Abstract: The research on which this thesis is based involves both a private narrative and a public narrative, with the story of cultural safety, and the history, theory and the future direction gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced cultural safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety Theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of cultural safety is undertaken. The role and application of the Treaty of Waitangi to the theory of cultural safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of cultural safety into the nursing education system and its implementation. The public and media reaction to the inclusion of cultural safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of cultural safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The author notes that the story of cultural safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, she points out that, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients.

Abstract: The researchers assessed the compliance rates with the rheumatic fever secondary prophylaxis programme established through the Auckland Rheumatic Fever Register and managed by community nursing services in Auckland. They undertook an audit of the 1998 and 2000 Auckland Rheumatic Fever Register data to establish the compliance rates of patients with the rheumatic fever secondary prophylaxis programme. The sample included all patients on the Auckland Rheumatic Fever Register during this time. Results showed compliance rates across the three Auckland DHBs ranging from 79.9% to 100% for individual community nursing offices. They found that a community-based nurse-led secondary prophylaxis programme for rheumatic fever heart disease is able to deliver excellent patient compliance levels. Secondary prophylaxis is the WHO-recommended cost effective first step to rheumatic fever/rheumatic heart disease control. Community health workers have a key role to play in facilitating this compliance.

Abstract: The researchers evaluate and compare the organisation of general practice in the UK and New Zealand. A key aim of the Primary Health Care Strategy is a reduction in health inequalities. Locally, some nurse leaders suggest that changing nurse practice employment from general practitioners to Primary Health Organisations will achieve this aim. The authors take lessons from the UK and suggest that nurses organising themselves into peer groups, remuneration of general practices for the attainment of positive patient outcomes, and a statutory duty of clinical governance, all contributed to the development of practice nurses' roles and expansion of numbers of nurse practitioners in general practice. Nurses have become partners with general practitioners in general practice in the UK, which the authors suggest is a much preferable alternative for some than employment by a Primary Health Organisation.

Abstract: The researchers present a survey of a sample population of 32 advanced practice nurses (APN) in the US about their experiences of acquiring and implementing prescriptive authority. The issues relevant to nurse practitioners in New Zealand are discussed, around acquiring knowledge and education, relationships with other professionals, establishing the role, and retaining the nursing role. The intent and scope of APN prescribing in the US is also discussed.

Abstract: The Ringa Atawhai Model is based on the principles of Whanau and partnership and founded on the Ottawa Charter and Treaty of Waitangi documents. The research looks at the work carried out by Ringa Atawhai members with both individuals and groups throughout Northland

Abstract: The second, biennial survey of NZNO members based on the RCN longitudinal survey. A snapshot of the employment, views and morale of the New Zealand Nursing workforce.
Comparisons with the 2009 survey show an increase in job insecurity, experience of restructuring, and continuing differences in wages and turnover in the different sectors of the workforce.
The Enrolled Nurse membership in particular is in the midst of change, opportunity and disquiet. While the profession continues to be in good heart, there are some concerns about loss of senior nursing positions, and lack of suitable posts for new graduates.

Abstract: The study explored the basis of the relatively low uptake of cervical screening and practice of breast self-examination among New Zealand women. Consistent with an interpretive approach to social phenomena it was anticipated that part of the explanation would lie in the meanings which women attach in general and to these specific health-protection practices.Theoretical sampling was effected by semi-structured interviews with 45 women. Transcripts of these interviews provided the substance data which were then analysed by the process of constant comparative analysis and other grounded theory strategies for analysis.The concept of a health-protective paradox centered around the core-variable 'vigilance-harmonizing which was generated to reconcile the seeming inconsistencies within, and between, individual women and their health practices. This conceptualisation was developed from the substantive date in order to provide a model designed to increase the effectiveness of nursing interventions for this area. The model, by illuminating processes from the client's perspective then can indicate those processes most suitable for incorporation in effective health education measures designed to promote the uptake of cervical screening and breast self-examination by women.As an adjunct to the study, a breast cancer case history is presented which shows the theory-in-use. The use of this case-history lies in the fact that it shares the substantive area of inquiry which serves to accentuate the viability, relevance and applicability of the grounded theory

Abstract: The study outlined here explored outcomes from the provision of primary health care to children aged 5-13 years in a nurse-led clinic based in a primary school in Auckland. This multi-faceted study collected both qualitative and quantitative data, however it is the results of the quantitative arm of the study that are presented here. Data were collected from a variety of sources concerning conditions seen, age and ethnicity of users, types of services provided and impact on hospital usage. Findings demonstrate that the provision of comprehensive primary health care by the nurse at the clinic impacts positively on hospital visitation by children from the area where the clinic is located.