Abstract: This thesis discusses the findings of a research study, informed by the work of van Manen (1997b), which explored the lived experiences of five mental health nurses who have had a patient die through suicide. Narrative was used as a method in interviews to uncover the essence of their lived experiences. Five interwoven themes uncovered in each of the interviews were: impact, support, feelings, closure and paradox. All of the nurses interviewed experienced a wide range of feelings about their patient's suicides, ranging from shock to guilt, to anger and sadness, and described their patient's suicide as having a significant impact on them. Support received by the nurses following their patient's suicide was variable, and they were often in the difficult position of trying to offer support to the patient's family. Common to all of the nurses was the lack of closure following the suicide. Paradox was found to be the overall essence of the experience of the mental health nurses interviewed. Three main paradoxical themes or statements were identified that are in many respects a summary of all of the themes that emerged. These were: unavoidable – responsible; inevitable – unprepared; duty of care – respect for patient's decision to end their life. The author suggests that the ability of the nurses interviewed to accept and reconcile the paradoxical issues that arise in relation to patient suicide, and accept the lack of closure they experience, is a fundamental element in their ability to continue to work in the mental health setting, despite the significant impact their patient's suicide has had on them. Four recommendations are made based on the insights gained from this research. These are: that every mental health service should have a suicide response policy; that undergraduate nursing education includes the impact of patient suicide; the development of policies which promote dialogue about suicide within the community; and the need for further research in this topic.

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: Explores how current nursing and health-care practices can be designed to facilitate effective type 1 diabetes (T1D) self-management in young adults aged 16-25 years. Reviews quantitative and qualitative literature published between 2017 and 2021. Identifies four themes by means of thematic analysis: digital information systems; glucose monitoring and insulin devices; group- and peer-education and peer support; diabetes care delivery style. Highlights the importance of adopting age-appropriate interventions to improve young adults' engagement in T1D self-management, requiring nurses and health-care practitioners to keep up to date with the rapid changes in digital technology and diabetes-related device technology.

Abstract: This dissertation was written to promote the author's understanding of the development of drug calculation competency in the undergraduate student nurse. It explores and critiques the literature surrounding the topic and examines the differing teaching methods that are currently used to promote this competency. Findings from the literature were compared to her experience of teaching drug dosage calculation competency to second year undergraduate nursing degree students. This dissertation suggests that drug dosage calculation may be an ongoing problem for nursing students not only during their course of study but also post registration. It appears that age and educational background may be factors in determining whether or not the student will truly master the concept. Although highly debated, it does appear that the use of a calculator assisted the nursing students within the author's class with their arithmetic operation. However, problems associated with conceptual understanding remain notable. The recommendations from this dissertation include the use of varied methods of instruction, integration of both the theory and practical components and the possible use of the dimensional analysis method in the teaching of drug dosage calculation. The author suggests that further research is required both locally within the School of Nursing where she is employed and nationally to fully examine the extent of this issue. Research which is not only focused on the student's calculation ability and its progression over the course of their study but which also allows the School to collate data on age, educational background, culture and learning style would allow lecturers to gain greater insight into student competency, progress and learning needs. She goes on to say that the continued ongoing exploration of her own practice utilising action research is also required as this would assist her in meeting the needs of students and lead to an overall improvement in her practice.

Abstract: Seeks to describe the perceptions and experiences of a sample of nurses working in a critical-care tertiary referral centre in New Zealand, engaged in mentorship of new staff and/or student nurses. Undertakes a descriptive study which identifies four barriers within the critical care environment: the impact that clinical workload has on the provision of mentorship; lack of acknowledgement of the mentorship role; challenge of assessment of new and student nurses; insufficient training and knowledge opportunities for mentors.

Abstract: Undertakes a descriptive exploratory study to ascertain the views of Generation Y NZ Registered Nurses (Gen Y nurses) towards nursing, work and career. Little empirical data exists about why young New Zealanders choose to become nurses in the 21st century. Further, little is known about their future career plans or their intentions to remain in the nursing workforce. Conducts a nationwide on-line survey of 358 Gen Y nurses from late 2009 to early 2010. Reports key findings: young NZ nurses are driven by traditional values of altruism, the desire to care for others, the ability to work closely with people, as well as being able to make a strong contribution to society when deciding to become a nurse, while seeking interesting, challenging and exciting work. Job security, the ongoing demand for nurses, the ability to leave and return, as well as the ability to combine work and family, are also important factors that help them to choose to become nurses.