Abstract: Conducts a study of 90 undergraduate Bachelor of Nursing (BN) students in order to identify factors that motivate student nurses to undertake self-directed learning (SDL). Adapts an overseas rating scale questionnaire to survey third-year BN students to identify intrinsic or extrinsic factors that influence students' SDL behaviour. Categorises survey results in relation to content and navigation of the learning package; monitoring and management of personal learning; and relevance to topic and link to paper assessment.

Abstract: Presents the personal reflections of four nurses who have lived and worked in different parts of the world, revealing the influence of their grandmothers in their career choice. Identifies common values of respect, courage and the importance of listening to others, imparted to the nurses by their grandmothers. Relates these attributes to fundamental elements of the International Council of Nurses (ICN) code of ethics.

Abstract: A community based registered nurse from Waikato District Health Board's Older Persons Assessment Team (OPAT) presents her experiences of working with older people with dementia. She uses a case study approach to highlight the issue of wandering, behaviour which can be difficult to modify and can cause carer distress. She outlines a team approach to the condition which requires good communication and co-ordination. Key aspects of management included a risk assessment plan, support for caregivers, and encouraging activity.

Abstract: This reports on an initiative at Whakatane Hospital, where a Nurse-Led pre-assessment (NLPA) was delivered at an outpatients clinic. NLPA involves taking a comprehensive medical history, a nursing assessment, physical examination, airway assessment, ordering appropriate investigations and carefully documenting the process and results. More valuably, it provides an opportunity for the patient to participate in planning their care. The aim of this initative was to short circuit delays and congestion in existing pre-assessment clinics, streamline the pre-assessment process and reduce the number of patient visits to hospital. Reducing cancellations of surgery (often on the day of surgery) and “did not appear” (DNA) numbers were also objectives. After a small pilot, a six-month trial was funded by the Ministry of Health. Over the six-month trial, 373 patients attended NLPA; 178 patients required anaesthetist review before surgery, and 198 could proceed directly to surgery following NLPA. An anonymous postal survey was made of patients, who indicated satisfaction with the service. Other outcomes are discussed, and the trial was deemed successful. Follow up plans have been disrupted by restructuring at the hospital and the clinic has yet to be implemented.

Abstract: The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role.

Abstract: The author investigates the premises that form the basis of nursing practice in acute care. Assumptions about patients and caregiving are often at odds with each other. The origins of these tenets are mapped from Florence Nightingale through to present nursing theorists. Overlapping areas of nursing and medical care in the acute care setting are examined, and the conflict that can arise between traditional nursing care and the expected medical nursing role is examined. He argues that the challenge for acute care nurses is to find a balance between normative nursing and the medical model.

Abstract: The aim of this paper is to increase neuroscience nurses' awareness of how the head is perceived as sacred by some cultures. This article will outline a definition of culture, discussion around the sanctity of the head for some cultures, the cultural significance of common neuroscience interventions, the use of traditional healing methods, and prayer. Examples will be provided of how nursing interactions and interventions affect some cultures, looking primarily at a Maori and Pacific Island perspective. The focus of this paper is within a New Zealand paediatric setting.