Abstract: The concept of cultural safety offers a unique approach to nursing practice, based on recognition of the power differentials inherent in any interaction. Clarification of the concept is offered, together with a review of the historical shift in nursing attitudes that has led to the emergence of “cultural safety” as a viable and valued component of nursing practice. The argument is made that cultural safety has allowed for a more reflective, critical understanding of the actions of nursing to develop. This includes recognition that nurses' attitudes and values have inevitably been influenced by social and political forces, and as such are in part reflective of those within the wider community. Comparison between the support given by nurses in the early 1900s to the theory of eugenics and the current acceptance of cultural safety is used to highlight this point. An examination of the literature identifies that ideological and conceptual changes have occurred in the approach of Aoteaoroa/New Zealand nurses to issues with cultural implications for practice. A review of background factors relating to Maori health status and the Treaty of Waitangi is presented as a necessary context to the overall discussion. The discussion concludes with an acknowledgement that while the rhetoric of cultural safety is now part of nursing culture in New Zealand, there is no firm evidence to evaluate its impact in practice. Issues identified as impacting on the ability to assess/research a concept, such as cultural safety, are discussed. For cultural safety to become recognised as a credible (and indispensable) tool, it is necessary to further examine the “end-point” or “outcomes” of the process.

Abstract: This literature review discusses the history of the inclusion of culture into nursing studies. There is a small sample of overseas literature for critique with a focus on the inclusion of cultural safety in New Zealand. The concept of cultural safety was first introduced into New Zealand in the late 1980s. It was adopted by the New Zealand Nursing Council for nurses and midwives in 1992 and became part of the basic curriculum for nursing and midwifery education.

Abstract: This article examines the knowledge and power relationships between the medical profession and nurses during the first half of the twentieth century. It argues that the 1901 Nurses' Registration Act allowed doctors to exert control over the nursing profession and that the hierarchal structure of the profession contributes to the culture of control and surveillance.

Abstract: Reports the findings of oral history research into nurses' experiences of training and working in hospitals in NZ during the 1970s and 1980s and their accounts of early collegiality forged as a result of residential living and training in hierarchical hospitals. Conducts two focus group discussions among 10 long-serving nurses from two district health boards (DHBs).

Abstract: The author describes the purpose of her writing as exploring the journeys that Maori have experienced within the nursing profession of Aotearoa/New Zealand. It presents the reader with insight into these journeys by examining a broad range of events and experiences from pre European contact up to contemporary times. The intention of providing these insights is for the reader to be made aware of not only the “uniqueness” that Maori nurses bring to the profession in New Zealand but to give voice to the many untold experiences of Maori nurses. The Nursing Council of New Zealand (NCNZ), numerous Maori and non- Maori academics have long acknowledged the uniqueness of Maori health perspectives and needs. However, the author notes there is limited literature which specifically discusses experiences of Maori consumers of health services and until recently, exploration of the experiences of Maori nurses has been limited. The Ministerial Taskforce of Nursing (1998) identified the paucity of research related to Maori nursing and acknowledges the need for Maori nurses to develop a body of knowledge specifically focused in this area. To this end, the author intended that this work would contribute to the increasing body of knowledge regarding this unique group within the nursing profession of Aotearoa/New Zealand.The discussion includes revisiting the history of nursing in Aotearoa/New Zealand and critiquing the participation of Maori nurses. The experiences of Maori nurses and students from within the education sector is detailed with a particular focus on their experiences of Kawa Whakaruruhau / Cultural safety. Contemporary issues for Maori nurses are critiqued and possible solutions offered along with details of the writer's vision for the future direction of Maori within the wider nursing profession in Aotearoa/New Zealand.

Abstract: This thesis examines the forces influencing the development of contemporary advanced nursing practice in New Zealand. It begins with an historical approach to explore the various meanings of advanced nursing practice from the late 1800s through the first years of the 21st century. Seven historical understandings of the meaning of 'advanced' nursing practice emerge. The author's analysis of the broad scope of New Zealand nursing history, including a case study of the development and implementation of the nurse practitioner, draws on theoretical perspectives from sociology, political science, and nursing. She develops a “framework of critical factors for nursing to take into account when considering how to ensure the profession is able to deliver on its great potential to improve the health of New Zealand communities”. Examining the work of a range of nursing leaders, past and present, and drawing on the work of political scientist, John Kingdon, the author describes the work of several nurses as “policy entrepreneurship.”

Abstract: Provision of a primary health care system that delivers timely, appropriate, affordable and effective care is a challenge throughout the world. The purpose of this work is to discuss the realities of collaborative practice in primary health care, where care is delivered by doctors and nurses in general practice settings in New Zealand. The close relationship between the two professions has been historically marked by the dominance of medicine over nursing. Unclear articulation of nursing practice by the nursing profession along with historical gender issues has further hindered a more collegial relationship between medicine and nursing. The author suggests that historical gender inequalities have also contributed to a system which has disadvantaged nurses in the execution of their work. Collaboration occurs when mutual respect is present between two parties intent on furthering mutual goals. Collaboration is not supervision or co-operation. It is therefore, the author suggests, questionable that collaboration exists in the New Zealand system other than through the good will of individual practitioners. An examination of these issues using the work of Jurgen Habermas and Michel Foucault offers insight into how the current working situation between medicine and nursing came about. The author concludes that the emergence of the nurse practitioner role in New Zealand along with a change in the way that primary health care is being managed nationally provides opportunities for the nursing profession to move into emancipatory collaborative practice roles.

Abstract: This social-cultural history explores the changing context, culture, and identity of psychiatric nurses working in New Zealand public mental hospitals between 1939 and 1972. Primary documentary sources and oral history interviews provided the data for analysis. The thesis is divided into two periods: 1939 to 1959 when asylum-type conditions shaped the culture of the institutional workforce, and 1960 to 1972 when mental health reform and nursing professionalisation challenged the isolation and distinct identity of mental hospital nurses. Between 1939 and 1959 the introduction of somatic treatments did not substantially change nursing practice in mental hospitals. Overcrowding, understaffing and poor resources necessitated the continuance of custodial care. The asylum-type institutions were dependent on a male attendant workforce to ensure the safety of disturbed male patients, and the maintenance of hospital farms, gardens, and buildings. Although female nurses provided all the care and domestic work on the female side, the belief that psychiatric nursing was physically demanding, potentially dangerous, and morally questionable, characterised the work as generally unsuitable for women. Introduction of psychiatric nursing registration which was a move toward professionalisation did little to change the dominance of a male, working-class culture. From 1960 to 1972 psychiatric nurses' identity was contested. New therapeutic roles created the possibility of the nurses becoming health professionals. Their economic security and occupational power, however, was tied to an identity as unionised, male workers. As psychiatric nurses were drawn closer to the female-dominated nursing profession through health service changes and nursing education reform, both men and women acted to protect both their working conditions and their patients' welfare. To achieve these ends, they employed working-class means of industrial action. By accepting the notion that psychiatric nurses' identity was socially constructed, this thesis provides an interpretation that goes beyond the assumption that nursing is a woman's profession. Instead, it presents psychiatric nursing as a changing phenomenon shaped by contested discourses of gender, class and professionalisation. Nursing in public mental hospitals attracted ordinary men and uncommon women whose collective identity was forged from the experience of working in a stigmatised role.