Abstract: As the clinical consequences of power failure in intensive care are seldom documented we reviewed the effects of a power failure on patient care, outcomes and the adequacy of our disaster plan. We reviewed clinical records of all ten patients in our department during a 20-minute total hospital power failure, determined the impact of the failure on the therapies being given, and the costs of failed equipment. We assessed the departments disaster plan and identified the causes of the power failure.Nine patients were intubated; six ventilated (one receiving nitric oxide) and three receiving continuous positive airway pressure. Two patients were ventilated by Servo 300,? which continued on batteries, the other four patients were ventilated manually. Six patients were receiving nine inotrope infusions through IMED Gemini,? (battery life 30 minutes). One patient was receiving high volume ultrafiltration using a Gambro? haemodialysis system, which failed. Blood flow to prevent clotting was maintained by turning the roller pump manually. All networked monitoring (SpaceLabs?) failed and three haemodynamically unstable patients were monitored by transport monitors (SpaceLabs Scout?). No patient suffered any ill effect. Failed electronic circuits cost $NZ11,724. The disaster plan was implemented and functioned well. The aged cables supplying Auckland Central failed during an El Nino summer. The hospital generators, supplying power to the city grid, failed to switch over to the hospital. During power failure infusion pumps should be only for inotropes. We now have external 12-volt battery backup. With good pre-planning, safe intensive care continued during a short power failure

Abstract: Reports on a local multi-component initiative to improve local Human Papillomavirus (HPV) vaccination coverage among Maori male students aged 13-17 years in a rural location in Aotearoa New Zealand. Backgrounds the initiative co-designed by the rural health nurse from a community clinic of the Hauora (Maori health provider) and the principal of the local area school, in order to improve health literacy and provide an environment to support student consent to vaccination. Undertakes an evaluation of the initiative in 2018, comprising 10 key informant interviews and a group discussion with eight male students. Identifies the factors associated with the success of the initiative.

Abstract: Therapeutic relationships are central to mental health nursing. The nurse's role in maintaining professional yet therapeutic boundaries within this relationship can be challenging. When therapeutic boundaries are breeched within the nurse adolescent relationship the adolescent's safety within this relationship is compromised. There is currently limited literature on how nurses are managing professional boundaries in relationships with adolescents in this setting. The adolescent's nature is to push boundaries; therefore the nurse needs to be acutely aware of this boundary pushing in everyday practice settings. For the safety of the adolescent and the nurse it is vital the nurse understands her role in managing the professional boundary. This thesis explores, through the use of narrative inquiry, four adolescent mental health nurses' experiences of assessing, understanding and maintaining therapeutic boundaries with adolescents in a mental health setting in New Zealand. The unique and specific implications for adolescent mental health nursing are discussed. Three key themes emerged from the analysis and findings: the importance of the nurse clarifying his/her role; the learning that occurs throughout the practice journey; and the role of the nurse in keeping the adolescent and the nurse safe. These findings highlight the importance of clinical supervision and open communication with senior nurses and mentors, which assist the nurse in monitoring practice. When nurses do not have sufficient knowledge of the fundamental principles of adolescent mental health nursing; such as knowledge and skills in both adolescent development and psychodynamic nursing, they are at risk of boundary crossings. Recommendations from this research include more emphasis on psychodynamic nursing principles in nursing education and nursing practice. There is a need for specialised education for nurses in child and adolescent mental health nursing. Nursing entry to practice programmes for new graduate nurses working in mental health, could assist in providing this. There is a call for further research into therapeutic relationships and professional boundaries in this complex nursing specialty.

Abstract: Student nurses rely on their teachers, both academic and clinical, to assist them to develop their capacity to practice safely. Yet, in relation to cultural safety, relatively little has been written to assist the integration of theoretical knowledge to the world of practice. This article presents the findings of a small project undertaken by lecturers whose experiences supporting students' learning during clinical placements in Auckland stimulated interest in the students' attempts to use their classroom learning to begin their journey towards culturally safe nursing practice. A qualitative descriptive approach was used to explore the experience of nursing clients from cultures other than one's own and to describe culturally safe practice from the perspective of third year students.

Abstract: This paper focuses on the work of primary health care nurses on chronic conditions, through both formal chronic care management (CCM) programmes and informal work. The author overviews the key components of CCM and describes Care Plus, a funding stream accessed via PHOs. The author gives examples of nurse led clinics and programmes in the general practice environment, and outlines the structures and processes necessary. A table summarises nurse involvement in several PHOs throughout the country. The author finds that the role of PHC nurses within a framework of inter-disciplinary chronic condition care is diverse and increasing.

Abstract: The focus of this thesis is the practice of the nurses employed in the Native Health Nursing Scheme in New Zealand from 1911 to 1930. These nurses were a vanguard movement for change in community nursing services as they established a new role and developed innovative ways of practicing nursing while claiming greater autonomy and accountability for nurses who worked in community settings. Consequently they contributed to an increase in status for nurses in New Zealand.The Native Health Nursing Scheme was established by the Health Department to replace the Maori Health Nursing Scheme, an initiative by Maori leaders for Maori nurses to provide nursing care for their own people. The original scheme had foundered amid under-resourcing, a lack of support from hospital boards and administrative chaos. Government policy for Maori health was openly assimilationist and the mainly non-Maori Native Health nurses carried out this policy, yet paradoxically adapting their practice in order to be culturally acceptable to Maori.Their work with the Maori people placed the Native Health nurses in a unique position to claim professional territory in a new area of practice. As they took up the opportunities for an expanded nursing role, they practiced in a manner which would develop the scope and status of nursing. The geographical isolation of their practice setting provided the nurses with the challenge of practicing in an environment of minimal administrative and professional support, while also offering them the opportunity for independence and relative autonomy. Obedience, duty and virtue, qualities highly valued in women of the day, were expected especially in nurses. These expectations were in direct contrast to the qualities necessary to perform the duties of the Native Health nurse. The conditions under which these nurses worked and lived, the decisions they were required to make, and the partnerships they needed to establish to be effective in the communities in which they worked, required courage, strength, organizational ability and commitment