Abstract: In this introduction to a special issue on nursing with indigenous peoples, the authors affirm the need for continued application of tools and strategies for thinking critically about issues of culture, history and race. Without these things, evidence of discriminatory policies and practices in the health system remain hidden to many health professionals. Attention to socio-political structures is as essential to promoting health and preventing illness as are nurses' activities with the individual clients. To develop critical consciousness in nursing requires educational strategies and frameworks that focus on the responsibilities and implications of practicing nursing in a postcolonial context where race and power continue to create patterns of inclusion and exclusion in health care settings. The authors suggest that many contemporary nursing programmes fail to provide such strategies and frameworks, and argue that nursing must view critical analyses of these issues as central aspects of nursing education, research, theory and practice. They go on to engage with the notion of cultural safety as a means of fostering a critical political and social consciousness in nursing to create an opportunity for social transformation.

Abstract: The paper is the report of two cumulative research projects studying the nature of nursing knowledge and methodology to develop it. They were undertaken as theses for masters and doctoral degrees at the University of Minnesota, USA. Nursing knowledge is depicted as relational: an evolving participatory process of research-as-if-practice of which 'health' (its meaning), dialogue, partnership and pattern recognition are threads inter-related around personal values of vision and community.

Abstract: Patients with myisthenia gravis (MG) face major pulmary problems as a part of the disease process. In this descriptive study, changes in selected pulmonary functions (respiratory rate, negative inspiratory force, tidal volume and forced total capacity) in 14 patients diagnosed with mild or moderate MG were measured every two hours from 8.00 a.m. to 8.00 p.m. Females comprised 64% of the sample while 36% were males. All subjects received anticholnesterase medication, and some subjects received additional treatment modalities. Most of the subjects were non-smokers or previous smokers, but two subjects continued to smoke. Ninety-three recent of the sample had forced vital capacities less than 60% of their predicted values. Myasthenic forced vital capacities were significantly lower (p=.0000) than those predicted for normal subjects. The inspiratory force for the sample was low sat 8:00 a.m. as well as in females over 55 years of age. There was a wide variation in total volume to normal values derived from random tables and predicted equations ws not significant. Th major implications from this study are the need to assess pulmonary function in the hospitalized myasthenic every two hours, and the need for a program of coughing, deep breathing and sighing after medication administration when the muscles are strongest

Abstract: A clinical audit was undertaken to assess the diagnostic skills of the nurse colposcopist measuring colposcopy: histology: cytology correlation. At National Women's Health the first New Zealand nurse colposcopist training programme was developed in 2000. A retrospective audit of the colposcopy clinical records was performed during the nurse's training programme between July 2000 and March 2002. An 82% (82/100) histology: cytology: colposcopy correlation was achieved by the nurse in the third phase of her training programme. The results are comparable with other reported studies involving medical and nurse colposcopists. Expertise in colposcopy examination can be incorporated into the broader role of a Nurse Practitioner working in the area of women's health.

Abstract: This paper identifies the issue of sexual misconduct by nurses in New Zealand. There is evidence that some nurses have been involved in sexual misconduct, resulting in disciplinary proceedings against them. Despite this, there is an absence of guidelines and discussion for New Zealand nurses to prevent such occurrences. This article identifies difficulties in naming and defining sexual misconduct, and discusses sexual misconduct as an abuse of power by nurses. New Zealand and international literature about sexual misconduct by nurses and other health professionals is described, as are guidelines designed to prevent sexual misconduct. Finally, the authors make recommendations for actions needed to facilitate New Zealand nurses in identifying and avoiding sexual misconduct in practice.

Abstract: The researchers conducted a study to compare self-reported changes in both frequency and quality of performance of nursing behaviours in a cohort of recently graduated nurses undertaking a one year entry to practice programme. Thirty-three nurses were surveyed, seven weeks after beginning the programme and again seven months later, using a modified version of Schwirian's (1978) Six-Dimension Scale of Nursing Performance (6-DSNP). Over the study period participants reported significant increases in frequency of performance for the domains of leadership, critical care, teaching/collaboration, and planning/evaluation. Significant increases in the quality of nurse behaviours in the domains of critical care, planning/evaluation and interpersonal relations/communication were also reported. The modified Schwirian 6-DSNP was found to be a useful instrument for measuring nurses' self reporting of performance during periods of transition.

Abstract: This article describes the move in mental health from institutional care to community arrangements. It draws on international literature and New Zealand health policy, which gives increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc and leave room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care.

Abstract: The aim of this article is to outline best practice management strategies for nurses during the clinical application of civil commitment of mentally ill persons. A literature search on 'coercion' and 'civil commitment' was undertaken. Published and unpublished research undertaken by the authors in New Zealand on this topic was drawn upon. This research considered the use of civil commitment during admission to acute mental health services, acute forensic mental health services and community mental health services. The experience of coercion by service users coincides with the degree of restriction associated with the service they are involved in. Socio-demographic factors, clinical factors and the experience of coercive events have little bearing on the amount of coercion experienced. Rather, it is the pattern of communication and the use of 'procedural justice' that has the potential to ameliorate the amount of perceived coercion. The authors conclude that 'Procedural justice' aligns with the emphasis placed on the therapeutic relationship in mental health nursing and is an important consideration for nurses during the clinical application of civil commitment