Abstract: Using the life history approach this study investigates the consequences of difference within the context of nursing. Life story interviews were conducted with 26 women nurses of varying racial, cultural and sexual identity backgrounds in the USA and New Zealand.The questions framing the interviews focused on the women's experience of difference and fairness in their lives and specifically within nursing.The creation of life story 'snippets' in the first level of analysis reflected the unique aspects of each woman's story and became the first step in the process of creating a thematic analysis or meta-story. The meta-story that emerged from the juxtaposition of the women's stories was “not fitting in to nursing”.The findings of this study suggest that in spite of the change in location of nursing education and its recent attention to the implications of client diversity, the continued imposition of traditional definitions of 'the nurse' by nursing institutions, renders difference amongst nurses invisible. This limits the ability of nurses to be authentic in their practice and also limits the extent to which they can implement the new policies recognizing difference amongst their client populations

Abstract: This thesis presents a study of the every-day moral decision making of experienced nurses. Eight experienced registered nurses participated in the completed research that is based on data gathered through interviews, document audit and literature review. A grounded theory approach was used to analyse the extensive data gathered for the study. This methodology generated a theoretical description involving the antecedents, processes and consequences of nursing moral decision making.Nursing practice has moral content, if not an entirely moral purpose, and moral decision making is the central component of this practice, yet the ethical aspects of nursing practice remain a comparatively recent field of study. It is therefore essential to nurses and their patients that this process is adequately studied and theorised. To date, very few studies have been undertaken in this area in New Zealand. This study aims to at least partially redress this situation by offering insights through conceptualisation and theoretical description of nursing moral decision making.The findings of the study reveal that antecedents such as personal moral development, upbringing and social experiences, contribute to a 'nursing ethic' in the moral decision making of experienced nurses. Furthermore, the study shows that the context and individual and shared perceptions of moral events influence the degree of nursing involvement in ethical situations. Finally, the study maintains that an intrinsic and persistent nursing ethic guides ethical decision making in nursing. This ethic is an undeniable phenomenon of considerable significance to nursing practice and education

Abstract: This research project, a descriptive study using narratives, explored the application of cultural safety theory and philosophy to clinical nursing practice. This application was illustrated through the stories of four experienced Pakeha,Tauiwi registered nurses in Aotearoa/New Zealand, who described their realities of applying cultural safety to daily clinical practice. The incentive for this study had been identified in light of the current political climate, pragmatic realities and in keeping with the current state of knowledge.Cultural safety was first identified by Maori nursing students and subsequently described and articulated by Maori nurses, as being a potential solution to improving Maori health statistics in Aotearoa/New Zealand. Many Maori and Pakeha/Tauiwi in this country accept that the Treaty of Waitangi, a covenant signed between Maori and the Crown in 1840, is the incentive for giving cultural safety status and credibility. While the Nursing Council of New Zealand has supported this concept and made it a requirement for all nursing education, there is little literature written concerning its application to practice from a Pakeha/Tauiwi perspective.The perceptions and insights of these nurses were heard when they were invited to describe how they saw cultural safety as part of their daily clinical practice and recount their struggles, realities, practice and experience. The literature review supported the use of narratives as an appropriate method for this study. The philosophy and assumptions of narrative appear to match the oral tradition of nursing and thus it was considered possible to contemplate the fit of narrative to nursing research.The stories of these nurses, gave examples of best nursing practice in which cultural safety was integral to practice, and provided exemplars of possible beginnings and possible endings. The depiction of cultural safety in practice surfaced as the weaving of four themes which were consistent in all the stories – themes of reflection, reverencing, the environment, and hidden blessings and healing. The research evidence suggested that cultural safety was visible in practice in many diverse ways; it emphasised the complexity of the concept; accented its evolving status; and identified a relative consistency in defining cultural safety despite the varied contexts of practice.Although this study was limited by the small sample, the findings indicated that there were potential implications for nursing education, research, nurses and nursing practice as well as for other health care providers working in the current health care system. They suggested that actions from nurse educators, nurse managers, health care managers and clinical nurses themselves, would be needed to ensure that cultural safety continued to be part of nursing practice and contribute to the improvement of all health statistics in this country as well as to encourage an increased development in the focus on Maori health issues.Further nursing research suggested by the findings include studies to appraise cultural safety from a patient's perspective, and consideration given to the evaluation and assessment of nurses and their culturally safe practice. In addition, exploration and research could ascertain the benefits and rewards of culturally safe practice and identify ongoing educational needs as well as examining the views of other members of the multi-discipline team

Abstract: This phenomenological research project focused on one womans experience following total removal of her larynx and aimed to faithfully capture the essential structure of the phenomenon of voice as it emerged for her. For women in particular gaining a new artifical voice following surgery that is considerably lower sounding, plus the large visible opening in the lower neck is psychologically challenging and can be socially isolating. Most literature relating to laryngectomy and rehabilitation comprises quantitative research with limited attention to womens issues. This could be attributed to the small number of women undergoing this surgery. A review of nursing literature revealed minimal research, with none referring specifically to women. Nor were any studies using entirely qualitative methods identified.This research project used a phenomenological approach informed by the work of Michael Crotty, described as within the parameters of mainstream phenomenology. Based on a traditional common core foundation which is critical, holistic and individualistic, mainstream phenomenology requires achieving co-researchership between researcher and participant while exploring phenomena as objects of authentic human experience.The study began with discussing Crottys stepwise method emphasising the activity of bracketing. The co-researcher was then left to ponder or meditate on her experience following bracketing all her prior understandings and ideas, as if this was the first time she had encountered the phenomenon. Three conversations followed which allowed exploration of the co-researchers written statements. The seven interwoven dimensions that emerged represented the essential structure, meaning and essence of 'what voice is for this woman following total laryngectomy

Abstract: This paper describes research carried out with clinical agencies and former students to ascertain the effectiveness of curriculum design within the third year of a problem-based Bachelor of Nursing programme.It shows that where holistic care, time management, prioritization of care, working as a team member, and sophisticated clinical reasoning were introduced as deliberate strategies in students' learning, the transition to the workplace was more successful

Abstract: This action research project explored the factors that helped or hindered student nurse clinical learning from the perspective of nurse educators, practitioners and students. Participant analysis of their own discussions identified both common and disparate views regarding the student's learning experience. Researcher analysis identified five practical and three organizational issues that influenced the development of more effective partnerships between these three stakeholder groups that would facilitate student clinical learning. The practical issues were how to deal with the 'problem' people in the learning process, how to clarify and develop the various roles in the learning context, how to generate more effective communication, how to respond more effectively to the impact of the changing environment, and how to maximize 'moments of learning'. The organizational issues were identified as the schisms between the disparate personal and organizational cultures that direct the way educators, practitioners and students, perceive, think, feel and act

Abstract: The purpose of this study was to determine if there was commonality amongst teachers, in perceptions of the role of student self-assessment in the nursing programme. Four nurse educators, who were teaching and supervising students undertaking self-assessment in clinical practice, participated in a semi-structured interview. Three focus questions guided the interviews and addressed the individual teachers perception of self-assessment, what the teacher considered the benefits of self-assessment to be, and how the teacher used student's self-assessment's in their role as clinical supervisor. The taped interviews were transcribed, and coded and general themes identified. The findings revealed a high degree of consensus amongst the teachers in regard to the co-operative nature of self-assessment, and the teacher's role as a facilitator. The need for students to develop skills of analysis and reflection on their performance as well as the need to furnish students with clear guidelines on what to self-assess, were highlighted