EDITORIAL
Abstracts of Articles published in this volume:
Invited Article
Jenny Carryer & Michal Boyd
The Myth of Medical Liability for Nursing Practice
Margaret Connor
Advancing Nursing Practice in New Zealand: A Place for Caring as a Moral Imperative
Sandi Evans
Child Abuse: Nurse Identification of At-Risk Children
Susan Jacobs
Advanced Nursing Practice: Time and Meaning
Esther Vallance & Sue Scott
A Critique of Problem-Based Learning in Nursing Education and the Contribution it Can Make Toward Beginning Professional Practice - Part Two
INVITED ARTICLE
THE MYTH OF MEDICAL LIABILITY
FOR NURSING PRACTICE
Jenny Carryer, RN, PhD, FCNA(NZ), MNZM, Professor (Nursing),
Executive Director, College of Nurses Aotearoa (NZ)
Michal Boyd, RN, ND, NP™, FCNA(NZ)
Senior Lecturer, Auckland University of Technology
Abstract
The myth of medical liability for nursing practice is widespread among doctors, nurses and the public at large. This myth is promulgated by the medical profession in various forums and is an artefact of the lingering stereotype of nurse as “handmaiden”. In fact, nurses are autonomous practitioners who do not require supervision by other health professionals when practicing within their designated scope. The question of medical liability for nursing practice has been fuelled recently in New Zealand by the development of the Nurse Practitioner™ role and the advent of nurse prescribers. This discussion explores the complexities of liability issues in the case of standing orders and vicarious liability by employers, as well as when nurses and doctors are in management roles. This discourse challenges the myths about medico-legal responsibility for nursing practice and invites nurses to challenge liability assumptions in public media, personal practice environments and policymaking arenas.
Key Words: Professional liability, vicarious liability, nursing practice
Article Order No: 193A
ADVANCING NURSING PRACTICE IN NEW ZEALAND:
A PLACE FOR CARING AS A MORAL IMPERATIVE
Margaret J. Connor, RGON, PhD, FCNA(NZ)
Independent Nursing and Health Researcher and Consultant and
Associate Lecturer, Graduate School of Nursing and Midwifery,
Victoria University of Wellington
Abstract
Advanced nursing practice is now formally endorsed in New Zealand. However, the framework of competencies that nurses applying for endorsement need to demonstrate is functionally oriented. There is no recognition of the relational competencies required to practice caring as a moral imperative. This gap denies the significance of nursing as a moral practice. In this paper it is argued that a more balanced framework would give equal attention to both functional and relational competencies. A practice exemplar is used to demonstrate positive outcomes from advanced relational competencies. Also evident in the practice exemplar is the view that practising the relational competencies associated with the nursing as a caring practice discourse ‘pushes the boundaries’ of the dominant discourse of nursing as a functional service. This paper explores the history of these two discourses and the assumptions that underpin them. When missing from descriptions of advanced nursing practice, relational competencies are rendered invisible and peripheral, rather than central and therapeutic. In our highly technological health service the recognition of human to human connection is more important than ever.
Key Words: Competency, advanced practice, Nurse Practitioner™, moral imperative
Article Order No: 193B
CHILD ABUSE: NURSE IDENTIFICATION
OF AT-RISK CHILDREN
Sandi Evans, RN
Paediatric Link Nurse, Intensive Care Unit, Christchurch Hospital
Nurse Lecturer in Health Assessment of Children,
Christchurch Polytechnic Institute of Technology
Abstract
“Child abuse is a problem for children, for families and for society as a whole, as the abused child may have life-long emotional and behavioural problems” (Murray, Baker & Lewin, 2000, p. 47). The nurse, often the first health care professional to see the abused child, must be alert to the physical, emotional and behavioural signs of abuse and know how to intervene. Risk assessment should be standard practice for Registered Nurses offering paediatric health care. There is a triad of factors that serve as predictors of increased risk of abuse. To further aid New Zealand health care professionals where child and/or partner abuse is suspected, identification and response strategies are outlined in the Family Violence Intervention Guidelines (Ministry of Health, 2002).
Nurses have an opportunity to assess children for abuse through the nursing observation, physical examination and history taking. The nurse’s actions to promote the hauora/wellbeing of each child in her/his practice may be the crucial determinant in the identification of and intervention for the abused child.
Key Words: Child, abuse, family, nurse
Article Order No: 193C
ADVANCED NURSING PRACTICE:
TIME AND MEANING
Susan Jacobs, RCpN, BScN, M.A., PhD candidate
Dean, Faculty of Health & Sport Science
Eastern Institute of Technology, Hawke’s Bay
Abstract
The particular, contemporary meanings ascribed to “advanced nursing practice” in New Zealand have been debated and delineated in the 1990s, culminating in the launch of the Nurse Practitioner™ at a conference sponsored by the Ministry of Health and the Nursing Council of New Zealand in August, 2001.
Drawing on archival materials, documents, other texts and voices, this article explores the evolution of connotations and meanings of the word “advanced” as applied to nursing in New Zealand. This exploration of time present, and time past, facilitates a perspective of the future.
Key Words: Advanced nursing practice, meanings over time, nursing history
Article Order No: 193D
A CRITIQUE OF PROBLEM-BASED LEARNING IN
NURSING EDUCATION AND THE CONTRIBUTION IT
CAN MAKE TOWARD BEGINNING PROFESSIONAL
PRACTICE - Part Two
Esther Vallance, MA, BN, RCpN, Senior Lecturer, School of Nursing
Christchurch Polytechnic Institute of Technology, Christchurch
Sue Scott, MA, BA, RGON, RM, Senior Lecturer/BN Programme
Co-ordinator, Wellington Campus, Massey University, Wellington
Abstract
Problem based learning (PBL) has recently been identified as a preferred method for teaching undergraduate nursing in New Zealand. In this article, the second of two that explores what this means for nursing and nursing education, the literature is examined to determine the ability of PBL to develop professional nursing practice. Professional practice depends on critical thinking for the development of both rational problem-solving skills and critical reflective thinking. This article proposes that PBL has the potential to develop the critical thinking skills required for problemsolving and decision-making. However PBL is less likely to promote the critical reflective thinking without which the transformative practice needed to drive health gains in the 21st century is unlikely to emerge.
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Key Words: Problem-based learning, problem-solving, critical thinking,
transformative practice
Article Order No: 193E
