Abstract: The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection.

Abstract: This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn't carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice. While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses.

Abstract: This article elaborates the meaning of partnership in practice for nurses practising in different and complementary way to nurses in specialist roles and medical practitioners. It positions partnership as the relational core of nursing practice. Partnership is presented as an evolving dialogue between nurse and patient, which is characterised by open, caring, mutually responsive and non-directive approaches. This partnership occurs within a health system that is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. It is the second of a series of articles written as a partnership between nurse scholars from Iceland, NZ and USA.

Abstract: The chapter explores the process of nursing practice and how it contributes to health, derived from research undertaken in New Zealand. It presents the nature of nursing research as if practice – the researcher as if practitioner – establishing a foundation for the development of nursing knowledge that would make a distinct contribution to health and health care. It includes the philosophy and practicalities of nursing through the use of a case study of nursing a family with complex health circumstances.

Abstract: This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development.

Abstract: Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural.

Abstract: This thesis explores the shortage of general hospital nurses in post World War II New Zealand between 1945 and 1955. Historical inquiry is used to identify the causes of the shortage and the response to the shortage by the Health Department, hospital boards and nurse leaders. Christchurch Hospital, administered by the North Canterbury Hospital Board, is used to illustrate the situation at one large, public, general hospital. Primary sources provided the majority of material which informed this thesis. Two themes emerge regarding the causes of the shortage of nurses: those that were readily acknowledged by nurse leaders and other health professionals at the time, and those which were less widely discussed, but which contributed to the nature of nursing work appearing less attractive to potential recruits. In response to the shortage the Health Department, hospital boards and the New Zealand Registered Nurses Association mounted several recruitment campaigns throughout the decade. As the shortage showed no sign of abatement the focus turned from recruitment to retention of nurses. While salaries, conditions and training were improved, nurse leaders also gave attention to establishing what nurses' work was and what it was not. Nurse leaders and others promoted nursing as a profession that could provide young women with a satisfying lifelong career. Due to these efforts, by 1955, this episode in the cycle of demand and supply of nurses had begun to improve.