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Issue 30 -12 Sept 2012

Books Available for Borrowing

1. Burns Trauma Nursing Procedures
by Chrissie Bosworth. [Published 1997]
Arranged in an action/rationale format, this clear and accessible guide describes and explains all the procedures that may be used in the treatment of burns trauma. Each aspect of burns trauma is described and, where appropriate, the physiology is explained.

2. Chronic Wound Care: A Problem-based Learning Approach
By Moya Morison; Liza Ovington & Kay Wilkie [Published 2004]
Chronic Wound Care used a problem-based learning approach. The book is a valuable resource, whether the approach taken to teaching the subject is 'pure' PBL, a hybrid approach, or where a more traditional approach is being taken. Its strengths lie in fostering skills which enable the reader to access knowledge from many sources and to solve complex clinical problems, which they may encounter in practice.

3. Degrees of Deprivation in New Zealand: An Atlas of Socioeconomic Difference[ Published 2004]
2nd edition
By Peter Crampton; Clare Salmond & Russell Kirkpatrick
This edition uses the latest Census data and mapping technology to present a clear image of New Zealand's socioeconomic landscape.  It provides background information on the theory of deprivation, the methods used to create the atlas, and discussion of ethical issues related to mapping deprivation.  The maps cover all New Zealand and are supported by graphical and numerical descriptions of territorial authority areas and census area units

4. Health and Society in Aotearoa New Zealand
2nd edition. edited by Peter Davis and Kevin Dew. [Published 2005]
This edition provides an up-to-date and comprehensive review of how the country's health care system operates.  The book considers the frameworks, social structures, cultural patterns and policy initiatives that influence the health of New Zealanders and the delivery of health care to them.


5.  Ethics and compromised consciousness
By Gallagher, Ann. [Editorial] Nursing Ethics 19. 4 (Jul 2012): 449-50
Recently, I was invited to speak at an event at London’s Wellcome Institute for the History of Medicine (see The event was entitled ‘Conscious’ and provided the opportunity to share perspectives and stimulate discussion relating to some of the ethical and philosophical issues that arise when consciousness is compromised. Neil Levy1 from the Oxford Centre for Neuroethics (http:// shared some of the ethical issues that arise from current areas of research in neurology. Roy Hayim2 shared his personal experience of botulism resulting in his being ‘locked in’, paralysed and totally dependent on hospital staff.

6.  First, do no harm: Confronting the myths of psychiatric drugs
By Barker, Phil; Buchanan-Barker, Poppy. Nursing Ethics 19. 4 (Jul 2012): 451-63
The enduring psychiatric myth is that particular personal, interpersonal and social problems in living are manifestations of ‘mental illness’ or ‘mental disease’, which can only be addressed by ‘treatment’ with psychiatric drugs. Psychiatric drugs are used only to control ‘patient’ behaviour and do not ‘treat’ any specific pathology in the sense understood by physical medicine. Evidence that people, diagnosed with ‘serious’ forms of ‘mental illness’ can ‘recover’, without psychiatric drugs, has been marginalized by drug focused research, much of this funded by the pharmaceutical industry. The pervasive myth of psychiatric drugs dominates much of contemporary ‘mental health’ policy and practice and raises discrete ethical issues for nurses who claim to be focused on promoting or enabling the ‘mental health’ of the people in their care.

7. Iranian intensive care unit nurses' moral distress: A content analysis
By Shorideh, Foroozan Atashzadeh; Ashktorab, Tahereh; Yaghmaei, Farideh. Nursing Ethics 19. 4 (Jul 2012): 464-78
: Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of moral distress among clinical nurses and nurse educators working in 12 cities in Iran. A content analysis of the data produced four themes to describe the nurses’ moral distress. The four themes were as follows: (a) institutional barriers and constraints; (b) communication problems; (c) futile actions, malpractice, and medical/care errors; (d) inappropriate responsibilities, resources, and competencies. The results demonstrate that moral distress for intensive care unit nurses is different and that the nursing leaders must reduce moral distress among nursing in intensive care.

