Abstract: This paper will examine how one woman, Madeleine's narrative can be constructed as symptomatic of the diagnosis of schizophrenia and how it can also be read from other perspectives, particularly a post-structural feminist one. The readings are presented as possibilities for understanding the woman's experiences and the implications of this for mental health nursing practice. A post-structural feminist reading acknowledges the gendered experiences of subjectivity and how those experiences are constructed in language.The purpose of this paper is to identify for mental health nursing practice an approach which recognises the figurative and literal characteristics of language in order to provide nursing care which positions the individual's experience of mental distress as central. This requires an acknowledgment of Madeleine's path into mental distress rather than simply a categorisation of what is observed in a clinical setting. Intervention may need to include a range of strategies: medical and non-medical, psychotherapeutic and social, physical and environmental. It may also require the provision of sanctuary and security while these options are explored

Abstract: Problem based learning (PBL) has been used in a Bachelor of Nursing course since 1996 and several modifications to this delivery have been made. These changes were in response to concerns from students and tutors that students knowledge level was not appropriate and they were unable to apply this knowledge to their practice. The pure PBL process has been adapted to gradually move from tutor direction to self-direction. This has enabled students to develop critical thinking, problem solving, information retrieval and evaluation skills and group work skills over an 18-week period.However, no rigorous evaluation of these changes had been undertaken and so the purpose of this study was to evaluate how the current format of PBL was meeting students learning needs. An action research method was chosen as most relevant to the context and the questions posed, namely: How useful are the classroom activities in developing students understanding and integration of knowledge? How well do the students perceive they are learning compared to traditional teacher-centred methods?Two cycles of the action research method (Cardno and Piggot-Irvine, 1994) were used, involving four tutors and 17 students. Data was collected both quantitatively and qualitatively. Findings indicated the importance of: explaining the purpose and process of PBL; communicating in detail the role of both students and tutors; keeping communication open between students and tutors; addressing timetabling issues and valuing this method of learning for nursing practice. Implications for nursing education are addressed

Abstract: Aim: To determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a primary school environment as an alternate or complementary way of addressing the health needs of 'at risk' children and families to the services already provided by the public health nurse.Method: Utilising needs analysis method, data was collected from three sources – known demographic data, 17 key informant interviews and two focus group interviews. Questions were asked regarding the health needs of the community, the perceptions of participants regarding the role of the public health nurse in order to determine if a public health nurse would be the most appropriate person to lead a primary health care clinic, and the practicalities of establishing a clinic including services participants would expect a clinic to provide. Analysis was descriptive and exploratory.Results: A wide range of health needs were identified from both the demographic data and from participant interviews. Findings also showed that participant's understanding of the role of the public health nurse was not great and that community expectations were such that for a public health nurse to lead a primary health care clinic further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed model that would serve to address the health needs of children and families in the area the study was undertaken.Conclusion: Overall findings indicated that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment is feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required. It is likely that a similar model would also be successful in other communities in New Zealand, however the health needs identified in this study are specific to the community studied. Further community needs assessments would need to be completed to ensure health services target health needs specific to the communities involved.

Abstract: This critical case study was undertaken for the purposes of illuminating information relating to new graduate nurses' experiences in their first clinical placement, in order to consider ways an established entry to practice programme can better support and enhance the students' transition from student nurse to staff nurse within psychiatric mental health nursing practice. Seven current students of the programme participated in the research. This provided the researcher with a variety of challenges related to her dual role as researcher and programme coordinator. Data was collected through the use of discussion groups, with participants and researcher jointly identifying the themes that were explored. These themes related to preceptorship and support, socialisation of the new graduate and risk management. The research has provided rich data that has already, and will continue to be used to inform future developments within both the educational and clinical components of the programme. The research has also provided opportunities for personal and professional growth through the sharing of experiences, and working together to identify emancipatory action which has in turn lead to transformation.

Abstract: This chapter explores the concept of islands particularly in relation to rurality, individual and community identities, and nursing. The author argues that all New Zealanders are islanders, and considers the implications of this on personal and community values, when they are shaped by geographic isolation and structural separateness. She explores commonalities between islanders and rural peoples in areas such as identity, isolation, and health, and outlines the impacts this has on rural nursing practice and competencies. A case study of a nurse on Stewart Island is briefly discussed.

Abstract: This research takes an autoethnographical approach to exploring the connections between being a nurse, doing nursing work, and experiencing a mental illness. Data is comprised of autoethnographical stories from 18 nurses. Drawing on Lyotard's (1988) postmodern philosophy of 'regimes of phrases' and 'genres of discourse,' the nurses' stories yielded three motifs: Nursing, Tangata Whaiora (people seeking wellness) and Bullying. Interpretation of the motifs was undertaken by identifying and exploring connected or dissenting aspects within and between the motifs.

Abstract: This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration.