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    Dying to know : a qualitative study exploring nurses' education in caring for the dying : a thesis presented in partial fulfilment of the requirements for the degree of Master of Education (Adult Education) at Massey University
    (Massey University, 2004) Davenport, Faye Alison
    This qualitative study explored how Registered Nurses with experience of caring for the dying share their knowledge and skills with new graduate nurses in the clinical setting. The Research Questions were: What clinical knowledge/skills do 'expert' Registered Nurses possess that allow them to care competently and confidently for patients in their final forty-eight hours of life? How might these experienced nurses most effectively share their knowledge/skills with new graduate nurses in the clinical setting? The aims of the study were, firstly to describe the clinical experiences of Registered Nurses with expertise in care of the dying in a variety of practice settings. Secondly, to develop a written document whereby experienced nurses can share their knowledge/skills of care of the dying with new graduate nurses (as a supplement to the findings of this study). The data was collected in terms of demographic information, and a single semi-structured interview was conducted with each participant. Each participant was also asked to complete a written clinical narrative. The data was analysed using Luborsky's method of thematic analysis. The interview transcripts were read and reread and similar topics were grouped as phrases and coded as themes. The major themes were described in detail using excerpts from the interviews and narratives of the participants. Clinical stories of practice shared by the participants in their interviews are included with the clinical narratives in the Resource Document. There was a strong emphasis in the findings of this study on one-to-one sharing between the experienced and new graduate nurse throughout the dying process. The sharing was in the hands-on care provided, stories of experience and reflection on the care given. The concept of 'care pairs', the use of resource nurses and the resource document discussed in the recommendations could be used in a variety of clinical settings.
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    Understanding preparedness : the influence of teaching and learning experience on bioscience integration by nursing lecturers : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Education, Massey University, Palmerston North, New Zealand
    (Massey University, 2014) Hardcastle, Jane
    This thesis explores how teaching and learning experiences influence nursing lecturers’ preparedness to integrate biosciences in their teaching practice. The biological sciences have been a problematic component of nursing education and practice for many years and bioscience knowledge levels amongst many nursing lecturers are reported to be poor. This research encompasses a detailed exploration of the teaching and learning experiences of ten New Zealand nursing lecturers to identify experiences that influence their preparedness with bioscience integration. The phenomenon of preparedness was explored from the perspective of transcendental phenomenological philosophy and the key theoretical construct of intentionality. Study participants’ subjective, conscious experiences were explored through in-depth interview and phenomenological analytical procedures to identify the universal experience and essences of how experiences came to be. Preparedness as a phenomenon is influenced by participants experiencing contrast, reflection and responsibility in learning, nursing, and teaching practice. These cognitive and affective processes occur as a result of the complex relationship between experiences, personal values and beliefs about ‘good’ nursing and teaching practice, and are found to be more influential than experience alone. This is an important discovery for nursing education as mere exposure to examples of bioscience in nursing may not affect students’ or lecturers’ perceptions of bioscience value. The way that bioscience knowledge is valued within personal perceptions of good nursing underpins lecturers’ preparedness, and shapes the way that learning, teaching and practice experiences are evaluated. The research demonstrates the importance of reflective learning and meaning perspectives in bioscience education, and the preparedness of nursing lecturers to practice integrated teaching. However, despite a willingness to integrate bioscience when teaching nurses, lecturers question their confidence with traditional academic perceptions of bioscience knowledge. The findings question contemporary pedagogies in bioscience education and epistemological perspectives of bioscience theory in the context of nursing as a practice-based profession. Recommendations are made to facilitate reflective learning, and lecturers’ preparedness with integrated teaching, through progressive spiral curricula that value clinical bioscience knowledge and the contribution of nursing lecturers’ clinical expertise.
