Abstract: A nurse presents a personal account of a typical day at Middlemore Hospital's 50-bed acute inpatient mental health unit Tiaho Mai. The article covers aspects of shift handover, working with multidisciplinary teams, developing care plans, working with families, and responding to emergencies.

Abstract: Sense-Making, a qualitative research method, was used to obtain and analyse data from interviews with 10 registered nurses, in order to study reflective thinking in actual nursing practice. Ten non-routine nursing situations were analysed for the presence of reflective thinking. Reflective thinking was extensively manifest, especially in moments of doubt and perplexity, and consisted of such cognitive activities as comparing and contrasting phenomena, recognising patterns, categorising perceptions, framing, and self-questioning in order to create meaning and understanding. Self-questioning was identified as a significant process within reflective thinking. By exploring and analysing the type of questions respondents were asking themselves, the study uncovered three hierarchical levels of reflective thinking, focussed on action, evaluation and critical enquiry. The findings of this study resulted in the development of a model of reflective thinking, which is discussed in terms of the implications for learning in nursing practice.

Abstract: Traditionally the use of advanced physical assessment skills when assessing a patient or client has been the domain of the medical profession. The last few decades has seen many changes in health provision that have influenced nursing practice, as a result of the social and economic trends impacting on New Zealand society. A notable change in nursing practice has been an increased emphasis on the use of advanced physical assessment skills by registered nurses, as an expected part of the registered nurse's health assessment. Nurses in the United States, and more recently Canada and Australia, readily include these skills as an expansion of their health assessment into their nursing practice. The purpose of this research is to investigate whether New Zealand registered nurses have done the same. The factors that influence the registered nurses' use of these skills are also explored. This descriptive design was chosen in order to focus on exploring and describing this phenomenon in a holistic fashion. Data collection involved one hour semi- structured interviews with seven participants who all completed the same postgraduate advanced health assessment educational course. Three themes were identified as influencing the use of advanced physical assessment skills; the registered nurse's work environment, the registered nurse's attributes and the registered nurse's original nursing education. The findings from this research have implications for nurses in practice and nurse educators, in both undergraduate and postgraduate education.

Abstract: This article details how an individual family planning nurse's practice concerning opportunistic testing for sexually transmitted chlamydia was improved through an audit of her testing rates and reflection on the outcome. The leading curable sexually transmitted infection in New Zealand, chlamydia, (including the incidence and spread of the infection and why it is a public health issue) is discussed, and the audit examined. The first audit of fifty consecutive client visits exposed a lack of opportunistic testing. The second looking at a similar but more recent group of client visits, made after the results of the first (zero opportunistic testing) were known, shows an increase in testing and education about chlamydia. Important clinical issues concerning chlamydia testing and treatment are considered. In conclusion the article challenges other nurses in the community to take a lead in raising awareness of the consequences of undiagnosed chlamydial infection and find ways of increasing opportunistic testing for chlamydia within their practice.

Abstract: Traces the establishment of acute pain services (APS) in the 1990s within hospitals both nationally and internationally. Explores, by means of a survey, the level of nursing satisfaction within one large hospital. Distributes questionnaires to 58 nursing staff working in association with the APS to ascertain satisfaction with regard to availability, communication and contribution to increased knowledge..

Abstract: This literature review is an exploration of nurse case management and it will provide the background for the introduction of a nursing case management model in the acute surgical environment at Western Bay Health. Case management is a collaborative process which assesses, plans, implements, co-ordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost-effective outcomes (Newell, 1996:.3). In undertaking this review it was the author's intention to include the findings as background to a business case seeking the introduction of a surgical nurse case management model within the surgical service.