Abstract: This thesis presents a study of a nursing 'practicum' from the perspectives of nursing students and staff 'buddies'. A grounded theory approach was used to interview six nursing students during their transition placement, the final practicum of their Diploma in Nursing programme. Five staff nurse buddies selected by the students were also interviewed. An informal, conversational interview was used and data was analysed from an experiential learning perspective.This study differs from others because it focuses on the clinical experience component of nursing education, 'practicum', and includess practitioners viewpoints. At present there is a re-evaluing of experience within nursing education with a new emphasis on practice-based learning. Experience-based learning is becoming increasingly acceptable within academia as a 'seamless' education system evolves.I identified three learning stages which students' experience during practicum – initiation, exploration and consolidation. The key stage for learning through experience was exploration. Learning during this stage was predominantly buddy-directed which contradicted the self-directed curriculum design. Students and staff nurses however agreed that communication between them during this stage enabled the development of 'competence'.The learning /teaching approach used by the students and staff nurses made it difficult for students to translate their 'all-round' competencies during practicum. It is argued that it is the useof such competencies during practicum which enable nursing students to become autonomous in the attitudinal and epistemological sense. The predominantly 'technical training' approach adopted was understood by students and staff nurses to be reinforced by 'silence' from tutors.Restructuring gives the opportunity for nursing to develop an ';investigative', enquiry-based approach in practice. There will increasingly be an emphasis on practice-based research as a result of the implementation of degree and post-graduate programmes in nursing. This study highlights some aspects of nursing education and it's relationship with practice which can assist the development of such an approach

Abstract: This thesis is about caring for males, especially those males who could be considered “difficult” to care for through their use of behaviours such as silence, anger or defensive humour. This thesis is positioned in the view that these behaviours are often expressions of distress, which typically distance males from those who attempt to care for them. The author suggests that the word “distress” more accurately reflects the theme of the thesis, and it is used throughout the work. This thesis explores the interface between gender issues, nursing practice and caring for males. It is informed by a review of relevant literature and data gathered from a focus group of nine registered nurses. The analysis is framed by questions that are developed from a series of reflections on my personal and professional life. Critical social theory, with its emphases on dominant dialogue, power and emancipation is used to inform and guide this analysis. What is most obvious is the contrast between themes arising from the literature and those arising from the focus group. It appears that the literature, in the main, is critical of males in regard to concepts of masculinity, issues related to gender, and men's health. Males are portrayed as arbitrators of their own misfortune, as deliberately choosing a lifestyle that reflects poorly on their health, their self-expression, and communication with others. Concepts such as power and control over others, both at a societal and individual level, often feature. Conversely, the literature is noticeably lacking in regard to information about the health related experiences of males and about caring for males. In contrast, the participants of the focus group frame their discussion in the positive. For example, they suggest that males are interested in their health but require an environment that supports this expression of interest. They support this by identifying a range of behaviours they believe are effective in caring for males. The participants also suggest that it is the registered nurse rather than the male who manages issues to do with power and control. The thesis concludes that creating and sustaining an environment supportive of, and sensitive to the needs of males, is an activity that requires considerable thought, skill and experience. These areas are not adequately addressed in academic dialogue, research activity, or in the education of registered nurses. The thesis suggests that this situation is inconsistent with an ethic of care and that nursing should make a priority of broadening its research and knowledge base to better understand and care for males.

Abstract: This thesis discusses the findings of a research study, informed by the work of van Manen (1997b), which explored the lived experiences of five mental health nurses who have had a patient die through suicide. Narrative was used as a method in interviews to uncover the essence of their lived experiences. Five interwoven themes uncovered in each of the interviews were: impact, support, feelings, closure and paradox. All of the nurses interviewed experienced a wide range of feelings about their patient's suicides, ranging from shock to guilt, to anger and sadness, and described their patient's suicide as having a significant impact on them. Support received by the nurses following their patient's suicide was variable, and they were often in the difficult position of trying to offer support to the patient's family. Common to all of the nurses was the lack of closure following the suicide. Paradox was found to be the overall essence of the experience of the mental health nurses interviewed. Three main paradoxical themes or statements were identified that are in many respects a summary of all of the themes that emerged. These were: unavoidable – responsible; inevitable – unprepared; duty of care – respect for patient's decision to end their life. The author suggests that the ability of the nurses interviewed to accept and reconcile the paradoxical issues that arise in relation to patient suicide, and accept the lack of closure they experience, is a fundamental element in their ability to continue to work in the mental health setting, despite the significant impact their patient's suicide has had on them. Four recommendations are made based on the insights gained from this research. These are: that every mental health service should have a suicide response policy; that undergraduate nursing education includes the impact of patient suicide; the development of policies which promote dialogue about suicide within the community; and the need for further research in this topic.

