Description:
In New Zealand, the state registration of nurses was instituted in 1901. This was a marker that nursing had achieved professional status. Although many registered nurses (RNs) worked in private practice or as district nurses in people's homes, lay home nurses had an essential role in caring for the sick. This article reports a comparative analysis of information available to lay home nurses in domestic health guides with information for RNs in professional nursing textbooks, for the period 1900–1935. It shows that despite RNs' professional status, domestic health guides gave more detailed information than nursing textbooks on many subjects until the end of the research time period. The boundary between registered and lay home nurses' knowledge and practice was therefore blurred. Exploring this indistinct boundary challenges understandings about the clear division between professional and lay knowledge and practice. This has particular relevance in a time when health systems increasingly depend on care provided in the home by family members. Home nursing has always been a crucial component in any system for the care of the sick. Historically, caring for people at the end of life or those with chronic and acute illnesses depended largely on the commitment of untrained women, nursing their own family members at home and supporting neighbors to care for the ill in other households.
Description:
Background Many tools are used to examine the Quality of Life (QOL) of patients with kidney disease, but little is known about how culturally relevant they are and why one should utilise one tool over another. As part of a larger study on the QOL of dialysis patients in United Arab Emirates, the cultural relevance of two tools (SF-36 and the QOL Index) was examined. This paper suggests a model to establish cultural relevance of QOL tools. Method A descriptive comparative survey design using a mixed method design was used in 2007 to study the QOL of 161 patients on dialysis and 350 people from the community. The cultural relevance of each tool was assessed by (i) examining missed questions, (ii) asking respondents about the cultural relevance of each tool, (iii) asking respondents what questions could be added or deleted to make the tools more culturally relevant and (iv) asking respondents to identify the factors that might contribute to their QOL. Results Of respondents, 94.7% from the dialysis sample and 90.4% from the community sample considered both tools culturally relevant. The QOL Index tool had more missing data. Many of the themes generated from the analysis of the qualitative data were addressed by the subscales of both tools. Themes not addressed by either tool were concerned with values, safety and country. Conclusion Cultural adaptation of QOL tools needs to follow well-established guidelines. The target population should be involved in establishing the cultural relevance of QOL tools.
Description:
The establishment in 1903 of a professional district nursing service in Wellington, New Zealand's capital city, was a philanthropic response to the need for skilled care for the sickpoor in their own homes, as hospital and charitable aid boards believed chronic patients drained their resources. This paper argues that it was the timely combination of the individual philanthropy of Sarah Ann Rhodes, the organisational philanthropy of the St John Ambulance Association and the new professional standing and availability of registered nurses such as Annie Holgate that ensured its successful foundation. It also argues that district nursing services blurred spatial, social, and public-private boundaries in new ways. Finally, it considers the district nurse's role as the philanthropist 's proxy, the means for realising the philanthropist's desire to help the sick poor.
Description:
The new role of 'backblocks' nursing, established in 1909 to provide a nursing, midwifery, emergency and public health service to New Zealand's remote rural regions, created opportunities and challenges for the profession. For three decades, the novel nature of the role also provided numerous stakeholders with the opportunity to contest their authority and influence. This article explores the professional, practice and political issues of backblocks nursing through a case study of Mokau, a remote rural community in the North Island of New Zealand, 1910-1940. In particular, it considers professional issues of recruitment and retention, practice issues in delivering the new service in a challenging environment with few resources, and political issues in defining the scope of nurses' practice and dealing with competing stakeholders keen to determine its potential and limits. These issues were exacerbated by the location of the Mokau district in two administrative health regions. (author abstract)
Description:
Aims and objectives To identify how nurses in the past determined best practice, using the context of New Zealand, 1930–1960. Background In the current context of evidence-based practice, nurses strive to provide the best care, based on clinical research. We cannot assume that nurses in the past, prior to the evidence-based practice movement, did not also have a deliberate process for pursuing best practice. Discovering historical approaches to determining best practice will enrich our understanding of how nurses' current efforts are part of a continuing commitment to ensuring quality care. Design Historical research. Methods The records of the Nursing Education Committee of the New Zealand Registered Nurses' Association, 1940–1959, and the 309 issues of New Zealand's nursing journal, Kai Tiaki, 1930–1960, were analysed to identify the profession's approach to ensuring best practice. This approach was then interpreted within the international context, particularly Canada and the USA. Results For nearly 30 years, nurse leaders collaborated in undertaking national surveys of training hospitals requesting information on different nursing practices. They subsequently distributed instructions for a range of procedures and other aspects of nursing care to standardise practice. Standardising nursing care was an effective way to ensure quality nursing at a time when hospital care was delivered mostly by nurses in training. The reasons for and timing of standardisation of nursing care in New Zealand differed from the international move towards standardisation, particularly in the USA. Conclusions Historically, nurses also pursued best practice, based on standardising nursing procedures. Relevance to clinical practice Examining the antecedents of the present evidence-based approach to care reminds us that the process and reasons for determining best practice change through time. As knowledge and practice continually change, current confident assertions of best practice should and will continue to be challenged in future.
