Abstract: The study reconceptualises the process of nursing practice where health is expanding consciousness. The praxis methodology and design derive from the findings of the previous study (Litchfield, 1993) through which a framework for personal practice was articulated. The philosophical premises were hermeneutic and dialogic reflecting a narrative orientation within a participatory paradigm. Ontology and epistemology merge and language is fundamental. The findings from this subsequent study depict the process of modeling practice as a tetrahedron to show inter-relatedness of four facets, each defined completely by the others: partnership, dialogue, pattern recognition and health as dialectic. Five young families with complex health circumstances were preferred by Plunket Nurses and visited at hole to talk about health and the family. Th e process of health patterning ended with indication of insight as the potential for action; the partnership ended as the closure of the initial contract to provide a summary text to the family. Transformative change in family living was identified. The continuous analysis of the scripts of the evolving conversations and summary text showed the relational, dialogic processes were identified as vision – finding purpose to act in the here-and-now against the backdrop of past and potential of the future; and community – a sense of being connected, participant and relevant in society. This process of research, as if practice, presented health and caring as synonymous and core of the discipline of nursing

Abstract: The study was undertaken as a project for the International Year of the Child. There was a need for information to identify what health care in needed in schools and to contribute to a review of the role of the nurses. Teachers and principals of all primary schools of the Wellington area were surveyed to describe the health care being provided and needed. Recommendations were made for school nurses who would support the health-related teaching by teachers, provide first aid and advice, and take an extended role for family health operating from a clinic in the school.

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: The transition of patients from intensive care to the ward environment is a regular occurrence in intensive care. Today patients are often transferred earlier and sicker due to the demands for intensive care beds. This results in patients with higher acuity being cared for in the wards. Here ward nurses have to meet the ongoing complex demands of caring for higher acuity patients, alongside managing high patient-to-nurse ratios, staffing concerns, and varying levels of experienced nurses. This research explored the experiences of ward nurses receiving patients transferred from intensive care. The aims were to identify any areas of concern, highlight specific problems that occur on transition and to address what information is pertinent to ward nurses when receiving patients from intensive care. A qualitative descriptive methodology using focus groups was utilised to gather information about these experiences. Three focus groups were held with ward nurses from various wards within the study setting hospital. All participants had considerable contact with intensive care and were familiar with the processes of transferring patients. Five themes emerged from the focus groups – Patients as intensive care staff say they are; Time to prepare the biggest thing; Documentation as a continuation of patient care; They forget what its like; and Families, a need to know about them. The theme Patients as intensive care staff say they are relates to reliable information sharing focused on the patient, their needs and condition. Participants expressed their concern that patients were not always in the condition that the intensive care staff stated they were on the referral. Having adequate time to prepare was considered important for the majority of ward nurses receiving patients from intensive care. Documentation was highlighted in the theme Documentation as a continuation of patient care particularly in relation to fluid balances and vital sign history. The theme They forget what its like suggests there is a perception that intensive care nurses have a lack of understanding of what the ward staff can actually manage. Decreased staffing levels during certain shift patterns and a lack of appropriately experienced staff on the wards is a common concern for ward nurses. Ward nurses also recognised that caring for families was part of their role. Patients and families may respond differently to the transfer process and their inclusion in transfer planning was seen as essential. Communication was a reoccurring element throughout all themes.The author concludes that communication is the paramount factor that impacts on a 'smooth transition' for ward nurses. A 'smooth transition' refers to the transfer of patients from intensive care to the next level of care. Subsequently, nurses' perceptions need to change, whereby transfer planning from ICU should be the focus rather than discharge planning. Transfer planning and education for all nursing staff is vital if the transfer process is to be improved. Consequently, transitional care within the context of ICU aims to ensure minimal disruption and optimal continuity of care for the patient. The knowledge gained from this research may provide better understanding of the multifaceted issues linked with transitional care that may be adapted for a wider range of patients in various clinical environments.

