Abstract: This paper continues presentation of the findings of a North Island based research project that explored the impact of clinically focused postgraduate education on advancing nursing practice. Like their international counterparts, increasing numbers of New Zealand nurses are enrolling in advanced practice programmes. Yet, despite international evidence supporting the usefulness of Masters level preparation for advancing clinical practice, questions about the need for such development persist. This paper argues that postgraduate education contributes to the development of courage and that this, in turn, is essential to overcoming the barriers that currently constrain the advancement of nursing practice.

Abstract: Interviews 14 participants, 10 older and experienced health professionals, and four managers. Describes the lived experience of health professionals ageing at work, and of the managers interacting with them. Demonstrates that the ability of older practitioners to adapt to meet the ongoing physical demands of practice and their shifting workplace environment determines whether they will be valued at work and remain in their roles.

Abstract: The researchers assessed the compliance rates with the rheumatic fever secondary prophylaxis programme established through the Auckland Rheumatic Fever Register and managed by community nursing services in Auckland. They undertook an audit of the 1998 and 2000 Auckland Rheumatic Fever Register data to establish the compliance rates of patients with the rheumatic fever secondary prophylaxis programme. The sample included all patients on the Auckland Rheumatic Fever Register during this time. Results showed compliance rates across the three Auckland DHBs ranging from 79.9% to 100% for individual community nursing offices. They found that a community-based nurse-led secondary prophylaxis programme for rheumatic fever heart disease is able to deliver excellent patient compliance levels. Secondary prophylaxis is the WHO-recommended cost effective first step to rheumatic fever/rheumatic heart disease control. Community health workers have a key role to play in facilitating this compliance.

Abstract: The purpose of this qualitative study was to analyse the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalisation; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalisation. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability.

Abstract: The intention of this research is, through collaborative discussion and selective conversations, to explore female caregivers' expectations and perceptions of primary health services for some Te Atiawa Maori children. The research process was developed in a partnership between the Maori women participants and the researcher. In addition, two local kuia actively participated in and supported the process. Emancipatory critical social theory underpinned and informed the project. Power relationships between the researcher and the participants can be overtly explored within this theoretical framework. In terms of this particular exploratory study, participatory research appeared to be applicable. The participants are female caregivers of Te Atiawa children. Data collection was done using group interactions and semi-structured interviews in the winter of the year 2000. A thematic analysis of the data was used, in which common themes were identified, compared and discussed. From the analysis of the data of the participants' conversations, key ideas were identified. The major findings have been identified within two main themes. These are: a concept of health is not the same for Pakeha as for Maori, and access issues are still problematic for the participants in this study. Many quotes from the interview participants are included in order to keep the focus of the project on the voices of the women interviewed. In terms of the significant contribution of this research, this study aims to allow voices of female caregivers of Te Atiawa Maori children to be heard. Individual and collaborative interactions offer insights into what is important to them in terms of Maori child health. Clearly, the primary health initiatives promoted by the New Zealand government are not reaching at least some of the people for whom they are intended. The research participants offered their ideas as to how these deficits could be remedied in their community.

Abstract: This thesis is a study of the experiences of four cultural safety lecturers in nursing education in Aotearoa / New Zealand. A review of literature reveals the recent and turbulent evolution of cultural safety. The media which documented this journey in a negative light in the 1990s prompted ministerial inquiries and the publication of the Nursing Council of New Zealand's guidelines for cultural safety in nursing and midwifery education (1996). Action research methods enabled the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action and reflecting. The findings of the research revealed that the participants not only coped with every day stressors of teaching but they were also required to formulate knowledge of cultural safety. For the Maori participants their stress was confounded with recruiting and retaining Maori students and macro issues such as commitments to iwi. Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that it was organisational in nature and out of their immediate control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations have been made which focus on supporting cultural safety educators to dialogue on a regular basis through attendance at related hui; the introduction of nurse educator programmes; paid leave provisions for cultural safety educators to conduct and publish research so that a body of knowledge can be developed; and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burn out.