Description:
All nurse researchers need to address, in the manner most appropriate to their research methodology, issues of quality related to their research material. This concern is not about the care needed in generating data, rather it relates to understanding and evaluating material that already exists. This article describes four historical sources relevant to the history of nursing in New Zealand and uses them to explain how nurse researchers can evaluate their research material. The dimensions of this evaluation are the provenance, purpose, context, veracity and usefulness of the historical sources. The article explains the questions that need to be addressed in each dimension of the evaluation. The different kinds of information available in the four historical sources are illustrated by references to individual nurses
Description:
Nurses have a long tradition of storytelling. Nurses in the New Zealand government’s Backblocks Nursing Service, established in 1909 for settlers in remote rural areas, related narratives of personal experience in articles, conference papers and letters to their chief nurse that were published in the country’s nursing journal. Analysis of the 16 stories published between 1910 and 1915 revealed 14 had a common storyline and structure. Structural elements included a call, arduous journey, arrival and reconnaissance, trial (difficult case or circumstance), resolution and homily. Using a literary folkloristics approach, this article argues that repetition of the story by nurses in different regions traditionalised it as a professional folktale, ‘The nurse’s odyssey’. It enabled nurses to debrief from difficult cases and write-into-being this new role and practice. Striking differences in the practice setting ensured the story’s reportability, while clinical details connected writer and readers through a common professional aesthetic context and strengthened the story’s credibility. For the chief nurse who was also a journal editor, publishing the stories allowed her to potentially attract nurses to the service while alerting them to its harsh realities, and show policy-makers the profession’s value in meeting new health service needs. [ABSTRACT FROM AUTHOR]
Description:
Objective Using issues in rural and remote area nursing as the example, this paper explores how nurses can use their historical imagination in considering professional issues today. Setting Rural and remote area nursing. Primary argument Historical imagination is the creative capacity to imagine possibilities of engaging with the past. Historical imagination in nursing has the potential to help nurses address current professional issues. Points of familiarity with the past can show nurses which issues are enduring and which are transient. A sense of familiarity can bring strength, encouragement and comfort. Points of difference can show nurses that problems are not necessarily permanent or can be dealt with differently. This paper uses aspects of the history of bush nursing in Australia to illustrate how nurses in rural and remote area nursing today could use their historical imagination in addressing current issues. It explores points of familiarity and difference between issues faced by bush nurses in the past and current issues in the international literature. Ways of using historical imagination in rural and remote area nursing recruitment are considered to illustrate the process. Conclusions As the example of engaging with the history of bush nursing in Australia attempts to demonstrate, nurses can use their historical imagination to identify points of familiarity and difference with the past to prompt a shift in thinking and strengthen creativity in addressing current issues
Description:
Aims and objectives. To examine the surgical nurse's role in preventing wound sepsis (infection) and how this was portrayed in nursing literature in the pre-antibiotic period, 1895-1935. Background. While the history of infection control in general has been researched for the mid-20th century, more detailed research is needed of the pre-antibiotic period, specifically of the surgical nurse's role in preventing wound sepsis. Closer examination is also warranted of the way the nurse's role was perceived in specific practice areas, such as surgeons' views of the surgical nurse's role. Design. Historical research. Methods. Analysis of historical British, Canadian, Australian and New Zealand nursing journals and British and Australian surgical nursing textbooks. Results. Between 1895-1935 skilled surgical nurses were valued as 'supporters' of the surgeon's heroic efforts, acting as diligent 'scrubbers' and vigilant 'sentries' to guard patients from microbial attack, yet tended to be blamed as 'saboteurs' and 'slovens' when wound sepsis occurred. The most noticeable changes in knowledge and practice related to greater use of sterilised dressing materials, less reliance on unnecessarily strong antiseptics, and less intensive methods in preparing surgical materials. Conclusions. Although the literature related the nurse's role to the surgeon rather than the patient, interpreting it merely as a subservient relationship would ignore the more complex portrayals evident in the literature. Surgeons looked for support rather than subservience, and a conscientious approach rather than obedience. Relevance to clinical practice. This historical research shows nurses both the enduring nature of aspects of clinical knowledge and practice as well as the slow process of change in others. It reminds nurses of the danger of infection, the constant vigilance required and the measures needed when practising without antibiotics.
Description:
Portrayals of vulnerable groups in public media, government reports and professional accounts tend, by definition, to focus on their deficits in order to identify need and shape appropriate health care responses. This article within the cultural history of nursing considers a different construction of one vulnerable group in the past, the 'sick poor' in early 20th-century New Zealand. The research analysed primary historical sources that offered rich descriptions of the sick poor, drawn from one major daily newspaper and the country's professional nursing journal, 1900-1920. The article argues that in co-constructing the sick poor as a vulnerable group, district nurses and journalists primarily used the trope of 'sunless lives'. However, they also constructed them as resourceful, resilient and determined. This article offers the construction of the sick poor by district nurses and journalists in early 20th-century New Zealand as an example of a more nuanced construction that goes beyond a one-dimensional portrayal of vulnerability.
Description:
Finding the most appropriate way to assess knowledge is an enduring issue. In the past, nurses seeking state registration or professional qualification through nursing association membership were required to pass state final or association examinations. This historical research describes final examinations in surgical nursing in Australia and New Zealand, 1905-1930, when the examination process and standards were first being established. A comparison shows more similarity than difference between the two countries' examinations. Not surprisingly, the most common topic in this pre-antibiotic period was prevention of wound infection. Despite the generally high pass rate, analysis of published examiners' comments in New Zealand reveals concern about areas of nurses' knowledge and level of general education. Examiners were concerned to ensure an effective examination but also provided advice on how to pass it. The research contributes to a consideration of surgeons' expectations of nurses, and relations and knowledge boundaries between the two professions.
Description:
The development of research capability in New Zealand nursing can be seen particularly from the 1970s onwards. However, by analysing past issues of Kai Tiaki - the country's longstanding nursing journal - over the five decades following its establishment in 1908, the present authors identified two precursors to this later stage. The journal fostered nurses' awareness of research and consistently promoted nursing scholarship. Successive editors developed nurses' capability in writing about their practice by publishing case studies, the winning essays in competitions run jointly with the professional association and nursing schools, and nurses' articles on practice or professional issues. Although promotion of research awareness and nursing scholarship were not deliberate strategies to develop nursing research capability, they were necessary forerunners to it.
Description:
More than 500 New Zealand nurses served overseas in World War 1. At the end of the war, nearly a quarter of the country’s nursing workforce was still overseas. Most nurses served with the New Zealand Army Nursing Service (NZANS) but, in the early months of the war, before the NZANS had been sufficiently organised to send nurses, some joined the Australian service. Others went independently to Britain or were already there and joined services such as the Queen Alexandra’s Royal Army Nursing Corps (QAs), the French Flag Corps and Red Cross, or worked in British military hospitals or hospitals in France run by wealthy British women.
Description:
On February 9, 2014, the town of Morwell in Victoria, Australia, was confronted with several bushfires, resulting in a blaze at the Morwell open cut coal mine adjacent to the Hazelwood power station. For 45 days, the local communities were impacted by smoke, ash, and reports of raised carbon monoxide levels. The duration of the crisis placed an unprecedented strain on the capacity of the community and the authorities to adequately respond. Many see Morwell as vulnerable to future events because it is surrounded by coal mines, power stations, forests, and pine plantations. Drawing on interviews from key stakeholders in the community and a detailed analysis of media reports and social media, this chapter examines the factors that both harm and promote community resilience. It emphasizes the complexity of resilience and the importance of communal narratives as community members react to and recover from traumatic experiences and unknown futures.
Description:
Background: In the early twentieth century, most women in Australia and New Zealand gave birth at home. As in colonial times, women living in the isolated New Zealand backblocks or Australian bush without access to a midwife, nurse or doctor, or women in towns who could not afford their service, gave birth with only a neighbouring woman, husband or older child to help. Most households had a domestic health guide as a source of health information and support in caring for themselves and others. This guide might therefore be the only assistance available to women and their lay attendants during childbirth. Aim: This research aimed to identify the information domestic health guides provided on childbirth, particularly if addressed to a person assisting the woman in the absence of a midwife, nurse or doctor, and to compare it with information midwives were expected to know. Methods: Using historical methodology, the researchers analysed the childbirth information in a range of domestic health guides available in Australia and New Zealand, 1900-1950. The information was also compared with midwifery textbooks and considered within the context of the increasing professionalisation of midwifery to discover how it reflected boundaries between lay and professional knowledge and practice. Findings: Some domestic health guides provided as detailed information as midwifery texts but without their scientific rationale that was a mark of professional knowledge and practice. Conclusion: By providing clear information, domestic health guides could have been a significant part of the culture of self-reliance and mutual aid, and of the cultures of health in both rural and urban environments in New Zealand and Australia in this time period.