Abstract: Accurate nursing assessment is a critical element in the identification of health problems and treatment strategies for older adults who have delirium and/or dementia. This practice update provides information on the differentiation between these two debilitating and adverse health events, along with some useful assessment frameworks and other resources. Comments from people with delirium and dementia are interspersed throughout the article to draw attention to the impact of these conditions on people's lives and well-being. The article includes the 'A presenting concern framework', useful mnemonic devices to help nurses assess an older person who may have delirium or dementia, and a list of online resources.

Abstract: Reports the findings of a study examining aspects of the implementation of the Primary Health Care Strategy on primary health care nursing in a small district health board (DHB) in NZ. Conducts an instrumental case study informed by onstructionism and underpinned by a qualitative interpretive design. Collects data from policy documents and strategic plans and by means of interviews with managers at middle and senior levels at the local DHB and two PHOs.

Abstract: Investigates how enrolled nurses (EN) and registered nurses (RN) perceive their experiences of direction and delegation. Employs narrative enquiry to describe communication during direction and delegation interactions.

Abstract: This paper reports on research into print media representations of industrial disputes in Canterbury in 2001, when mental health nurses undertook a variety of strike actions after stalled negotiations with the local district health board. One response to these actions was the temporary reduction of many of the regions' mental health services. The researchers identified themes of juxtaposed but largely deprecatory images of both mental health nursing and of consumers of services. Some professional nursing voices were given print space during the strike; however, these were largely incorporated into existing discourses rather than offering a nursing viewpoint on the strike. The researchers suggest organisational efforts to focus on ways of ensuring that mental health nurses are seen as a legitimate authority by the media.

Abstract: Nursing literature reflects that nurses have been exploring and experiencing the process of clinical supervision for well over a decade. Nurses in the United States, United Kingdom, Scandinavia, and Australasia have written much over the past fifteen years. However, the author notes that nurses grapple with what clinical supervision is within nursing development and disquiet continues to emerge in the literature. This literature review expands on themes that surround this disquiet. These centre on continued confusion and lack of clear definition; whether psychotherapy is implemented under the guise of clinical supervision, who uses it, and the dearth of empirical evaluation of its effectiveness. The lack of significant empirical evidence of its ability to assist practitioners to deliver improved patient/client care continues despite claims of improved professional and personal development, therapeutic relationship, and occupational stress management. These claims come from both supervisees and supervisors. The manner in which clinical supervision is portrayed in nursing in that it is frequently referred to as a support system, rather than one of learning a complex set of communication skills is also highlighted. The continued debate on what model(s) best suit nurses, or whether line management should provide clinical supervision as a means to ensure quality standards and control over nursing practice and optimal patient care is discussed. Whether nursing should stop borrowing from other fields and develop their own model(s) is also raised. Two emerging stances focus on a process that is practice-based as identified by senior staff and management, or one that continues along the lines of what psychotherapy has developed with practitioner-identified developmental needs. These issues raise many questions for further development in nursing, one being are nurses developed enough in their self-awareness to understand what they are to adopt into their practice? Authentic voices from those nurses experienced in the practice of providing and receiving clinical supervision, are shaping therapeutic practice for nurses in the future, and continue to sharpen the debate. Some reference to unpublished data and local practice in the Wellington area have been included as a stimulus for further incorporation of clinical supervision in local practice development.

Abstract: Examines nursing students' knowledge about services, their access to facilities and their confidence in referring sources of health promotion to other students. Offers a web-based survey to nursing students at 23 nursing schools providing undergraduate nursing education in NZ. Conducts descriptive statistical analysis and compares groups based on age, year of study and ethnicity, using 2-sample t-tests. Describes the responses regarding service availability, health-promoting aspects of each campus, and confidence in provision of health advice.