Abstract: Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities.

Abstract: In this article, the second of two, the literature is examined to determine the ability of problem-based learning to develop professional nursing practice. Professional practice depends on critical thinking for the development of both rational problem-solving skills and critical reflective thinking. This article proposes that problem-based learning has the potential to develop the critical thinking skills required for problem solving and decision-making. However problem-based learning is less likely to promote the critical reflective thinking without which the transformative practice needed to drive health gains in the 21st century is unlikely to emerge.

Abstract: For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes.

Abstract: Discontinuation of life support measures for an extremely low birthweight or very premature baby is controversial and difficult for both the parents and the healthcare professional involved in caring for the infant. This study seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Part 1 reviewed the literature on this subject. Part 2 reports the results of a survey carried out in a New Zealand NICU.

Abstract: Computerised technology has become a way of life. As nurse graduates enter a computer driven health care system we have a responsibility as nurse educators to ensure that they are computer familiar as borne out by the recent discussion papers released by the Nursing Council of New Zealand (2000a), which define the requirements for the practitioner of the future. Concurrently there is a call from the discipline of nursing for practitioners who have a form of knowledge that will bring about change within the socio-political context of the discipline as an outcome of critically reflective knowledge skills. Jurgen Habermas' (1971) treatise on knowledge and human interests, which offers a multi-paradigmatic approach to three forms of knowledge culminating in the emancipatory form provides a conceptual framework for many under-graduate pre-registration nursing curricular in Aotearoa-New Zealand. This thesis explores the author's ideas about contemporary undergraduate pre-registration nursing preparation in Aotearoa-New Zealand, associated knowledge outcomes, and the consequent links with contemporary computer-mediated communication (CMC) technologies. It positions a framework for integrating CMC technologies and the action of critically reflective practice as a learning journey. The framework is hypothetical and pragmatic. It emerges from the exploration of the thesis and is posited as a way toward integrating CMC technologies within extant undergraduate pre-registration nursing curricular in Aotearoa-New Zealand. The learning journey is comprised of three dimensions, learning-for-practice, learning-from-practice and learning-with-practice and draws on four different cyber constructs: being, knowing, relating and dialoguing. Knowing, relating and dialoguing are ontological positions taken in relation to being. The learning journey sustains some derivation from Habermasian (1971) based conceptual framework. There is a need for nurse educators to consider this in relation to contemporary CMC technologies. The author hope that this framework will serve those with an interest in nurse education and who are interested in a future using CMC technologies within the realities of nursing practice and education.

Abstract: Analysis of the research literature on prison nursing revealed a paucity of research, both in New Zealand and internationally. The aim of this research was to describe the working life of the nurse in a New Zealand prison and provide an understanding of and documentation on prison nursing in New Zealand. A qualitative descriptive study was undertaken to determine what it is like to nurse in a New Zealand prison. Ten nurses working at two public prisons and one private prison took part in the study. Data was collected by the use of semi-structured interviews and analysed thematically into four main themes. The participants' descriptions of their working lives as prison nurses expose the multifaceted nature of this work and the inherent relational dynamics. These dynamics determine the nurse's ability to practise effectively in the prison setting. Findings highlighted many paradoxical situations for nurses when working in this environment. The very aspects of the work that participants described as negative were also identified, in some instances, as challenging and satisfying.

Abstract: A thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy, The University of Massey.