Massey Documents by Type
Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/294
Browse
2 results
Search Results
Item The creation and development of an integrated nursing service within a rural community health team : an action research study : a thesis presented in partial fuflilment of the requirements for the degree of Master of Arts in Nursing at Massey University(Massey University, 1995) Cornish, Margaret ElizabethThis Action Research study, guided by the philosophy of Critical Social Science, was undertaken to facilitate District and Public Health Nurses working in a multidisciplinary team in a rural area to reflect on and change their practice. The goal was to explore the possibility of combing their two separate roles into one integrated role. The idea was initiated by management who anticipated that an integrated role would ensure survival of their nursing service in the competitive environment created by the New Zealand Health Reforms. The study resulted in planned participative change brought about by this nursing group. Analysis of the process increased knowledge about rural community nursing and showed that the research group created a local theory. Through their reflection the nurses isolated and related factors about their work. From this, they created a model that represented a combined nursing practice while retaining their specialist roles. Using this model the nurses planned strategies that they predicted would bring specific results. During action and evaluation, these strategies were tested and culminated in putting the emergent model into practice. The model has potential to be generalised to other community nursing groups. Analysis of data showed that many factors enhanced the change process. Observation revealed that some group dynamics also had potential to inhibit change. When analysed with the group, the nurses recognised that there was a relationship between these dynamics and their job structure, their socialisation as women and their indoctrination as nurses. It also highlighted differences between how these District and Public Health Nurses think about their work and their roles. This critical reflection increased their self understanding and ensured that any planned change was more likely to endure. For the participants, this study has resulted in a positive sense of the value of their work, a strong sense of group cohesion, a better co-ordinated communication network, and confidence in their ability to make decisions for themselves. This has, in turn, given them a stronger nursing representation within their team and organisation.Item Needs assessment and decision making in the Plunket nurse setting : what's the story? : a thesis presented in partial fulfilment of the requirements of the degree of Master of Philosophy (Nursing), Massey University, Wellington, New Zealand(Massey University, 2011) Hussey, Alison LouiseProgrammes delivered to populations of young children have had a high profile in recent years, as the relationship between childhood health and long term wellbeing is emphasised and funders and policy makers seek effective interventions to reduce health outcome disparity between some groups of children. Plunket nurses are employed by the Royal New Zealand Plunket Society (Inc) (Plunket) to deliver a programme of contacts to families with children aged from birth to five years, under a primary health care programme known as the Well Child Framework (Ministry of Health, 2010c). Seven universal or ‘core’ visits result in an assessment of family health need which informs decisions about the additional support offered to reduce risk to child health outcomes and improve health equity. This study was undertaken to clarify how Plunket nurses think about needs assessment, describe how Plunket nurses make decisions when planning care, and explore the influences on Plunket nurse needs assessment and decision making. A constructivist paradigm provided the framework for qualitative interviews with seven Plunket nurses. Data were analysed using narrative and thematic methods to construct three group narratives. The findings add to knowledge of New Zealand well child practice established through the limited previous studies in the Plunket nurse setting. Plunket nurses’ relationships with families emerged as the foundation for needs assessment, a process study participants described as complex, where a range of social, economic and community determinants are considered to establish family resilience and identify risks to child health outcomes. Decisions about planned care are contingent on family participation and agreement, and are influenced by peer and Clinical Leader supervision, the nurse’s knowledge and experience, and the available referral options. The study findings emphasise the importance of facilitative funding models to accommodate the unpredictable nature of work with families in the community, and consistent leadership to translate the underpinnings of service specifications to the reality of practice. Support for the Clinical Leader role, and further research to establish Plunket nurse professional development needs and to improve understanding of the dynamics in relationships between Plunket nurses and families are recommended.