Mrs Natalie Elizabeth Anderson

BHSc MIT, BA MSc(Hons) Auck., RN

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Professional Teaching Fellow
Doctoral Candidate - Doctor of Philosophy

Biography

I am a Professional Teaching Fellow and currently-practising Registered Nurse, with clinical experience in pre-hospital, intensive care and emergency department settings.  My dual-discipline academic background in nursing and health psychology has led to a research interest in the behaviour and experiences of health professionals when faced with challenging clinical, ethical or emotional situations

Research | Current

 

The decision to terminate cardiopulmonary resuscitation can be a challenging one.  It effectively transitions a scene characterised by hope and valiant, demonstrative efforts to restore life, to one of hopelessness, grief and defeat.  During resuscitation, there is a patient – a person – to be saved.  Once resuscitation efforts ceases, death is declared, and the status of the lifeless patient changes - to corpse.

 

Every year thousands of people, at homes or in the community, cardiac arrest - their hearts stop pumping blood around their body.  Timely commencement of basic life support gives patients with reversible causes of cardiac arrest the best chance at survival.  However, the window for effective intervention is fleetingly brief.  In some cases, cardiac arrest may herald an unavoidable or expected, death.  Accordingly, the vast majority of out of hospital cardiac arrest resuscitation attempts fail to restart the patient’s heart, or only prolong life by a few hours, or days.

Worldwide patient outcome data has been used to validate medical criteria for termination of resuscitation, but establishing medical futility is sometimes fraught.  Authority for paramedics and other professional resuscitators to withhold or terminate resuscitation efforts, and criteria for such a decision, varies internationally. 

Where patients cardiac arrest in the community, there may be very limited contextual information. With a focus on commencing basic life support with minimal delay, it can take time for resuscitators to gather reliable information, to make their decision.  Although the challenges of resuscitation decision-making are widely acknowledged, there is little research exploring paramedic’s perspectives on resuscitation decision-making.

My doctoral research explored the experience of those tasked with deciding when to start, continue, withhold or terminate resuscitation attempts.  An initial, qualitative phase revealed characteristics of ethically and clinically challenging resuscitation decision-making, and explicated the factors NZ ambulance personnel use to inform their decisions.  Subsequent phases investigated how paramedics and paramedic students are prepared and supported for termination of resuscitation and death in the field.

Awareness of the key factors informing resuscitation decision-making could improve communication between providers, as they better prioritise gathering and handover of information.  Understanding the needs of paramedics tasked with this complex and demanding decision-making will assist with paramedic confidence and coping. Findings from this research will be used to provide recommendations to clinical educators, policy-makers and future researchers, to better support paramedics, where resuscitation decision-making is most challenging.

Teaching | Current

Nursing 105: Nursing in Practice

Nursing 201: Nursing Clients with a Pathophysiological Problem

Nursing 302: Professional Nursing Practice

Distinctions/Honours

2018 Dennis Pickup Clinical Educator Award

2018 College of Emergency Nurses New Zealand Conference Grant 

2017 Winner Best Poster Presentation Australian Resuscitation Council "Spark of Life" Conference 

2017 Academic Career Exploration Scholarship

2014 University of Auckland Doctoral Scholarship

2008 University of Auckland Faculty of Science Masters Award

2008 Gretta and Harry Hamblin Trust Research Grant

 

Areas of expertise

Resuscitation

Emergency Department Nursing

Critical Care Nursing

Simulation Teaching

Stress and Coping

Clinical Decision Making

Interpretative Phenomenological Analysis

Committees/Professional groups/Services

College of Emergency Nurses New Zealand national committee member

Selected publications and creative works (Research Outputs)

  • Anderson, N. E., Slark, J., Faasse, K., & Gott, M. (2019). Paramedic student confidence, concerns, learning and experience with resuscitation decision-making and patient death: A pilot survey. Australasian emergency care, 22 (3), 156-161. 10.1016/j.auec.2019.07.001
    Other University of Auckland co-authors: Julia Slark, Merryn Gott
  • Anderson, N. E., Slark, J., & Gott, M. (2019). Unlocking intuition and expertise: using interpretative phenomenological analysis to explore clinical decision making. JOURNAL OF RESEARCH IN NURSING, 24 (1-2), 88-101. 10.1177/1744987118809528
    Other University of Auckland co-authors: Julia Slark, Merryn Gott
  • Anderson, N., Slark, J., & Gott, M. (2019). How are ambulance personnel prepared and supported to withhold or terminate resuscitation and manage patient death in the field? A scoping review. Australasian Journal of Paramedicine, 16.10.33151/ajp.16.697
    Other University of Auckland co-authors: Julia Slark, Merryn Gott
  • Anderson, N. E., Gott, M., & Slark, J. (2018). Grey areas: New Zealand ambulance personnel's experiences of challenging resuscitation decision-making. International Emergency Nursing, 39, 62-67. 10.1016/j.ienj.2017.08.002
    URL: http://hdl.handle.net/2292/44630
    Other University of Auckland co-authors: Merryn Gott, Julia Slark
  • Anderson, N. E., Gott, M., & Slark, J. (2018). Beyond prognostication: ambulance personnel's lived experiences of cardiac arrest decision-making. Emergency medicine journal : EMJ, 35 (4), 208-213. 10.1136/emermed-2017-206743
    URL: http://hdl.handle.net/2292/43426
    Other University of Auckland co-authors: Merryn Gott, Julia Slark
  • Anderson, N. E., Gott, M., & Slark, J. (2017). Commence, continue, withhold or terminate?: a systematic review of decision-making in out-of-hospital cardiac arrest. European Journal of Emergency Medicine, 24 (2), 80-86. 10.1097/mej.0000000000000407
    URL: http://hdl.handle.net/2292/33288
    Other University of Auckland co-authors: Julia Slark, Merryn Gott
  • Anderson, N. E., Kent, B., & Owens, R. G. (2015). Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death. International Journal of Nursing Studies, 52 (3), 695-704. 10.1016/j.ijnurstu.2014.12.005
    URL: http://hdl.handle.net/2292/28938

Identifiers

Contact details

Primary office location

M&HS BUILDING 505 - Bldg 505
85 PARK RD
GRAFTON
AUCKLAND 1023
New Zealand

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