Abstract: This research uses focus group methodology to examine the public health nursing practice with children living with a mentally ill parent. These children are often neglected, yet are at increased risk of developing mental illnesses themselves. The research data identified the burgeoning impact on public health nurses of such care, and found their role to be primarily assessment and advocacy.

Abstract: Practice nurses are primarily responsible for the administration of vaccinations in New Zealand, although many other health professionals contribute to the success of the National Immunisation Schedule by providing vaccination information and advice to parents. Vaccination uptake remains relatively low, indicating many parents choose not to vaccinate their children. A literature review was undertaken to gain an understanding of factors which may influence parents when they are making decisions about childhood vaccinations. Four key themes were identified within the literature: Perceived risk; Vaccine safety and efficacy; Child characteristics; and the Influence of health professionals/supporting vaccination structures. Increased knowledge and awareness about influential factors creates opportunities for health professionals and policy makers to develop strategies to increase vaccination uptake. Implications and recommendations are made for practice, with particular emphasis on the role of the primary healthcare nurse.

Abstract: A qualitative descriptive approach was undertaken to explore the experience of eight registered nurses and two hospital play specialists who care for children hospitalised with burn injuries. The research participants were recruited from a paediatric ward that offers centralised specialty care to children with burns. Emerging out of the data was the over-arching theme of 'passionate dedication' that shows the nurses and hospital play specialists genuine compassion and commitment to meet the needs of the children with burns. The findings of the study reveal that the participant's dedication is shaped and determined by a dynamic process that involves having professional integrity and in-depth knowledge of caring for children and burn management. The nurses and the hospital play specialists have a common understanding of what their role entails and the skills required to provide quality care and support to the children and the children's family. On a personal and professional level the participants encounter several challenges in this care context that are physically and emotionally overwhelming. Despite becoming overwhelmed the participants are revealed as being resourceful and resilient in their aptitude to find ways that enable them to cope and get through. The author suggests that this study supports international literature that suggests that caring for children with burns is equally rewarding, as much as it is physically and emotionally demanding. The author identifies that the implication in this study for the organisation is to seriously consider issues regarding productivity and efficiency of the workforce with acknowledgement that nurses and hospital play specialists cannot do this emotional work without effective systems of support in place.

Abstract: The prevalence of allergic disease has increased significantly in western countries over the last decade. However, the author points to the availability of specialist allergy services in New Zealand being limited to the large cities, resulting in a lack of, or fragmentation of, the allergy-related services in smaller regions. As a public health nurse in Otago working with a rising number of families with severely food allergic children, the author had become aware of the challenges many parents face in accessing accurate information about their child's allergy and the negative impact this has had on them and their child. The purpose of this dissertation is to explore how an Allergy Nurse Specialist (ANS) led service could improve the experiences and health outcomes of the families and children with severe food allergies living in Otago. A critical analysis of the literature on allergy nursing, advanced nursing roles, and related food allergy issues was conducted and applied to the Otago region. Drawing on the 'Nurse with a Special Interest in Allergy' model of nurse-led allergy care outlined by Cross (2005) and the existing Otago District Health Board's (2004) clinical nurse specialist role, the author proposes that an ANS-led model of care, incorporating advanced nursing practice, primary care access and multidisciplinary collaboration could complement the existing allergy related services in Otago. The focus of the ANS's care will be on facilitating timely access to accurate assessment and advice for families regarding the management of their child's food allergies.

Abstract: When a child lives with a life-threatening illness there is a range of emotions that affect the child, family and people close to the child. This study utilises a narrative approach to explore what the child puts emphasis on in what is important to them as they live with serious illness. The study incorporates the nurse as narrator with the 'narratives' of the children integrated into her reflections to gain a broader understanding. The focus is on listening intently to the spoken needs of children, their story and the meaning they make of their situation when they live with their illness. 'Children' in this study are between the ages of six years to 15 years. The aim of this research is to provide a clear understanding of the lived experience, which may illuminate the needs of the child and what is required throughout the time of illness; therefore informing health professionals of a culture of care that may support these needs. A broader understanding and deeper insight into the complexity of children living with life-threatening illnesses provides a basis for the development of sensitive, humanistic quality nursing care for both the child and his/her family, this then enhances the potential for best practice for children living with a life-threatening illness.

Abstract: This article reports one aspect of a phenomenological study that described the lived experience of mothering a child hospitalised with acute illness or injury. The significance for mothers that nurses do the 'little things' emerged in considering the implications of this study's findings for nurses in practice. Seven mothers whose child had been hospitalised in the 12 months prior to the first interview agreed to share their stories. The resulting data were analysed and interpreted using van Manen's interpretation of phenomenology. This description of mothering in a context of crisis is useful in the potential contribution it makes to nurses' understanding of mothers' experience of the hospitalisation of their children. It supports the philosophy of family-centred care and highlights the ability of individual nurses to make a positive difference to a very stressful experience by acknowledging and doing 'little things', because it is the little things that matter to the mothers of children in hospital.

Abstract: Grounded theory methodology has guided the grounded theory methods used to explore the acute care paediatric nurses' perspective of what they do when a child has had a severe accident. The research was initiated from the experience of nursing children in the context of a rehabilitation centre and wondering how acute care nurses promoted a child's recovery after a severe unintentional injury. Many avenues were used to search international and New Zealand literature but the scarcity of literature related to what acute care paediatric nurses do was evident. Nursing children in the acute care ward after a severe accident is complex. It encompasses nursing the family when they are experiencing a crisis. It is critical that the acute care nurse monitors and ensures the child's physiological needs are met, and the nurse “works with” the child to maintain and advance medical stability. Nursing interactions are an important part of “working with”, communication is the essence of nursing. This research has focussed on the nurses' social processes whilst caring for the physical needs of the child and interacting with the family and multidisciplinary team when appropriate. An effective working-relationship with a nurse and family is founded on trust. Grounded theory methods supported the process of exploring the social processes of “building trust” whilst “working with” families in a vulnerable position. Nurses rely on rapport to be invited into a family's space to “work with” and support the re-establishment of the parenting role. The “stepping in and out” of an effective working-relationship with a family is reliant on trust. Nurses build trust by spending time to “be with”, using chat to get to know each other, involving and supporting the family to parent a “different” child and reassuring and giving realistic hope to help the child and parents cope with their changed future. A substantive theory of the concept of “building trust to work with” has been developed using grounded theory methods. The theory has been conceptualised using the perspective of seven registered nurses working in paediatric acute care wards that admit children who have had a severe traumatic accident.