Abstract: This dissertation came out of the author's wondering why there are still so few men going into nursing especially when the history of nursing reveals that men have been a part of nursing for a long time. In New Zealand it is only since the mid seventies that men have been able to gain the exact same nursing qualifications as their women colleagues. The author notes that men in nursing are still seen as unusual in that they work in a predominantly female occupation and have had their masculinity questioned by the myth that all men in nursing must be gay. There is also the notion that caring is a difficult task for men and is seen by society as a uniquely feminine ability. Both issues are related to dominant notions of masculinity. In addition to this there is currently a crisis in terms of a nursing shortage and it has been suggested that one way to resolve this crisis is to encourage more men into nursing. Thus this exploration as to why there are so few men in nursing is timely. Men who choose nursing as a career risk challenging the traditional roles of their gender stereotype. A comprehensive search of the literature from different disciplines reveals deeper issues than just the commonly held assumption that nursing is not masculine. Exploring the issues of gender with a particular focus on masculinity has uncovered the concept of hegemonic masculinity. This describes how gender is practiced in a way that legitimises patriarchy, reinforcing the dominant position of men over women as well as over other groups of men. It is these patriarchal attitudes that have seen men marginalised within nursing. On the one hand men in nursing could be seen as challenging the current dominant masculine ideal. However, on the other hand men in nursing may not challenge this hegemonic masculinity; instead often supporting the status quo in an effort to maintain their own masculinity. The author suggests that the implication for nursing, if it is to increase the numbers of men in the profession, is to challenge this notion of hegemonic masculinity. This needs to be done appropriately by critically examining this concept rather than by merely replacing one hegemony with another. He goes on to say that it is now time for nursing education to include a critical exploration of gender issues and how it relates to men as part of undergraduate nursing education for both men and women students.

Abstract: Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services.

Abstract: Discourse about women assuming greater control over their childbirth experience has received much attention in contemporary childbirth and womens' studies publications. Research in the domain of childbirth has shown that a sense of control over one's birth experience is related to childbirth satisfaction. More specifically, studies have used Locus of Control measures and have found a significant relationship exists between expectations for control and choice of birth place. Choice of birth place features in some articles as a factor that determines the degree to which control can be exercised. Home, as a place of birth, is considered a setting in which a woman can have optimum control over her experience. Many women are discouraged from taking up this option, based on fears about safety. Reflection on why women continue to pursue a home birth against the wishes of their care giver rekindled and interest in Locus of Control. This study was undertaken to explore the relationship between urban women's choice of birth place setting and their scores on two different measures of Locus of Control (LOC). The aims of the study were: to test whether LOC scores predict choice of birth place for women who chose hospital, home or a birthing centre as their place of birth; to test which of the two LOC scales (Levenson's generalised measure or Wallston et al's more specific scale) is the most useful in predicting the influence of LOC and choice of birth place and to explore the relationship between choice of birth place LOC, demographic and contextual factors surrounding pregnancy. The method used in the study was a descriptive correlational design. One hundred and ninety four pregnant urban women who accessed a range of maternity care providers in the greater Auckland , Wellington , Christchurch and Dunedin cities responded to a “Birth Choice Survey” between April and June 1996. Tests of significance found significant differences for powerful others and chance Locus of Control among the three groups of women who chose hospital, home or a birthing center as a place of birth. Differences were significant at p = 0.05. No significant differences were ffound in the scores for internal Locus of Control for women in the three groups. Limitations in the sample sixe prevented linear discrimination being successful in predicting the influence and choice of LOC variables and choice of birth place for both scales. A classification tree was employed to identify key variables which might affect choice of birth place and indicated that women who were extremely happy with their birth place choice were more likely to be those who chose home birth. Locus of Control measures are interesting, and if used specifically, may be helpful in relation to understanding a women's choice of birth place. However general assessment of the contextual factors appears just as relevant. Implications of this study are the while women may differ in how they perceive their outcomes are determined, an overwhelming majority of women who participated in this study value their ability to make choices about their birth location. Identifying consumer perceptions about control and the contextual factors that influence women's choice of their birth place has the potential to clarify women's preferences for responsibility in their birth experience. Limitations of the study were addressed and included suggestions to improve response rates and thus generalizability of findings. Implications for further research were also considered

Abstract: Te watea taupuhipuhi, the space of symbiosis is a framework for nursing practice. It examines the notion of the nursing presence as holding continuity and multiplicity of viewpoint in space of symbiosis. The author developed a teaching-learning situation as an introduction of key ideas in his work where the Maori word “ako” becomes the catalyst of a particular pedagogy that outlines the central notions of symbiosis. Thus, he notes, his work realises that symbiosis occurs not only on the clinical arena of nursing but in the teaching – learning environment as well, his own space of symbiosis. Four rites of passage coalesce a totality of experience within the space of symbiosis, revealing that the central role of the nursing presence is to surface meaning and sense for all of experience which can be fearful, mysterious, paradoxical and chaotic. These four rites of passage are described as the interpretive, integrative, transformations and transcendent. The twelve dynamics of nursing from the axle around which a praxis of nursing revolves. An analysis of those twelve dynamics in rite of passage is situated within narratives taken from the author's nursing practice. He also draws extensively from Maori ontology and autobiography in positioning his exposition within this local context.

Abstract: This aim of this thesis was to explore and describe registered nurses' experiences of undertaking the statutory role of Responsible Clinician under the Mental Health (Compulsory Assessment and Treatment) Act 1992. The role of Responsible Clinician has been available to nurses since 1992 yet to date there has been little research into nurses' experiences of undertaking this role. An exploratory descriptive approach was therefore used in this study. A convenience sample of four nurses who had been undertaking the role of Responsible Clinician was recruited. Their experiences were elicited through in-depth interviews. Analysis of the interview material revealed the themes of legitimacy, relationships, expanding practice, responsibility and accountability, approaches to care, nurses' responsiveness to the role and support of the role. The author points to this research being important to nurses who are working in the psychiatric mental health area so that they can understand the role more fully. In this way, more nurses may choose to undertake the role of Responsible Clinician.

Abstract: This project undertakes a critique and review of a decade (1990-2000) of available New Zealand literature to reveal the current state of nursing informatics utilisation in nursing practice. Since the early 1990s, nurses from diploma and baccalaureate nursing programs have been graduating with knowledge and skills in nursing informatics. Yet, when scrutinising the two main nursing publications for New Zealand, the author found scant publication of articles that pertain to this topic area of nursing. Competencies as product of the 1989 Guidelines for Teaching Nursing Informatics are a key consideration in this discussion, including ways in which the articles may reflect the content or intent of the Nursing Informatics curriculum as prescribed in these guidelines. This commentary discusses how nursing informatics has evolved in New Zealand nursing practice, situating its growth, or lack of, in the context of concurrent sociopolitical influences as well as conditions created by national and international nursing trends. Several recommendations are discussed to guide the future direction of nursing informatics for nursing education and practice in New Zealand.