Abstract: This inquiry is an in-depth exploration of one middle aged woman's experience of strife in chronic illness and her nursing care involving four nurses (including the author) in a community context over a three-year period. The study is praxiological in that the understanding achieved is derived from practice within a 'research as praxis' methodology positioned in the disciplinary perspective of nursing as a practical human science. Five methodological premises inform the research processes: reflexivity, dialogue, moral comportment, re-presentation in narrative and critique. They emanate from an eclectic ontological praxiology based on the research framework constructed from Gadamerian philosophical hermeneutics, components of other philosophical praxiologies evolved from an exploration of the practical discourse in philosophy and my preferred health and nursing assumptions. The research processes include researcher journalling, a summary of Sarah's nursing record and dialogical meetings with Sarah and the nurse co-participants. Using the research material a narrative is then co-constructed. The narrative is structured around what Sarah viewed as the overall nursing contribution to her care; the 'sharing of her burden of illness'. This, she maintained, enabled her to live safely in the community. Finally there occurs a critique of the narrative within a discursive framework. Three themes, embedded in particular discourses, emerged from the narrative both in Sarah's and the nurses' experience; paradox, moral meaning and metaphor. Sarah's experience is interpreted as taking place in the 'in-between space' of the disease and health-illness discourses. Two main concepts which depict the tension experienced in this space are the 'the ontological assault of illness' and 'entrapment in the disease discourse'. The nurses, in this instance, 'pushed the boundaries' to create a space for the nursing as a caring practice discourse on the margins of nursing as a functional service discourse. The author notes that, within the nursing as a caring practice space, many 'fine lines' were walked with Sarah. Walking the 'fine line' of an 'intense relationship' was seen as advanced nursing practice. The research highlights important implications for a person and/or families who live with chronic illness and practice and educational issues for advanced nurse practitioners. Further, it promotes praxiological methodologies as advantageous for expanding nursing knowledge.

Abstract: This is an oral herstory of two West Coast Women in conversation with a contemporary, and all are nurses. The conversations are presented as whole patterns which are quilted together to form a story within a story. I have woven in my story, with the commonality of being a nurse and having lived on the West Coast for five years.Until the 1960s, women on the West Coast had had very little written about their lives and the nursing records on the Coast were very limited, even in the 1990s. The women in this study conveyed the childhood memories and the nursing days, as they reflected on a training that was strictly disciplined, hierarchical in a hospital based apprentice system.The opportunity to do this project has enabled me to explore some of the aspects of the lives of women on the West Coast, particularly through the eyes of two wonderful women. Their contribution has been particularly valuable, in that they were able to convey how it was for them as children, and also the experiences of their mother and other women. Both were nurses who trained at Grey River Hospital between 1933 and 1946, and they were able to recall their nursing days on the Coast and make a contribution to West Coast history.It has enabled me to rediscover my own nursing story and to gain insight into the conversations that will inspire my nursing, and enable me to hand on stories to other nurses. This thesis will also be of interest to nurses of the future, reflecting on the past and experiencing how it was then

Abstract: This literature review is an exploration of nurse case management and it will provide the background for the introduction of a nursing case management model in the acute surgical environment at Western Bay Health. Case management is a collaborative process which assesses, plans, implements, co-ordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost-effective outcomes (Newell, 1996:.3). In undertaking this review it was the author's intention to include the findings as background to a business case seeking the introduction of a surgical nurse case management model within the surgical service.

Abstract: This paper documents a practice development initiative with the aim of formulating a rationale for the professional practice development of a relatively recently conceived nursing initiative; that of a Palliative Care Liaison Nurse (PCLN) role. The project involved conducting an inquiry through a search of the literature with the aim of discovering ways to articulate, then develop, the role to meet the needs of elderly people living in Residential Aged Care Facilities (RACFs), their family and the whanau. The paper initially explores the concept of liaison roles globally, to consider how this role might be located as an interagency position between palliative care and aged care within the context of Aotearoa/New Zealand. The paper then reveals the perceived skills and personal attributes required by a person in the PCLN role that the author, drawing from personal and professional experience of having been appointed to this position, considers are necessary to effectively manage the diverse dimensions of this role. Bridging the gap is a key role discussed which centres on the capacity to organise and present an effective education programme while supporting, encouraging and role modeling for staff providing the day to day nursing care. This role involves practice wisdom and advocating for change and tolerance within everyday practice. An example of this dimension is discussed in depth, because the researcher considers that through staff working together, they can effectively bridge the knowledge-practice gap which exists between specialist palliative and gerontological nursing care.

Abstract: This paper explores the reaction of the author's colleagues when she returned to work disabled after recovering from an injury. In order to understand the new experience of disability and discrimination and to help answer what changed the behaviour of colleagues, the author considered evidence from the published literature. After considering many different models of disability, the social model of disability helped clarify and frame her own experience. Reflecting on this literature and personal experience, she suggests that there is acknowledgement that society's attitudes are changing slowly through governmental action and the activism of the disabled. However, she goes on to say, it is only through progressing education, experiencing disability, and continuing emancipatory research that progress will be made to release people with disabilities from their bonds of prejudice and oppression.

Abstract: This paper is a literature review of the psychogeriatric specialty and describes the clinical role, practice and knowledge of the psychogeriatric nurse. Literature reviews provide a useful means for evaluating what is currently known and understood in a particular area of interest to help nurses' build current opinion into practice. Psychogeriatric nursing is a specialised field of practice that focuses on the mental health needs of people over the age of 65 (including younger people who have acquired needs that are similar in 'like' and age and 'interest'). The literature asserts the urgent need to develop the role and practice of the psychogeriatric nurse in order to address the complex needs of our ageing population in areas such as home care, hospitals, primary health, and long term care institutions. The findings highlight aspects of nursing care that are essential to the role and practice of the psychogeriatric nurse. Knowledge that is necessary for best practice in psychogeriatric nursing care is drawn mainly from the field of general psychiatry and gerontology but also from general medicine, psychology, neurology, and disability. Nurses' working with older adults affected by psychogeriatric conditions must possess a broad knowledge of physical and mental health issues that affect the elderly, including also knowledge and understanding of psychosocial risk factors that can also have an impact on the health and behaviour of older people and their carers. Despite these literal assertions however there appears to be a dearth of literature available to support the requirements for developing the psychogeriatric nursing specialty in clinical practice, research, and education. The author notes that authorities in this specialised field of practice generally agree that with an increasing aging population looming in the future more research in the field of “old age psychiatry” will be critical.

Abstract: This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration.