Abstract: Pain management practices within emergency departments require a more patient focused approach due to extended waiting times for analgesia. This dissertation questions current methods of providing timely and appropriate delivery of analgesia. Nurses represent the biggest resource in emergency departments therefore are in a position to be able to access patients in a timely fashion. A review of the literature pertaining to nurse initiated analgesia protocols has been evaluated and information relating to efficiency and safety utilised to discuss the processes for planning and implementation of a similar protocol. The author finds that the literature provides no evidence that nurse initiated analgesic practices prior to medical assessment compromises patient safety or delays diagnosis. A discussion of the benefits to patients, nurses and the institution has been included to highlight the appropriateness of extending nursing roles.

Abstract: This dissertation is an exploration of what underpins and informs clinical nursing practice by telephone in mental health emergency settings. A critical review of the literature provides the foundation for discussion. Points of reflection explore links between the literature and the author's own experience and thoughts about clinical practice. Findings are presented within three main sections. 'Historical Context' considers the development and function of mental health emergency service telephone work. Practical aspects are discussed under `Service Provision Context.' 'Nursing Context' explores the fundamental skills involved in clinical reasoning and the preparation of staff for telephone work. Whilst 'Best practice' in the area of nursing by telephone is yet to be well defined, this work aims to provide a foundation for further inquiry, research and dialogue.

Abstract: In this thesis the nursing roles in respect of tuberculosis in New Zealand from 1928 to 1966 are identified, and then examined by contextualising them in relation to the changing social, political, demographic, scientific and technological environments in which the treatment and prevention of tuberculosis took place. The history of the various institutions is described in order to show some of the circumstances that led to the evolution of the roles of dispensary nurse, district nurse, school nurse, public health nurse, sanatorium nurse, and hospital nurse. 1928 to 1966 covers a sufficiently long period of intensive activity and change in the detection, treatment and research of pulmonary tuberculosis in New Zealand, to enable comparisons between nursing roles to be made. It was found that nurses had an individualised approach to their work. This was defined by the physical environments within which they worked, whether it was a hospital, sanatorium, dispensary, school or in a patient's home. Also, the medical treatments advocated and implemented by the medical practitioners, the rules and regulations which governed the various work areas, and the availability of staff, funds, facilities and resources all had an impact upon how nurses were able to work and how their respective roles developed. In addition, some of the factors which contributed to nurses getting tuberculosis and the initiatives to improve the nurse's conditions of work are examined, because these had an impact on the performance of the nurse's work and evolution of her role. Apart from practical nursing care, nurses also had a role in the on-going inspection, monitoring, notification, emotional support of patients and families, morale boosting and education. Each role had these components. The differences were in the time and emphasis given to each.

Abstract: This paper discusses how students become able to work with sick patients for whom they may feel disgust or discomfort. It is a sustained engagement with the literature on abjection and disgust and is not the outcome of evaluation research. It considers the role of problem-based learning pedagogy in facilitating students' negotiation of their own discomfort and horror, and describes experiences which enable them to approach abject patients with more comfort and less disgust. The paper argues the importance of creating spaces where students can explore issues which are distressing and disturbing so that they will feel able to remain in nursing.

Abstract: This paper explores the relationships within teaching, learning and practice development in critical care nursing and questions the popular assumption that 'post graduate (Master's level) education fits all'. The need for critical care nurses to apply advanced knowledge and technical skills to complex and dynamic practice situations necessitates the development of critical thinking and a problem-solving approach to clinical practice that can be fostered through education and experience. Discussion focuses on the successful development and implementation of graduate level education for critical care nurses in the South Island of New Zealand and how this development is challenging existing approaches to the provision and evaluation of formal critical care education in New Zealand.

Abstract: A preceptorship programme of 100 hours duration was developed and delivered by a nurse education institute, in consultation with a health care organisation. The purpose of the study was to examine preceptors, preceptees, and nurse managers' preceptions of the preceptor role and factors which influenced the performance of preceptors. Using focus groups, participants were each asked to identify the outcomes of the programme in practice. Study findings highlighted the importance of formal preceptor preparation, personal and professional development of the preceptors, and the promotion of positive partnerships between nurse educators and nurse practitioners. The need for formal recognition of the preceptor role in practice, particularly in relation to the provision of adequate time and resources, emerged from the study. The research findings enabled the development of an evaluative model of preceptorship, which highlights the intrinsic and extrinsic factors impacting on the preceptor role

Abstract: The present paper reports on the results of a telephone survey of 217 alcohol and drug treatment clinicians on their beliefs and practice, in relation to service provision for women. Nurses comprised the second largest professional group surveyed. Seventy-eight percent of clinicians believed that women's treatment needs differed from men's and 74% reported a range of approaches and interventions, such as assisting with parenting issues and referral to women-only programmes. Several differences emerged in relation to approaches and interventions used, depending on clinician gender, work setting and proportion of women on clinicians' caseload. Implications for mental health nursing include the need to more systematically incorporate gender-based treatment needs into practice and undergraduate and postgraduate education and training programmes.

Abstract: This paper presents an analysis of mixed methods research, which the authors suggest is captured by a pragmatically inflected form of post-positivism. Although it passes for an alternative methodological movement that purports to breach the divide between qualitative and quantitative research, most mixed methods studies favour the forms of analysis and truth finding associated with positivism. The authors anticipate a move away from exploring more philosophical questions or undertaking modes of enquiry that challenge the status quo. At the same time, they recognise that mixed methods research offers particular strengths and that, although it serves as a Trojan Horse for positivism, it may productively carry other paradigmatic passengers.