Nursing Praxis in New Zealand
Vol. 19 No.1 - March 2003

 

EDITORIAL

Abstracts of Articles published in this volume:

Lynne Giddings & Pamela Wood
From Resistance to Passion: An Interview with Brian McKenna on Quasi-Experimental Research

Elmar Beekman & Lesley Patterson
Nurse Prescribing in New Zealand: Professional Gain or Political Loss?

Kaye Milligan & Stephen Neville
The Contextualisation of Health Assessment

Annette Mortensen
The Process of Destigmatisation: The Work of Sexual Health Nurses

 

FROM RESISTANCE TO PASSION:
AN INTERVIEW WITH BRIAN MCKENNA ON
QUASI-EXPERIMENTAL RESEARCH
Lynne S. Giddings, RGON, RM, PhD, Associate Professor
School of Nursing and Midwifery
Auckland University of Technology
Pamela J. Wood, RGON, PhD, Associate Professor
Graduate School of Nursing and Midwifery
Victoria University of Wellington

Abstract
Quasi-experimental methodologies fit within the continuum of quantitative research approaches. Integral to the evidenced-based practice movement, these methodologies are viewed by this movement as the more legitimate of the various approaches to researching nursing and midwifery problems and issues. This is the ninth article in a series based on interviews with nursing and midwifery researchers, designed to provide the beginning researcher with a first-hand account of the experience of using particular methodologies. This article focuses on the quasi-experimental methodology as described by Brian McKenna (RCpN, BA, MHSc [Hons]) who is currently completing his PhD. Brian used this methodology to investigate patient perception of coercion on admission to acute psychiatric services in New Zealand. The interview with Brian also highlights the initial resistance many nurses and midwives feel when confronted with the requirement to add ‘research’ to an already far too busy work schedule.

Key Words: Research, methodologies, quantitative research, quasiexperimental, positivism, post-positivism.

NURSE PRESCRIBING IN NEW ZEALAND:
PROFESSIONAL GAIN OR POLITICAL LOSS?
Elmar Beekman, RCpN, PostGrad. Dipl. HSM., Drs.,
(Maastricht University, The Netherlands). Previously Lecturer, School of Health Sciences, Massey University, Wellington
Lesley Patterson, BEd, Dip. Women’s Studies, BA (Hons).
Lecturer, School of Sociology, Social Policy, and Social Work,
Massey University, Wellington

.
Abstract
Change in the work of nurses is currently being driven by two main developments. Some nurses can now be legally mandated to undertake the traditional medical task of prescribing, while at the same time the delegation of routine nursing work to unregistered care workers has become more common. An optimistic reading of these changes might suggest they illustrate the successful professionalisation of nursing, by and for nurses. However, by locating changes to nursing’s scope of practice within the historical context of the Health Reforms, an alternative reading is possible. With particular reference to nurse prescribing, we argue that changes in nursing work are often politically driven, rather than being simply outcomes of nurse-led developments towards extending autonomous nursing practice.

Key Words: Nurse prescribing, health reforms, professional autonomy,
commodification

THE CONTEXTUALISATION OF
HEALTH ASSESSMENT
Kaye Milligan, RGON, MA (Hons), Dip Tchg (Tertiary), MCNA(NZ)
Lecturer, Faculty of Health and Sciences,
Christchurch Polytechnic Institute of Technology, Christchurch
Stephen Neville, RCpN, MA (Hons), FCNA(NZ)
Lecturer, School of Health Sciences - Albany, Massey University, Auckland

Abstract
Health assessment is a term which is increasingly being applied within nursing in New Zealand, yet there is a lack of clarity about the meaning of this concept. This article seeks to define health assessment and claims that it is a tool nurses should be using as a means of improving health outcomes for clients. Nurses utilise interview skills, physical assessment skills and skills of critical analysis as well as documentation when performing a health assessment. Four different levels of data gathering for a health assessment are identified, providing a range of contexts where it is a useful tool. An historical perspective is also provided in order to contextualise health assessment and to trace the development of these skills as they have been incorporated into nurses’ practice in North America from the 1960s and in Australia from the 1980s. In New Zealand health assessment is now being taught in some undergraduate degree programmes, is included in some registered nurses’ practice, and advanced assessment competencies are now required of Nurse Practitioners™.

Key Words: Health assessment, physical assessment, nursing practice.

THE PROCESS OF DESTIGMATISATION:
THE WORK OF SEXUAL HEALTH NURSES
Annette Mortensen, RCpN, M.Phil (Hons), Dip Ed.
Refugee Health Coordinator, Public Health, Auckland District Health Board
Gillian White: MA (Hons), PhD. Associate Professor,
School of Health Sciences, Massey University, Auckland

Abstract
In 2001 the Ministry of Health undertook to develop a Sexual and Reproductive Health Strategy in recognition that there are gaps in service provision and that the sector lacks the strategic direction needed to improve. The intention of this plan is to provide the Ministry of Health, District Health Boards and other organisations across the health sector with the basis from which to develop service specific plans and make funding decisions. The process for development of a Sexual and Reproductive Health Strategy has two phases, the first being the release of the overarching direction. This is to be followed by development of a series of action plans to address key issues, such as reducing sexually transmitted infections (including HIV/AIDS), sexual abuse and unwanted/unintended pregnancies, and at the same time maximising the health of at-risk groups such as youth, Maori and Pacific peoples. The focus of this article is on the findings of a grounded theory study of sexual health nursing in New Zealand. Nurses' experiences of providing sexual health care are described and theoretical explanations generated. The emphasis in this article is on countering stigma which emerged as a recurrent problem for nurses in the study. A comparative analysis of the nurses' counter reactions with Gilmore and Somerville's (1994) model of stigmatised reactions towards people with sexually transmitted diseases was done. The model describes the processes of disidentification, depersonalisation, scapegoating, and discrimination, which characterise stigmatised reactions. Destigmatising in the context of this study means that the nurse is engaged in the process of counteracting the prejudice and negative social attitudes towards people who attend sexual health clinics and who have sexually transmitted infections. The process occurs in the interactions between the nurse, the client and the community. This process is dynamic and reflects changes in patterns of social sexual relations in society and community attitudes towards these. Essentially this study shows that for nurses the basic social processes of destigmatisation are based on complex factors including gender, culture, and sexuality of both the practitioner and client, not all of which can be explored fully in the space of this article. Nurses’ understandings of the impact of socioeconomic conditions and gender/power relations in society have an important role to play in how nurses manage care. As a consequence of their work nurses in this study encountered professional stigma. The practice of sexual health care results in being professionally marginalised.

Key Words: Sexual health nursing, destigmatisation, cultural safety