Abstract: This article reports on the New Zealand part of an international study, using agreed study design and instruments, to determine the direct and indirect costs of nursing turnover. These costs also include the systemic costs, estimated by determining the impacts of turnover on patient and nurse outcomes. It presents the findings from the pilot study conducted in six countries to test the availability of costs and suitability of the instrument. Reports the results from a survey of directors of nursing in 20 of the 21 district health boards on turnover and workplace practices.

Abstract: This article reports data from 15 schools of nursing, surveyed to identify difficulties experienced by nurse educators with respect to entry, progression and programme completion of undergraduate nursing students. Risk assessment, along with a lack of clear policy and procedures were found to be the main problem areas. Difficulties were exacerbated for educators when there were challenges to their professional judgement, either from the Nursing Council of New Zealand or from within their own institution. The authors argue for more recognition of the dual role of nurse educators, and greater clarification of the Nursing Council of New Zealand role in regulating the student's programme entry and progression, and ultimate admission to the Register. It is suggested that the recently passed Health Practitioners Competence Assurance Act (2003) provides nursing with an opportunity to address some of these issues.

Abstract: The authors report a clinical audit that, combined with anecdotal evidence, verifies the practice of putting section 8B medical certificates on the files of voluntary mental health patients at the time of admission. This is seen as a strategy to balance the requirement to support and promote the autonomy of voluntary patients with the need to protect those patients or other people. A conceptual analysis of these issues indicates that such a practice is both legally questionable and ethically inappropriate. The authors suggest an alternative framework for practice that is legally and ethically preferable for both nurses and patients.

Abstract: The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings.

Abstract: For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes.

Abstract: This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analysed thematically. Three themes, prioritising time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented.

Abstract: Nurse migration flows in and out of New Zealand are examined to determine impacts and regional contexts. A descriptive statistics method was used to analyse secondary data on nurses added to the register, New Zealand nurse qualifications verified by overseas authorities, nursing workforce data, and census data. It found that international movement of nurses was minimal during the 1990s, but from 2001 a sharp jump in the verification of locally registered nurses by overseas authorities coincided with an equivalent increase in international registered nurses added to the local nursing register. This pattern has been sustained to the present. Movement of local registered nurses to Australia is expedited by the Trans-Tasman Agreement, whereas entry of international registered nurses to New Zealand is facilitated by nursing being an identified “priority occupation”. The author concludes that future research needs to consider health system and nurse workforce contexts and take a regional perspective on migration patterns.