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 thesis explores the customary kaupapa of Matauranga Maori or Maori knowledge, which the author identifies as the appropriate technique to determine how health care should be maintained by and for Maori. The research highlights the need to meld these kaupapa with that of a contemporary Maori viewpoint, to focus more on a deeper enhancement of these kaupapa, and develop an understanding of the social, cultural, educational, political and economic contexts these concepts have on Maori as a people. This research identified six Maori registered women nurses, who shared their experiences regarding Matauranga Maori and its importance to their nursing practice. Over a period of one year, in-depth conversations unfolded and produced data on what Matauranga Maori involves and how the six participants in the study believe it influences their nursing practices. All were currently practicing nurses within various health settings such as psychiatric and comprehensive nursing. From the inception of this study, the focus was to introduce Matauranga Maori as the epistemological framework of choice. The author notes that the findings of this research indicate that a collection of key kaupapa, namely whakapapa, whanaungatanga, te reo Maori, wairuatanga, tuurangawaewae, manaakitanga and rangatiratanga are crucial to the health and wellbeing of Maori as a people. These kaupapa enable Maori to determine and strengthen their worldview, which in turn reflects the concept of being Maori thereby contributing to the health and status of their whanau, hapu and iwi. She goes on to say that the findings support the view that there is a substantial collection of kaupapa, which are inherent in Matauranga Maori as being able to provide a framework for theoretical research. These kaupapa will provide a framework for nursing practice and educational curricula that will develop and maintain nursing standards to meet the needs of Maori.

Abstract: This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice.

Abstract: The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme.

Abstract: This article examines the therapeutic relationship, a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realised in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualisations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses.

Abstract: This thesis describes the journey of a practicing independent nurse practitioner and naturopath through the stories of five clients. The thesis is presented as a narrative and begins with an account of the events in the practitioner's life that lead to the specific study of natural therapies and the development of a cohesive practice using holistic health practices from a nursing perspective. The text essentially describes the process of establishing a private practice combining two disciplines of nursing and naturopathy in New Zealand. The study reveals how a nurse and naturopath's practice is based on the premise that it is crucial to recognise that the personal life and professional life of the nurse inform and influence each other and are always part of the process of care in such a practice. Three healing modalities that are central to the practice are described in detail. The description is informed by theory and research from nursing, the social sciences and the natural sciences. The study reveals the practical value of postmodern nurse theorists, Jean Watson and Margaret Newman to this practice. This study also briefly discusses the concepts from quantum theory, evolutionary theory and psychoneuroirnmunology that are used in the practice.

Abstract: In this article the authors introduce an alternative way that nurses can be with families, using a relational process that can enhance nurses' responses when working with those transitioning to parenthood. Seasons of Life, a framework adapted from the Maori health model He Korowai Oranga, emerged from practice to offer a compassionate and encouraging stance, while at the same time respecting each family's realities and wishes. The model allows the exploration of the transition to parenthood within a wellness model, and takes a strengths-based approach to emotional distress. This approach provides a sense of “normality”, rather than of pathology, for the emotions experienced by new parents. The specific issues men may face are discussed, where despite recent culture change that allows men a more nurturing parental role, there is still no clear understanding of how men articulate their sense of pleasure or distress at this time. Practitioners are encouraged to examine their own assumptions, values and beliefs, and utilise tools such as reflective listening, respect, insight and understanding. The most significant aspect of relationship between nurse and parents is not the outcome, but how nurses engage with families. Examples from practice will demonstrate some of the differing ways this relational process framework has been effective.

Abstract: Psychiatric consultation liaison (PCL) nursing is an evolving specialist area of mental health nursing in the USA, UK, Australia and New Zealand. The aim of this dissertation is to explore models of PCL nursing practice in order to develop and discuss a PCL nursing model applicable to the New Zealand context. The role of the PCL nurse was of particular interest to the author as a new practitioner in this specialist area. While there have been PCL nurses in practice for over 50 years, the literature does not offer much clarity about models of PCL nursing. From a review of the literature, four themes were recurrent in the work of PCL nurses. These themes represent four functions which are vital to the role of the PCL nurse: partnership, expertise of the PCL nurse, therapeutic relationship and organisational consultation. The needs of the patient are the core of this model and the primary objective is to improve the quality of care of patients in the general hospital with co-existing physical and psychological problems. It is imperative that PCL nurses evaluate their practice and embark on research to investigate clinical outcomes, cost effectiveness and the impact of PCL nurse practice on patients and staff. This PCL nursing model provides a beginning for this process. It also clarifies and articulates the role of the PCL nurse which enables the service to be promoted to colleagues. This PCL nursing model represents a critique of the author's understanding of the role of the PCL nurse. As expertise develops, the model will continue to be tested and refined.