Abstract: Assesses the safety of actively avoiding endotracheal suction in post-operative cardiac surgical patients ventilated for less than 12 hours. Describes local endotracheal suction practice, and elucidates patient experience of the endotracheal tube and endotracheal suction. Conducts an observational audit describing endotracheal sucion practice within the cardiothoracic and vascular intensive care unit in Auckland City Hospital. Undertakes a prospective, non-inferiority, randomised controlled trial investigating the safety of avoiding endotracheal suction.

Abstract: In 1973, two trial pre-registration nursing education programmes were piloted in New Zealand polytechnics. These represented an alternative to traditional hospital-sited schools of nursing. The establishment of nursing education in the tertiary sector marked a radical challenge to the cultural heritage of apprenticeship-style nursing training associated with paternal and medically-dominated health institutions. This thesis offers a Foucauldian and feminist poststructuralist analysis of discourses employed by fifteen senior nursing educators in the comprehensive registration programmes between 1973 and 1992. The women employed to teach in the comprehensive programmes faced unique challenges in establishing departments of nursing, in developing curricula that would promote a reorientation of nursing and in supporting candidates to attain their nursing registration. Through semi-structured interviews and discourse analysis methods, a set of unique characteristics shared by this group of early leading comprehensive nursing educators has emerged. The women's narratives were underpinned by discourses that centre around the valuing of education as a vehicle for emancipation and an upholding of a legitimacy of difference in nursing educators' work. The participants upheld the importance of clinical practice skills and drew on their own student nursing experiences as incentives for reforming nursing education. These nursing educators conceptualised an idealised type of graduate, and commonly employed an heroic metaphor to describe their experiences as senior comprehensive educators. Their engagement with such discourses and their shared characteristics demonstrate unique re-constitutions of power, knowledge and relations with their colleagues and clients throughout the education and health care sectors. The author proposes that these traits characterise the women as strategic and astute professionals who successfully negotiated the construction of comprehensive nursing programmes as a legitimate and transformative preparation for nursing registration.

Abstract: Explores the experiences of overseas-trained nurses (OTNs)who have migrated to NZ within the last two years. Focuses on OTNs' lived experiences and the difficulties they may have experienced when making the transition to practice in the NZ health system. Employs an exploratory, qualitative descriptive methodology to elucidate themes.

Abstract: Describes four historical sources relevant to the history of nursing in NZ. Uses them to explain how nurse researchers can evaluate their research material. Outlines the five dimensions of evaluation: provenance, purpose, context, veracity, and usefulness. Explains the questions that must be addressed in each dimension of the evaluation. Illustrates the different kinds of information available in the 4 selected historical sources, by references to individual nurses.

Abstract: Discourse about women assuming greater control over their childbirth experience has received much attention in contemporary childbirth and womens' studies publications. Research in the domain of childbirth has shown that a sense of control over one's birth experience is related to childbirth satisfaction. More specifically, studies have used Locus of Control measures and have found a significant relationship exists between expectations for control and choice of birth place. Choice of birth place features in some articles as a factor that determines the degree to which control can be exercised. Home, as a place of birth, is considered a setting in which a woman can have optimum control over her experience. Many women are discouraged from taking up this option, based on fears about safety. Reflection on why women continue to pursue a home birth against the wishes of their care giver rekindled and interest in Locus of Control. This study was undertaken to explore the relationship between urban women's choice of birth place setting and their scores on two different measures of Locus of Control (LOC). The aims of the study were: to test whether LOC scores predict choice of birth place for women who chose hospital, home or a birthing centre as their place of birth; to test which of the two LOC scales (Levenson's generalised measure or Wallston et al's more specific scale) is the most useful in predicting the influence of LOC and choice of birth place and to explore the relationship between choice of birth place LOC, demographic and contextual factors surrounding pregnancy. The method used in the study was a descriptive correlational design. One hundred and ninety four pregnant urban women who accessed a range of maternity care providers in the greater Auckland , Wellington , Christchurch and Dunedin cities responded to a “Birth Choice Survey” between April and June 1996. Tests of significance found significant differences for powerful others and chance Locus of Control among the three groups of women who chose hospital, home or a birthing center as a place of birth. Differences were significant at p = 0.05. No significant differences were ffound in the scores for internal Locus of Control for women in the three groups. Limitations in the sample sixe prevented linear discrimination being successful in predicting the influence and choice of LOC variables and choice of birth place for both scales. A classification tree was employed to identify key variables which might affect choice of birth place and indicated that women who were extremely happy with their birth place choice were more likely to be those who chose home birth. Locus of Control measures are interesting, and if used specifically, may be helpful in relation to understanding a women's choice of birth place. However general assessment of the contextual factors appears just as relevant. Implications of this study are the while women may differ in how they perceive their outcomes are determined, an overwhelming majority of women who participated in this study value their ability to make choices about their birth location. Identifying consumer perceptions about control and the contextual factors that influence women's choice of their birth place has the potential to clarify women's preferences for responsibility in their birth experience. Limitations of the study were addressed and included suggestions to improve response rates and thus generalizability of findings. Implications for further research were also considered

Abstract: The process of describing her scope of practice led the author to become interested in just how she has advanced her practice and the journey that unfolded. The author was introduced to a number of models or frameworks and these frameworks have been critiqued within this dissertation.

Abstract: Considers whether the Canterbury Dedicated Education Unit model of clinical teaching and learning can support graduate registered nurses in their first year of practice. Uses a descriptive exploratory case-study approach to gather data via three focus groups with a total of eleven participants. Undertakes thematic analysis to identify patterned meaning across the dataset from which two primary themes emerge: support, and recruitment and retention. Identifies five associated sub-themes: peer support, organisational support, liaison nurse support, team support for the graduate registered nurses, and team support for the staff. Reveals the significant contribution made by the Nurse Entry-to-Practice Programme Liaison Nurse as a conflict broker.

Abstract: Explains the implications of pressure injuries as an indicator of quality of care and how the Waterlow scale is used in international guidelines for prevention of such injuries. Explores the effectiveness and validity of the Waterlow scale in acute care settings for the prevention of pressure injuries by means of a synthesis of the information from 11 studies examining the validity, reliability, feasibility and cost implications of using the Waterlow scale. Recommends its use in conjunction with clinical judgement.