Abstract: Over the last century the nursing profession has drawn from numerous theories and disciplines to construct its own theoretical foundations. While this diversity and flexibility may be one of the nursing profession's strengths it may have contributed to nurses' difficulty in explaining the complexities of their every day clinical work. This is a particular challenge for the domain of mental health nursing. This dissertation discusses how nursing models that have credibility at a clinical level can contribute to informing and advancing nursing practice. Models can achieve this by assisting nurses to conceptualise and articulate what it is they do that makes a difference to patient outcomes. Through this process nurses can maintain a distinct professional identity and establish themselves as effective members of multidisciplinary health team. Specifically, the application and limitations of Godkin's (2001) proposed model of a 'healing presence' to the author's own practice in a one-to-one nurse-adolescent client relationship in the mental health nursing is examined. It is claimed that a 'healing presence' provides a meaningful way to understanding the author's own practice. The proposed model of a 'healing presence' embraces the diversity of her background, and allows the author to maintain a nursing identity by providing a nursing framework to critique her practice, furthering her understanding of what it is that 'expert' nurses do and how this impacts on patient outcomes. Also suggested is that a 'healing presence' can contribute to the author's own and other nurses advanced nursing practice by making nursing visible to the multidisciplinary health team and to articulate “what it is that I do 'when I am nursing'”. Through presenting this dissertation, the author wishes to inspire other nurses to examine and understand their own practice.

Abstract: This research explores the issues and experiences of mental health nurses who experience or have experienced mental illness. This project was prompted by the author's concern for colleagues and friends in this situation. The research topic was approached using a mix of critical ethnography and action research principles. Five mental health nurses who all work for the same district health board were interviewed about their experiences of being mental health professionals with mental illness and the issues that arose from this. The themes that emerged from this research are: the reactions of nurse colleagues, the effects on participants' own mental health treatment, employer responses, professional experiences and issues and strategies for coping. Discussion and recommendations focus on the need for improvements to the responses that mental health nurses with experience of mental illness encounter in their workplace. Recommendations from this research encompass suggestions for both individual and organisational education, action and change.

Abstract: This research paper reports on an exploration of the key elements nurses need to be aware of to effectively nurse adolescents in an adult inpatient unit. It describes the developmental needs and significant influences that affect this age-group, that when incorporated into nursing care, nurses can gain a therapeutic relationship with the adolescent. By means of a literature review, sharing the author's experience in nursing adolescents, and through vignettes of practice, an illustration of some common situations that may occur during the adolescent's inpatient stay are described. These situations are explored and a perspective is offered on how nurses may be effective in their nursing of an adolescent patient from the point of admission through to discharge. More research is needed on adolescent mental health nursing, however the author anticipates that nurses will be able to use this report as a helpful resource in their current practice.

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.

Abstract: This paper is an analysis of the cultural and traditional factors that the author presents as essential considerations in the treatment of Samoan people who have been diagnosed with a mental illness. Just as important to any clinical diagnosis, is the spiritual nature of Samoan culture and traditions, which inform belief systems. A full understanding of these will explain how the traditional beliefs and cultural values of Samoan people have an impact on their perception of mental illness, its causes and cures. The thesis places emphasis on 'ma'i -aitu', the Samoan term for most ailments pertaining to the mind or psyche. The focus is on defining 'ma'i -aitu' as part of a Samoan world view and likewise a description of a similar type of manifestation in the Papalagi (western) context of a psychiatric disorder and how treatment and management is usually undertaken. The issues addressed in this paper aim to highlight the Samoan client's world view from a Samoan perspective of mental illness which then poses the question of how they can be managed holistically and appropriately under the Papalagi medical system. Furthermore, it questions if the traditional belief system of Samoans run deeper than originally thought and can the replacement thereof by a foreign culture be responsible for the increased mental problems in Samoans living in New Zealand? This paper emphasises the importance of integrating the western medical model and Samoan health models, for appropriate mental health service delivery to Samoan people.