Abstract: This paper examines the difficulties health professionals face daily when providing care for the mentally disordered offender in the court environment. The role of the court nurse is to provide care for people with mental health needs in the court and health professionals can find this a restrictive environment to work in. This is mainly due to the court's legal processes which are designed to punish rather than offer therapeutic alternatives. By advocating for the mentally disordered offender, the court nurse ensures the court is aware of an individual's mental health needs, thus reducing the prospect of inappropriate sentencing, and the associated stigmatisation that may occur as a result of a criminal conviction.

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 research project, a descriptive study using narratives, explored the application of cultural safety theory and philosophy to clinical nursing practice. This application was illustrated through the stories of four experienced Pakeha,Tauiwi registered nurses in Aotearoa/New Zealand, who described their realities of applying cultural safety to daily clinical practice. The incentive for this study had been identified in light of the current political climate, pragmatic realities and in keeping with the current state of knowledge.Cultural safety was first identified by Maori nursing students and subsequently described and articulated by Maori nurses, as being a potential solution to improving Maori health statistics in Aotearoa/New Zealand. Many Maori and Pakeha/Tauiwi in this country accept that the Treaty of Waitangi, a covenant signed between Maori and the Crown in 1840, is the incentive for giving cultural safety status and credibility. While the Nursing Council of New Zealand has supported this concept and made it a requirement for all nursing education, there is little literature written concerning its application to practice from a Pakeha/Tauiwi perspective.The perceptions and insights of these nurses were heard when they were invited to describe how they saw cultural safety as part of their daily clinical practice and recount their struggles, realities, practice and experience. The literature review supported the use of narratives as an appropriate method for this study. The philosophy and assumptions of narrative appear to match the oral tradition of nursing and thus it was considered possible to contemplate the fit of narrative to nursing research.The stories of these nurses, gave examples of best nursing practice in which cultural safety was integral to practice, and provided exemplars of possible beginnings and possible endings. The depiction of cultural safety in practice surfaced as the weaving of four themes which were consistent in all the stories – themes of reflection, reverencing, the environment, and hidden blessings and healing. The research evidence suggested that cultural safety was visible in practice in many diverse ways; it emphasised the complexity of the concept; accented its evolving status; and identified a relative consistency in defining cultural safety despite the varied contexts of practice.Although this study was limited by the small sample, the findings indicated that there were potential implications for nursing education, research, nurses and nursing practice as well as for other health care providers working in the current health care system. They suggested that actions from nurse educators, nurse managers, health care managers and clinical nurses themselves, would be needed to ensure that cultural safety continued to be part of nursing practice and contribute to the improvement of all health statistics in this country as well as to encourage an increased development in the focus on Maori health issues.Further nursing research suggested by the findings include studies to appraise cultural safety from a patient's perspective, and consideration given to the evaluation and assessment of nurses and their culturally safe practice. In addition, exploration and research could ascertain the benefits and rewards of culturally safe practice and identify ongoing educational needs as well as examining the views of other members of the multi-discipline team

Abstract: This research paper reports on the findings of a literature review conducted to establish and analyse the international magnitude, context and effectiveness of nurse-led heart failure initiatives. The research revealed that the underlying philosophy in establishing nurse-led disease management programmes of care is that, by treating chronic heart failure as a continuum, it is possible to decrease exacerbations and improve patient outcomes. Regardless of the type of heart failure management programme, critical components of care include a collaborative supportive approach that educates and empowers the patient (including family/whanau) to recognise the early indicators of exacerbation, access expedient care, and to adhere to evidence based treatments. The author points to significant evidence to support the establishment of nurse-led heart failure programmes. The positive outcomes associated with this model of care delivery include decreased readmissions, reduction in mortality, and cost efficiencies. However, the organisational model of care, or programme components that are the most effective in optimising patient outcomes, need to be selected on the basis of local healthcare infrastructure, services and resources. The author suggests that New Zealand has a unique opportunity to encompass the recent emergence of the Nurse Practitioner role in facilitating, coordinating and monitoring of heart failure programmes across the continuum of care. The delivery of evidence-based, cost effective, heart failure programmes is a prerequisite to improving the delivery of optimal treatment and ensuring that heart failure patients have the opportunity to attain quality care outcomes.

Abstract: Practice development, situated at the nurse-patient interface, is a crucial aspect of professional development as a whole. The Nursing Development Unit (NDU) is one model of structured clinical practice development. NDU have their origin in a desire to provide the best possible care for patient through the support and development of autonomous therapeutic nurses. All possible sources of NDU-related literature from 1983-1999 were reviewed to determine the effectiveness of the NDU model. The purpose of the research was to establish the role of the parent organisation in supporting the ongoing viability of NDU; to describe the key processes and activities of NDU that are instrumental in the development of nursing practice; to clarify the role of the NDU in contributing to improved patient outcome; and finally to identify the critical indicator of successful NDUs for their application in the New Zealand context. The study found that British nursing journals have played a large part in promoting the NDU model. The pioneering units were given positive coverage and this has by and large continued. Accreditation systems have been important in maintaining standards and providing a generic framework for implementation. The trend is now towards internal funding from the parent organisation. The review identified a number of key features for the successful establishment of NDUs. NDUs appear to have under emphasised the development of socio-political acumen in the nursing staff. However, the NDU does offer a model for the development of confident, assertive, autonomous professionals. The NDU model values nursing as professional practice. The author concludes that the NDU model has stood the test of time, and demonstrated the ability to be at the vanguard of contemporary practice development. The model is flexible and its potential is maximised when it is tailored to meet the need of the parent organisation. The model has been successfully established in Australia, and has the potential to be adapted and refined for the New Zealand context.