Abstract: The nurse practitioner role is an important addition to nursing workforce development in New Zealand. At present there are relatively few nurse practitioners, however the number of nurses seeking Nursing Council endorsement continues to grow. These nurses are in a unique situation as pioneers having achieved the highest level of autonomous advanced nursing practice. This position will bring with it many challenges for those nurses who are among the first in the profession. Traditionally, nurses have always had formal and informal methods of support such as preceptors, role models and the hierarchy of nursing to help and guide them in their work. This network has generally been comprised of nurses more senior and qualified than the nurse needing support. Yet the nurse practitioner, considered to be the leading clinical nurse in New Zealand, may have very limited resources available for the clinical support needed to sustain their professional practice while keeping them refreshed, curious, creative and committed. The intent of this dissertation is to provide a framework of supportive mechanisms on which the emerging nurse practitioner can draw in their new professional domain throughout their career. The author explores the meaning of support, why there is a need for support for the nurse practitioner, the various methods of support noted in current literature and how these various methods can enhance the nurse practitioner's professional growth and development, maintain clinical safety, and foster job satisfaction.

Abstract: For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes.

Abstract: This research is about preceptorship in nursing. There is considerable emphasis placed on health care organisations to support newly appointed graduate nurses, and preceptorship is a recommended model. Despite this emphasis, the author suggests that little is known about how preceptorship partnerships work in practice. The primary focus of this exploratory descriptive qualitative study was to explore the perspectives that preceptors and preceptees, who had worked in partnership, had about how they established and sustained their respective roles. Three sets of registered nurses who had recently completed a preceptorship experience were interviewed about their partnership. Content and thematic analysis of this descriptive data revealed four main themes. The preceptorship relationship grows out of respect for each another and develops as a result of honest and open communication. Preceptees who have an initial positive experience into their new work area settle quickly and efficiently into their new role. Preceptees appreciate preceptors who are welcoming, supportive and willing to undertake the role, while preceptors are happy to undertake the role if the graduate displays an interest in learning and are willing to be guided. The preceptee learns what it means to be a registered nurse in the particular working context, while the preceptor learns how to support learning processes and evidence-based practices. The author goes on to say that further exploration and investigation of these themes and of the relationships that evolve during preceptorship partnerships is needed. By understanding these findings, organisations can prepare both the preceptor and preceptee as they begin to undertake their role to ensure future partnerships will be successful.

Abstract: Clinical studies on adult ventilated patients demonstrate that bacterial contamination of the condensate occurs in ventilator circuits. The purpose of this research is to find out if this is also true of the condensate in the Continuous Positive Airway Pressure (CPAP) circuit. It aims to determine whether there is bacterial contamination in the humidifier reservoir of the CPAP system when the condensate is drained back into the humidifier reservoir without disconnecting the circuit, or when the inspiratory tubing is disconnected to drain out the condensate.

Abstract: Examines the lived experiences of adults with myasthenia gravis(MG). Uses an interpretive phenomenological approach applying the research methodology of van Manen (1990). Interviews seven people living with MG and records their experiences of the disease. Poses broadly-worded questions about various topics related to MG, that include diagnosis, symptoms, treatments and coping strategies, guided by individual experiences. Reveals by means of thematic analysis that MG affects every aspect of a person?s ?lifeworld?: their sense of time, body, and space and their relationships with others. Highlights three main themes embedded in the data experienced by a person with MG: living with uncertainty, living with weakness and living with change.

Abstract: In this research paper for a Master of Nursing (Clinical), the author suggests that graduate nurses can successfully adapt to emergency nursing when supported with intensive domain-specific transition programmes to complement the national nursing entry to practice (NETP) programme in New Zealand. This outcome conflicts with the present traditional emergency department recruitment strategy that nurses must have two years acute care experience. The graduate believes they are prepared for practice for any healthcare setting but do need time to resolve the rift between theory and practice. This research project confirms the perpetuation of experienced nurses' perceptions that graduates are not work-ready but are unrealistically expected to hit the floor running following ad hoc orientation ranging from three days to four weeks. By creating domain-specific programmes with a minimum twelve-week staged rotation orientation package, graduate nurses can be nurtured as emergency nurses. The influential role of the organisation and experienced nurses is vital to limit reality shock and complement NETP. Preceptorship and mentorship programmes promote the graduates' confidence in themselves to become competent team members. Limits to this research are the non-differentiation between nurses new to emergency nursing and the graduate nurse in the published studies. Assumptions have therefore been made regarding successful transition in regard to newly qualified registered nurses in the emergency department. Further study and evaluation applicable in the New Zealand context is also recommended by the author where anecdotally only a few emergency departments are involved in socialising graduate nurses into the workforce regardless of the urgent need for more first-year-of-practice clinical placements.

Abstract: The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings.

Abstract: This aim of this thesis was to explore and describe registered nurses' experiences of undertaking the statutory role of Responsible Clinician under the Mental Health (Compulsory Assessment and Treatment) Act 1992. The role of Responsible Clinician has been available to nurses since 1992 yet to date there has been little research into nurses' experiences of undertaking this role. An exploratory descriptive approach was therefore used in this study. A convenience sample of four nurses who had been undertaking the role of Responsible Clinician was recruited. Their experiences were elicited through in-depth interviews. Analysis of the interview material revealed the themes of legitimacy, relationships, expanding practice, responsibility and accountability, approaches to care, nurses' responsiveness to the role and support of the role. The author points to this research being important to nurses who are working in the psychiatric mental health area so that they can understand the role more fully. In this way, more nurses may choose to undertake the role of Responsible Clinician.