Abstract: A pilot study to determine the effectiveness of the assessment tool as a data collection device was crucial to the effectiveness of the major study. The pilot sample consisted of 10 patients who participated in the assessment phase of the Nursing process. Patients complied with therapeutic objectives to control urinary incontinence when they participated in the assessment phase and when 24 hour Nursing support is available. The removal of this support ( within the Hospital environment) may be integral to long term compliance

Abstract: A nurses working party was formed by the primary health care SSDG in 1979 to investigate the feasibility of integrated community based nursing services. A six month trial was held in a mainly urban area (population 5637) testing these ideas in 1980. Using the existing time of the four nursing services in the area a team approach was used with all nurses being responsible to a coordinating nurse. The present role of the public nurse and district nurse was integrated – this new nurse was called a community health nurse. These two nurses worked from a base located in te trial area. Liaison and coordination were established with the Plunket and practice nurse. The results of the trial enabled the primary health care SSDG to prepare a plan on community based nursing services

Abstract: The suitability of human breast milk for the nurturing and development of the human species is proven over hundreds of thousands of years. Human milk is without peer in containing all the nutrients required for the growth and development of the human infant.Over and above the nutrient factors, human milk has significant immunological, anti-infective, and anti-allergy properties that should be foremost in deliberations of neonatal nurses and doctors, before one considers calorie counts and weight gain. Lucas and Cole ( 1990) have shown the terrible consequences of using formula in preterm babies over those fed only human milk, The NZ Cot Death Studies' first year results have shown the significance of breast feeding in reducing the incidence of cot death., giving an oblique reference to the effects of neonatal staff attitude on mothers milk of at risk babies.A ready supply of human breast milk used to be available to neonatal staff from the milk bank. All but a very few of these banks were closed down all over the world due to AIDS phobia rather than by any scientific fact. Sufficient time has gone by for science and nationality to govern the use of human breast milk, and a case is made for the reopening of the Milk Banks

Abstract: This study presents information, obtained from health service managers, on the present use and possible future use of second level nurses within the region encompassing the Wanganui, Rangitikei, Manawatu, Tararua, Palmerston North City and Horowhenua districts. “ Second level nurses” are currently known as enrolled nurses and, in accordance with Section 53A of the 1983 Amendment to the Nurses Act, are required to work under the direction and supervision of registered nurses or medical practitioners. Enrolled nurses are usually allocated less responsibility for nursing assessment and judgement than registered nurses.Management perspectives, from seventy seven health workforce managers, were sought in relation to the future workforce need, the scope and boundaries of practice, and the alternatives for the future educational preparation of second level nurses. Seventy two percent of managers said that they thought enrolled nurses were essential to New Zealand's future nursing workforce. They predicted increased opportunities for enrolled nurses in care of the elderly and community care settings. Patterns in the current workforce utilization of enrolled nurses, however, did not support these views.In relation to the education of enrolled nurses, managers indicated that hospital-based training was the most preferred option. However, managers asserted that, in view of the current lack of employment opportunities no more enrolled nurses should be prepared at the present time.Although questions about education were focussed on the educational preparation of enrolled nurses, many of the respondent managers also expressed opinions about the educational preparation of comprehensive nurses. As a result, an evaluation of comprehensive nursing programmes is suggested.While the numbers of second level nurses being prepared and used is decreasing, there is a concomitant increase in the preparation and use of caregivers. This rapidly increasing group isfast becoming a “cheaper” second level workforce. The increase in the use of caregivers is seen to result from the pressure on healthcare employers to reduce spending within the current highly competitive, de-regulated economy. Managers asserted that enrolled nurses are not cost effective in comparison with either caregivers or registered nurses.The study concludes with thirteen recommendations which are made under the following four groups;1. Manawatu Polytechnic – provider of nursing education.2. Healthcare employers – users of nursing education.3. Enrolled nurses – participants in nursing education.4. Professional nursing bodies – guardians of nursing education

Abstract: The author takes a multidisciplinary approach to examine how the location and concept rural is defined and provides a critique of the disparate definitions available. Definitions encompass different disciplines such as sociology and anthropology, and there are national distinctions based on historical factors. The chapter also investigates the way researchers speak about rural people, particularly as the human aspect of health is a primary concern to nursing. The focus is on the socio-cultural, occupational, ecological, and health aspects of rurality. The Rural Framework Wheel is introduced, which is a method to categorise rural contextual definitions. Rurality is presented as a variable and evolving concept that provides particular challenges to nursing practice.

Abstract: This is the first of three chapters that describe nursing practice. The author presents the Rural Framework Wheel to elaborate aspects of the rural context. The Framework comprises four systems which describe aspects of rurality; being are socio-cultural, occupational, ecological, and health. These systems each comprise of subsystems, which provide a detailed analysis of the way nursing practice is particular in diverse rural settings. The Framework is presented as a work in progress, and is grounded in international nursing literature. It highlights rural nursing as a unique and challenging field, with the dominant themes of partnership and nursing emerging as underpinning the practice when nurses live and work in small, sometimes isolated communities.

Abstract: This chapter firstly presents the development of a mobile operating theatre project, which was implemented in 2002 to provide rural day-stay surgery. Secondly, it discusses the process and findings of a research project undertaken with the purpose of evaluating a perioperative (theatre and recovery) reskilling programme offered to 42 rural nurses from nine secondary hospitals, conducted over nine months in 2001. The training was given to nurses prior to the introduction of a mobile operating theatre service, and was seen as a key part of the service contract.

Abstract: This chapter firstly offers background information relating to the management and guidance of resuscitation within secondary rural hospitals. Secondly, it discusses the evidence related to issues concerning resuscitation and not-for-resuscitation, including issues involving medical and nursing staff, the patient experience, appropriate documentation, and cultural factors. Thirdly, it presents the findings through an implementation and evaluation plan.