Abstract: Nursing the Stranger You Know demonstrates how combining aspects of nursing theory, the work of Ken Wilber, a leading writer in the field of transpersonal psychology and my own reflections have enhanced how I am able to experience and practice nursing in a primary health care setting.This study acknowledges and values the power of the connections which link us all together. The greatest strength of this work is that it shows, through the use of personal writing, how it is possible to nurse beyond the present and beyond the obvious when clinical, theoretical and self knowledge are all equally respected and incorporated into nursing practice

Abstract: A Heideggerian Hermeneutical Analysis (HHA) approach was used for a study of returning registered nurse students (RRNS) from a nursing/health management context. In essence a descriptive interpretive study the intent has been to unveil the common meanings embedded in the lived experience of RRNS return to formal (advanced) studies. The phenomenon or issue of interest was pursued in the form of a question: What is meaningful and significant for participant RRNS in their everyday world on re-engaging in formal (advanced) nursing studies?Research from the RRNS viewpoint is scarce, so the focus of the study was to understand what RRNS themselves found to be the highlights of the experience. Participants included RRNS coming from a management background and, therefore, very much at the cutting edge of rapid and continuing change in health care provision. In addition to personal and professional reasons for returning to study, what the narratives disclosed was the compelling need experienced by the RRNS to increase understanding of changing requirements in the workplace. They looked for new possibilities to transform management of nursing/health services and for learning experiences favorable to that purpose. A key aspect of their concern related to the interactive nature of their lived experience as a RRNS with the entire context of their everyday world, that is, with the connections and relations between the study-work-homespace.Fourteen RRNS from an established university nursing programme participated in an expended non-structured interviews lasting 60 – 90 minutes. The interviews were held during 1993 in places selected by participants, some in the home but mostly in the work setting. With the consent of the participants interviews were audiotaped and then transcribed. The texts (transcriptions) were analysed hermeneutically using Heideggerian phenomenology, a particular tradition of philosophy whose concern is the meaning of Being. The concern is to make visible participants' experience of their 'world'. In this instance, it was the everyday 'world' of the participant RRNS and the lived meanings of what they experienced on return to formal (advanced) studies. Hence everyday lived experience is the focus of attention in Heiedeggerian phenomenology. In this research approach what is sought is understanding not explanation. It is a premise of phenemenology that, in general, an understanding of the meaning and significance of the lived experience can be required from the 'things' (the phenomena under study) themselves. Approaching a participant as an expert by virtue of directly experiencing the phenomenon, is basic to phenomenology. Hermeneutic analysis of the texts of the participant RRNS affirmed the authenticity of those assumptions.The study revealed several common or major themes, two relational themes and one constitutive pattern were identified through the process of textual interpretation. The constitutive pattern expressing the full complexity of the relations and connections between the themes, was found to be present in all fourteen texts; the nature of a constitutive pattern being 'that it's always there'. The constitutive pattern 'Nursing is Dwelling in Thoughtful Concern as Context Calls Forth', emerged as the major finding of the study. This pattern witnesses to the pragmatism that is inherent in nursing and commonly found in nurses' responses to the challenges presented by continuing and rapid change. For the participant RRNS nursing had become a way of engaging their energies in the workplace as appropriate to a given place, time and culture. The two relational themes accent particular aspects of the constitutive pattern. 'Nursing' is a whole pile of things'; and 'Curriculum: Reflective Openness' reveal the inherent meanings of the constitutive pattern. Firstly, that nursing is diverse in practice and has many dimensions; and,, secondly, that a curriculum befitting the diversity of nursing requires us to constantly challenge ad test the learning experiences we provide for RRNS.The fourteen participants traversed diverse pathways to acquire the understanding and skills required for altered health care structures. Adopting new relationships and 'leaping-ahead' (Heidegger, 1962), to be able to see the whole picture of what was being experienced in nursing/health care, reveals the RRNS becoming-as interpreters for both colleagues and clients. Leaping-ahead is reflective of thoughtful concern as the pattern of responding to presenting need. This way of living a life transforms work. The participant RRNS disclose that, dwelling in such a way in nursing/health work opens up a future of possibilities which brings all the presenting needs into focus. Sharing the story of their lifeworld as RRNS, the participants have exemplified the ' reflective openness' Senge(1990) advocates, as being a pre-requisite for 'learning organisations'. Contemporary oganisations require us to challenge our own thinking as well as being free to speak our minds ('participant openness'). Since, however much we value our daily life practices and understandings, they need to be 'always subject to test and improvement'. In effect, what the participants have bestowed on us is that, within the framework of a curriculum for RRNS and the content learning of a given course, we must generate a process of learning amenable to both individual and group requirements

