Abstract: This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.

Abstract: This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.

Abstract: The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.

Abstract: Sexual health clinics and the people who visit them commonly face stigma. Sexually transmitted infections have historically been used to divide people into “clean” and “dirty”. A grounded theory study of the work of sixteen nurses in six sexual health services in New Zealand was undertaken to explore the management of sexual health care. The study uncovered the psychological impact of negative social attitudes towards the people who visit sexual health services and to the staff who work there. Sexual health nurses manage the results of stigma daily and reveal in their interactions with clients a process of destigmatisation.

Abstract: The authors defines health assessment and argue that it is a tool nurses should be using as a means of improving health outcomes for clients. The skills involved in health assessments are analysed, and four levels of data gathering are identified. The authors present an historical perspective, tracing the development of these skills as they have been incorporated in nursing practice in North America and Australia.

Abstract: The purpose of this paper is to examine the discourses of scientific mothercraft and their implications for the nurse-mother relationship, drawing on the author's recent research into surveillance and the exercise of power in the child health nursing context. The application of Foucauldian discourse analysis to the texts generated by interviews with five New Zealand child health nurses confirms that this paradoxical role has never been fully resolved. Plunket nurses primarily work in the community with the parents of new babies and preschool children. Their work, child health surveillance, is considered to involve routine and unproblematic practices generally carried out in the context of a relationship between the nurse and the mother. However, there are suggestions in the literature that historically the nurse's surveillance role has conflicting objectives, as she is at the same time an inspector and family friend.

Abstract: This research aims to clarify the knowing and wisdom that inform clinical nurse educators' responses through unpredictable situations. The author referred to philosophical literature on the notions of tacit knowledge, practical wisdom, smooth activity and the Unready-to-Hand experience. She created an explanatory framework and utilised this in a thought experiment by reflecting on personal experiences. To add clarity to these reflections, two layers of interviewing with nurse educators teaching in practice were carried out. The first layer was an interview with eight clinical nurse educators who in their role experienced Unready-to-Hand situations. The second layer consisted of four clinical nurse educators who volunteered to be involved in more in-depth interviews. An interpretive analysis of these clinical nurse educators stories illuminated the “Unready-to Hand as Adventure”, highlighting the uncertainty and energy associated with opening in the adventure, not knowing what will unfold, yet committed to remaining engaged and doing the best they can. Through the process of attuning to difference, accessing and deciphering knowing, nurse educators create meanings of situational complexities. By preserving the ideals of good practice and engaged caring, nurse educators salvage learning by creating opportunities for learning and teaching.