Abstract: This paper examines the difficulties health professionals face daily when providing care for the mentally disordered offender in the court environment. The role of the court nurse is to provide care for people with mental health needs in the court and health professionals can find this a restrictive environment to work in. This is mainly due to the court's legal processes which are designed to punish rather than offer therapeutic alternatives. By advocating for the mentally disordered offender, the court nurse ensures the court is aware of an individual's mental health needs, thus reducing the prospect of inappropriate sentencing, and the associated stigmatisation that may occur as a result of a criminal conviction.

Abstract: This paper is a culmination of the author's inquiry, reflection and critical thinking on the transitional phase that practice nursing is currently undergoing as part of the New Zealand Primary Health Strategy. The paper utilises both reflection-in-action and reflection-on-action as well as reflection-before-action, as a process. The author's starting point for this inquiry was attending the New Zealand Nurses Organisation Primary Health Conference in Wellington and reading a report from the Expert Advisory Group on Primary Health Care Nursing. Knowing that practice nurses are the majority of nurses working in primary health, she was concerned that changes to primary health were being driven with little reference or participation by them. The paper explores how practice nursing evolved in New Zealand and the developments that have occurred in the 30 plus years since its inception. It describes the role and current work of practice nursing in general practice, and highlights the constraints that have held back development and continue to do so. The 2002 New Zealand Primary Health Strategy is shown to provide an opportunity for development and enhancement, if some of the constraints are removed. As part of looking to the future the possibilities for practice nurses to lead the way in primary health development are explored.

Abstract: This paper presents an exploration of a foundational goal of palliative care nursing which is to help patients die with dignity. The paper presents this practice exploration as a journey to gain understanding of the concept of dignity; the author notes that it does not avoid the difficulties encountered in practice situations because dying with dignity is unique and curiously also invisible and different for everyone. Much of human life is conducted through stories and much of nursing involves telling and listening to stories. Many of our social institutions are comprised almost entirely of opportunities for telling and retelling stories. Nurses are constantly listening to patients telling them what is going on in their lives and because of this the stories related here are written bold and raw. The three stories explore and reveal in-depth details of nursing practice that evolved and changed after reflection. The paper also reveals and explores the untold and often painful stories that challenge nurses' capacity to offer dignified care. To deepen the exploration towards discovering ways to articulate the complexity of dignity, the author reflected on the nature of the practice changes documented in the stories and then used a range of diverse literature and her love of the paintings and philosophy of a New Zealander, Ralph Hotere, to support her ideas that dignity is indeed a complex phenomenon.

Abstract: This project is a study of the barriers perceived by perioperative nurses to accessing and using research-based information. A survey questionnaire was distributed to 184 perioperative nurses working in five public and two private hospitals in the Auckland area. The number of completed questionnaires was 106 (57.6%). The results showed that the lack of time during work hours was ranked as the highest barrier. The results also showed that many nurses feel they do not have the skills to find and appraise research articles.

Abstract: This research paper aims to explore the contribution of the Strengths Perspective to mental health nursing practice. The Strengths Perspective emerged from the area of social work and is primarily concerned with emphasising the strengths and resources of the person, as they define them. The premise is that if a person is able to identify and call on those strengths then he or she is able to improve the quality of their life. The paper outlines the historical, philosophical and moral foundations of the Strengths Perspective and discusses the humanistic approach to mental health nursing. The aim is to demonstrate that the Strengths Perspective and mental health nursing have a strong alignment, particularly with regard to a person-centred approach to care. The influence and constraints of the biomedical model on both mental health nursing and strengths based practice is a theme of the paper. The contention is that the biomedical or pathological approach to care can often disable, not enable consumers of health care, whereas an approach that centres on a person and their strengths is more likely to empower and liberate. The paper concludes with a discussion of themes that emerged from reflection on the literature and propositions are then made about how mental health nurses might orientate their thinking and practice to utilise the Strengths Perspective to augment their clinical work.

Abstract: This study aims to identify work related factors contributing to New Zealand nurses' intent to leave the job. Two hundred and seventy five surveys (response rate = 68.8%) from a random sample of 400 nurses employed in one district health board were used to explore intent to leave the job. Three research questions directed the description of levels of job satisfaction, job stress, and burnout found in nurse participants, correlations between the three variables, and the identification of variables predicting intent to leave the job through regression analyses. The survey found levels of job satisfaction were high, job stress was low, and burnout was average. Specifically, lack of opportunity to participate in organisational decision making, control over work conditions, control over what goes on in the work setting (key Magnet Hospital characteristics) were not evident, and with pay rates, were the main sources of job dissatisfaction. Workload was the most frequently experienced source of stress by nurse participants. Twenty-five per cent of nurse participants reported high levels of intent to leave the job. Correlations suggested that reductions in job satisfaction influenced increases in job stress and burnout. Job stress was associated with increases in emotional exhaustion. Emotional exhaustion was influenced by eight job satisfaction, job stress, and burnout subscales. Five subscales (professional opportunities, praise and recognition, interaction opportunities, extrinsic rewards, lack of support) explained 26.2% of the variance in nurse participant's intent to leave. The author concludes that issues of power and control were associated with job dissatisfaction, job stress and burnout in nursing practice. However, predictors of intent to leave the job suggest a growing realisation by nurse participants that postgraduate education and nursing research may provide the tools to create positive change in the health care environment and make nursing visible, valued and appropriately rewarded.

Abstract: This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of the author's own particular horizon of meaning as researcher and mental health nurse. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, he explores the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. Recovering was a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change.