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    Nurses' perceptions of factors that encourage or discourage registered nurses to remain in practice in a public hospital setting : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University
    (Massey University, 1998) McHaffie, Jacqueline Margaret
    As a registered nurse with over twenty years in clinical practice I was concerned at the lack of experienced nurses employed in public hospital settings. There appeared to be a stability in the workforce in terms of employment of nurses but this did not reflect the experience of the nurses employed there. Hospital settings are the predominant employment area for registered nurses. Public hospitals are usually where new graduates from nursing programmes begin their nursing experience. They require the support and mentoring of experienced nurses to guide their progression from a novice practitioner to an experienced practitioner. This exploratory pilot study was designed to determine a) what factors encouraged or discouraged registered nurses from remaining in practice in a specific public hospital setting and b) what recent changes in the work environment were perceived as positive or negative. Three focus groups were utilised consisting of experienced registered nurses with more than five years experience, new graduate nurses of less than twelve months experience, and Maori registered nurses. The use of focus group interviews allowed the researcher to gain knowledge of the participants' attitudes, values and perceptions of the particular topic in a non threatening environment. Krueger (1988) and Morgan (1988) identified characteristics of a focus group as being people who possess certain characteristics and who provide data of a qualitative nature in a focused discussion. Questions concerning participants' perceptions of changes over the last twelve months and factors enhancing or reducing job satisfaction and morale were used to initiate discussion. These were followed up by questions to elicit more specific information. Common themes and ideas were identified from each group and summarised by the groups at the end of the interview. The cut and paste method was used to collate the data for analysis. Results of the study indicate that all three groups were encouraged by job security, professional development, and professional autonomy while discouraged by internal politics, external politics and political correctness. All of these factors contributed overall to the theme of job satisfaction. Communication was an underlining problem for all three groups. Recommendations resulting from the findings of this study include: orientation and professional development programmes; adequate resources in terms of equipment and staff skill mix; and clearly defined lines of communication.
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    Making sense of the Director of Nursing structural positioning in New Zealand public hospitals (2006-2012) : a thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Massey University
    (Massey University, 2013) Hughes, Kerri-ann
    This dissertation reports on research examining and analyzing nursing leadership structures in New Zealand public hospitals, and in particular, the Director of Nursing (DoN) structural positioning. Leadership in hospital nursing is critical if the profession is to meet the challenges facing health services in the 21st century. The research has been undertaken using case study methodology and focuses on how organizational decision-making structures have impacted on nursing leadership in public hospitals. ‘Sense-making’ has been used as a theoretical construct to understand both the formal and informal structures that influence organizational decision-making. Phase one of the research involved examining twenty District Health Board (DHB) organizational and nursing charts. In phase two and three, the Directors of Nursing (DoNs) and the Chief Executive Officers (CEOs) were surveyed using a series of demographic and qualitative questions to draw out understanding of the Director of Nursing (DoN) role. The research has found that the constructs of power and authority influence the decision making processes at the executive level of the DHB. An analysis of the data indicates that the current structural positioning of the DoN is hindered by the existing dual accountability line reporting structures in DHBs and this is a barrier to alignment with Magnet hospital principles which provide evidence of effective patient outcomes. The focus primarily adopted by District Health Boards on professional line reporting only for nursing is not conducive to achieving effective and safe patient outcomes as it removes authority from the DoN and yet places unrealisticexpectations on accountability of how the DoN can achieve effective and safe patient outcomes within the public hospital setting.