Abstract: The Guthrie Test has become the standard screening test for early detection of congenital metabolic disorders for newborn babies in New Zealand and is an accepted part of neonatal care. In neonatal care, decisions are made on behalf of babies usually by their parents and, for the Guthrie Test there is a requirement that health professionals obtain informed consent. This qualitative research utilised focus group methodology to discover what neonatal nurses in clinical practice consider when obtaining informed consent from parents for newborn screening, the Guthrie Test. The convenience sample consisted of seven registered nurses who volunteered to participate in the study. They all practice in the Neonatal Intensive Care Unit at Dunedin Public Hospital that provides Level 3 intensive care to neonates in the Otago/Southland regions. There are proven benefits of the current newborn screening programme and in the experience of this focus group not many parents choose to refuse. These neonatal nurses identified the rights of parents to have that choice and to make an informed decision. The findings from this research indicate the importance neonatal nurses place on patients' rights and the information provided to ensure that their rights are respected. However, the results indicated that there is a need for clarification of the purpose and process of informed consent for the Guthrie Test in the Neonatal Intensive Care Unit. Therefore providing sufficient, relevant information at an appropriate time and manner is considered necessary. The findings will be used to inform discussion related to the provision of best practice.

Abstract: This book covers obstetrical care from a nursing perspective at the Dunedin Hospital's Maternity Units. The researcher found little information on the two lying-in (maternity) wards of the first two Dunedin Hospitals. The book presents historical records outlining obstetric nursing procedures and maternity culture at the Dunedin Hospitals, The Benevolent Institution, The Batchelor Maternity Hospital, and Queen Mary Hospital. It covers cultural, social and legislative changes over the period, and examines conditions and pay for nursing staff across this time. A chapter on the evolution of baby care looks at changes in acceptable practices around nursery care, breast and bottle feeding, and medical procedures. The book has an extensive list of appendices, including staff lists, training notes for staff, duty lists, and interviews with staff and patients.

Abstract: A Grounded Theory approach was taken to explore the concept of the gap between theory and practice, whereby they are seen to be discrete entitites. For this study, the first phase of data collection was a series of computer mediated group discussions, and the second a number of individual interviews. In both sets of interviews participants were asked to describe how they experienced and managed differences they perceived between theory and practice in nursing. The participants referred to different types of theory relevant and central to effective nursing practice. The first was private theory; the second was formal theory and third was situational theory. For the students it was a conflict that produced uncomfortable emotions, distrust of others and personal self doubt. In an effort to reduce this discomfort the students sought an explanation for the differences between theory and practice, some of which challenged their key personal values. However, the most emotionally neutral explanation that also preserved the integrity of their key values was that there was a gap between the theory and the practice of nursing. The theory Negotiating Different Experiences has implications for the education of nurses in that personal knowledge and experiences must be incorporated in a programme of study and the feelings evoked by learning must be acknowledged as a catalyst to enhance learning. Further, the different forms of theory to which students will be exposed must be made explicit and nursing educators who must involve the individual student as an active partner in the mapping of a personalised programme, which includes the creation of individual assessment methods.

Abstract: The focus of this study is the management of unsafe nursing students within the tertiary education context. The moral dilemmas experienced by nurse educators, specifically linked to the issue of accountability for public safety, are explored. The theoretical framework for the thesis is informed by the two moral voices of justice and care identified by Gilligan and further developed using the work of Hekman and Lyotard. Case study methodology was used and data were collected from three schools of nursing and their respective educational organisations. Interviews were conducted with nurse educators and education administrators who had managed unsafe nursing students. Interviews were also conducted with representatives from the Nursing Council of New Zealand and the New Zealand Nurses Organisation to gain professional perspectives regarding public safety, nurse education and unsafe students. Transcripts were analysed using the strategies of categorical aggregation and direct interpretation. Issues identified in each of the three case studies were examined using philosophical and theoretical analyses. This thesis explores how students come to be identified as unsafe and the challenges this posed within three educational contexts. The justice and care moral voices of nurse educators and administrators and the ways in which these produced different ways of caring are made visible. Different competing and conflicting discourses of nursing and education are revealed, including the discourse of safety – one of the language games of nursing. The way in which participants positioned themselves and positioned others within these discourses are identified. Overall, education administrators considered accountability for public safety to be a specific professional, nursing responsibility and not a concern of education per se. This thesis provides an account of how nurse educators attempted to make the educational world safe for patients, students, and themselves. Participants experienced different tensions and moral dilemmas in the management of unsafe students, depending upon the moral language games they employed and the dominant discourse of the educational organisation. Nurse educators were expected to use the discourses of education to make their case and manage unsafe students. However, the discourses of nursing and education were found to be incommensurable and so the moral dilemmas experienced by nurse educators were detected as differends. This study bears witness to these differends.