Abstract: This study was undertaken to ascertain the opinions of nursing students at Wellington Polytechnic (now Massey University Campus of Wellington) about their current uniform worn on clinical placements. As the NZNO National Student Unit representative at Wellington Polytechnic, it was brought to my attention by my fellow students that the current uniform was not particularly functional. As a result of these comments I concluded the best way for students to voice their opinions further was to circulate a survey. The survey questioned the students about the current uniform and what they thought the future uniform might be. The survey was available for collection by students for a two week period in July 1998. Participation was voluntary and anonymous. It was approved by the Research and Ethics Committee, School of Nursing, Health and Environmental Sciences, Wellington Polytechnic. The results were that sixty percent of students supported a change in the current uniform. Most students chose a tunic top as their preferred option. If there was to be a change, students would be prepared to spend $20-49. Consequently permission has been granted by the Head of Department – School of Nursing to investigate a change to a tunic style top. The item will be trialed by those who wish to purchase it in 1999. I believe that it is of utmost importance that student satisfaction with their clinical uniform is assessed at regular intervals to ensure that the students take a pride in their presentation and the uniform serves the purpose for which it is intended

Abstract: This study was conducted to investigate the practise of Nurses when working with depressed patients in an In Care setting. A survey of the literature shows that the role commonly prescribed for nurses who work in psychiatric settings is one that emphasises a one- on -one relationship based on models of psychotherapy and focuses on individual illness, pathology, systems and psycho dynamics. It is suggested that this is not a role which most Nurses working in New Zealand psychiatric settings would be able to implement in practise. Three perspective's of Nursing practise were explored in the study. What Nurses were seen to do in practice. What they thought they should do as evidenced in results of an exercise to rank different possible interventions, and what patients said were helpful Nursing interventions. A framework was developed for the study which depicts the process of helplessness(depression) as the negative 'mirror -image' of the process of self care. Results were analysed within this framework to determine whether or not Nurses tended to support behaviours which were indicative of movement towards helplessness or encourage those which indicated progress towards self care by their interventions. There was little evidence of positive reinforcement for independent or coping behaviours with patients in the study sample. Further, the nursing practise showed little relationship to the role prescribed in the literature. The Nurses did demonstrate a warm caring friendly approach that seemed to stem from a more traditional 'succouring, mothering' view of Nurses' role

Abstract: This study sought to examine whether practice nurses were prepared to provide exercise prescriptions to clients. It involved administering questionnaires to 53 practice nurses in Otago to examine their understanding of green prescriptions and their knowledge and participation in exercise prescription.

Abstract: This study sought to determine the attitudes, beliefs and values towards clinical work organisation of students entering undergraduate medicine, nursing and pharmacy programmes in order to frame questions for a wider study. University of Auckland students entering medicine, nursing and pharmacy programmes completed a questionnaire based on that used by Degeling et al. in studies of the professional subcultures working in the health system in Australia, New Zealand, England and elsewhere. Findings indicate that before students commence their education and training medical, nursing and pharmacy students as groups or sub-cultures differ in how they believe clinical work should be organised. Medical students believe that clinical work should be the responsibility of individuals in contrast to nursing students who have a collective view and believe that work should be systemised. Pharmacy students are at a mid-point in this continuum. There are many challenges for undergraduate programmes preparing graduates for modern healthcare practice where the emphasis is on systemised work and team based approaches. These include issues of professional socialisation which begins before students enter programmes, selection of students, attitudinal shifts and interprofessional education.