Abstract: The purpose of this grounded theory study was to identify, describe and provide a conceptual explanation of the process of care offered by midwives and the effects of that care on women's experiences of childbirth on hospital. Ten couple participants and their attendant midwives provided the major source of data. The primary data collection methods used in this study were participant observation during each couple's experience of labour and birthing, antenatal, hospital and postnatal interviews with couples along with formal and informal interviews with midwives.Constant comparative analysis of data eventuated in the identification, in the context of this study denotes a process that is engaged in by both midwives and birthing women in order to establish practice, and the experience of giving birth, as being individually genuine and valid.Authenticating is multifaceted and is seen to include the intertwined and simultaneously occurring phases of 'making sense', 'reframing', 'balancing' an 'mutually engaging'.The process of authenticating is proposed as a possible conceptual framework for midwifery practice. It identifies the unique contribution the midwife can make to a couple's experience of childbirth and serves in a conceptual way to unite the technical and interpersonal expertness of the midwife. The conceptual framework of authenticating legitimizes 'being with' women in childbirth and facilitates a women-centred approach to care with consequent implications for practice, education and research

Abstract: This thesis explores the process of an annual appraisal strategy, 'clinical conversation', from the perspective of seven nurses who were assessed using this technique. The findings demonstrate that clinical conversation is a strategy which facilitates reflection, both as a solitary exercise and with others, to ensure that learning from experience is optimised. The research used a qualitative interpretive approach informed by the model of Grounded Theory espoused by Strauss and Corbin. All eight nurses who were assessed using the clinical conversation strategy were advanced practitioners working within the scope of sexual and reproductive health. Two of the actual appraisals were observed and seven of the nurses were interviewed within eight weeks of being assessed. The outcome of the clinical conversation was primarily one of learning; the acquisition of new insights into self as practitioner. The learning was facilitated through the process of narration; telling the story of clinical practice. Three distinct narrative cycles were identified, each an experiential learning episode. The experience of undertaking a variety of assessment activities created a narrative with self and triggered an internal reflective thinking process; the experience of working with a peer created an additional narrative, a mutual dialogue reflecting back on practice; the experience of sharing practice with an assessor created a further and final narrative, a learning conversation. Each narrative can be seen as a catalyst for change. Primarily, the nurses felt differently about themselves in practice, the way they saw themselves had shifted. Such a change can be described as an alteration in perspective. These alterations in perspective led all nurses to identify ways in which they would change their actual clinical practice. In this way the nurses attempted to align their espoused beliefs about practice with their actual practice. The author notes that the study shows that each nurse responded differently to each narrative learning cycle: for some the conversation with the assessor was more of a catalyst for change than for others. In this way clinical conversation may be flexible enough to respond to a variety of differing learning styles. Learning was person specific which is an imperative for the continued professional development of already highly skilled clinicians. The implication of the research is that whilst clinical conversation was designed as a tool for appraising clinical competence, its intrinsic value lies in supporting the professional development of nurses.

Abstract: The author considers the issue of mixed-sex rooming (MSR) in New Zealand hospitals. A review of the literature is presented, with a focus on the attitudes and experiences of patients in the UK, where the issue has been most practised and studied. Findings of a survey of a group of New Zealand female patients are presented. The patients feelings of embarrassment and loss of dignity and privacy are discussed. The legal issues are explored, with the practice evaluated against the patient's rights detailed in the Code of Health and Disability Services and the Privacy Act 1993.

Abstract: Mobile computing is rapidly becoming a reality in New Zealand health care settings. Personal Digital Assistants (PDAs) are the most frequently used of these mobile technologies, giving nurses access to clinical learning resources, including drug references, medical encyclopaedias and diagnostic information. The implementation of mobile computing at Waikato Institute of Technology (Wintec) will ensure graduates of our Bachelor of Nursing Programme are able to meet health care service demands for knowledge in contemporary information technologies as well as the information technology requirements defined by the Nursing Council of New Zealand and the Health Practitioners Competency Assurance Act 2003 for registration as a nurse in New Zealand. This paper presents strategies for the implementation of mobile computing as a core element of the curriculum for the Bachelor of Nursing Programme at Wintec in Hamilton.

Abstract: Examines the mobility experiences and needs of morbidly-obese patients before and during hospital admission. Undertakes semi-structured interviews with seven morbidly obese patients. Identifies two categories of mobility problems: 'compromised pre-existing mobility', with a subcategory of 'accessing services prior to admission' and 'mobilisation difficulties during hospitalisation', with a subcategory of 'dissonance between dependency and need for assistance'. Recommends bariatric-care pathways for the morbidly-obese patient.