Abstract: A dissertation in partial fulfilment of Master Health Sciences (Clinical)through University of Otago
The nurse practitioner is one of the newest nursing health care professionals to be introduced to the New Zealand health system for many years. Eighty-six nurse practitioners are credentialed in New Zealand, with three working in urban Emergency Department settings. Nurse Practitioners are common internationally especially in the United States, Canada, United Kingdom and Australia. The purpose of this integrated literature review is to explore current research and literature in regards to the Emergency Department Nurse Practitioner, and their role within emergency settings. This review presents the growth and development of the nurse practitioner as an advanced practice nursing position. Four key themes emerge from the literature review; education of the Emergency Nurse Practitioner , how and who defined the Emergency Nurse Practitioner role, practice setting of the Emergency Nurse Practitioner, and what the barriers are to independent practice. The economic, legal and governance aspects of the Nurse Practitioner role are also portrayed. This integrated review documents the potential for further development and expansion of the Emergency Nurse Practitioner scope of practice to provide a broad range of patient care services within Emergency Departments, and emergency care settings. Future research is essential for the promotion of autonomous practice of the Emergency Nurse Practitioner within the international and New Zealand health care system.

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: A paper presented at the annual conference of Nursing Informatics New Zealand (subsequently incorporated into the collective organisation, Health Informatics NZ).

Abstract: A research portfolio submitted in partial fulfilment of the requirements for the degree of Master of Health Sciences, The University of Auckland, 2010.
Background:
The 2006 New Zealand (NZ) Guidelines for Rheumatic Fever (RHF) (National Heart Foundation of New Zealand and Cardiac Society of Australia and New Zealand, 2006) have an over-arching objective to support appropriate management of RHF to prevent recurrent attacks and reduce mortality and morbidity from RHF and Rheumatic Heart Disease (RHD) (Craig, Anderson, & Jackson, 2008; National Heart Foundation of New Zealand and Cardiac Society of Australia and New Zealand, 2006).
Aims:
The aims of this study were to audit current practice and service provision associated with RHF programmes and initiatives in NZ District Health Boards (DHBs) against the 2006 NZ Guidelines for RHF and to identify the barriers and facilitators to clinicians meeting the guidelines.