8. Consequences of clinical situations that cause critical care nurses to experience moral distress
By Wiegand, Debra L; Funk, Marjorie.
Nursing Ethics 19. 4 (Jul 2012): 479-87
Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and a thematic analysis. Each line of the data was reviewed and coded, and the codes were collapsed into themes. Methodological rigor was established. Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families.

9. Nurses' perceptions of and responses to morally distressing situations
By Varcoe, Colleen; Pauly, Bernie; Storch, Jan; Newton, Lorelei; Makaroff, Kara. Nursing Ethics 19. 4 (Jul 2012): 488-500.
Research on moral distress has paid limited attention to nurses’ responses and actions. In a survey of nurses’ perceptions of moral distress and ethical climate, 292 nurses answered three open-ended questions about situations that they considered morally distressing. Participants identified a range of situations as morally distressing, including witnessing unnecessary suffering, being forced to provide care that compromised values, and negative judgments about patients. They linked these situations to contextual constraints such as workload and described responses, including feeling incompetent and distancing themselves from patients. Participants described considerable effort to effect change, calling into question the utility of defining moral distress as an ‘‘inability to act due to institutional constraints’’ or a ‘‘failure to pursue a right course of action.’’ Various understandings of moral distress operated, and action was integral to their responses. The findings suggest further conceptual work on moral distress and effort to support system-level change.

10. What actions promote a positive ethical climate? A critical incident study of nurses' perceptions
By Silén, Marit; Kjellström, Sofia; Christensson, Lennart; Sidenvall, Birgitta; Svantesson, Mia. Nursing Ethics 19. 4 (Jul 2012): 501-12
Few qualitative studies explore the phenomenon of positive ethical climate and what actions are perceived as
promoting it. Therefore, the aim of this study was to explore and describe actions that acute care ward nurses perceive as promoting a positive ethical climate. The critical incident technique was used. Interviews were conducted with 20 nurses at wards where the ethical climate was considered positive, according to a previous study. Meeting the needs of patients and next of kin in a considerate way, as well as receiving and
giving support and information within the work group, promoted a positive ethical climate. Likewise, working as a team with a standard for behaviour within the work group promoted a positive ethical climate. Future research should investigate other conditions that might also promote a positive ethical climate.

11. A multidimensional analysis of ethical climate, job satisfaction, organizational commitment, and organizational citizenship behaviors
By Huang, Chun-Chen; You, Ching-Sing; Tsai, Ming-Tien. Nursing Ethics 19. 4 (Jul 2012): 513-29
The high turnover of nurses has become a global problem. Several studies have proposed that nurses’ perceptions of the ethical climate of their organization are related to higher job satisfaction and organizational commitment and thus lead to higher organizational citizenship behaviors. This study uses hierarchical regression to understand which types of ethical climate, facets of job satisfaction, and the three components of organizational commitment influence different dimensions of organizational citizenship behaviors. Questionnaires were distributed to 450 nurses, and 352 usable questionnaires were returned. The findings of the article suggest that hospitals can increase organizational citizenship behaviors by influencing an organization’s ethical climate, job satisfaction, and organizational commitment. Hospital administrators can foster within organizations, the climate types of caring, law and code and rules climate, satisfaction with coworkers, and affective commitment and normative commitment that increase organizational citizenship behavior, while preventing organizations from developing the type of instrumental climate and continuance commitment that decreases it.

12. Safeguarding children in clinical research
By Edwards, Steven D. Nursing Ethics 19. 4 (Jul 2012): 530-7
Current UK guidelines regarding clinical research on children permit research that is non-therapeutic from the perspective of that particular child. The guidelines permit research interventions that cause temporary pain, bruises or scars. It is argued here that such research conflicts with the Declaration of Helsinki according to which the interests of the research subject outweigh all other interests. Given this, in the context of clinical research, who is best placed to protect the child from this kind of exploitation? Is it the medical researcher, the child’s parents or the nurse advocate? This article describes the problem, possible responses to it, and closes with a consideration of, and rejection of, a defence of current guidelines that claims moral parity between clinical research and clinical

13. Health and human rights advocacy: Perspectives from a Rwandan refugee camp
By Pavlish, Carol; Ho, Anita; Rounkle, Ann-Marie. Nursing Ethics 19. 4 (Jul 2012): 538-49
Working at the bedside and within communities as patient advocates, nurses frequently intervene to advance individuals’ health and well-being. However, the International Council of Nurses’ Code of Ethics asserts that nurses should expand beyond the individual model and also promote a rights-enabling environment where respect for human dignity is paramount. This article applies the results of an ethnographic
human rights study with displaced populations in Rwanda to argue for a rights-based social advocacy role for nurses. Human rights advocacy strategies include sensitization, participation, protection, good governance, and accountability. By adopting a rights-based approach to advocacy, nurses contribute to health agendas that include more just social relationships, equitable access to opportunities, and health-positive living situations for all persons.

