Abstract: Changes brought by the Mental Health Act (MHA) to clinical practice, and some of the problems it has created for nurses, are examined in this article. Compulsory assessment and treatment orders (CATO) and the role of Duly Authorised Officers (DAO), and moral dilemmas that can arise as a consequence of CATOs used by DAOs are examined. The requirement for DAOs to act as patient advocates and to safeguard cultural beliefs are highlighted. The MHA promotes self responsibility and a treatment philosophy rather than detention of the mentally ill.

Abstract: The aim of this article is to outline best practice management strategies for nurses during the clinical application of civil commitment of mentally ill persons. A literature search on 'coercion' and 'civil commitment' was undertaken. Published and unpublished research undertaken by the authors in New Zealand on this topic was drawn upon. This research considered the use of civil commitment during admission to acute mental health services, acute forensic mental health services and community mental health services. The experience of coercion by service users coincides with the degree of restriction associated with the service they are involved in. Socio-demographic factors, clinical factors and the experience of coercive events have little bearing on the amount of coercion experienced. Rather, it is the pattern of communication and the use of 'procedural justice' that has the potential to ameliorate the amount of perceived coercion. The authors conclude that 'Procedural justice' aligns with the emphasis placed on the therapeutic relationship in mental health nursing and is an important consideration for nurses during the clinical application of civil commitment

Abstract: This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.

Abstract: The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation.

Abstract: Examines the psycho-social effects for adults living with the chronic dermatological condition. Undertakes a meta-synthesis of research into subjects' experiences of the condition, which yields 19 studies, from which three themes are identified: self-identity, personal well-being, and cultural identity. Makes recommendations for research and education.

Abstract: This thesis describes an exploratory study of registered nurses within a local district health board which pursued 'if' and 'how' professional practice frameworks assisted nurses in their individual professional practice. Self assessment and performance appraisal are identified as critical elements of professional development by the Nursing Council of New Zealand, and this became the focus of the author's research. A qualitative descriptive framework was utilised to explore the research question, where experiences of registered nurses employed within inpatient adult medical and surgical settings were collected through questionnaire. Analysis of the data was through general inductive thematic approach. Eight themes arose, of which, two have sub-themes. The first four themes relate to self assessment and performance appraisal and the second four themes relate to professional practice. The findings from the participant's perspective provide an understanding of how participants' utilised self assessment and performance appraisal to inform their professional practice. There are significant implications for professional practice within the findings of this study, which are presented along with recommendations for future practice, and future avenues for research.

Abstract: This article examines the concept of clinical supervision as “professional supervision”. Professional supervision contains many elements, is structured and not without effort. Fundamentally it is about being safe and professional. 'Reflective learning' and 'Live/tutorial' models are reviewed in different contexts for assisting nurses work through everyday issues, conflicts and problems of their role. The author concludes that regardless of which model is used there are benefits for safety and professionalism.

Abstract: Huarahi whakatu describes a pathway for recognising the expertise of nurses working in kaupapa Maori mental health services and recommends a professional development programme that can lead to advancement along the pathway. An emphasis on dual competencies – cultural and clinical – underlies the rationale for regarding kaupapa Maori mental health nursing as a sub-specialty. Eight levels of cultural competencies and twelve levels of clinical competencies are used to differentiate career stages and it is recommended that movement from one level to another should be matched by increased remuneration. The report also contains a recommended professional development programme to support the operationalisation of the career pathway.