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    "Stepping beyond the known" : the lived experience of returning registered nurse students : an interpretive descriptive study : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy, Massey University, College of Education, Palmerston North, New Zealand
    (Massey University, 1997) Idour, Margaret; Idour, Margaret
    The thesis employed a Heideggerian Hermeneutical Analysis (HHA) approach for a study of returning registered nurse students (RRNS) from a nursing/health management context. In essence, a descriptive interpretive study the intent has been to unveil the common meanings embedded in the lived experience of RRNS return to formal (advanced) studies. The phenomenon or issue of interest was pursued in the form of a question: What is meaningful and significant for participant RRNS in their everyday world on re-engaging in formal (advanced) studies? There is a marked scarcity of research from the RRNS viewpoint, so the focus of the study was to understand what RRNS themselves found to be the highlights of the experience. The study participants included RRNS coming from a management background and, therefore, very much at the cutting edge of rapid and continuing change in health care provision. In addition to personal and professional reasons for returning to study, what the narratives disclosed was the compelling need experienced by the RRNS to increase their understanding of changing requirements in the workplace. They looked for new possibilities to transform management of nursing/health services and for learning experiences favourable to that purpose. A key aspect of their concern related to the interactive nature of their lived experience as a RRNS with the entire context of their everyday world, that is, with the connections and relations between the study-work-homespace. Fourteen RRNS from an established university nursing programme offering graduate courses of study in nursing participated in extended non-structured interviews lasting 60 to 90 minutes. The interviews were held during 1993 in many different places, as chosen by participants, some in the home but mostly in the work setting. This had an unanticipated benefit because participants, acting as the researcher's host/hostess being at 'home' and comfortable in telling their 'stories' took 'charge' of the occasion. The interviews, with the consent of the participants, were audiotaped and then transcribed. The texts (transcriptions) were analysed hermeneutically using Heideggerian phenomenology as the philosophical background. HHA is centred on a particular tradition of philosophy whose concern is the meaning of Being. The concern is to make visible participants' experience of their 'world'. In this instance, it was the everyday 'world' of the participant RRNS and the lived meanings of what they experienced on return to formal (advanced) studies. Hence everyday lived experience is the focus of attention in Heideggerian phenomenology. In this research approach what is sought is understanding not explanation. It is a premise of phenomenology that, in general, an understanding of the meaning and significance of the lived experience can be acquired from the 'things' (the phenomena under study) themselves. Approaching a participant as an expert by virtue of directly experiencing the phenomenon, is basic to phenomenology. Hermeneutic analysis of the texts of the participant RRNS affirmed the authenticity of those assumptions. In the present study several common or major themes, two relational themes and one constitutive pattern were identified through the process of textual interpretation. The constitutive pattern, expressing the full complexity of the relations and connections between the themes, was found to be present in all fourteen texts; the nature of a constitutive pattern being 'that it's always there'. The constitutive pattern 'Nursing is Dwelling in Thoughtful Concern as Context Calls Forth', emerged as the major finding of the study. This pattern witnesses to the pragmatism that is inherent in nursing and commonly found in nurses' responses to the challenges presented by continuing and rapid change. For the participant RRNS nursing had become a way of engaging their energies in the workplace as appropriate to a given place, time and culture. The two relational themes accent particular aspects of the constitutive pattern. 'Nursing is a whole pile of things'; and 'Curriculum: Reflective Openness' reveal the inherent meanings of the constitutive pattern. Firstly, that nursing is diverse in practice and has many dimensions; and, secondly, that a curriculum befitting the diversity of nursing requires us to constantly challenge and test the learning experiences we provide for RRNS. The fourteen RRNS participating in the study traversed diverse pathways to acquire the understanding and skills required for altered health care structures. Adopting new relationships and 'leaping-ahead' (Heidegger, 1962), to be able to see the whole picture of what was being experienced in nursing/health care, reveals the RRNS becoming-as interpreters for both colleagues and clients. Leaping-ahead is reflective of thoughtful concern as the pattern of responding to presenting need. This way of living a life as a nurse transforms work. The participant RRNS disclose that, dwelling in such a way in nursing/health work opens up a future of possibilities which brings all the presenting needs into focus. Sharing the story of their lifeworld as RRNS, the participants have exemplified the 'reflective openness' Senge (1990, 277 - 281) advocates, as being a prerequisite for 'learning organisations'. Contemporary organisations require us to challenge our own thinking as well as being free to speak our minds {participant openness). Appreciating that, however much we value our daily life practices and understandings, they need to be 'always subject to test and improvement'. In effect, what the participants have bestowed on us is that, within the framework of a curriculum for RRNS and the content learning of a given course, we must generate a process of learning amenable to both individual and group requirements.