inquiry founded by Dorothy Smith. Institutional ethnography can be described as a \"Marxist-feminist, reflexive-materialist, qualitative method of inquiry\" (Hussey, 2012, p. 2). Since Smith's early writings during the 1970s, IE has continued to be shaped and developed by Smith along with a growing group of well-respected researchers and theorists from North America and, increasingly, other parts of the world. Institutional ethnography publications listed on Scopus have more than doubled for each five year period from 1990, to a total of 184 in August, 2014. Institutional ethnography is now being used across a wide diversity of disciplines, including health, social work, law and justice, and education, because of its relevance to exploring and making visible the relationship between the everyday activities and experiences of people, and the institutional construction of the social world. The term institutional ethnography explicitly connects an emphasis on the structures of power - institutions - with the everyday practices and experiences of people at the local level - ethnography (Appelrouth & Edles, 2011).This paper introduces IE as a valuable research approach for health and nursing in New Zealand and adds to previous articles on methodology published in this journal. The theoretical underpinnings of IE as an alternative sociology, and the key concepts of the ruling relations and experiential knowledge in the everyday world are described. Finally, a brief overview is provided of how IE is being used for research on nurse practitioners in rural primary health care.Dorothy Smith (b. 1926), a Canadian sociologist and feminist activist, began her work developing an alternative sociology during the second-wave of the contemporary women's movement in the 1960s and 1970s. She has been described as \"a worldrenowned Marxist feminist scholar and activist and a formidable intellect\" (Carroll, 2010, p. 9). Her work in founding IE stemmed from what Smith described as the disjuncture she experienced early in her career between being a sociologist in a male dominated and gendered institution, and a single mother of two young children (Smith, 2005). She objected to the ways that traditional positivist sociology categorised people into designated groups, including housewives and single mothers, and then sought to explain their activities, behaviours, or their culture. She believed that this generated ideology not knowledge, and served further to perpetuate oppression and discrimination, particularly for women (Smith, 1974, 1990a). She identified that her own experience and knowledge of her everyday life was disconnected from the official or authoritative representations of her world and work as a sociologist (Bisaillon, 2012). However, as her work progressed Smith updated her terminology from a sociology for women to that of a sociology for people clearly signalling that we must begin our u","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"68 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74516522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Prescribing Diabetes Nurse Specialist Views of Nurse Prescribing in Diabetes Health","authors":"Hazel I A Philips, Wellington Hutt Valley Dhb, J. Wilkinson","doi":"10.36951/NGPXNZ.2015.001","DOIUrl":"https://doi.org/10.36951/NGPXNZ.2015.001","url":null,"abstract":"IntroductionDiabetes mellitus (DM) is one of the most common chronic diseases throughout the world. Its management is complex and requires a lifetime of behaviour modification (Courtenay & Carey, 2008; Kara, van der Bijl, Shortridge-Baggett, Asti, & Erguney, 2006). The World Health Organisation (WHO) has predicted that there will be 366 million people with diabetes by 2030 (Kara et al., 2006). Price-Waterhouse-Coopers estimate the financial implications of diabetes will reach NZ$1000 million by 2021 (Joshy & Simmons, 2006). There will be a profound impact on the New Zealand health service as the number of people with diabetes increases along with life expectancy. Diabetes nurse specialist (DNS) prescribing has the potentialto increase accessibility and services to people with diabetes, help alleviate some of the pressure on the health service, and provide a more holistic model of care (Latter, Maben, Myall, Young, & Baileff, 2012; Wilkinson, Carryer, & Adams, 2013).Nursing practice has evolved considerably over the last 20 years with nurses extending their roles, taking on new roles, and specialising in particular areas (Bodington, 2011). Nurses who specialise in diabetes can be professionally recognised by means of a voluntary accredition process available through the New Zealand Nurses Organisation (NZNO) (Aotearoa College of Diabetes Nurses, 2014). Accreditation is defined by the National Diabetes Nurses Knowledge and Skills Framework (KSF) (New Zealand Society for the Study of Diabetes, 2009) and is aligned with the Nursing Council of New Zealand (NCNZ) requirements for professional development and recognition programmes. There are four levels in the KSF, with the most advanced being 'specialist diabetes nurse' (level 4). These nurses have developed expert diabetes practice and provide care for people with diabetes who have complex health needs. Specialist nurses have undertaken post graduate study towards or completion of a Masters degree.In addition to supporting people with diabetes to make lifestyle changes, many nurses who specialise in diabetes make changes to the dose or frequency of insulin or oral hypoglycaemic medications using standing orders (Medicines (Standing orders) Amendment Regulations, 2011). Any prescriptions for new or repeat medicines however must be provided by an authorised prescriber. Until recently, nurse practitioners have been the only nurses able to