Abstract: As has been the case internationally, deinstitutionalisation of dual diagnosis (intellectual disability and mental illness) services has also occurred in New Zealand. Inpatient services have been redefined to respond to the more acute focus that has arisen out of this deinstitutionalisation process and nurses are having to redefine their roles in response. This study was undertaken to explore and describe the culture of nursing practice in a dual diagnosis inpatient unit in one psychiatric hospital. A focused ethnographic approach was used to triangulate data gathered from fieldwork observations, review of documents and semi-structured interviews. Schein's (1985) levels of culture model, was used to identify and explore the artifacts, values and assumptions evident in this nursing practice. Analysis presents three key themes categorised as 'communication', 'assessment' and 'safety'. While these key themes are shown to be evident in the everyday practice of the nurses, how these relate to the notion of 'dual diagnosis nursing' is not clear. Therefore, the author describes the major finding of this study as revealing a nursing culture holding tight to traditional psychiatric and psychopaedic nursing practices and struggling to develop a distinctive culture in the absence of a defined dual diagnosis knowledge base. The author concludes that these findings suggest an urgent need to provide nurses with support in gaining contemporary knowledge regarding dual diagnosis nursing. Support for nurses in advancing these areas then impacts on support for the patients. It is suggested that additional research is undertaken to assess the learning needs of the nurses in order to develop clinical practice guidelines for this area. Further recommendations are made to address system issues which are contributing to the gap in knowledge.

Abstract: Report to the Winston Churchill Memorial Trust on Professional Supervision for registered Nurses and Midwives, May 1998.
Objective of Project:
To explore the extent of the development of a model of clinical supervision for nurses in the United Kingdom.
Some of the key points that emerged:
- Clinical supervision is a strong and accepted part of nursing culture in Britain. While not mandatory and not available to, or accepted by, all nurses, it is nevertheless generally known about and discussed at main nursing forums
- The strong support and directives coming from nursing leadership is a major factor in the adoption of clinical supervision as a developmental, support and quality control
- The increasing availability of resource material, courses, and in particular the investment made by the Department of Health and the Scottish Home and Health Office in funding a 23 site evaluation project has stimulated implementation of clinical supervision

Abstract: This study describes the impact of a sudden, traumatic natural disaster on a bachelor of nursing programme, and the capacity and processes required to minimise disruption to programme delivery and student learning. This descriptive case study, undertaken across 2011-2012, collected data through interviews, a survey and artefact collection. Six key themes emerged from the inductive and descriptive statistical analyses: context; communication; leadership and followership; decision making; the need to balance shifting priorities around professional responsibilities and personal imperatives; and taking action and action plans. The conclusions reached emphasise safety as the first priority, encourage personal risk mitigation, and emphasise the importance of ongoing support and flexibility for all staff and students as well as the need for clear communication and decision-making. What is perhaps most important to take from this experience is that a plan does not, by itself, equal preparedness; every institution must look to its own context, consider its own priorities, and formulate its own approach to preparedness.

Abstract: A nurse's journey in cultural safety and how this is reflected in her nursing practice and described through her artwork.

Abstract: This qualitative thesis uses discourse analysis to examine parental resistance towards medical treatment of critically ill children. It is an investigation of the 'mobile and transitory' discourses at play in instances of resistance between parents, physicians and nurses within health care institutions, and an examination of the consequences of resistance through providing alternative ways of perceiving and therefore understanding these disagreements. The philosophical perspectives, methodology and methods used in this thesis are underpinned by selected ideas taken from the works of Michel Foucault and Pierre Bourdieu and supported by relevant literature in the fields of media, law, children, parenting, caring, serious childhood illness, medicine and nursing. It is argued that from an examination of interview based texts, parental resistance is an omnipresent but transitory occurrence that affects many of the interactions between the parents of seriously ill children and clinical staff. It is maintained that within these interactions, the seeds of this resistance are sown in both critical decision making situations and in everyday occurrences between doctors, nurses and parents within healthcare institutions. Contributing factors to parental resistance include the use of power games by staff, the language of medicine, forms of symbolic violence, the presence or absence of trust between parents and medical staff, the effects of medical habitus, and challenges to the parental role and identity. Overall, it is proposed in this thesis that parents who resist treatment for their seriously ill child are not exceptions to the normative patient-physician relationship.

Abstract: A dissertation submitted in partial fulfilment of the requirements of the degree of Master of Nursing at Otago Polytechnic, Dunedin, New Zealand.
As the healthcare system moves toward a consumer-driven paradigm, visiting hours for family and significant others of the intensive care unit patient have become a topic of interest and discussion. Research since the 1970s has generated controversy and speculation over the ideal visiting practices in the adult intensive care unit. Analysis of the growing body of research can now be reviewed to enable existing visiting policies to be revised.