Abstract: The purpose of this project was to explore the experience of nurses related to incident reporting. The reporting of incidents is important as it identifies professional risks for nurses. A descriptive qualitative approach was the methodology used and individual interviews of five senior nurses was the method of data collection. Attention was given to finding out about the supports for and barriers against nurses in reporting incidents; the outcomes for nurses of incident reporting; and the organisational culture and scope of 'professional' behaviour of nurses around incident reporting. The findings revealed that nurses identified themselves as the major reporters of incidents. They considered there was not 'a level playing field' for all professionals around who, how and why incidents were reported, investigated and within the post incident processes. The nurses reported that they made daily decisions about what was an incident, and whether to report events as incidents. They identified aids and supports to the decisions they made such as the medium for reporting and fear of what happened when the incident form left the nurse and went to management. A number of significant implications were identified for nursing, management and organisations in this research. Nurses need to feel they work in organisations which have a culture of safety around incident reporting. Management need to clearly communicate policies, processes and organisational expectations related to incident reporting. This should include how incidents will be reported, investigated and the purposes for which management use incident reporting information. It is also important that adequate structures are in place to support nurses when an incident occurs as thay can have stressful consequences for the nurses involved.

Abstract: This research project explored nurses' perceptions of clinical leadership in mental health nursing practice. Within New Zealand no research exists that evaluates the role and impact the clinical leadership has in mental health nursing practice. From personal experience and discussion with colleagues the author argues that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses. The prime objective of this study was to increase knowledge about clinical leadership in mental health nursing practice. This research used a quantitative descriptive methodology, utilising survey design. A questionnaire was used to rank the attributes of the person the respondents identified as a clinical leader. The data was collected from 30 registered nurses working in mental health settings within the central region of New Zealand. Findings indicate that there is room for improvement with regard to clinical leadership in mental health nursing practice. Clinical leadership is perceived to be more effective by nurses in their second year of practice and in community settings. A statistically significant difference was indicated between nurses in their second year of practice and nurses in their third year of practice in terms of their ranking of clinical leadership abilities. Overall the respondents perceived poor communication and poor attitude as the biggest barriers to effective leadership. Support and good role models were said to influence nursing practice positively and the skills that were identified as being helpful in assisting and retaining nurses were mentorship and good communication. The results of the study are discussed in relation to the literature on transformational leadership skills. Finally, the general limitations of the study are outlined and implications for future research are discussed.

Abstract: Using a qualitative descriptive research design, this study explored nurses' knowledge and views on their talking therapy training and skills in practice. The study examined the use of talking therapies, or specialised interpersonal processes, embodied within the Te Ao Maramatanga: New Zealand College of Mental Health Nurses Inc (2004) Standards of Practice for Mental Health Nurses in New Zealand. A survey questionnaire was sent to 227 registered nurses from a district health hoard mental health service and a sample of eight nurses participated in a semi-structured interview. Content analysis based on the headings “knowledge views, skill acquisition and skill transfer” established the major themes from the data collection processes. The findings confirmed that nurses believe their knowledge and skills in evidence-based talking therapies to be vitally important in mental health nursing practice. Nurses identified that talking therapy training courses needed to be clinically relevant and that some learning strategies were advantageous. The identification of some knowledge gaps for, nurses with limited post graduate experience, and for nurses who currently work in inpatient areas suggests that further consideration must be given to ensure that a cohesive, sustainable approach is ensured for progression of workforce development projects relevant to training in talking therapies for mental health nurses in New Zealand.

Abstract: This study explored the perspectives of Pacific nurses on what it is like for them to work in a Pacific community mental health (PCMH) service within a district health board. Five Pacific Island nurses who worked in the three Pacific community mental health services based in the Auckland region participated in the project. The study employed narrative inquiry to gather data through focused storytelling method. The results of the study have indicated that PCMH nursing is a unique nursing field as well as highlighting significant practice issues for nurses. Complex service infrastructure and language have been found to be the major contributing practice constraints. The findings suggest the need for district health board authorities, Pacific mental health service management, professional nursing education and development programs to consider addressing these practice issues to prevent further increase in the problem of PCMH nurses shortage and enhance recruitment and retention of these nurses.

Abstract: In this review, the author illustrates the connection between diabetes, stress and barriers to care, and the impact these have on Maori who have type 2 diabetes. A literature review, which focused mainly on indigenous peoples, and more specifically on Maori was undertaken. The connections between all the factors involved are explored, and combined with reflections from the author's own clinical practice experience. She argues that stress, diet, exercise and barriers to care place a heavy burden on the lives of Maori who live in Aotearoa/New Zealand, suffering from the disease of diabetes. By empowering them to face their situation and see this from a wellness rather than an illness perspective, they can take control of their diabetes and so will live a healthy, longer life, ensuring quality time with their mokopuna/grandchildren.

Abstract: This thesis reports a mixed methods study, longitudinal in nature, of consenting Age Related Residential Care (ARRC) hospitals in the upper half of the North Island, which was conducted to examine several factors, including AARC hospital efficiency at producing adverse event free days for residents. An interpretativist approach examined what best practice strategies were implemented by the ARRC hospitals that were identified to be most successful at producing adverse event free days for the residents.

Abstract: The primary aim of this research was to advocate for, and make known, the role of the community oncology nurse, and to bring alive the hidden issues of nursing people in the community who have active cancer treatment. This study is also about the author's journey from novice to expert in developing the role as a community oncology nurse. The research also aimed to identify and understand practice that community oncology nurses do and often take for granted. To capture the essence of this study the method of reflective topical autobiography was utilised, which gave the opportunity to gather advanced nursing inquiry, and generate new nursing knowledge. To obtain insight into the highs and lows in everyday interaction with patients, reflective practice stories are presented. The thesis generated by this research is that care required by cancer patients at home goes beyond the scope of traditional community health. It requires nurses to be competent in technological skills as well as bringing in-depth expertise to the practical and human needs of people experiencing cancer. The role involves holistic, family-centered care; anticipating patient and family needs; educating; managing symptoms; advocating; confronting ethical issues; coordinating complex care; and monitoring progress.