prescribe medicines in New Zealand.The primary legislation governing the supply, manufacture and prescription of medicines in New Zealand is the Medicines Amendment Act 2013. This Act enables prescribing for two classes of prescriber: authorised prescribers (medical practitioners, nurse practitioners, dentists, optometrists and midwives); and designated prescribers (nurses working in diabetes health, pharmacists and dietitians). Designated prescribers a re able to prescribe from a limited formulary within their area of practice. Specific regulations were passed in 2011","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"36 1","pages":"5-17"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81185081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maori perspectives: A deeper understanding of nursing and smoking","authors":"H. Gifford, Denise Wilson, A. Boulton","doi":"10.36951/ngpxnz.2014.010","DOIUrl":"https://doi.org/10.36951/ngpxnz.2014.010","url":null,"abstract":"BackgroundSignificant health gains can be made by reducing the smoking prevalence for Maori nurses (20%) and student nurses (30%) (Gifford, Wilson, Boulton, Walker, & Shepherd-Sinclair, 2013b). While evidence indicates that targeted, sensitive smoking cessation approaches are more likely to lead to successful smoking cessation in health professionals (Berkelmans, Burton, Page, & Worral-Carter, 2011; Daley et al., 2006; Dawson, Cargo, Stewart, Chong, & Daniel, 2013; Edwards et al., 2012) it is critical to understand how smoking is socially constructed for this group.Maori nurses are strongly positioned to influence Maori communities and whanau as vital and trusted healthcare practitioners. Just over half of the respondents to a national Maori nursing survey indicated a strong intention to quit, with almost 20% thinking about quitting in the next month (Gifford et al., 2013b). Consequently, understanding the characteristics of smoking for Maori nurses, and designing specific and innovative solutions to optimise smoking cessation for this group, is essential.The research discussed in this paper is part of a larger study initiated by the New Zealand Nurses Organisation (NZNO) and funded by the Health Research Council. Phase One of the envisioned two-phase study has been completed. Phase One was the robust development of a smoking intervention framework. Using exploratory multi-methods research, and drawing on empirical evidence, we sought to design an intervention to increase the number of quit attempts in Maori nurses and to ensure stimuli, such as workplace policy, assists them to remain smoke free. Specific objectives of Phase One were to:a. describe the current situation of smoking among Maori nurses;b. explore the personal and professional contexts of their smoking;c. identify quitting triggers within the contexts of national regulation, workplace policies and personal life;d. identify potential smoking cessation intervention points,e. identify relapse prevention strategies to encourage maintenance of quit status beyond the initial quitting phase;f. design a tailored smoking cessation support intervention for Maori nurses; andg. test the feasibility of implementation and likely uptake of the proposed cessation support intervention.Phase One involved three distinct stages to answer research objectives described above; Stage One: quantitative data collection (a survey of all Maori NZNO members) and literature review; Stage Two: qualitative interviews with nurses and student nurses; literature review; and early intervention development; Stage Three: finalise intervention and feasibility testing with research participants, Advisory Group members and wider stakeholders. Phase Two involves implementing the intervention and is dependent on further research funding.In this paper we present the results of the Phase One, Stage Two qualitative interviews conducted with Maori nurses, community health workers (CHWs) and nursing students. Quantitative results","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"3 1","pages":"35-45"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75520617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising Cultural Safety and Comfort during Gynaecological Examinations: Accounts of Indigenous Maori Women","authors":"C. Cook, Clark, M. Brunton","doi":"10.36951/ngpxnz.2014.009","DOIUrl":"https://doi.org/10.36951/ngpxnz.2014.009","url":null,"abstract":"Procedures that disrupt women's usual boundaries of space and privacy are commonplace in clinical care. Clinicians' provision of culturally safe care requires awareness that 'every-day' interventions are often outside of the realms of'normal' for people physically, emotionally and spiritually (Cook, 2011; Cook & Brunton, 2014). The term, clinicians, is used in this article to signify nurses and doctors where they are referred to collectively. Clinicians' ability to engage in a culturally competent manner is described by Durie (2001) as a relational skill, which improves the performance of health professionals. The aim of this article is to provide Maori women's examples of such relational skills, to highlight how cultural competency can be expressed by Pakeha (non-indigenous) nurses and doctors in ostensibly routine, invasive clinical situations. In this article we report on the accounts of ten women identifying as Maori, who described experiences of examinations provided by Pakeha clinicians. This analysis is significant as there are considerable quantitative data about the marginalised position of Maori compared to other ethnicities within Aotearoa in relation to sexual, maternal and gynaecological health and cancer diagnoses (Brewer, Pearce, Jeffreys, Borman & Ellison-Loschmann, 2010; Lamb, Dawson, Gagan & Peddie, 2013; McKenzie, Ellison-Loschmann & Jeffreys, 2011; Morgan, Donnell & Bell, 2010). However, there are few studies of Maori accounts about clinical care by Pakeha (see for example Pitama et al., 2012; Wilson, 2003).The operational definitions of cultural safety and cultural competency are drawn from the Nursing Council of New Zealand (NCNZ) (2011), which evolved from the innovative work of Maori nurses, led by Irihapeti Ramsden (1992). Also pertinent are Papps' and Ramsden's (1996) rationale for cultural safety, and the imperative for Maori health initiatives and the Treaty of Waitangi to be upheld within social policy (Kingi, 2007; Lyford & Cook, 2005). Culturally safe health service delivery to Maori is determined by the recipients of care, including families. For clinicians to foster cultural safety requires an appreciation of people as whole beings. A holistic orientation acknowledges worldviews encompassing beliefs about morality, behaviour and rituals, and recognises that people are connected physically, emotionally, intellectually and spiritually to others (living and ancestral), and to the land. Cultural competency requires clinicians to reflect on the significance of their own cultural identity and its impact upon practice (NCNZ, 2011). This cognisance entails appreciation of historical, political and social influences on health, rather than a narrower awareness of rituals and practices. Clinicians committed to providing culturally safe care are mindful of power relations, and adapt care to meet diverse needs. Commitment to cultural competency is a politically active position (Giddings, 2005). Respect for difference requires ","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"29 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89318258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of the child health and development book. Part 2: 1945-2000.","authors":"J. Clendon, Karen McBride-Henry","doi":"10.36951/ngpxnz.2014.005","DOIUrl":"https://doi.org/10.36951/ngpxnz.2014.005","url":null,"abstract":"This is the second part of a historical review of the New Zealand child health and development record book (also known as the Well Child/Tamariki Ora Health book or Plunket book). It focuses on the years between 1945 and 2000. The first article highlighted how the book documented the development of \"scientific mothering\", which marginalized women-generated mothering knowledge. The present article highlights how during the reviewed time period women began to challenge notions of \"scientific mothering\", these changes are signaled in the content of the Well Child/Tamariki Ora Health book over time. In addition, women's movements, such as LaLeche league and Parent Centre, reflected significant societal changes during this era in relation to mothering and child-rearing practices, the influence of which had a significant impact on the Plunket book's development. However, tensions between health professionals and women in relation to the value placed on types of knowledge continued to exist as evidenced by the language employed in the Plunket books throughout the time period reviewed. Being mindful of the tensions that exist between competing discourses and knowledge sources is important as they call us to engage with how we value and develop our relationships with women and mothers as health care professionals.","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"24 1","pages":"5-17"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87227778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse prescribing: the New Zealand context.","authors":"Anecita Gigi Lim, N. North, J. Shaw","doi":"10.36951/ngpxnz.2014.006","DOIUrl":"https://doi.org/10.36951/ngpxnz.2014.006","url":null,"abstract":"The purpose of this study was to examine the introduction of nurse prescribing in New Zealand, especially with respect to the basis of concerns related to level of knowledge and skills required of practitioners for safe prescribing; and further to compare experiences in New Zealand with those in other countries where nurses are authorised to prescribe. It is argued that prescribing rights previously extended to Nurse Practitioners and now being extended to other groups of nurses, and also to other health professions, is a matter provoking concern with respect to patient safety and adequacy of educational preparation. Unlike in the UK where extending prescribing rights to nurses did not involve rigorous educational preparation, Nurse Practitioners in New Zealand now undergo a stringent process involving Masters degree preparation in biological sciences and pharmacology (similar to USA). However, despite differences between policy environments, in New Zealand, criticisms grouped into concern about knowledge, patient safety and the impacts on team work and the health system echoed that voiced in the UK. The view that the educational model to prepare medical practitioners to prescribe is the 'gold standard' is critiqued and alternative models supported for extending prescribing rights to nurses and other professions. The expectation now is that extended prescribing rights are unlikely to be reversed. As the first two professions to be granted prescriptive authority in New Zealand, experiences in preparing both midwives and nurses educationally are expected to influence the models of educational preparation for other professions. The focus of the debate needs to shift from arguing against extending prescribing authority (especially to nurses), to consideration of how practitioners can be best prepared for and supported in the role.","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"123 1","pages":"18-27"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85645019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}