Abstract: New Zealand's older population is gradually increasing. This will men the number of people with problems related to psychological and general well-being will also rise. When compared to women, men do not live as long, are more likely to die from intentional injury and use primary health services less. There is a paucity of research on older men, particularly within a New Zealand context. Because nurses work closely with people in primary, secondary and tertiary care settings they are well placed to undertake research and utilise research findings from studies relating to the older adult to promote health and well -being. The intention of the present study was to gain a greater understanding of those factors which impact on the well-being in older men. Based on Wan, Odell and Lewis's (1992) model of general well-being, mental, social and physical well-being indicators were investigated to examine their relationships to overall psychological well-being and physical health.The data for the present study was collected from a non-probability sample of 217 males (over 65 years) residing in the Wanganui area. Multiple regression analysis reveled that of the mental, social and physical indicators only satisfaction with social supports and number of visits to the doctor in the previous 12 months were significantly related to psychological well-being, and number of medications and illness/disabilities were significantly related to physical health as measured by self ratings of health.Findings are discussed in relation to the literature. It ids clear that nurses, and other health professionals, need to be aware of the relationship between objective health status and subjective well-being, and the distinction between the quality and quantity of support in order to provide effective care to older men. Finally the general limitations and future research implications are discussed

Abstract: Questionnaires were completed in the work place. The participants had all experienced a chronic illness. The results revealed that the manager has the responsibility to deal openly with the staff member who is ill, and for some managers this is difficult to do

Abstract: This study aimed to explore the range of issues that surround the continuity of wound care between hospital and community care settings in a provincial area of New Zealand, from the perspective of the health care professionals providing the wound care. Previous research into continuity of care concentrated predominantly upon purely nursing issues. This means that both the profound implications of the interprofessional relationships of the various health care professionals involved in wound care, and the far-reaching effects of the socio-economic context within which wound care was given were often not considered. A critical ethnographic approach was employed to explore continuity of care in this community. Health professionals were interviewed twice. A first interview discussed some of the unacknowledged power relations and the contextual issues that effect continuity of wound care, as well as offering the opportunity for the participants to reflect on the issues that emerged. Following preliminary analysis of the data from the first interview, a summary of findings was given to each of the participants which served as a focus for the second interview. Following these, the data were analysed, and the main themes that influenced the continuity of wound care for the participants were identified. Analysis of the data revealed all the participants practicing under considerable socio-political constraints which interfered with their ability to provide high quality wound care for their patients: these constraints dictated both who gave the wound care and how they were able to do it. The data also revealed the various relationships between the different professionals as another major area of influence upon continuity of wound care. Medical dominance was identified as having a profound impact upon nurses ability to optimise continuity of wound care. The study concluded there are a number of areas that need to be addressed in order to optimise continuity of wound care, at both local and governmental level. The development of a nurse-led wound clinic is one initiative that would go a long way to address these issues

Abstract: The New Zealand Nurses organsation agreed to become the accrediting body for nurses in NZ in 1994 and Susanne Trim, NZNO Professional Nursing Adviser, worked with the National Practice Nurse Section to develop and pilot a model for accreditation.A consultative process was used to develop a framework and process during 1995 and this was unanimously endorsed in the April 1996 National Practice Nurse Section AGM.Implementation occurred from May 1996 to March 1998 with a comprehensive evaluation of the model collection of data from practice nurse applicants, non-applicants, the Practice Nurse Accreditation Board, National PN Sections and the project co-ordinator.The number of applications received exceeded expectations 212 (14% NZNO practice nurse members). There was a high level of satisfaction expressed by applicants.A number of content issues were identified during the pilot as needing review, clarification and amendment. These were of a minor nature rather than recommended changes to the structure itself.The accreditation Board processes were modified part way through the implementation to improve efficiencies and were found to be satisfactory. The training model and timing were appropriate.Administrative support and central co-ordination through designated NZNO staff member proved to be time consuming but vital.Practice Nurses embraced accreditation however as a group they have some minor unique characteristics. This should caution NZNO to proceed gradually with accreditation of other Section Nurses and monitor progress closely