Abstract: This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners.

Abstract: This pilot descriptive study examines and measures the characteristics of preceptors of new graduate registered nurses undertaking the Nurse Entry to Practice Programme in an acute hospital in New Zealand. Thirty-three new graduate registered nurses at the five month stage of the programme completed a questionnaire pertaining to the characteristics of their preceptors. The questionnaires were adapted from the Ferrans and Powers (1998) Quality of Life Questionnaire. The adapted questionnaires were designed to measure the importance, satisfaction and overall quality of the preceptor's characteristics as perceived by the new graduate registered nurse, using a Likert Scale. Literature both international and national was examined to gain an understanding of the importance of the characteristics in question, in relation to the new graduate registered nurse preceptee experience. Descriptive data revealed the importance of characteristics as perceived by the new graduate nurse preceptee, and how satisfied the new graduate nurse was with their particular preceptor's characteristics. The results identified that the majority of new graduates were satisfied with the characteristics of their preceptor but there was evidence of negative discrepancies between the mean importance and satisfaction scores. The range of data between the scores of the overall quality of the preceptor uncovered areas where the quality of preceptorship was unsatisfactory as perceived by the new graduate nurse. The discrepancies in the data were examined and recommendations made for additional research, regarding selection and evaluation of preceptors of the new graduate registered nurse within the hospital environment.

Abstract: This paper presents the findings from research that investigated the feasibility of developing a specialty return to mental health nursing programme in New Zealand. This was achieved through a scoping of existing return to nursing programmes; a survey of non-active nurses; and stakeholder consultation via interviews or focus groups. Existing generic programmes fail to attract non-active nurses wishing to focus on mental health nursing. The non-active nurses survey found 142 nurses who presently would or might possibly return to mental health nursing and participate in a programme. Most stakeholders supported the idea of implementing such a programme. The findings from this research indicate both feasibility and enthusiasm for the introduction of return to mental health nursing programmes. It is recommended that all aspects of this course mirror the service user focused 'recovery paradigm' that is a central tenet in contemporary mental health service delivery.

Abstract: This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being.

Abstract: This descriptive case study was undertaken to provide an account of chemotherapy practice in a nurse-led clinic located within a rural New Zealand area. The researcher, an oncology nurse specialist, worked alongside colleagues for thirteen months to enable practice development. This clinic developed out of a need to have services closer to rural patients in order to address issues of equity, access, care integration and the fiscal and social constraints associated with the cancer burden of care. Capturing the range of data applicable to this case; the ability to conceptualise it as a service within its context was possible using case study research methods. Four nurses involved in the chemotherapy clinic were participants in this study. The findings of this study reveal that what could be perceived as barriers to outcomes and practice can in essence be turned into opportunities to develop new ways of caring for the patient and supporting nursing practice. These nurses view their practice as safe within the clinic despite resource constraints. They work in many ways to support each other and to cushion the patient from the impact of situational and contextual influences. Nursing practice was shown to evolve as a direct result of internal and external influences which were the impetus for nurses taking responsibility for their own competency. This study also explored what it meant to be an experienced nurse but novice in a speciality practice. It challenges previously held assumptions that, to deliver chemotherapy successfully, a nurse needs to be operating from a previously held body of oncology nursing knowledge. Many challenges are faced on a day to day basis in a rural practice environment to just maintain consistent care and promote good patient outcomes. The nurses are well aware of their role in contributing to patients' quality of life and the roles they take to meet the growing needs of the patient as a consumer. This study delves into the multifarious nature of this nurse-led clinic and discusses the processes and relationships that are forged to deliver care.

Abstract: This chapter reviews some effects of the growth of tourism, including adventure tourism and the numbers of tourists over 50, on rural nursing practice. Tourism contributes to socio-cultural change within a community, and health resources that previously met the needs of the local community may not meet the expectations of growing numbers of tourists. The transient visitor includes both the tourist and the seasonal worker, and has become a feature of rural nursing. Major effects on rural nurses include the increased volume of work, the advanced scope of practice required to meet more complex needs of visitors, and challenges to personal and professional safety.

Abstract: This chapter focuses type 2 diabetes as it relates to one rural Maori community within New Zealand. It provides an in-depth discussion relating to diabetes including the burden of diabetes in New Zealand and evidence for prevention which is played out in an increasing obesogenic environment. The process and findings of a research project to 'map out' the food environment within the Southern Lakes District are reported. Purposive sampling was used to survey 124 food outlets in the area, and findings confirmed the existence of an obesogenic environment for Maori. Such an environment is characterised by an abundance of cheap, energy dense foods, and pricing gradients that favour consumption of such foods.