Abstract: This inquiry is an in-depth exploration of one middle aged woman's experience of strife in chronic illness and her nursing care involving four nurses (including the author) in a community context over a three-year period. The study is praxiological in that the understanding achieved is derived from practice within a 'research as praxis' methodology positioned in the disciplinary perspective of nursing as a practical human science. Five methodological premises inform the research processes: reflexivity, dialogue, moral comportment, re-presentation in narrative and critique. They emanate from an eclectic ontological praxiology based on the research framework constructed from Gadamerian philosophical hermeneutics, components of other philosophical praxiologies evolved from an exploration of the practical discourse in philosophy and my preferred health and nursing assumptions. The research processes include researcher journalling, a summary of Sarah's nursing record and dialogical meetings with Sarah and the nurse co-participants. Using the research material a narrative is then co-constructed. The narrative is structured around what Sarah viewed as the overall nursing contribution to her care; the 'sharing of her burden of illness'. This, she maintained, enabled her to live safely in the community. Finally there occurs a critique of the narrative within a discursive framework. Three themes, embedded in particular discourses, emerged from the narrative both in Sarah's and the nurses' experience; paradox, moral meaning and metaphor. Sarah's experience is interpreted as taking place in the 'in-between space' of the disease and health-illness discourses. Two main concepts which depict the tension experienced in this space are the 'the ontological assault of illness' and 'entrapment in the disease discourse'. The nurses, in this instance, 'pushed the boundaries' to create a space for the nursing as a caring practice discourse on the margins of nursing as a functional service discourse. The author notes that, within the nursing as a caring practice space, many 'fine lines' were walked with Sarah. Walking the 'fine line' of an 'intense relationship' was seen as advanced nursing practice. The research highlights important implications for a person and/or families who live with chronic illness and practice and educational issues for advanced nurse practitioners. Further, it promotes praxiological methodologies as advantageous for expanding nursing knowledge.

Abstract: The low numbers of nurses attracted to work in mental health is a concern particularly with the increased demand for mental health services. Strategies are required to increase recruitment to this less popular area of nursing to ensure that a high quality of care is provided for people suffering from mental illness. The World Health Organisation is aware that this area of health has been neglected and that it is time to promote mental health. This study aimed to examine the influences involved in nurses choosing to work in this area. A descriptive survey using a questionnaire was given to seven groups of new graduates enrolled in the New Graduate Mental Health Nursing programme through five educational institutes. At the time of writing there were no published studies around this topic in New Zealand. This study will attempt to inform nurses, the Nursing Council of New Zealand, tertiary institutions and the government of New Zealand that there is evidence of a need to develop and change practices to address the predicted workforce decline.

Abstract: The use of massage by nurses is a popular activity in many fields of nursing practice. The last ten to fifteen years have seen a rising popularity in the literature. Whilst the literature within nursing is plentiful it often does not present the empirical evidence necessary to support nursing actions. The objective of this analysis is to present the extant literature discussing soft tissue massage from a Western health perspective. Massage has first been contextualised as an ancient as well as modern healing activity. There is evidence of early modern medical interest in the therapeutic benefits of massage for a number of ailments. From this contextual perspective it is then possible to track the evolution of modern complementary health practices since 1980, and the professional and practical issues surrounding their use. Against the backdrop of twenty-first century health care there is increased evidence of the importance of maintaining the human aspect of caring, and massage is seen as an ideal way to provide this. The author argues that the discipline of modern nursing must increase its awareness of the empirical evidence around the use of massage, to provide safe and effective nursing care. This physiological and psychological evidence is presented and critiqued, based on the principles of evidence-based practice. This critique has enabled some sound research-based practical statements on the effects of massage to be made. These statements will enhance the practice of massage within a nursing context. The final part of the journey has been to explore the actual practice of massage within nursing, including the current use of massage by a sample of New Zealand nurses. The educational opportunities have also been presented, alongside some main professional issues. Massage can now be viewed as a legitimate nursing tool that has value in a range of nursing settings by enhancing the quality of patient care. The techniques are easy to learn, simple to perform and do not add undue workload to nurses. The author notes that there is a considerable amount of literature to support this, but the quest for further knowledge cannot be ignored.

Abstract: Accountability has been described by nurses as an elusive concept or myth. The author suggests that this elusive concept or myth can partly be attributed to accountability becoming visible usually following a critical incident. The overall goal of this project is to provide nurses working within mental health with the incentive to raise their awareness and explore what their roles and responsibilities are within the accountability process in a more positive scenario. This research paper reports on an exploration of the key components of accountability within the New Zealand mental health environment. It describes significant influences that affect accountability. This is achieved by the means of a literature review, sharing of the author's experience of being involved in a national inquiry, and the adaptation of a who what and how framework, in conjunction with a diagram displaying accountability levels and lines for mental health nurses. The author points out that the domains of accountability for nurses will continue to evolve and expand but what remains important is that consumers have access to good quality mental health care.

Abstract: This research investigates the impact of fifteen psychiatric nurses' personal experiences on their therapeutic relationships with clines. A hermeneutic phenomenological methodology informed by Heidegger is employed to gain an understanding of the human experience of these nurses in the context of the therapeutic relationship.The research illuminates the significant impact of these nurses' experiences on their relationships. Some experiences are found to enhance therapeutic readiness while the other personal experiences impede it, some impeding it to a degree that nurses are unable to work therapeutically with certain clients. The stories that describe the personal experiences that lead towards therapeutic readiness care special, as are the accounts of the professionalism and care that these nurses bring to their clients

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

Abstract: An exploratory study of the functioning of four multi disciplinary health care teams ( HCT) in the New Zealand services and possible implications foe Health personnel education. This research seeks to 1. establish form structure and functioning of the HCT in the relation to the delivery of comprehensive primary health care. 2. Determine what collaborative skills are being used, the extent of interdependence and these factors which inhibit the use of these skills in providing primary health care. 3. Identify the key requirements for, and these factors which limit the successful functioning of the HCT in the provision of comprehensive primary health care. Data has been collected through structured interviews and observations. The analysis will compare and contrast the functioning of the social groups in the different settings in terms of their responses to both HCT index and appropriate contextual variables such that differences and similarities are delineated