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Rhonda McKelvie

Doctor of Philosophy, (Nursing)
Study Completed: 2019
College of Health


Thesis Title
Where we are and how we got here: An institutional ethnography of the Nurse Safe Staffing Project in New Zealand

Read article at Massey Research Online: MRO icon

Nurse short staffing increases the risk of patients not leaving the hospital alive. Nurses in New Zealand hospitals still work on short-staffed shifts more than a decade after staffing strategies were developed and implementation began. By 2021, all District Health Boards are required to implement these strategies but they are yet to demonstrate material gains for frontline nurses that reduce risks to patient safety and consistently repair staffing shortages. Using institutional ethnography, Ms McKelvie's research provides a detailed description and analysis of how aspects of the strategies actually work in everyday hospital settings. Knowledge contributions include analytic discoveries about how nurse's knowledge and work is critical to patient safety and hospital performance, and navigating patients through fractured care processes and flawed hospital systems. Nurses' accomplished knowledge based practice is missing from official accounts of their work and fundamentally eroded by chronically under-resourced care environments and competing institutional priorities.

Professor Jenny Carryer
Dr Janet Rankin
Dr Kerri-Ann Hughes