Abstract: ABSTRACT
BACKGROUND: Emergency nursing is a specialty concerned with the care of people of all ages, with either perceived or actual unwellness presenting to the emergency department(ED) for assessment, resuscitation, investigation, treatment and review of their illness or injury. Emergency nurses apply specialty knowledge and expertise in the provision, delivery and evaluation of emergency nursing care. Over recent decades social, political and professional changes have affected nursing care delivery and nursing education. In particular the 21st century has witnessed the development of state funded postgraduate nursing education programmes, developing nurses specialty or advanced nursing knowledge, quality patient/client care and nursing practice within the tertiary education system.
AIM: The aim of this study is to investigate emergency nurses? perceptions of the impact of postgraduate education on their practice in New Zealand (NZ).
METHODS: This study utilises critical social theory as the overarching framework, informed by the writing of Jürgen Habermas (b.1929- ). It is the three phases of
Habermas?s practical intent of critical social theory; namely enlightenment, empowerment and emancipation, that this study is concerned with. This descriptive research study employs both quantitative and qualitative methods and is therefore known as mixed-methods research. Data collection took place over 12 weeks, from August to November 2006, using a survey questionnaire obtained with permission from Ms Dianne Pelletier, Sydney, Australia. The sample included 105 emergency nurses from District Health Board (DHB) emergency departments in NZ, 10 respondents from this sample self-selected to be interviewed by telephone. Ethical approval for this study was obtained from the University of Otago Ethics Committee for research involving human participants. Data was analysed using the Statistical Package for Social Sciences (SPSS).
RESULTS: Two main themes arose from the thematic analysis; these being positive and negative, these themes were further divided into 10 sub-themes. The results indicate that postgraduate study (PGS) has increased nurses? perception of their knowledge; leadership and understanding on the quality of patient care delivered, increased their academic and research skills and increased their confidence/self-esteem and recognition by their colleagues and team. Therefore the majority of respondents perceive postgraduate education has been an instrument of liberation and a process of empowerment and emancipation. A smaller percentage of respondents perceived that PGS had no effect on various aspects of patient care and another significantly smaller percentage of respondents reported negative results from PGS. This research identified similarities between this study and that of Pelletier and colleagues? (2003; , 2005; , 1998a; , 1998b) Australian study.
CONCLUSION: This study adds to the existing literature on postgraduate studies undertaken by nurses. No known study has previously investigated solely emergency nurses?perceptions of the effects of PGS, either nationally or internationally. The results of this study offer enlightening information regarding emergency nurses? perceptions of their PGS within NZ and offers a platform from which other studies may be undertaken. It also has the potential to inform nurses contemplating PGS and educators facilitating these programmes,as well as provide implications for policy development by the Nursing Council of NZ, NZ Universities, DHBs and the Ministry of Health.

Abstract: A paper presenting the findings of a small research project involving a group of self-selected senior nurses of Wellington Hospital to explore the nature of nursing practice in the care and management of hospitalised patients and to formalise the language that would acknowledge its significance in the current effort of hospitals to define patient care pathways. The nature of hospital nursing practice was described in themes of a generic process of nurse-patient care that articulates a distinct specialism of hospital nursing, whatever the hospital department in which nurses hold positions.

Abstract: A report on the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of ?successful design and delivery of rural health services? as a step towards a measurement tool. Participants were grouped as general practitioners (GPs), nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health.

Abstract: The nursing education environment is complex and varied, and is affected by both the education and health systems. This report backgrounds the funding systems that underwrite the Tertiary Education Commission (TEC) processes. The two primary objectives that have guided this collation are: to stimulate awareness and discussion of the issues around funding nursing education in New Zealand; and to promote understanding of the complex funding structures currently in place in New Zealand by students, nurses, nurse educators and nurse managers.

Abstract: Current research has confirmed that cigarette smoking is a risk factor for cervical cancer. The objective of this pilot study was to observe if women who smoked and were referred to the colposcopy department at Christchurch Women?s Hospital, required more follow up visits, treatments and re-referrals compared to non-smokers. New patients (n=494) who attended at the Christchurch Women?s Hospital colposcopy department in 2001 had their data observed for a six year period. The results identified that women who smoked were three times more likely to need a third follow up visit and twice more likely to need further treatments to remove abnormalities when compared to non-smokers. This pilot study also identified that 71% of Maori women attending the clinic were smokers compared to 44% of non-Maori women. The results are being used to highlight to health professionals that treatment has a greater chance of success if patients cease smoking. The results have also supported the maintenance and development of the smoking cessation clinic for colposcopy patients at Christchurch Women's Hospital where the link to cervical abnormalities and smoking is explained and behaviour modification is offered. We also found that Maori women were poor attendees for colposcopy when compared to non-Maori and these results identified a need for further research and development of strategies to improve attendance.

Abstract: The Well Child/Tamariki Ora Health Book (the Plunket book) is a small booklet given to New Zealand mothers on the birth of a child. Although use of the book has decreased since it?s inception in 1920, it is frequently kept within the family and handed on from mother to child. Utilising an oral history approach, this study has traced the development of the Plunket book over time and explored the experiences of a group of 34 women and one man who have reflected on their ownership of, or involvement with, Plunket books. The study found that the book remains an effective clinical tool for mothers and nurses. Nurses use the book as a tool to help develop a relationship with a mother and her family, and to identify and build on strengths. Mothers have used the book as a tool to link past with present, to maintain kinship ties across generations, to deal with change intergenerationally, and in a manner that contributes to their self-identity as woman and mother. The study recommends that nurses and other health professionals continue to use the Plunket book as a clinical tool mindful of the fact that the book remains in use beyond the health professional?s immediate involvement with the mother and child, playing an important role in the context of the New Zealand family across generations.

Abstract: This book examines in detail the confluence of personalities and professional and practice agendas, out of which emerged the research section, intent on placing research at the centre of the profession's evolution. It provides a fascinating look at how a group of women, utterly committed to nursing, drove their research agenda and it expands understandings of why nursing research is significant for the development of nursing. It also provides an insight into that web of relationships between the professional body, NZNA, the Department of Health, service delivery and education.
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