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    The experiences of becoming and being a nurse leader in Aotearoa New Zealand in the 21st century : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, at Massey University, Manawatū, Aotearoa New Zealand
    (Massey University, 2025-11-27) Kerr, Dianne
    The Experiences of Becoming and Being a Nurse Leader in Aotearoa New Zealand in the 21st century This thesis explores the experiences of current registered nurses who have attained leadership positions in Aotearoa New Zealand (NZ). A feminist deconstruction of gender framework serves as a lens to examine how masculine and feminine binaries affect the experiences of nurse leaders in a neoliberal environment that has commodified and devalued the act of caring. Particular attention was paid to the different challenges experienced by Māori nurses as the indigenous people of a post-colonialist Aotearoa. The research employed a qualitative design using an exploratory, descriptive survey, grounded in a pragmatic philosophical approach. It was conducted in two phases: an online questionnaire followed by two rounds of interviews. In total 49 participants completed the questionnaire and 13 participants were interviewed. All participants held NZ nurse registration and had been in leadership roles in healthcare for at least three years, during which time they were responsible for overseeing staff. Respondents represented diverse practice backgrounds and localities. The findings indicate that most participants achieved leadership roles primarily through chance and personal determination. In many cases, pursuing post-graduate education or serendipitous opportunities broadened their perspectives on nursing. The nurse leaders in this study realised they could have a significantly greater impact on the quality of care they wished to provide by stepping into leadership positions. However, they faced challenges related to nursing's strong association with femininity and often experienced subordination to the male-dominated fields of medicine and management. There is ample evidence linking empowered nurse leadership to effective care; however, nursing input in healthcare decisions is often overlooked due to the prevailing assumption that traditionally feminine traits do not significantly contribute to patient outcomes. Despite the proven value and significance of nurse leadership, this research indicates that leadership is not adequately planned for or supported in a way that reflects the size of the nursing workforce. Post-graduate education has been shown to raise nurse consciousness, yet NZ healthcare systems and academic institutions fail to invest in or value the critical thinking and awareness needed for nurse leaders to function and contribute effectively in the current neoliberalist environment. This research suggests that preparation for leadership in nursing should focus on helping nurses gain an awareness of their identity within a gendered profession before developing their leadership skills. Highlighting nurses who have succeeded in roles beyond bedside care and providing mentorship and networking opportunities for emerging leaders will cultivate future nurse leaders who can advance the profession. Key findings: • gendered socialisation continues to impact the career trajectories of nurse leaders, • neoliberalist environments create challenges for nursing autonomous practice • ongoing issues of colonialism, racism and sexism influence the career pathways of nurses in Aotearoa
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    There is more than one way of nursing : new graduate nurses' experiences of their first year of practice : a thesis presented in partial fulfilments of the requirements for the degree of Master of Philosophy in Nursing at Massey University, Albany, New Zealand
    (Massey University, 2021) Ingram, Lisette
    This research was undertaken with the aim of generating a theoretical explanation of the experience of new graduate registered nurses (NGRNs) undertaking a nurse entry to practice programme (NETP) in Aotearoa New Zealand. The objective was to construct a theory from focus group data utilising constructivist grounded theory (CGT) method. An integrative literature review focused on NGRN experiences of practice showed that there was a strong deficit focus in research, with much written on clinical risk and transition shock. Minimal research focused on the strengths of NGRNs, and what benefit they may bring to the work areas they are a part of. There was no research on the impact of culture on new graduates other than related to negative nursing behaviour. Given that healthcare is multicultural, the workforce diverse, and Aotearoa New Zealand has an expectation of improving equity for Māori, a deficit in research related to cultural need, or indigenous new graduate need, demonstrates an opportunity for research. Waikato District Health Board (DHB) has been running a NETP programme under a bicultural model since 2018, and this provided an opportunity for research in a programme not run elsewhere. Nurses are continuing to experience a complex and stressful work environment which leads NGRNs to align with workplace culture and preceptor expectations in an attempt to prioritise safety and care that is most visible, but this research showed that NGRNs are also motivated to prioritise cultural safety. This research delivered the theoretical explanation that NGRNs are ‘valuing culture to connect to patient need’. The ability to value others’ cultures was seen in those who were able to take the time to first explore their own culture. Graduates experiencing NETP within a bicultural programme utilised a safe learning environment to reflect, reached the developmental stage to become aware of and understand other cultures, and over time and with clinical competence were able to discuss cultural needs with patients to connect to need. Through exploring their identity with others as part of their NETP programme, NGRNs had a clear idea of their own identity as nurses and as individuals. Those who were able to prioritise cultural safety and treating the patient as an individual found connection with patients. Connection was iterative, with NGRNs needing to approach patients more than once, share and communicate their availability and willingness to understand in order for patients to share of themselves. Barriers to valuing culture and making connection were complex and diverse across specialty areas, but short staffing, stress and fear, pressure to work to key tasks, and lack of insight into the cultural needs of patients from other team members were key features across multiple specialties. New graduates are entering the workforce with an openness and optimism to meet the expectations of health equity in their nursing care delivery. Graduate programmes need to provide a safe space for reflection and enough knowledge and stimulus to provoke insight and assist them on this journey.
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    An exploration of the educational experiences of new nurses who are men within Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Health Science in Nursing at Massey University, Manawatu, New Zealand
    (Massey University, 2020) Guy, Max Timothy
    Despite worldwide efforts to recruit more men into nursing, males still hold minority status within the profession, which is unsustainable for many reasons. For one, a projected health crisis looms due to the baby boomer generation facing retirement by 2035. This section of the population will require more nursing care due to an increased life expectancy with more complex health needs. To compound this problem, many of those who will be retiring are nurses themselves. New Zealand subsequently faces an increased demand for nursing care, underscored by a critical nursing shortage. Ideally, it is here that males should be available to fill this shortage, as they constitute half the population. However, men presently make up only 9% of the New Zealand nursing workforce, a figure mostly unchanged since the 1990s. Men may be unwilling to enter a career in nursing due to societal attitudes, stigma, media representations, and the ingrained feminine construct of nursing. Consequently, this leaves an untapped pool of potential nurses who could help meet the demand of predicted population demographics. Using a descriptive qualitative design underpinned by social constructionism, this study explored the experiences of male nurses prior, during and after the Bachelor of Nursing degree. This research aimed to inform future curriculum design to support, retain, and attract more New Zealand men to nursing. Nine participants from across New Zealand provided data via semi-structured interviews. Through thematic analysis, two overarching themes surfaced. Firstly, men often feel a sense of isolation during training that is perceived as unfavourable, but not without benefits. Secondly, participants saw that an inaccurate awareness of the scope of the modern nurse remains constructed within the public consciousness. Addressing both of these themes is imperative to ensure balanced gender diversity within nursing, but to also empower nursing as a whole.