Abstract: The purpose of this article is to review evidence about nurse workload, staffing, skill mix, turnover, and organisational characteristics' effect on outcomes; discuss methodological considerations in this research; discuss research initiatives currently under way; review policy initiatives in different countries; and make recommendations where more research is needed. Overall, an understanding of the relationships among nurse staffing and organisational climate to patient safety and health outcomes is beginning to emerge in the literature. Little is known about nursing turnover and more evidence is needed with consistent definitions and control of underlying patient characteristics. Research and policy initiatives in Australia, Canada, New Zealand, and the United States are summarised.

Abstract: There has been considerable public debate on the range of complementary health practices throughout the western world, perhaps especially in Australia, United States and Europe. Most often, the research critique of these practices is restricted to quantitative or non-user qualitative research methodologies. Consequently, there is a significant gap in the research profile of complementary health services that need to be addressed particularly in view of the rapid and ongoing increase in the use of complementary services, even in the face of sometimes adverse media publicity. This paper demonstrates the contribution that phenomenologically-based research can make to fill this lacuna by explicating, in detail, the client experience of a complementary health practice. The paper explores patient experience of a ginger compress, as applied by anthroposophically trained nurses, to demonstrate various therapeutic effects. Four key themes emerged including an increase in warmth and internal activity in the major organs of the body, changes in thought-life and sensory perception along with a greater sense of well-being and self-focus with the perception of clearer personal boundaries. These themes, emerging from a patient sample in New Zealand, compared favourably to the Filderklinik Study completed in 1992 in a large German state hospital.

Abstract: Eighteen months after the first of many large earthquakes, Christchurch-based home health care provider Nurse Maude surveyed staff to identify the impact on the well-being of their mainly elderly clients. Responses from 168 staff identified five key issues. These were: mental health, anxiety, and depression, symptoms similar to post-traumatic stress disorder (PTSD); unsafe environments; loneliness and isolation; difficulty coping with change; and poor access to services. To meet the needs of clients in this challenging environment, staff felt they needed more time to care, including listening to stories, calming clients and dealing with clients who had become slower and more cautious. Damaged and blocked roads, and the fact that many clients moved house without warning, added to the time it took to deliver care in the home. This survey has helped Nurse Maude build on its initial post-earthquake responses to better meet the needs of clients and support health-care workers in this stressful environment.

Abstract: The aim of this research was to ascertain the opinions of ward nurses (registered and enrolled nurses) on a critical care outreach (CCO) service and the early warning score (EWS) tool and how CCO helps them care for ward patients whose condition is deteriorating. An 18-item Likert scale questionnaire was adapted to gain opinions on three aspects of the service: The usability of the EWS tool and the escalation protocol; the role and usefulness of the critical care outreach nurse (CCON); and education and sharing of critical care skills. The research was conducted in a 270-bed New Zealand hospital with a nurse-led outreach team. The survey was distributed to adult general wards. It found 45 percent of ward nurses found EWS useful in identifying patients whose condition was deteriorating, 58 percent found EWS easy to use and 82 percent found EWS helped them prioritise workloads. On the role and usefulness of the CCON, 41 percent of surveyed nurses found the post-ICU review helpful, 65 said CCONs were approachable, 71 percent found the CCON shift time of 3pm-11pm was useful, 69 percent said the CCON demonstrated sound clinical knowledge, and 54 percent rated CCONs teaching as sufficient for their needs. When CCO was present, nurses were able to formulate an effective management plan for potentially deteriorating patients and acquired critical care skills needed to manage such patients. The results are comparable with other research which sought nurse opinion of CCO. It indicates nurses believe CCO to be instrumental in increasing critical care skills to prevent deterioration in the clinical area.

Abstract: This research aims to design and test the feasibility of an intervention promoting smoking cessation, and reducing smoking relapse, among Māori nurses who smoke. It is being conducted in two phases. Phase one, a national web-based survey, conducted in December 2012, explored the views of Māori nurses (smokers, ex-smokers and non-smokers) regarding smoking. This paper reports on the analysis of qualitative responses from 410 nurses and nursing students identifying as Māori who completed an online survey. Five themes were identified: beliefs about smoking; ?for our tamariki?; personal stories of quitting; dissatisfaction with current approaches; and plans for future strategies. The findings confirm that nurses who smoke may experience feelings of conflict, and regard their behaviour as inconsistent with their role as nurses and health promoters. Nurses who smoke must be supported to become, and to stay, smokefree. Tailored Māori-specific cessation initiatives are needed.

Abstract: In New Zealand, there is a festering debate over a theory-practice gap in nursing. Joint appointments present as a potential solution to this issue. Joint appointments refer to a variety of arrangements whereby concurrent employment occurs within an educational institution and a clinical setting.Advantages for the appointees include job satisfaction, and professional growth. Clinical credibility for nurse educators enables improved facilitation of student learning. In clinical areas, benefits in patient care are associated with the marrying of academic rigor with clinical practice. Some appointees input into staff development, act as consultants on nursing issues and undertake research. Disadvantages in the concept focus on role conflict (incongruity between the roles) and role ambiguity (lack of clarity concerning expectations). Success of the ventures depends upon the personal attributes of appointees; realistic expectations; flexibility to allow the concept to evolve; and support from colleagues and management.This research describes a case study of a joint appointment between a nurse lecturer and a senior staff nurse in an acute forensic psychiatry unit. Advantages, disadvantages and reasons for success are discussed in relation to the literature findings. The discussion focuses on the need to develop research methodology to further clarify potential benefits and advantages

Abstract: This paper, firstly, examines the linkages and shifts in the evolution of of praxis. The concept of praxis, also known as the practical discourse in philosophy, has been expressed in different ways in different eras. However, the linkages from one era to another and from one paradigm to another are not well explicated in the nursing literature. Blurring of the linkages occurred from the popular association of praxis within the emancipatory paradigm. Integral to the concept of praxis, since the time of Aristotle, is the notion of phronesis: a process of moral reasoning enacted to establish the 'good' of a particular situation, often referred to as practical wisdom. Secondly, the paper, promotes and affirms the importance of praxiological knowledge development in the discipline. Furthermore, increased appreciation of the concept of praxis provides an important vehicle for the advancement of nursing as a moral endeavour and the nurse as moral agent.

Abstract: This paper presents the findings from research that investigated the feasibility of developing a specialty return to mental health nursing programme in New Zealand. This was achieved through a scoping of existing return to nursing programmes; a survey of non-active nurses; and stakeholder consultation via interviews or focus groups. Existing generic programmes fail to attract non-active nurses wishing to focus on mental health nursing. The non-active nurses survey found 142 nurses who presently would or might possibly return to mental health nursing and participate in a programme. Most stakeholders supported the idea of implementing such a programme. The findings from this research indicate both feasibility and enthusiasm for the introduction of return to mental health nursing programmes. It is recommended that all aspects of this course mirror the service user focused 'recovery paradigm' that is a central tenet in contemporary mental health service delivery.