Abstract: The aim of the study was to determine the practice of nurses employed in integrated care projects in New Zealand from late 1999 to early 2001. Integrated care was a major health reform strategy that emphasised primary health care as a means to improve service provision between the health sectors. An investigation of nurses' practice sought to determine the extent to which primary health care principles had been adopted in practice, as a comprehensive primary health care approach has been advocated globally in the management of chronic conditions; the leading cause of disability throughout the world and the most expensive problems faced by health care systems. The philosophical basis of the research was postpositivism. The study employed a quantitative non-experimental survey design because it allowed numeric descriptions of the characteristics of integrated care projects to be gained for the purpose of identifying nurses' practice. The unit of inquiry was the integrated care project, and 80 comprised the study population. Data were obtained on projects from expert informants (n=27) by telephone survey using a structured interview questionnaire developed by the researcher. Data obtained from interviews were statistically analysed in two stages. First, data were produced to comprehensively describe the characteristics of integrated care projects and nurses practice. The 'Public health interventions model' was used as a framework to analyses the interventions (activities) and levels of population-based practice of nurses. Following this, the social values embedded in nurses' practice were determined using 'Beattie's model of health promotion' as a framework for analysis. A strong association was found between nurses' practice in projects and strategies used in integrated care, such as information sharing, guideline development and promotion, and case management, and projects with an ethnic focus, low income focus, chronic condition focus, and well-health focus. Whilst nurses undertook interventions most frequently at the individual practice level they were also strongly associated with the small proportion of interventions that were undertaken at the community level. The majority of interventions by nurses reflected the health promotion value of health persuasion, indicating a paternalist and individual-oriented philosophy. Nurses were engaged in two interventions that indicated a collective-oriented philosophy – coalition building and community development, the latter reflecting health promotion values of negotiation, partnership and empowerment. The study demonstrated that nurses' practice in projects was predominantly centred on individual-focused population-based practice suggesting the need for a framework to assist nurses to transition their practice to include more activity at the community and systems levels. Without a reorientation of practice, nurses will remain limited in their ability to achieve health gains for populations. In response to this conclusion, and drawing on research results and reviewed literature, a new model, The 'Primary Health Care interventions model' was constructed. Recommendations include advocacy for the acceptance of the model by the health funder, professional nursing bodies, health organisations, educational institutions, nurses, communities, and individuals.

Abstract: The author suggests that the thesis as a production of disciplined work presented in a creative style is congruent with performance and presentation best practice in community arts. As a practising nurse artist the author describes creating spaces of alternate ordering within the mental health field environment. “I also inhabit the marginal space of the artist working in hospital environments. This Other Place neither condones nor denies the existence of the mental health field environment as it is revealed. Yet, it seeks to find an alternative to the power and subjectivity of the [social] control of people with an experience of mental illness that inhabit this place both voluntarily and involuntarily. I have used a variety of texts to explore the experience and concept of Otherness. The poems are intended to take you, as a reader where you could not perhaps emotionally and physically go, or might have never envisaged going. They also allow me as the author to more fully describe the Otherness of place that is neither the consumer story nor the nurse's notation, but somewhere alternately ordered to these two spaces. Drawing on the heuristic research approaches of Moustakas and literary psychogeography , particularly the work of Guy Debord, this thesis creates the space to explore the possibilities of resistance and change and the emergence of the identity of the nurse artist within the mental health field environment”.

Abstract: This literature review focused on research that primarily addresses the issues related to medications that arise in tertiary care facilities. It finds that investigations into medication errors have primarily focused on the role of nurses, and tended to identify the nurse as deliverer of unsafe practice. Over the past few years a shift in how medication errors are understood has led to the identification of systems-related issues that contribute to medication errors. The author suggests that nurses should contribute to initiatives such as the 'Quality and Safe Use of Medicines' and develop nursing led research, to address some of the safety related issues with a view to enhancing patient safety.

Abstract: Recent changes to the way that health services are provided and issues related to the rural health workforce are creating an international crisis in the availability of rural maternity care. International trends show a workforce decline in rural general practitioner obstetric specialists and rural midwives, as well as a decline in rural births. The aim of this study is to highlight the maternity needs of rural New Zealand women. Further, it discusses how the changes to maternity services in New Zealand, over the last sixteen years, have impacted on the rural nurse and midwife role and therefore on service provision. This information is intended to identify issues that could be used as the basis for development of a uniquely rural model of maternity care.

Abstract: This article examines the role of nurses working in intensive care units who may need to work with families as they face the death of a loved one. How the nurse communicates with relatives during these crucial hours prior to the death can have profound implications on their grief recovery. Universal needs for families in this situation have been identified in the literature, and include: hope; knowing that staff care about their loved one; and having honest information about their loved one's condition. A case study is used to illustrate key skills and techniques nurses can employ to help meet these universal needs. In the first stage of grief the bereaved is in shock and may feel a sense of numbness and denial. The bereaved may feel confused and will have difficulty concentrating and remembering instructions, and they may express strong emotions. Studies on families' needs show that honest answers to questions and information about their loved one are extremely important. It is often very difficult for the nurse to give honest information when the prognosis is poor. Good communication skills and techniques are discussed, in which hope is not offered at the expense of truthfulness, and the nurse facilitates the process of saying goodbye and expressing emotions. Practical techniques, such as including the family in basic care such as foot massaging and simple hygiene routines, may also be used to move the family from being bystanders to the impending death, to comforters.

Abstract: Conducts thematic analysis to identify two predominant gender scripts: of nursing as women's work, and that men who nurse are homosexual. Notes the associated themes of the effect of negative stereotyping on male nurses' career choice, and their resistance to the stereotype of normative masculinity. Considers that the same barriers to men becoming nurses have remained unchanged since first identified and discussed in the 1960s.

Abstract: This project was initiated by the Ministry of Health to ensure a nationally coordinated approach to mental health nursing. The purpose of the project is to provide a national strategic framework for mental health nursing that will strengthen both nursing leadership and practice within the multi-disciplinary clinical environment. The framework reviews a range of key workforce issues identified by the Ministry of Health and provides strategies to move mental health nursing forward. The framework integrates directions from government mental health strategies, policies and directions, national and international literature as well as professional nursing requirements which aim to create a sustainable mental health nursing workforce using evidence based practice. The framework considers a range of key workforce issues identified by the Ministry of Health including: nursing leadership, nurse practitioners, standards, skill mix, clinical career pathways, professional supervision, education, research and recruitment and retention.