Abstract: The use of massage by nurses is a popular activity in many fields of nursing practice. The last ten to fifteen years have seen a rising popularity in the literature. Whilst the literature within nursing is plentiful it often does not present the empirical evidence necessary to support nursing actions. The objective of this analysis is to present the extant literature discussing soft tissue massage from a Western health perspective. Massage has first been contextualised as an ancient as well as modern healing activity. There is evidence of early modern medical interest in the therapeutic benefits of massage for a number of ailments. From this contextual perspective it is then possible to track the evolution of modern complementary health practices since 1980, and the professional and practical issues surrounding their use. Against the backdrop of twenty-first century health care there is increased evidence of the importance of maintaining the human aspect of caring, and massage is seen as an ideal way to provide this. The author argues that the discipline of modern nursing must increase its awareness of the empirical evidence around the use of massage, to provide safe and effective nursing care. This physiological and psychological evidence is presented and critiqued, based on the principles of evidence-based practice. This critique has enabled some sound research-based practical statements on the effects of massage to be made. These statements will enhance the practice of massage within a nursing context. The final part of the journey has been to explore the actual practice of massage within nursing, including the current use of massage by a sample of New Zealand nurses. The educational opportunities have also been presented, alongside some main professional issues. Massage can now be viewed as a legitimate nursing tool that has value in a range of nursing settings by enhancing the quality of patient care. The techniques are easy to learn, simple to perform and do not add undue workload to nurses. The author notes that there is a considerable amount of literature to support this, but the quest for further knowledge cannot be ignored.

Abstract: The well known premise that 'healthy children grow into healthy adults' should reinforce the need for us to engage with parents and caregivers to ensure that we support them with meeting their child's health care needs. This scholarship enabled the author to see what the UK, Sweden, the US, and Canada were doing to strengthen and support children under five and their families across the continuum of care. Part of the Margaret May Blackwell Scholarship Reports series.

Abstract: There are a number of factors recognised as significant for nursing staff retention. These include, a lack of organisational care, bullying (commonly referred to as horizontal violence), and high workload acuity. However, there does not appear to be any indication that these factors influence the retention of nurses within the speciality of acute perioperative nursing. A descriptive study using postpositivist methodology and triangulation of methods was designed to answer the question: What are the critical factors that influence staff retention in an acute perioperative environment? Forty-eight perioperative nurses answered a questionnaire in relation to individual needs, provision of nursing care and administration and management. Four nurses subsequently participated in a focus group interview that explored in more depth, the survey data related to the following characteristics: Educational opportunities; Level of workload acuity; Rostering flexibility; Management; Established policies/Quality assurance; Graduate orientation programs and Professional relationships in an acute perioperative setting. Data analysis revealed that > 90% of respondents agreed that these characteristics are important for job satisfaction and influence staff retention in an acute perioperative environment. A sense of belonging appears to be the most important theme that emerged from the qualitative data. Job satisfaction and staff retention are attained when nurses have a sense of belonging in the workplace. To achieve this nurses need to identify barriers, develop their communication and leadership skills and determine the ideal professional practice model. The author suggests that the themes “Finding time” and increased “sick leave”, in relation to workload acuity are new findings that provide a platform for future research.

Abstract: There has been considerable public debate on the range of complementary health practices throughout the western world, perhaps especially in Australia, United States and Europe. Most often, the research critique of these practices is restricted to quantitative or non-user qualitative research methodologies. Consequently, there is a significant gap in the research profile of complementary health services that need to be addressed particularly in view of the rapid and ongoing increase in the use of complementary services, even in the face of sometimes adverse media publicity. This paper demonstrates the contribution that phenomenologically-based research can make to fill this lacuna by explicating, in detail, the client experience of a complementary health practice. The paper explores patient experience of a ginger compress, as applied by anthroposophically trained nurses, to demonstrate various therapeutic effects. Four key themes emerged including an increase in warmth and internal activity in the major organs of the body, changes in thought-life and sensory perception along with a greater sense of well-being and self-focus with the perception of clearer personal boundaries. These themes, emerging from a patient sample in New Zealand, compared favourably to the Filderklinik Study completed in 1992 in a large German state hospital.