Abstract: Chronic stress and 'burnout' have been extensively researched in nursing populations, but very little is known about the impact of specific acutely stressful or significant events. A novice nurse's first encounter with patient death may pose considerable cognitive, emotional and clinical challenges. Using a mixed methods design, this study explored the clinical circumstances, impact and challenges and rewards of nurses' early experiences with patient death.

Abstract: In 1997, Advanced Mental Health Nursing Programmes were funded nationally by the Clinical Training Agency using the funds made available subsequent to the 1996 Mason Report. The training leads to an award of either a post graduate certificate or diploma awarded by a tertiary education provider.A review was conducted with the aim to monitor the impact on service provision of advanced mental health nurse practitioner training. This was done by obtaining feedback through using an agreed standard questionnaire from course participants and mental health service providers.In seeking to learn more about the impact of these programmes, the CTA identified the following key issues:- what effect the courses may have had on mental health workforce make-up, skills and retention.- perceptions of programme delivery and content.- the impact on service delivery.Overall findings are shared which highlight that the course was seen as well organised and participants and service providers would recommend it to their colleagues. The greatest effect of the course appeared to be in developing more understanding of clinical supervision. Participating in the course had also led to positive changes in relationships with the clients and colleagues for more than three quarters of the group.The provision of an Advanced Mental Health Nursing Programme in 1997 has had many positive effects. The funding strategy and delivery models that have evolved may provide a useful template for other nursing specialty areas

Abstract: Case study research, as a qualitative methodology, attracts some criticism, especially related to rigour, reliability and validity. A New Zealand-based study that explored complex phenomena – flexible learning for postgraduate nurses – provides a practical example of how the case study design can address these criticisms. Through describing the mixed methods used, different sources and methods of data collection, and data analysis, the process of achieving data quality and trustworthiness are highlighted.

Abstract: This study presents information, obtained from health service managers, on the present use and possible future use of second level nurses within the region encompassing the Wanganui, Rangitikei, Manawatu, Tararua, Palmerston North City and Horowhenua districts. “ Second level nurses” are currently known as enrolled nurses and, in accordance with Section 53A of the 1983 Amendment to the Nurses Act, are required to work under the direction and supervision of registered nurses or medical practitioners. Enrolled nurses are usually allocated less responsibility for nursing assessment and judgement than registered nurses.Management perspectives, from seventy seven health workforce managers, were sought in relation to the future workforce need, the scope and boundaries of practice, and the alternatives for the future educational preparation of second level nurses. Seventy two percent of managers said that they thought enrolled nurses were essential to New Zealand's future nursing workforce. They predicted increased opportunities for enrolled nurses in care of the elderly and community care settings. Patterns in the current workforce utilization of enrolled nurses, however, did not support these views.In relation to the education of enrolled nurses, managers indicated that hospital-based training was the most preferred option. However, managers asserted that, in view of the current lack of employment opportunities no more enrolled nurses should be prepared at the present time.Although questions about education were focussed on the educational preparation of enrolled nurses, many of the respondent managers also expressed opinions about the educational preparation of comprehensive nurses. As a result, an evaluation of comprehensive nursing programmes is suggested.While the numbers of second level nurses being prepared and used is decreasing, there is a concomitant increase in the preparation and use of caregivers. This rapidly increasing group isfast becoming a “cheaper” second level workforce. The increase in the use of caregivers is seen to result from the pressure on healthcare employers to reduce spending within the current highly competitive, de-regulated economy. Managers asserted that enrolled nurses are not cost effective in comparison with either caregivers or registered nurses.The study concludes with thirteen recommendations which are made under the following four groups;1. Manawatu Polytechnic – provider of nursing education.2. Healthcare employers – users of nursing education.3. Enrolled nurses – participants in nursing education.4. Professional nursing bodies – guardians of nursing education

Abstract: This article explores the impact a chronic illness has on an adolescent patient, their family, and social, work, cultural and spiritual aspects of their life. The discussion will focus on the patient's healthcare experience and the nursing strategies undertaken to help maintain her optimum health. The personal information used in this article was gathered from an interview with the patient during a second-year undergraduate nursing student clinical learning experience.

Abstract: A research portfolio submitted in partial fulfilment of the requirements for the degree of Master of Health Sciences, The University of Auckland, 2010.
Background:
The 2006 New Zealand (NZ) Guidelines for Rheumatic Fever (RHF) (National Heart Foundation of New Zealand and Cardiac Society of Australia and New Zealand, 2006) have an over-arching objective to support appropriate management of RHF to prevent recurrent attacks and reduce mortality and morbidity from RHF and Rheumatic Heart Disease (RHD) (Craig, Anderson, & Jackson, 2008; National Heart Foundation of New Zealand and Cardiac Society of Australia and New Zealand, 2006).
Aims:
The aims of this study were to audit current practice and service provision associated with RHF programmes and initiatives in NZ District Health Boards (DHBs) against the 2006 NZ Guidelines for RHF and to identify the barriers and facilitators to clinicians meeting the guidelines.

Abstract: A research portfolio submitted in partial fulfilment of the requirements for the degree of Master of Nursing, The University of Auckland, 2009
This paper is a report of a study seeking to understand the experience of New Zealand rural dwelling Mäori clients with end-stage renal disease who receive haemodialysis. End stage renal disease (ESRD) is related to lifestyle, genetic factors and environment, and Mäori are at higher risk of renal disease which results of need for renal replacement therapy to sustain their lives. Dialysis clients are a group of ?silent? clients under the care of the dominant health professionals. Adherence with therapeutic regimes has been a main issue for health care professionals and service delivery, as it directly contributes to the efficacy of the treatment and cost effectiveness. Mäori clients? experience of living with haemodialysis has not been explored. Although there are a number of studies describing the experience of patients living on dialysis so far, no studies have yet focused specifically on the experience of Mäori clients towards their renal replacement therapy. The continual demands of dialysis treatment are significant and given the high proportion of Mäori having dialysis. It is timely to explore the experience of Mäori clients and their family/whänau in order to understand the need for quality of care and to promote Mäori health outcomes in chronic kidney disease management

Abstract: The New Zealand nursing workforce is increasingly made up of overseas trained nurses. There is extensive literature from elsewhere in the world on the impacts of international nurse recruitment and migration on individual nurses and on health services. The literature also portrays evidence of abuse and exploitation, yet few studies are available relating to the experiences of migrant nurses in New Zealand. This research conducted a survey of overseas-trained nurses, specifically focusing on those nurses for whom English is not their first language, to understand the experiences and factors affecting migrant registered nurses in New Zealand. Given the importance to the New Zealand workforce of overseas-trained nurses, this research highlighted that more warnings and advice regarding recruitment agencies and information about nursing in New Zealand and the Nursing Council requirements for registration should be made available to nurses prior to their migration. Nursing leaders should be particularly alert to any evidence of bullying or discrimination based on race or overseas origin.