Abstract: The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.

Abstract: The Well Child/Tamariki Ora Health Book (the Plunket book) is a small booklet given to New Zealand mothers on the birth of a child. Although use of the book has decreased since it?s inception in 1920, it is frequently kept within the family and handed on from mother to child. Utilising an oral history approach, this study has traced the development of the Plunket book over time and explored the experiences of a group of 34 women and one man who have reflected on their ownership of, or involvement with, Plunket books. The study found that the book remains an effective clinical tool for mothers and nurses. Nurses use the book as a tool to help develop a relationship with a mother and her family, and to identify and build on strengths. Mothers have used the book as a tool to link past with present, to maintain kinship ties across generations, to deal with change intergenerationally, and in a manner that contributes to their self-identity as woman and mother. The study recommends that nurses and other health professionals continue to use the Plunket book as a clinical tool mindful of the fact that the book remains in use beyond the health professional?s immediate involvement with the mother and child, playing an important role in the context of the New Zealand family across generations.

Abstract: A dissertation in partial fulfilment of Master Health Sciences (Clinical)through University of Otago
The nurse practitioner is one of the newest nursing health care professionals to be introduced to the New Zealand health system for many years. Eighty-six nurse practitioners are credentialed in New Zealand, with three working in urban Emergency Department settings. Nurse Practitioners are common internationally especially in the United States, Canada, United Kingdom and Australia. The purpose of this integrated literature review is to explore current research and literature in regards to the Emergency Department Nurse Practitioner, and their role within emergency settings. This review presents the growth and development of the nurse practitioner as an advanced practice nursing position. Four key themes emerge from the literature review; education of the Emergency Nurse Practitioner , how and who defined the Emergency Nurse Practitioner role, practice setting of the Emergency Nurse Practitioner, and what the barriers are to independent practice. The economic, legal and governance aspects of the Nurse Practitioner role are also portrayed. This integrated review documents the potential for further development and expansion of the Emergency Nurse Practitioner scope of practice to provide a broad range of patient care services within Emergency Departments, and emergency care settings. Future research is essential for the promotion of autonomous practice of the Emergency Nurse Practitioner within the international and New Zealand health care system.

Abstract: A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Nursing.

Abstract: This dissertation by Deborah Alleyne explores the current context of nursing in New Zealand prisons through rediscovering the history of its introduction and development, and review of relevant literature. Prison nursing is recognised as a unique branch of the wider nursing profession by virtue of the environment in which nurses work and the population for whom they provide care. Four key themes are identified from the literature review: custody versus caring; nurses' relationship with custody staff; nurses' relationship with prisoners; isolation.

Abstract: Examines the lived experiences of adults with myasthenia gravis(MG). Uses an interpretive phenomenological approach applying the research methodology of van Manen (1990). Interviews seven people living with MG and records their experiences of the disease. Poses broadly-worded questions about various topics related to MG, that include diagnosis, symptoms, treatments and coping strategies, guided by individual experiences. Reveals by means of thematic analysis that MG affects every aspect of a person?s ?lifeworld?: their sense of time, body, and space and their relationships with others. Highlights three main themes embedded in the data experienced by a person with MG: living with uncertainty, living with weakness and living with change.

Abstract: A study of work patterns on a surgical ward