Abstract: In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing.

Abstract: In November 2005, the Oxford Community Health Centre (OCHC) introduced an innovative way of delivering primary health care to the residents of Oxford. This was in response to the difficulty with recruitment and retention of medical staff for the solo General Practitioner (GP) at OCHC. Primary health care services are now the shared responsibility of the Rural Nurse Specialists (RNS) and the GPs. This initiative is underpinned by a collaborative approach in sharing patient care between the GPs and RNSs to improve access to primary health care and foster staff retention. The team at OCHC is keen to consolidate and enhance the success of collaboration. Therefore, this dissertation has reviewed a range of literature in order to identify lessons that can be learned for the future. Two key factors that have implications for OCHC are the structural effects of the organisation and the interpersonal relationships between the GPs and RNSs. The structural effects include: the structure and philosophy at OCHC, and the social, cultural, and educational influences within the organisation. It is the nature of the interpersonal relationships that can affect the development and success of collaboration through a willingness to collaborate and the existence of mutual respect, trust, and effective communication between the RNSs and GPs. Strategies to foster collaboration at OCHC in the future include: staff participation in making collaboration visible within the philosophy at OCHC, a workshop for staff to further define roles and differentiate activities according to skill-mix; and the involvement of a nurse in decision-making at the organisational level. The author suggests that these strategies could also be beneficial to other rural practices that are striving to maintain a sustainable primary health care service.

Abstract: In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare.

Abstract: In this article four theories of adult learning theory are presented: self directed learning; experiential learning; constructivist theory; and critical thinking. These are discussed alongside theories about motivation to learn. Suggestions for how the theory may be applied to the clinical learning environment are offered.

Abstract: In this article the authors introduce an alternative way that nurses can be with families, using a relational process that can enhance nurses' responses when working with those transitioning to parenthood. Seasons of Life, a framework adapted from the Maori health model He Korowai Oranga, emerged from practice to offer a compassionate and encouraging stance, while at the same time respecting each family's realities and wishes. The model allows the exploration of the transition to parenthood within a wellness model, and takes a strengths-based approach to emotional distress. This approach provides a sense of “normality”, rather than of pathology, for the emotions experienced by new parents. The specific issues men may face are discussed, where despite recent culture change that allows men a more nurturing parental role, there is still no clear understanding of how men articulate their sense of pleasure or distress at this time. Practitioners are encouraged to examine their own assumptions, values and beliefs, and utilise tools such as reflective listening, respect, insight and understanding. The most significant aspect of relationship between nurse and parents is not the outcome, but how nurses engage with families. Examples from practice will demonstrate some of the differing ways this relational process framework has been effective.

Abstract: In this article, the author integrates literature pertaining to the implementation of kawa whakaruruhau, or cultural safety, with the findings of a hermeneutic project that described the experience of nursing people from cultures other than one's own. It is argued that the Gadamerian notions of “horizon,” “prejudice,” and “play” can be used to facilitate understanding of the tensions and contradictions inherent in cross-cultural practice. Strategies are recommended that enable students to explore the prejudices, paradoxes, and possibilities experienced personally and professionally.

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.