Abstract: The author defines and describes PTSD, and looks at how it may apply to nurses. Primarily affected by delayed PTSD, nurses may experience it as burn-out, after exposure to trauma over time. The Critical Incident Stress Management programme instigated at Healthcare Hawkes Bay is outlined.

Abstract: The aim of this study was to examine and compare Australian and New Zealand nurses' experience of workplace stress, coping strategies and health status. A postal survey was administered to 328 New South Wales (Australia) and 190 New Zealand volunteer acute care hospital nurses (response rate 41%) from randomly sampled nurses. The survey consisted of a demographic questionnaire, the Nursing Stress Scale, the WAYS of Coping Questionnaire and the SF-36 Health Survey Version 2. More frequent workplace stress predicted lower physical and mental health. Problem-focused coping was associated with better mental health. Emotion-focused coping was associated with reduced mental health. Coping styles did not predict physical health. New South Wales and New Zealand scored effectively the same on sources of workplace stress, stress coping methods, and physical and mental health when controlling for relevant variables. Results suggest mental health benefits for nurses who use problem-solving to cope with stress by addressing the external source of the stress, rather than emotion-focused coping in which nurses try to control or manage their internal response to stress. Cultural similarities and similar hospital environments could account for equivalent findings for New South Wales and New Zealand.

Abstract: This research is an exploration and interpretation of the lived experiences of family members since they lost a close family member to suicidal death. The findings have implications for nurses and counsellors working in the area of suicide bereavement. Heidegger's hermeneutic phenomenology was utilised and informed by van Manen's and Benner's work. Data from in-depth interviews with six participants, the researcher's journal entries and published literature were analysed. Findings gave rise to a grief model where suicide survivors moved through four modes of being-in-the-world characterized by 13 lifeworlds or themes. Surviving suicide was a transformative process that in time enabled survivors to discover new ways of understanding and relating to the world.

Abstract: This study explores the archetypal dimension of nursing reality in nurses' stories through a window of nurse-nurse relations. The thesis argues the existence of the unconscious psyche and its importance for nursing, and the study unfolds a methodology that attends to unconscious processes and is congruent with analytical psychology and its practice. It is a two strand inquiry informed by general hermeneutics and Jungian thought engaging a synthetic interpretive methodology using interweaving intellectual and imaginistic processes. In the first strand of the inquiry five female registered nurses share their individual stories which become the text for a nursing narrative that reveals the what-is of nursing reality in essences of Story and Kinship, and a Lifeworld undermined by high levels of Stress. In the second strand of the inquiry the researcher engages imaginistic process to access the archetypal dimension of the nursing narrative, resulting in a sub text from which archetypal images emerge to reveal the more-than of nursing reality. The emergent images are amplified to reveal their symbolic meanings, and their connection to the nursing narrative is explored. An interpretation that is consistent with analytical psychology is offered in a synthesis of the material arising from the nurses' stories and the imaginistic process. The author notes that this synthetic understanding is teleological in nature and directs attention to the need for nursing to grow a differentiated consciousness that is honouring of the feminine principle in the psyche in contradistinction from an overweaning masculine patriarchal consciousness that compromises the nursing endeavour.

Abstract: Hope is considered an elusive, vague, over-used, and ambiguous concept in nursing practice which lacks clarity, but hope is essential to the quality of life in the terminally ill. Therefore, hope is an important concept to research further. A gap in nursing research has been identified in the area of hope in terminal illness. The aims of this research were to clarify the concept of hope as perceived by patients with a terminal illness; to develop hope as an evidence-based nursing concept; and to contribute new knowledge and insights about hope to the relatively new field of palliative care. Utilising Rodgers' (2000b) evolutionary concept analysis methodology and thematic content analysis, 17 pieces of research-based literature on hope as perceived by adult patients with any terminal illness pathology (from the disciplines of nursing and medicine) have been reviewed and analysed. Hope's attributes, antecedents, consequences, social-cultural variations, temporal variations, surrogate terms, and related concepts have been considered. An exemplary case of the concept in action is presented along with the evolution of the concept hope in terminal illness. Ten essential attributes of the concept were identified in this research: positive expectation, personal qualities, spirituality, goals, comfort, help / caring, interpersonal relationships, control, legacy, and life review. The evolution of hope in terminal illness has evolved from patients hoping for a prosperous healthy future to an enrichment of being is more important than having or doing. Patients' hopes and goals are scaled down and refocused in order to live in the present and enjoy the time they have left with loved ones. Hope in the terminal phase of one's illness is orientated in the past and the present, hope in the here and hope in the now. The author concludes that by completing all the steps to Rodgers' (2000b) evolutionary view of concept analysis, a working definition and clarification of the concept in its current use has been achieved, providing a solid conceptual foundation for further study. Recommendations are made for hope-enhansing strategies, that may help to maximise the quality of life of terminally ill patients in the future.

Abstract: This article reports a study that sought to understand the experience of a group of Caucasian men with end stage renal failure managing their own haemodialysis therapy in their homes. The study used a critical interpretive methodology. The renal setting was critically viewed as a specialised health care context constituted by several interrelated discourses. Although established by the dominant professional discourse, it also includes a number of others, in particular an obscure client discourse that is a response to the dominant discourse. Initially, participants' own interpretations of their individual experiences were outlined. These were then collectively reinterpreted by contextualising them in terms of the critical view of the renal setting, in order to discern their own views as renal clients that were obscured by the language and ideas of the dominant discourse with which they had been enculturated. From an analysis of the set of accounts derived from interviews with six participants, four concerns of the renal client discourse were identified. These concerns were: (1) suffering from continuing symptoms of end stage renal failure and dialysis; (2) limitations resulting from negotiating dialysis into their lifestyle; (3) ongoingness and uncertainty of life on dialysis; and (4) altered relationship between autonomy and dependence inherent in living on dialysis. One specific implication of this study is that the distinctive potential of the nursing role in renal settings lies beyond the performance of a range of technical tasks, in addressing the experience of people living on dialysis, described here as the concerns of the renal client discourse.