Abstract: The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.

Abstract: This article describes the effect of an education programme for Paediatric Intensive Care Unit (PICU) staff, developed as part of the roll out of revised clinical guidelines. In 2005, the International Liaison Committee on Resuscitation released advisory statements and a revised universal algorithm for Infant, Child and Adult Cardiopulmonary Resuscitation (CPR). Subsequently the New Zealand Resuscitation Council developed and disseminated revised guidelines for use within the New Zealand Healthcare System. Within the PICU the challenge of integrating new practice standards whilst ensuring compliance with CPR guidelines, was how to disseminate information to over 80 staff nurses working 12 hour shifts. Following implementation of an education programme, a survey completed by 20 staff members demonstrated that staff felt well supported with the introduction of the new CPR guidelines (90%) and confident that they understood the changes to the resuscitation guidelines (90%). Staff identified that the poster display (95%) and the mail sleeve “flyer” (80%) helped them understand the changes to CPR.

Abstract: The author presents the approach of a nursing team at Christchurch's Princess Margaret Hospital, in the regional specialist service for people with anorexia nervosa. This unit provides the only specialist inpatient unit in the country, consisting of a six or seven-bed facility that shares a unit with a mother and baby unit. A multidisciplinary team of psychiatric nurses, dietitians, occupational therapists, psychiatrists, psychologists and social workers all make significant contributions. The Christchurch unit uses a cognitive-behavioural therapy model (CBT) across the disciplines, a multidimensional approach incorporating psychotherapeutic, psychoeducational, biomedical and behaviourist paradigms. This occurs within a “lenient flexible approach”. Within the Unit, the eight nurses constitute what could be seen as an “intra”-disciplinary team within the wider “inter”-disciplinary or MDT team. They apply an evidence-based nursing approach with a commitment to partnership and advocacy with their patients. They use collaborative techniques for defining shared goals, and the careful management of the introduction of food. As one of the team members, the author envisages that the job of specialised nurses is to form a therapeutic alliance with patients, which takes account of the dynamic ways that patients may negotiate their own complex understandings of health, care, and recovery.

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: This article is from a conference paper presented to the 12th World Conference on Surgical Patient Care. It presents cultural safety, as differentiated from transcultural nursing, and investigates how it relates to perioperative nursing. Examples are presented of how nurses can adhere to medical requirements, and address the cultural needs of Maori patients.

Abstract: This clinical case study takes an integrated approach to investigation and critical analysis of the complex physiological and pathophysiological treatment modalities instigated when a patient presents following acute traumatic head injury. A broad overview of the developmental physiology of the brain and an explanation of the mechanism of traumatic brain injury as it relates to alterations in cerebral blood flow, intracranial pressure and cerebral metabolism is presented. The author describes in narrative form the clinical presentation of a patient, her symptoms and initial treatment rationale. It concludes with analysis of the patients initial treatment priorities and symptom management during the first 48 hours of her care.

Abstract: This study explores the experience of being an orthopaedic nurse. As an orthopaedic nurse the author had concerns that the validity of orthopaedic nursing as a unique scope of practice was being questioned. In this thesis, the case for orthopaedic nursing is argued, by showing it as a specialty in its own right. A qualitative approach informed by the author's interpretation of philosophical hermeneutics as articulated by Heidegger (1927/1962) and Gadamer (1976; 1989) was undertaken. Phenomenology seeks to uncover 'taken-for granted' meanings in everyday experience and hermeneutic research recognises that the historical and cultural horizons of participants and researcher influence the interpretation. Eight nurses working in various orthopaedic settings were interviewed. Data was analysed using the interpretive thematic approach described by van Manen (1990). The nurses' stories from practice yielded two essential themes, 'being part', and 'gaining and maintaining integrity'. The author concludes that these themes interrelate and together reveal meanings and insights about being an orthopaedic nurse. 'Being part', shows the essential nature of relationships between orthopaedic nurses and others. 'Gaining and maintaining integrity' describes the embodied nature of the phenomenon. The overall thematic finding 'seeing the world through orthopaedic eyes' reveals the nature of orthopaedic nursing as a unique scope of practice.

Abstract: This research study examined the role of the public health nurse. Utilising community needs analysis method, 17 key informants and two focus groups were asked questions to determine perceptions of the public health nurse. Findings indicated that participants lacked knowledge regarding the role. Additional findings intimated that participants had difficulty in accessing public health nurse services and that 'knowing the system' was beneficial to receiving needed care. One of the major conclusions of this study was that many facets of care managed by public health nurses were invisible to the communities in which they work. Conclusions suggest that public health nurses need to enhance their service by improving accessibility to services and promoting their service in a more visible manner.