Abstract: It is evident from the prevalence of items in the popular press and incased research by health professional that, over the last two decades, menopause as been discussed more openly. However, medical information is still largely oriented toward menopause as a disease with emphasis on the pharmacological interventions needed to correct the disease. Literature in medical and nursing journals is also predominantly oriented towards menopause as a state of oestrogen, nurse researchers and feminists writers are challenging this viewsThe aim of the research was to discover how women gain knowledge about menopause, and how they make decisions about “managing” their menopause. In the study knowledge was defined as being more than information. It is seen as being more than information. It is seen as understanding derived from synthesis of data about menopause collected from various sources. Eleven women aged 46-55 recruited through a letter in the researcher's local newspaper, were interviewed. The resulting data was analysed by the constant comparison method as used in grounded theory.A descriptive model was developed including the basic social process of “integrating menopause into midlife”. A tertiary level of education and good social support were found to be associated with the women being seekers of knowledge about their menopause. These women, the majority of the participants, revealed themselves as being self-controlling with respect to their menopause. Among the few who had allowed their menopause to be managed by others, if they experienced adverse effects of the treatment, then there was a move toward greater self management.,Generally, nurses were not seen by the participants as possible sources of information. That finding highlights menopause as an area of health education in which nurses have the potential to play a more active role

Abstract: This thesis concerns the Professional Development Programme at Lakeland Health. In New Zealand, such programmes were introduced as a mechanism to openly recognise the clinical expertise of nurses. Clinical Career Pathways were introduced to nursing in North America in the 1970's at a time of nursing shortage. Prior to their inception, nurses wishing to develop their careers had to move to administration, management or education. The programmes recognised and rewarded expertise in practice. A qualitative, descriptive approach (using focus groups) was used with Registered Nurses to gather their perceptions of what helps nurses enroll in the Professional Development Programme. The ideas and insights of nine Registered Nurses were clustered around three main categories: The People (fear; being struck; motivation; feedback; peer support; ways of learning); the Programme (relevance; flexibility; Bachelor's Degrees; implementation; supporting information; fairness); the Place (time; regular and accessible; support from nurse leaders; management). These perceptions are discussed in more detail in the context of nursing at Lakeland Health and of Clinical Career Pathways in New Zealand. The findings are helpful for the evaluation and future development of the Professional Development at Lakeland Health. The research contributes to our understanding of what helps nurses enroll in a Clinical Career Pathway, and emphasises the importance of the People, the Programme and the Place.

Abstract: This study originates from the author's practice experience working for the New Zealand Fire Service back in the late 1980's and early 1990's as an Occupational Health Nurse where she piloted a Critical Incident Stress Peer Support programme in the No.4 Region. The author identified work-related stress and related it to Critical Incident Stress (CIS) from firefighters exposure to critical incidents. This study explores four firefighters experience of Critical Incident Stress Debriefing (CISD) within a Region of the New Zealand Fire Service. It explores the application of CISD as one component of Critical Incident Stress Management (CISM), and the Nurse Researcher's philosophy of Clinical Nurse practice in relation to the application of CISD. The knowledge gained from the analysis of the data has the potential to influence professionals understanding of their experience and affect future practice and that of others working in the field of CISM. Much of the literature that supported CISD appeared to offer a rather superficial understanding of the firefighters experience in relation to CISD. A narrative approache was chosed as the methodology, utilising four individual case studies as a method of social inquiry in order to explore the experience of CISD. The narratives were able to creatively capture the complexity and the dynamic practice of CISD. An overall pattern of the formalised process was uncovered through the participants' narratives. Eight dominant themes were highlighted from the narratives which included safe environment; ventilating the stress reaction; similar feelings; getting the whole picture; peer support; bonding and resolution. While these themes were common to all the participants, each participant had a particular theme/s which was unique to their experience.

Abstract: This thesis is about what the author terms the 'invisible bodies of nursing'. The physical body of the nurse, the body of practice, and the body of knowledge. The physical body of the nurse is absent in most nursing literature, it is sometimes inferred but seldom discussed. The contention is that the physical body of the nurse is invisible because it is tacit. Much nursing practice is invisible because it is perceived by many nurses to be inarticulable and is carried out within a private discourse of nursing, silently and secretly. Nursing knowledge is invisible because it is not seen as being valid or authoritative or sanctioned as a legitimate discourse by the dominant discourse. These issues are approach through an evolving 'specular' lens. Luce Irigaray's philosophy of the feminine and her deconstructing and reconstructing of psychoanalytic structures for women inform this work. Michel Foucault's genealogical approach to analysing discourses is utilized, along with Maurice Merleau-Ponty's phenomenology. Nursing's struggle for recognition is ongoing. The author discusses strategies that nurses could use to make themselves more 'visible' in healthcare structures. The exploration of the embodied self of the nurse and through this the embodied knowledge of nursing is nascent.

