Abstract: This thesis concerns the Professional Development Programme at Lakeland Health. In New Zealand, such programmes were introduced as a mechanism to openly recognise the clinical expertise of nurses. Clinical Career Pathways were introduced to nursing in North America in the 1970's at a time of nursing shortage. Prior to their inception, nurses wishing to develop their careers had to move to administration, management or education. The programmes recognised and rewarded expertise in practice. A qualitative, descriptive approach (using focus groups) was used with Registered Nurses to gather their perceptions of what helps nurses enroll in the Professional Development Programme. The ideas and insights of nine Registered Nurses were clustered around three main categories: The People (fear; being struck; motivation; feedback; peer support; ways of learning); the Programme (relevance; flexibility; Bachelor's Degrees; implementation; supporting information; fairness); the Place (time; regular and accessible; support from nurse leaders; management). These perceptions are discussed in more detail in the context of nursing at Lakeland Health and of Clinical Career Pathways in New Zealand. The findings are helpful for the evaluation and future development of the Professional Development at Lakeland Health. The research contributes to our understanding of what helps nurses enroll in a Clinical Career Pathway, and emphasises the importance of the People, the Programme and the Place.

Abstract: Up until the 1980s most of the historical writing about nursing and nurses in this country has been told from the points of view of past nursing leaders. The realities of day-to-day nursing in New Zealand general hospitals were relatively unknown.This thesis examines the experience of general hospital nursing between 1945 and 1960. The recollections of thirty-four nurses who nursed during this period have provided the key sources from which the major themes of this study have emerged. These themes, of dirty work, authoritarian control and discipline, and learning nursing are discussed within the context of an expanding hospital system and a shortage of nurses.The study demonstrates the vast differences between the recollections of nurses of the experience of nursing and the rather high-flown rhetoric of the nursing leadership.Changes to the amount of cleaning, the ;level of discipline and control, and ways in which learning nursing was organised were small and gradual and occurred in the late 1950s.Overall, though, nursing in general hospitals by 1960 ws almost unchanged from the 1930s.An ethos of selfless service, opposition to unionism, and Christian altruism was till dominant amongst the nursing leadership. Nurses in training still worked a six day week, were expected to stay on duty until the work was done, and were supervised closely in, on and off duty time

Abstract: This action research study explores the experiences of 'patient education' from the perspective of a group comprising two nurses, two people with asthma, and the researcher who is a nurse who has asthma. The method used is emancipatory action research (Grundy, 1990) with critical social theory and feminism as theoretical underpinnings.The focus moves from patient education to a broader view of living and working with asthma. The story of the group is presented in the format of a play. A play within the play tells of living and working with asthma.An action research spiral is formed which reflects the way the group moves through the three modes of action research described by Grundy (1990). The acts of the play represent each of the stages of the action research process. The emphasis moves from power and control through to practice wisdom.The main issues explored are: the nature of patient education by nurses; the implications this has for relationships with patients and nursing education; power and control in the secondary setting; the lived experience of chronic illness and the practice wisdom of nurses and people with asthma. The work concludes with recommendations for change in each of these areas based on the work of the group

Abstract: There has been a great deal written about the efforts of the nursing profession to achieve full professional status but little about individual nurses' aspirations in seeking this goal. A group of 6 co-researchers, myself included, looked at this perceived gap in nurses' dreams for the profession.The philosophical underpinnings of the research were feminist and reflected postmodern feminist and some radical feminist concepts. This philosophical positions guided our research to uncover the knowledge of how we actively construct ourselves into dominant social values. This means we were searching for how our dreams were constructed and how we reflected the values of society in the way we produced our dreams. Peace and Power (Chinn & Wheeler, 1989) was used to guide the group interaction and Memory-Work (Hague, 1987) for data collecting and analysis. The co-researchers wrote individual stories about their dreams for the nursing profession. Collective analysis of the stories occurred in order to uncover the was in which the dreams were constructed. From this collective analysis the individual co-researchers redrafted their stories. Each redraft contained new insights, motives and actions of ourselves and others, forgotten experiences and inconsistencies, as a means of identifying and questioning dominant ideologies. The aim was to move towards empowerment through making the unconscious conscious.Four common dreams emerged from analysis of the stories: the first was that individual nurses want full professional status and autonomy; the second asked the nurses to care and support each other; a high standard of patient and nursing-focussed care was the third dream; and the fourth was for continuing education and knowledge to be shared between nurses. Although the dreams were common across the group it was found that the dreams varied in their construction. The dreams for each group member reflected multiple realities that emerged from different contexts, influenced by historical and socially dominant cultural values.Through studying and theorising our dreams for the nursing profession, we increased our understanding of how they were shaped so that we were able to initiate change and make our dreams become a reality. This has implications for the nursing profession. We live our lives collectively, as nurses and women, as others influence our being and reality. Although others influence us, it is each individual nurse who contributes to actively construct her/himself in to the dominant cultural values held by society and therefore up to each individual to initiate change. If nurses are able to make dreams a reality then positive changes will occur within the profession; I.e. decreased staff turnover, increased morale and increased quality in patient care