14. Implied consent and nursing practice: Ethical or convenient?
By Cole, Clare A. Nursing Ethics 19. 4 (Jul 2012): 550-7
Nursing professionals in a variety of practice settings routinely use implied consent. This form of consent is used in place of or in conjunction with informed or explicit consent. This article looks at one aspect of a qualitative exploratory study conducted in a Day of Surgery Admission unit. This article focuses on the examination of nurses’ understandings of implied consent and its use in patient care in nursing practice. Data were collected through one-on-one interviews and analysed using a thematic analysis. Nurses participating in this study revealed that they routinely used implied consent in their nursing practice. This article will look at whether implied consent supports or impedes a patient’s autonomy.

15. Including adults with intellectual disabilities who lack capacity to consent in research
By Calveley (née Clark), Julie. Nursing Ethics 19. 4 (Jul 2012): 558-67.
The Mental Capacity Act 2005 has stipulated that in England and Wales the ethical implications of carrying out research with people who are unable to consent must be considered alongside the ethical implications of excluding them from research altogether. This paper describes the methods that were used to enable people with severe and profound intellectual disabilities, who lacked capacity, to participate in a study that examined their experience of receiving intimate care. The safeguards that were put in place to protect the rights and well-being of participants are described, and it is argued that the approaches used in this study met the requirements set out in the Mental Capacity Act 2005. Although this paper is based on research involving people with intellectual disabilities, it has implications for research involving other groups who may also lack capacity to consent, including people with mental health problems, head injuries and dementia.

16. The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students
By Park, Mihyun; Kjervik, Diane; Crandell, Jamie; Oermann, Marilyn H. Nursing Ethics 19. 4 (Jul 2012): 568-80
This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n ¼ 506) and senior students (n ¼ 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were higher in senior students than in freshman students.
Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students.

Journal - Table of Contents

17. From the Journal of Infection Prevention, July 2012; 13 (4)  
. Going for Gold [You’ve done the preparation. It’s time for the main event. The infection prevention and control practitioner moves towards the starting point, hands glistening with alcohol gel, sleeves rolled above the elbow, ring off and name badge on]
. Evaluation of the cleaning efficiency of microfibre cloths processed via an ozonated laundry system
17C. The prevalence of nasal carriage of meticillin resistant Staphylococcus aureus among healthcare workers in a non-acute healthcare facility
17D. Surgical team members’ compliance with and knowledge of basic hand hygiene guidelines and intraoperative hygiene
17E. Surveillance swabbing for MRSA on neonatal intensive care units – is weekly nasal swabbing the best option?
Outbreak column 3: outbreaks of Pseudomonas spp from hospital water
17G. Does this look familiar? Blind ends and dead legs


18. The Drivers of Positive Youth Development - The Collaborative Trust's 5th Annual Research Hui
Date: Thursday 13th and Friday 14th September 2012
Venue: Avonhead Baptist Church, 102 Avonhead Road, Christchurch
Registration forms available shortly online:
Cost: $250 waged, $100 non-waged, students and scholarship students

News - National

19.  Dunedin firm ordered to pay workers $14,000
A major Dunedin-based cleaning company which has launched a campaign against part of the Employment Relations Act has again been hit by a court decision and ordered to pay an Auckland couple more than $14,000.

20.  Ambulances will no longer be sent to minor 111 calls as part of sweeping changes to help stem St John's $15 million-a-year loss
Instead, such calls will be redirected to a GP or other health care, or a St John officer will be sent in a car - not a double-crewed ambulance. St John's annual operating loss has nearly doubled from $8 million in five years, and ambulance bosses say that is unsustainable.


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