Abstract: October 2003 marked the centenary of Wellington district nursing. Annie Holgate, a 'trained, professional' nurse, was employed to care for the sick poor in 1903. The Wellington St John Ambulance District Nursing Guild funded district nursing for over fifty years. The first president, Sarah Ann Rhodes, left a legacy of a solid financial and administrative base for the whole of the Guild's existence. From 1945 the Wellington Hospital Board assumed responsibility for district nursing and expanded the service to the greater Wellington region. In 1974 the Community Health Services were formed, with Pauline MacInnes as the nurse leader. Expansion of healthcare in the community ensued, with district nurses pivotal to client-centred, community-based, collaborative healthcare. This service was dismantled in the wake of health sector restructuring in 1989. The philosophy and operation of the Community Health Service of this period bears a striking resemblance to the current concept of Primary Health Care. Primary sources from Wellington St John, Kai Tiaki and data from official publications were used to compile this history. Emergent themes are the autonomy of district nurses' practice, the invisibility of district nursing and the impact of visionary leadership. All have implications for the future of district nursing. District nursing, initially dependent on philanthropy, has been publicly funded in New Zealand since 1944. District nursing is now an essential component of health care.

Abstract: Offers an understanding of how nursing discourse is embedded within legislation, regulatory bodies, and nursing practice and its direct impact on the health and well-being of Maori nurses. Argues that nursing discourse marginalises and undervalues tikanga. Explores the experiences of Maori registered nurses (RN) using a kaupapa Maori, mixed-method approach. Surveys over 300 Maori RNs about career and professional development, use of tikanga, cultural identity, and racism/discrimination at work.

Abstract: On September 3, 2010, the night nurses at Christchurch Hospital in New Zealand went to work unaware of the personal and professional challenges that were about to unfold in the following hours. This paper, derived from the results of a phenomenological research project, explores the issues that helped and hindered nurses during that night shift and in the three days following the 7.1 earthquake, which struck in the early morning of September 4, around 20km from the hospital. This narrative article allows the world to hear the voices of Christchurch nurses who were providing care in the first 24 hours and during the three days following that major seismic event.

Abstract: One proposed method for addressing concerns about a `theory-practice gap' in nurse education and perceived clinical shortcomings in beginning practitioners, is improved collaboration between education and practice. This paper is about a New Zealand nursing initiative to promote optimal learning outcomes for nursing students through supported hospital clinical experiences. It is implemented through a contractual partnership between Lakeland Health Limited in Rotorua, and Waiariki Institute of Technology. An associated “Clinical Nurse Educator Programme”, developed by lecturers at Waiariki's nursing school, prepares hospital nurses to be Clinical Nurse Educators. These “C.N.Es” replace and enhance the clinical role formerly provided by nursing lecturers, and short term contracted nurses. The programme is entering its fourth year with positive evaluations, and has extended into another hospital. Literature suggests that although educators are important, students may consider hospital nurses much more significant for their clinical learning and developing confidence 'in the real world'. These nurses are on hand, and generally have clinical credibility not afforded to academic staff. However, ward nurses, like contracted nurse teachers, have reported not having enough curriculum knowledge, nor teaching skills to optimise student learning. This C.N.E programme addresses these shortcomings through its selection of experienced nurses in current practice, and 50 hours of theoretical and practical course content, to prepare them for the role. This paper provides a clinical and personal perspective of the C.N.E programme, its beginnings, how it works locally, and process for its ongoing development. Not only does this programme provide a bridge between theory and practice for students during their clinical practicum placements, but communication, consultation and collaboration between education, practice and the workplace have also improved. Nurses in both sectors are confident that through the developing partnerships, students and future practice will benefit from the aim to provide students with 'the best of both worlds'.

Abstract: Otago women who had been treated for breast cancer were asked by questionnaire about patterns of arm swelling post treatment. Almost one third indicated they had had swelling at some time. Few had received preventive advice or what to do should arm swelling occur

Abstract: Outlines the history, emergence, necessity, challenges, and strategies of the patient safety movement. Explores the challenges for staff working to reduce harm and implement safety improvement in NZ hospitals. Considers medical harm as a persistent and expensive threat to public health. Analyses health policy in the US, England and NZ using the theory of countervailing powers, and a shift from medical to managerial dominance. Reviews theories of accidents and risk, and the safety improvement literature. Provides staff perspectives from NZ by means of interviews with doctors, nurses and managers in two hospitals.

Abstract: Over the last century the nursing profession has drawn from numerous theories and disciplines to construct its own theoretical foundations. While this diversity and flexibility may be one of the nursing profession's strengths it may have contributed to nurses' difficulty in explaining the complexities of their every day clinical work. This is a particular challenge for the domain of mental health nursing. This dissertation discusses how nursing models that have credibility at a clinical level can contribute to informing and advancing nursing practice. Models can achieve this by assisting nurses to conceptualise and articulate what it is they do that makes a difference to patient outcomes. Through this process nurses can maintain a distinct professional identity and establish themselves as effective members of multidisciplinary health team. Specifically, the application and limitations of Godkin's (2001) proposed model of a 'healing presence' to the author's own practice in a one-to-one nurse-adolescent client relationship in the mental health nursing is examined. It is claimed that a 'healing presence' provides a meaningful way to understanding the author's own practice. The proposed model of a 'healing presence' embraces the diversity of her background, and allows the author to maintain a nursing identity by providing a nursing framework to critique her practice, furthering her understanding of what it is that 'expert' nurses do and how this impacts on patient outcomes. Also suggested is that a 'healing presence' can contribute to the author's own and other nurses advanced nursing practice by making nursing visible to the multidisciplinary health team and to articulate “what it is that I do 'when I am nursing'”. Through presenting this dissertation, the author wishes to inspire other nurses to examine and understand their own practice.