Abstract: This paper reports a study to explore Well Child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of Well Child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognise the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of Well Child telenurses.

Abstract: This study aimed to articulate how sexual identity impacts on the therapeutic relationship between the client and the lesbian nurse in psychiatric mental health nursing. There is little consideration given in the literature or in research as to how sexuality of the nurse impacts on nursing practice. Most attitudes held by the public and nursing staff are based on the assumption that everyone is heterosexual, including nurses. Fifteen lesbian psychiatric mental health nurses from throughout New Zealand volunteered for two interviews and shared their experiences of becoming and being a lesbian psychiatric mental health nurse. The stories they told give new insights into how these nurses negotiate and position their lesbian identity in the therapeutic relationship. To work therapeutically with people in mental distress the nurse uses personal information about themselves to gain rapport with the client through appropriate self-disclosure. Being real, honest and authentic are also key concepts in this relationship so the negotiation of reveal/conceal of the nurse's identity is central to ongoing therapeutic engagement. One of the most significant things arising from the research is that participants are able to maintain their honesty and authenticity in the therapeutic relationship whether they self-disclose their lesbian identity or not. This is because the experiences in their personal lives have influenced how the participants 'know themselves' and therefore guide how they 'use self' in their therapeutic nursing. The concept of a 'licensed narrative' has also been developed during this research reflecting the negotiated understandings between the researcher and the participants. Further, the use of NVivo a qualitative software package helps to track and make transparent the research processes. These two aspects make a unique contribution to the field of narrative inquiry.

Abstract: The research outlined in this paper used Heideggerian phenomenology to examine the phenomenon of expert public health nursing practice within a New Zealand community health setting. Narrative interviews were conducted with eight identified expert practitioners who are currently practising in this speciality area. Data analysis led to the identification and description of themes which were supported by paradigm cases and exemplars. Four key themes were identified which describe the finely tuned recognition and assessment skills demonstrated by these nurses; their ability to form, sustain and close relationships with clients over time; the skilful coaching undertaken with clients; and the way in which they coped with the dark side of their work with integrity and courage.

Abstract: The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.

Abstract: This paper reports a study to investigate the roles and experiences of nurses caring for clients undergoing assisted reproductive technologies (ART). Nurses are in a potentially unique position in the assisted reproductive technology environment as they maintain a more constant contact with the client. A qualitative approach was taken and a convenience sample of 15 nurses from New Zealand was interviewed in 2005. Data were analysed using interpretive description. The overarching theme identified was that of the potential role of the nurse to 'hold together' multiple components of the assisted reproductive technology process: holding together clients' emotional and physical experiences of assisted reproductive technologies; holding together the roles of different specialist team members; and holding together personal own emotions. It encompasses practices such as information-giving, interpreting, supporting and advocating. The researchers note that recognition of and support for the complexity of the role of ART nurses may positively contribute to clients' experiences.

Abstract: This study focuses on power themes in the nurse-patient relationship. The study is a critical reflection of the author's practice using a humanistic perspective from Hartrick Doane and Varcoe's (2005) model of relational family practice. It reviews the literature relating to power relationships in communication between nurses and patients and compares the ability to provide relational care in the home with hospital care. Practice examples demonstrate the shift in power relationships that the author had noticed since changing roles from hospital based to home care nursing. This is related to cultural, socio-environmental, historical and traditional influences on power in communication. The study is based on her reflection of the paradigm shift in her practice. Her practice moved from a problem solving approach to an empowerment, strengths based approach within partnership. The ethical challenges of discussing her practice in relation to clients has been managed by scrambling patient data so that it is not related to a single person and is focused on the author's nursing practice.

Abstract: Aims to understand the experiences of Indian internationally-qualified nurses (IQN) making the transition into a NZ bachelor of nursing (BN) programme. Conducts a focus group with four Indian IQN students enrolled in an 18-month bridging course. Identifies four themes: adaptation to a new way of learning; cultural differences in living and working in NZ; adaptation to a different clinical environment; and cultural safety.

Abstract: Introduces the Clinical Communication Assessment Framework (CCAF), adapted by Nelson Marlborough Institute of Technology from communication assessment guidelines developed in Australia to assess nursing students' English language proficiency. Uses this framework to assess nurses, before the competency assessment programme (CAP) four-week clinical nursing placement, for the first time in NZ.