Abstract: The aim of this thesis is to present a phenomenological exploration of the experiences of four woman who have had an adolescent child die of cancer. Using the method of hermeneutic phenomenology, as described by van Mann (1984,1990) the study drew on the stories of four woman. From their stories eight emerging themes became apparent.The analysis of the themes is described under the following headings:- wanting to protect; wanting to be with; maintaining normality; feeling positive and hopeful; facing finality; realizing that death was imminent; coping with the common reality; and interacting with health professionals.Further interpretation of the emerging themes revealed “hope expectations” as the phenomenon of concern that captures these mothers' experiences. The hope expectation phenomenon reveals how the mothers coped with adversity, differing hope expectations in the common reality, oscillating hope expectations throughout the journey and hope expectations inspired by the health professionals.The outcome of this work is to provide professional, especially nurses, with insight and knowledge of the maternal experience of caring for the dying adolescent. It is hoped this research will contribute to the body of nursing knowledge and influence the care of parents who experience the trauma of caring for their dying adolescent child

Abstract: The aim of this qualitative study is to explore four clinical tutors' perceptions of their role on facilitating Bachelor of Nursing students' learning in the practice setting of the health sector in New Zealand. Participants were asked to share their personal experiences including the positive aspects and the difficulties and challenges they encountered when working with students.Contract clinical tutors, are employed because of their clinical experience and expertise to enable students to apply the knowledge learned in theory and the professional competencies learned in the laboratory into the reality of clinical practice. This requires that clinical tutors be familiar with the curriculum so that their role as supervisor, teacher, facilitator, guide ands mentor can assist the student in fulfilling their learning requirements when in clinical practice. They are not, however, involved in the development or the teaching of the theoretical component of the programme. The difficulties and challenges identified by the contract clinical tutors in this study, resulted in discussion concerning strategies that could be adapted by the faculty to support clinical tutors in their role of ensuring the students receive the best possible learning opportunities when assigned to the clinical areas.Focus groups interviews were chosen as a means of collecting data from four registered nurses currently or previously employed as contract clinical tutors to work with students from an undergraduate degree programme at a small polytechnic.A two hour focus group interview was held as a means of uncovering the shared thoughts and experiences of participants. A second focus group interview was conducted to qualify information and elaborate on some issues. From the data collected a number of recommendations were identified which if adopted by polytechnics will enhance quality teaching by contract clinical tutors.

Abstract: This thesis is about caring for males, especially those males who could be considered “difficult” to care for through their use of behaviours such as silence, anger or defensive humour. This thesis is positioned in the view that these behaviours are often expressions of distress, which typically distance males from those who attempt to care for them. The author suggests that the word “distress” more accurately reflects the theme of the thesis, and it is used throughout the work. This thesis explores the interface between gender issues, nursing practice and caring for males. It is informed by a review of relevant literature and data gathered from a focus group of nine registered nurses. The analysis is framed by questions that are developed from a series of reflections on my personal and professional life. Critical social theory, with its emphases on dominant dialogue, power and emancipation is used to inform and guide this analysis. What is most obvious is the contrast between themes arising from the literature and those arising from the focus group. It appears that the literature, in the main, is critical of males in regard to concepts of masculinity, issues related to gender, and men's health. Males are portrayed as arbitrators of their own misfortune, as deliberately choosing a lifestyle that reflects poorly on their health, their self-expression, and communication with others. Concepts such as power and control over others, both at a societal and individual level, often feature. Conversely, the literature is noticeably lacking in regard to information about the health related experiences of males and about caring for males. In contrast, the participants of the focus group frame their discussion in the positive. For example, they suggest that males are interested in their health but require an environment that supports this expression of interest. They support this by identifying a range of behaviours they believe are effective in caring for males. The participants also suggest that it is the registered nurse rather than the male who manages issues to do with power and control. The thesis concludes that creating and sustaining an environment supportive of, and sensitive to the needs of males, is an activity that requires considerable thought, skill and experience. These areas are not adequately addressed in academic dialogue, research activity, or in the education of registered nurses. The thesis suggests that this situation is inconsistent with an ethic of care and that nursing should make a priority of broadening its research and knowledge base to better understand and care for males.