Abstract: The aim of this qualitative study is to explore four clinical tutors' perceptions of their role on facilitating Bachelor of Nursing students' learning in the practice setting of the health sector in New Zealand. Participants were asked to share their personal experiences including the positive aspects and the difficulties and challenges they encountered when working with students.Contract clinical tutors, are employed because of their clinical experience and expertise to enable students to apply the knowledge learned in theory and the professional competencies learned in the laboratory into the reality of clinical practice. This requires that clinical tutors be familiar with the curriculum so that their role as supervisor, teacher, facilitator, guide ands mentor can assist the student in fulfilling their learning requirements when in clinical practice. They are not, however, involved in the development or the teaching of the theoretical component of the programme. The difficulties and challenges identified by the contract clinical tutors in this study, resulted in discussion concerning strategies that could be adapted by the faculty to support clinical tutors in their role of ensuring the students receive the best possible learning opportunities when assigned to the clinical areas.Focus groups interviews were chosen as a means of collecting data from four registered nurses currently or previously employed as contract clinical tutors to work with students from an undergraduate degree programme at a small polytechnic.A two hour focus group interview was held as a means of uncovering the shared thoughts and experiences of participants. A second focus group interview was conducted to qualify information and elaborate on some issues. From the data collected a number of recommendations were identified which if adopted by polytechnics will enhance quality teaching by contract clinical tutors.

Abstract: Patients with myisthenia gravis (MG) face major pulmary problems as a part of the disease process. In this descriptive study, changes in selected pulmonary functions (respiratory rate, negative inspiratory force, tidal volume and forced total capacity) in 14 patients diagnosed with mild or moderate MG were measured every two hours from 8.00 a.m. to 8.00 p.m. Females comprised 64% of the sample while 36% were males. All subjects received anticholnesterase medication, and some subjects received additional treatment modalities. Most of the subjects were non-smokers or previous smokers, but two subjects continued to smoke. Ninety-three recent of the sample had forced vital capacities less than 60% of their predicted values. Myasthenic forced vital capacities were significantly lower (p=.0000) than those predicted for normal subjects. The inspiratory force for the sample was low sat 8:00 a.m. as well as in females over 55 years of age. There was a wide variation in total volume to normal values derived from random tables and predicted equations ws not significant. Th major implications from this study are the need to assess pulmonary function in the hospitalized myasthenic every two hours, and the need for a program of coughing, deep breathing and sighing after medication administration when the muscles are strongest

Abstract: It is evident from the prevalence of items in the popular press and incased research by health professional that, over the last two decades, menopause as been discussed more openly. However, medical information is still largely oriented toward menopause as a disease with emphasis on the pharmacological interventions needed to correct the disease. Literature in medical and nursing journals is also predominantly oriented towards menopause as a state of oestrogen, nurse researchers and feminists writers are challenging this viewsThe aim of the research was to discover how women gain knowledge about menopause, and how they make decisions about “managing” their menopause. In the study knowledge was defined as being more than information. It is seen as being more than information. It is seen as understanding derived from synthesis of data about menopause collected from various sources. Eleven women aged 46-55 recruited through a letter in the researcher's local newspaper, were interviewed. The resulting data was analysed by the constant comparison method as used in grounded theory.A descriptive model was developed including the basic social process of “integrating menopause into midlife”. A tertiary level of education and good social support were found to be associated with the women being seekers of knowledge about their menopause. These women, the majority of the participants, revealed themselves as being self-controlling with respect to their menopause. Among the few who had allowed their menopause to be managed by others, if they experienced adverse effects of the treatment, then there was a move toward greater self management.,Generally, nurses were not seen by the participants as possible sources of information. That finding highlights menopause as an area of health education in which nurses have the potential to play a more active role

Abstract: The study reconceptualises the process of nursing practice where health is expanding consciousness. The praxis methodology and design derive from the findings of the previous study (Litchfield, 1993) through which a framework for personal practice was articulated. The philosophical premises were hermeneutic and dialogic reflecting a narrative orientation within a participatory paradigm. Ontology and epistemology merge and language is fundamental. The findings from this subsequent study depict the process of modeling practice as a tetrahedron to show inter-relatedness of four facets, each defined completely by the others: partnership, dialogue, pattern recognition and health as dialectic. Five young families with complex health circumstances were preferred by Plunket Nurses and visited at hole to talk about health and the family. Th e process of health patterning ended with indication of insight as the potential for action; the partnership ended as the closure of the initial contract to provide a summary text to the family. Transformative change in family living was identified. The continuous analysis of the scripts of the evolving conversations and summary text showed the relational, dialogic processes were identified as vision – finding purpose to act in the here-and-now against the backdrop of past and potential of the future; and community – a sense of being connected, participant and relevant in society. This process of research, as if practice, presented health and caring as synonymous and core of the discipline of nursing

Abstract: The report of a research project commissioned by the Wellington Division of the New Zealand Cancer Society to provide a foundation for policy to give direction to development of its services. The research approach and methodology had an ecological theory foundation. It involved a survey and in-depth interviews with people with cancer and those caring for them to understand their experience. Needs were identified from the data and presented according to three distinct phases in the course of living with cancer. People moved from the shock of diagnosis, through the time of treatment when usual living was suspended and focus narrowed on the intensive fight against the disease, then into a very different phase of on-going ?wait-and-see? time requiring a new way of living with uncertainty for both patient and carers. The last phase was where most of the unmet needs lay. Recommendations were made for services to provide a continuous caring relationship for patients and carers with a knowledgeable person from the point of diagnosis.

Abstract: The independently funded 10 month pilot project demonstrated the autonomy of nursing practice for a new role family nurse. The findings were presented as the health experience of families in strife with complex health circumstances, a description of a beginning model for the nursing practice that addressed the needs of these families as their circumstances changed over time, and its cost-effectiveness. A caseload of nineteen families was found to be optimum. The evaluation research continued throughout as a form of praxis expressed as health patterning, a methodology developed in previous research (Litchfield, 1993). The family nurse'spractice demonstrated qualities common to all nurses: the caring relationship and fiscal responsibility. The unique practice was characterised by a professional partnership of limited duration: the families referred to the service in a predicament of strife, trapped in the immediate present, gained a view to a future, moved towards assuming control over health circumstances, seeking and using services with discernment, and increasing community as family/group members and citizens. Cost containment was achieved through: a) development of a co-operative approach amongst family members, between families and professionals, and amongst all health workers, and b) the families discerning use of services by anticipating a future. Through one family case, cost of saving over the 7 months with the family nurse was estimated as $4000, a possible saving of $16000 over 13 months if the family nurse had been involved earlier, and projected savings in the long term of over a million dollars. The satisfaction of clients, nurses and professionals was shown. The service was positioned within the new health system of health reforms