Abstract: A nurse presents research and her own experiences of contracting. Contracting, as defined in this article, refers to a nurse not employed permanently on a wage. It covers agency nursing, short and long fixed-term contracts and secondments. The author identifies the need to continue to develop professionally, which is now a mandatory requirement under the Health Practitioners Competence Assurance (HPCA) Act. Contractors have little, if any financial support to develop professionally, and time taken to do courses is not paid. Taking study leave within a contract may also not be an option. Options for managing professional development in these conditions are offered, including goal setting, investing in education or training, and considering some longer contracts. Practical financial advice and examples are given, including managing accounts and consideration of employment law. The author recommends that skilled nurses looking for interesting ways to develop their careers and to branch out in an entrepreneurial way should seriously consider taking up contract work.

Abstract: The author examines the current practices around the surgical counts of sponges, sharps and instruments, which is an integral component of safe perioperative nursing practice. Current practice, legislative requirements are reviewed, and the guidelines from the Perioperative Nurses College of New Zealand are reproduced. Case studies of errors in counts are used to illustrate the legal standards of practice.

Abstract: This article explores the implications of clinical decision making by primary health care nurses in relation to identifying family abuse, particularly partner abuse. The historical and sociological background to family violence in New Zealand, and government-led strategies are considered, along with issues for Maori and Pacific peoples. The concept of health literacy in relation to family violence is also briefly discussed.

Abstract: This article reports the implementation of a collaborative project undertaken to monitor and improve the effectiveness of the prescribing practicum papers delivered within two Master's degree programmes in advanced nursing practice. The recent introduction of Nurse Practitioner registration in New Zealand has resulted in the development of a number of Master's degree programmes in which students can complete a Nursing Council of New Zealand approved programme for prescribing. For the study, a developmental action research approach was used. Data were collected through interviews with practicum students, their medical supervisors and academic staff. Formative findings were progressively used to refine delivery of the practicum papers and a thematic analysis of summative findings identified areas for further improvement. The findings suggest that the processes being implemented are developing well. The researchers recommend that further education is required to clearly differentiate medical and advanced nursing roles. They recommend that greater attention needs to be paid to the preparation of medical supervisors and, most significantly, revision of funding is required to more equitably support the ongoing development of nurses for advanced practice roles.

Abstract: The authors present the results of a 2001 New Zealand survey on nurses' perception of staffing, work organisation and outcomes, comparing this with the 2001 International Hospital Outcomes Study (US, Canada, England, Scotland and Germany). The report describes the findings for job dissatisfaction, burnout and the intent to leave, the work climate in hospitals, workforce management, the structure of nurses' work, and quality of care. The authors discuss these findings and their implications for nursing in New Zealand.

Abstract: Research suggests that the experience of being a preceptor can be rewarding, but there are challenges which may impact on their ability to fulfil the preceptorship role. In an effort to understand the experiences of being a preceptor and the factors that impact on that role, a qualitative descriptive study was undertaken in a small provincial hospital in New Zealand. A purposeful sample of five registered nurse preceptors completed semi-structured audio-taped interviews. Seven common categories were developed from the data – willingness to engage, building a relationship, letting go, support, workload, students in the clinical setting and making judgements. The author notes that this research has highlighted that preceptors need prior notice that they are going to be having student nurses so that they can be better prepared; preceptors and student nurses also need to be rostered together for the whole placement to allow a one-on-one relationship to develop. Preceptors would benefit from having a lighter workload during the first few days of preceptoring as then they can spend more time teaching the student. Schools of nursing and hospitals also need to have an ongoing collaborative relationship in planning and supporting the preceptorship program; this would further support preceptors in their role. The lecturer from the school of nursing needs to be contactable and available to both the preceptor and the student to clarify any misunderstandings and as a resource should any problems arise.

Abstract: Traditionally the use of advanced physical assessment skills when assessing a patient or client has been the domain of the medical profession. The last few decades has seen many changes in health provision that have influenced nursing practice, as a result of the social and economic trends impacting on New Zealand society. A notable change in nursing practice has been an increased emphasis on the use of advanced physical assessment skills by registered nurses, as an expected part of the registered nurse's health assessment. Nurses in the United States, and more recently Canada and Australia, readily include these skills as an expansion of their health assessment into their nursing practice. The purpose of this research is to investigate whether New Zealand registered nurses have done the same. The factors that influence the registered nurses' use of these skills are also explored. This descriptive design was chosen in order to focus on exploring and describing this phenomenon in a holistic fashion. Data collection involved one hour semi- structured interviews with seven participants who all completed the same postgraduate advanced health assessment educational course. Three themes were identified as influencing the use of advanced physical assessment skills; the registered nurse's work environment, the registered nurse's attributes and the registered nurse's original nursing education. The findings from this research have implications for nurses in practice and nurse educators, in both undergraduate and postgraduate education.

Abstract: This dissertation considers the implications of the relationship between nurses and the patient's family, when family members visit intensive care units (ICUs) following the acute admission of a relative there. In particular it explores the issues of power and control, nurses might have in this setting, the culture that supports that, and the implications this has for practice in the New Zealand context. A comprehensive literature review on the perspective of nurses in relation to relatives visiting adult intensive care units was conducted. The author concludes that nurses modify policies related to visiting access for family members to suit themselves, and the needs of their patient. Nurses use a variety of tactics to maintain a position of power and control by looking out for themselves first, their patient second, and relatives third. The need of the patient and their families is not well understood by nurses, and nurses feel they have inadequate skills to cope with the needs and stresses of visiting relatives. The author suggests that for nurses to provide family focused care in ICU they must develop a therapeutic relationship with all concerned. ICU nursing culture affects nurses ability to focus on caring for their patients and their families. Nurses in ICU appear to need to maintain power and control over their environment but further research is needed to identify the current situation in New Zealand ICUs.