Abstract: The authors conduct an audit of medical activity at Christchurch Hospital, a 650 bed tertiary centre, between 2230 and 0800 hours. They measured the volumes of tasks requiring completion overnight and identified the competencies required for this as well as the level of teamwork that existed. They found several organisational areas of concern, that indicate new approaches are required to staff the “hospital at night,” and an Out of Hours Multidisciplinary Team is recommended. Specific issues included the lack of teamwork from the Resident Medical Officers (RMOs), with some overextended while others were inactive. House officer tasks were largely generic rather than specialty specific; there was no formal handover from the afternoon or day shifts and the level of hospital medical staffing did not reflect the activity levels over the time period studied. The researchers also recommend an urgent review of the beep policy. A third of the admissions were to General Medicine, and basic medical activities (including admitting, reviewing, and prescribing drugs and fluids) for patients admitted under all specialties represented the majority of the night workload. Medical registrars had reduced some of the traditional multiple clerking by admitting patients themselves.

Abstract: The objective of this paper is to establish if there is any documented research and literature evidence that describe what the presenting clinical symptoms of Mai Aitu is, and also to explore an alternative frame-work to assess Pacific Islanders who present to mental health in crisis. As a community mental health nurse in the Crisis Assessment and Treatment Team (CATT), the author reports being confronted almost every day with an increasing number of Pacific Islanders presenting in crisis with symptoms consistent with the well documented signs of psychosis. For instance, symptoms like hallucinations, delusion and paranoid ideation which are also well known for describing schizophrenia. Her concern is that mental health nurses may be compromising their practice, the safety of the Pacific Island population and possibly the credibility of the profession with what appears like a lack of knowledge and awareness regarding the clinical symptoms of some Pacific Island mental illness. In Tonga it is called Avea Avanga, in Fiji it is referred to as Lialia, in Samoa it is known as Mai Aitu. The author notes that the issue becomes apparent when Samoan clients present in crisis with what appears to be psychosis but the fanau believe their love one is not mentally unwell, that he or she is simply suffering a traditional Samoan illness. Therefore they insist he or she be treated at home, instead of through admission to the psychiatric hospital, and also that they be seen by a Samoan healer instead of a psychiatrist.

Abstract: This research study was designed to identify ways of enhancing patient safety during the administration of medications within the New Zealand context. The researchers employed a multi-method approach that included a survey using the Safety Climate Survey tool, focus groups and three clinical practice development groups. The authors conclude that the outcomes of this study indicate that practice development initiatives, such as the ones outlined in this project, can have a positive effect on nurses' perceptions of organisational safety, which in turn has been demonstrated to have a positive impact on patient safety.

Abstract: This paper summarises research which addresses the question What might constitute Maori nursing practice? The research design adopted was influenced by kaupapa Maori methodology and used a semi-structured, qualitative, in-depth interview process. It was found that by understanding the current experiences of Maori registered nurses, their reflections on their preparation for practice, and their current practice, it is possible to identify the present and future training and practice needs of Maori nurses. Maori nursing practice can be characterised as having five features: the promotion of cultural affirmation including cultural awareness and identity; the support of, and access to Maori networks; the adoption of Maori models of health; the enabling of visibility and pro-activity as Maori nurses; and, the validation of Maori nurses as effective health professionals. Three recommendations for promoting Maori nursing practice are made in relation to staff in the workplace and in nurse education programmes: all nursing staff need to be alert to: 1. the impact of western scientific models on Maori healthcare; 2. the (often passive) non-acceptance of Maori within mainstream institutions; and iii) the benefits of valuing indigenous nursing programmes.

Abstract: This research considers the issues raised by the transfer from New Zealand to India of a degree for registered nurses. In the context of globalisation and the continuing migration of nurses, many countries are actively facilitating the transfer of educational programmes from other countries into their own. This transfer brings with it particular challenges for educators establishing and implementing programmes in a new environment and culture. Based on the experience and reflections of one educator involved in such a transfer, this research considers pedagogical issues such as addressing cultural safety in course content and delivery, expectations of teaching and learning styles, as well as the ethical issues raised by transferring a programme to another country in order to facilitate nurses' migration from it.

Abstract: This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours.

Abstract: This study examines the experience of managing Type 2 diabetes from the perspective of part-European people from Fiji who have this disorder. A qualitative approach was used, and the methodology was grounded theory based on the theoretical perspective of symbolic interactionism. Data was collected from the in-depth interviews of nine participants who have been living with Type 2 diabetes. Text from the interview transcripts was analysed using the version of grounded theory advocated by Strauss and Corbin (1998). This process facilitated the discovery of 'Carrying On With Life And Living' as the main concern shared by part-Europeans managing Type 2 diabetes. It also identified the substantive theory of 'Walking The Line' as the core category and the basic social and psychological process by which part-Europeans resolve their main concern of 'Carrying On With Life And Living'. This was a three-stage process involving firstly 'Carrying on Regardless', secondly 'Attempting Balance in Time and Motion and Control', and thirdly 'Balancing, Unbalancing, and Recovering Balance'. The results of this study reveal that the social and historical contexts of part-European culture, such as heavy drinking, carrying on with life and living in the face of adversity, and taking traditional medicine impact significantly throughout their managing process. Findings of this study may contribute to development of some culturally aware strategies that could assist healthcare services to provide appropriate support, intervention, and education for part-Europeans with Type 2 diabetes. This study also addresses the lack of studies concerned with the management of Type 2 diabetes in Pacific peoples and serves to inform research initiatives and priorities set by the Health Research Council of New Zealand.

Abstract: The author's art project “Posthuman Pathology” is a postmodern examination of the resolutely modernist culture of critical care medicine. She uses conceptual art practices in conjunction with the techniques of anti-aesthetics in order to dismantle, open out and critique ideas which are foundational to the culture of critical care.