Abstract: This research project utilised a case study approach to give ward managers a voice in the literature, by exploring and describing from their perspective the benefits and challenges of one particular nursing undergraduate clinical education model. The tertiary education provider contracts the health provider to provide Clinical Nurse Educators (CNEs) to support second and third year undergraduate nursing students during their clinical experiences. The CNEs are seconded from their respective wards to meet the organisation's contractual obligations. Data were gathered from two ward managers using semi-structured interviews. The findings elucidate the role of the undergraduate CNE, highlighting benefits such as the CNE being supernumerary to ward rosters and having time to teach, not only supervise students. CNEs are student-focused and easily accessible as they are based on site. The CNE was the one person who was 'there' for a student as a student's preceptor can change shift-by-shift and day-by-day. One significant challenge which emerged was the replacement of ward staff, not only of senior nurses who can leave their wards for up to 12 weeks to undertake the CNE role but also that of the student's preceptor if the student's preceptor was on annual, sick or study leave. Other challenges such as the inability of ward managers to pre-book casual staff; preceptor work-loads; skill-mix issues and fluctuating fulltime equivalents are also discussed.

Abstract: This historical research study examines some of the factors that caused problems for early New Zealand trained nurses upon their introduction into New Zealand hospitals, between 1885 and 1914. Eight incidents in the professional lives of nurses of the period are used as illustrations of the strains and discord that were apparent in this time of change. Analysis of these incidents attempts to answer the question as to whether the introduction of trained nurses into the New Zealand hospital system did add new considerations to problems encountered by nurses in their professional life. The conclusion is that there was a new dimension of difference added to the system with the introduction of the trained nurse. This developed from the evidence that these nurses, particularly if they were also matrons, had to fit into the existing power structures, which were not really ready to accept them, either through choice or lack of foresight. Enmeshed within these considerations is the influence of Florence Nightingale; her effect on nursing itself, and the consequent public and official perception, or misperception, of who nurses should be.

Abstract: This paper is a culmination of the author's inquiry, reflection and critical thinking on the transitional phase that practice nursing is currently undergoing as part of the New Zealand Primary Health Strategy. The paper utilises both reflection-in-action and reflection-on-action as well as reflection-before-action, as a process. The author's starting point for this inquiry was attending the New Zealand Nurses Organisation Primary Health Conference in Wellington and reading a report from the Expert Advisory Group on Primary Health Care Nursing. Knowing that practice nurses are the majority of nurses working in primary health, she was concerned that changes to primary health were being driven with little reference or participation by them. The paper explores how practice nursing evolved in New Zealand and the developments that have occurred in the 30 plus years since its inception. It describes the role and current work of practice nursing in general practice, and highlights the constraints that have held back development and continue to do so. The 2002 New Zealand Primary Health Strategy is shown to provide an opportunity for development and enhancement, if some of the constraints are removed. As part of looking to the future the possibilities for practice nurses to lead the way in primary health development are explored.

Abstract: The author examines how writing shapes her practice and how she nurses, her way of being and doing. She notes that “as human beings we cannot be broken into subsets, my personal and professional being inform each other, therefore you will find woven into the fabric of this paper my personal and professional becoming united by the dominant thread of nursing”. The paper is structured using the different phases of her career as a staff nurse, nurse practitioner and charge nurse. In each section she has linked the stories of children and young adults with reflections on her writing and how it has impacted her practice. She goes on to say that question and reflection are vital adjuncts to nurses' development as individual practitioners and to the profession. They facilitate journeying past the superficial into the deep of a relationship with patients and colleagues. She identifies a responsibility as nurses is to engage with the individual and help them find a space where they can regain a sense of hope and personal power. This paper follows the author's journey, leaving her with a clearer understanding of who she is and how she nurses.

Abstract: This study traces the author's transition from being a mental health nurse to becoming a facilitator of an education programme, the Health and Wellbeing course, for those in recovery from mental illnesses. Within this transition, she describes a journey from disease-focused paradigms toward emancipatory paradigms, evidenced by her application of the recovery approach to her teaching. The 'recovery approach' proposed by the Mental Health Commission in November 1998, and other models of health, are explored using the methodology of descriptive/interpretive philosophical inquiry, autobiographical narrative and a dialectical research design. The author draws from the philosophies of phenomenology and existentialism to present excerpts from her journals, exemplars, poetry and artwork which illuminate epiphanies occurring as she integrates health paradigms in the design of the Health and Wellbeing course. Within this process the recovery approach is revealed as being consistent with the teaching principles of the Health and Wellbeing course. The author goes on to say that the dialectical research design reveals paradoxes and transformations in nursing, medical, psychological, and humanistic paradigms within the New Zealand socio-political context from the 1970s to 2003. The way these are integrated into her practice as an educator, becomes evident in the dialectical research cycles of being, thinking, developing a project, the encounter of teaching, making sense and communication. These cycles reveal her being in the roles of nurse and educator and the thinking through of paradigms that lead to the design and philosophy of a Health and Wellbeing course, the encounter of teaching, and the communication of insights gained. The author's main objective is to show the importance of nurses and educators developing a reflective consciousness when working with sufferers of mental illness. This reflective consciousness involves three levels: The primary level, or raw experience; the social level, or our socio-political contexts and social values, and, the realised level, insights gained about knowledge and experience.