Abstract: In this paper the author argues that the term interdisciplinary team leadership should be embraced cautiously. Preliminary research suggests that interdisciplinary team leadership is a model of shared leadership that requires more development if it is to become the cornerstone of interdisciplinary team practice in a radically reforming health sector. Stewardship is proposed as a potential philosophy for interdisciplinary team leadership, and a new, shared leadership role of practice leader is suggested.

Abstract: The author examines the role of technology in high dependency units, which can alienate nurses from patients. The ethical issues raised by technology are reviewed, particularly the allocation of expensive interventions, and the implications of life-sustaining technology on the application of informed consent. The author highlights the challenge facing nurses to bridge the gap between medical technology and humane caring.

Abstract: There are a number of factors recognised as significant for nursing staff retention. These include, a lack of organisational care, bullying (commonly referred to as horizontal violence), and high workload acuity. However, there does not appear to be any indication that these factors influence the retention of nurses within the speciality of acute perioperative nursing. A descriptive study using postpositivist methodology and triangulation of methods was designed to answer the question: What are the critical factors that influence staff retention in an acute perioperative environment? Forty-eight perioperative nurses answered a questionnaire in relation to individual needs, provision of nursing care and administration and management. Four nurses subsequently participated in a focus group interview that explored in more depth, the survey data related to the following characteristics: Educational opportunities; Level of workload acuity; Rostering flexibility; Management; Established policies/Quality assurance; Graduate orientation programs and Professional relationships in an acute perioperative setting. Data analysis revealed that > 90% of respondents agreed that these characteristics are important for job satisfaction and influence staff retention in an acute perioperative environment. A sense of belonging appears to be the most important theme that emerged from the qualitative data. Job satisfaction and staff retention are attained when nurses have a sense of belonging in the workplace. To achieve this nurses need to identify barriers, develop their communication and leadership skills and determine the ideal professional practice model. The author suggests that the themes “Finding time” and increased “sick leave”, in relation to workload acuity are new findings that provide a platform for future research.

Abstract: This study sought to examine the effects that hospital re-engineering may have on adverse patient outcomes and the nursing workforce. In 1993, New Zealand implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. All medical and surgical discharges from New Zealand's public hospitals (n=3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n=65,221 nurse responses) from 1993 through 2000 were examined. Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. The authors conclude that in the chaotic environment created by re-engineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organisational change plays in patient outcomes, the unintended consequences of health care re-engineering and market approaches in health care, and nursing's unique contribution to quality of care.

Abstract: This thesis tells a story from within and between the boundaries of my professional work as a nurse and my private life as the wife of a patient with life threatening illness. The events related in the thesis are told using a technique I have called writing back to myself, where my own journals and stories of the experience of living with life threatening illness provide data for analysis. The reader is invited to participate in these representations and to consider the potential for the skilful practice of nursing which may be read in the stories, and the analysis I have developed from them. I have developed the theoretical and methodological positionings for the thesis from the work of Foucault (1975,1979,1982,1988), Deleuze (1988), Ellis (1995), Richardson (1998) and other writers who utilise genealogical or narrative approaches. The analysis of my own stories in the thesis explores the philosophical and contextual positionings of the nurse as a knowledge worker through genealogies of practice and the specific intellectual work of the nurse. Local and contextual epistemologies are considered as ways of theorising nursing practice through personal knowledge, which is surfaced through the critical analysis of contextual positionings and the process of writing as inquiry.

Abstract: Examines the psycho-social effects for adults living with the chronic dermatological condition. Undertakes a meta-synthesis of research into subjects' experiences of the condition, which yields 19 studies, from which three themes are identified: self-identity, personal well-being, and cultural identity. Makes recommendations for research and education.

Abstract: Addresses the concerns of health professionals working collaboratively in palliative care. Conducts 25 interviews wit 23 participants to arrive at a theory of sharing time to explain the social process of collaboration while individually managing and maintaining their own areas of concern. Explains the concept of health professionals making time in their work days for and with each other to find common ground.