Internationally qualified nurses' perceptions of the competencies that pertain to patient safety.

Internationally qualified nurses represent 25% of the New Zealand nursing workforce, similar to Australia, Canada, the US and UK. The transition from vastly different health systems can have implications for patient safety. Through understanding the perspectives of internationally qualified nurses, educational and healthcare agencies may be better able to support this transition. This study investigated internationally qualified nurses' perceptions of the competencies that pertain to patient safety. These were analysed alongside the Nursing Council of New Zealand (NCNZ) competencies designed to define and measure competence for patient safety. Qualitative case studies of four internationally qualified nurses were discussed using Communities of Practice theory as the conceptual framework. The primary data sources were two semi-structured interviews with each of the internationally qualified nurses during a Competency Assessment Programme to obtain New Zealand nursing registration. Competency Assessment programme documents also provided data. Thematic analysis of the individual cases followed by cross-case analysis revealed that the social, cultural, and historical context of the health system and nursing role mediates how maintaining patient safety is perceived and enacted in practice. Recommendations from the findings of this study are important for ongoing internationally qualified nurses' transition support.

Training needs analysis - The essential first step for continuing professional development design.

Nursing services are expected to be dynamic in response to changing health care needs. This expectation requires the purposeful and effective development of nursing workforce capability through continuing professional development (CPD). An evidence based approach to training needs analysis (TNA) is a highly recommended yet often missing first step in designing a CPD strategy for service improvement. This study used the Hicks-Hennessey questionnaire, a validated TNA tool to inform regional educational commissioning to meet the aims of a community social sector trial (SST) project. The SST objectives were to improve access to appropriate primary care through reducing Ambulatory Sensitive Hospitalisations and Emergency Department attendances among people aged 0-74 years. Using a descriptive research approach with the Hicks-Hennessey questionnaire, ten priority training needs were identified by regional primary health care nurses to inform the design of a purposeful educational response and hence support an enhanced model of care.

'Sunless lives': district nurses' and journalists' co-construction of the 'sick poor' as a vulnerable population in early twentieth-century New Zealand.

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.

Work and wellness hand-in-hand: the role of the New Zealand PATHS program nurse in improving health and employment outcomes.

PURPOSE: Providing Access to Health Solutions (PATHS) is a New Zealand primary care based interdisciplinary, intersectoral vocational rehabilitation program working with clients who are unemployed and have health challenges inhibiting employment. This study examined the contribution of the nurse working in the PATHS program. METHODS: A case study approach included in-depth interviews of PATHs program clients, stakeholders, and a documentation review. RESULTS: Five themes emerged from the triangulated data: assessment and planning, personal and systems advocacy, persevering to the goal, the nursing approach, and respecting timing. DISCUSSION: Program stakeholders valued the nurse's role in client assessment, risk analysis, ongoing client monitoring, and client coaching. Clients valued the nurse's work in supporting health literacy, joint health planning, advocating for timely provision of health and lifestyle behavior services as well as supporting, coaching, and prompting. CONCLUSION: These roles together with those of other PATHS team members have led to many clients successfully entering or re-entering employment.

Cultural safety in New Zealand and the United States: looking at a way forward together.

Cultural safety emerged in Aotearoa, New Zealand as a nursing response to bicultural interactions between indigenous Maori and other New Zealanders. The purpose of this research is to describe the meaning and experience of cultural safety as depicted by nurses in New Zealand and to illustrate the potential for this to inform U.S. nursing education and practice. This interpretive hermeneutic study explored cultural safety as described by 12 experienced nurses who were selected through snowball and purposive sampling. Audiotaped interviews were conducted after ethics approval. Interpretive analysis uncovered five themes that are described with data and paradigm cases. Cultural safety considers the perspective of the patient as the norm in contrast to the culture of health care. Understanding historical power differences and personal biases can help challenge victim-blaming responses by health care providers. Incorporating these understandings into reflective practice enhances the possibility of culturally safe learning for students and culturally safe care for patients.

Poverty, philanthropy, and professionalism. The establishment of a district nursing service in Wellington, New Zealand, 1903.

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.

Adding value to stretched communities through nursing actions: the Wellington South Nursing Initiative.

Nurses provide health services to many groups with unmet health needs. Communities with consistently unmet needs are generally 'stretched' as they are under pressure. For children and families this pressure impacts their ability to live healthy lifestyles. The Wellington South Nursing Initiative involves two nurses providing an innovative population-based nursing service to stretched urban communities, particularly children and families, predominantly through networking and project work. Projects are specifically focused activities developed and implemented to address areas of health need. The projects cluster around five overarching areas: enhancing individual and community potential, growing safer families and communities, minimising negative harmful or risky behaviour, maximising general health and wellbeing and addressing specific health needs. Critical elements of the nurses' practice are the use of public health principles combined with a community development approach, relational practice and working for sustainability. The initiative provides important insights into how nurses can enter and work with communities and enhance the potential of children, families and the wider community.