Abstract: This thesis presents a grounded theory study following Glaser's methodological stance. It explores nursing of the 10-24 year old client through interviews with thirteen registered nurses. The participants worked in a variety of clinical settings including community, hospital and specific adolescent services. From the analysis of the data emerged the complexity of the nurses work with the chosen age group. The study identifies that the quality of the nurse/client encounter may enable the young person to feel accepted and to be empowered to make their own health choices.This thesis identifies how Having Attitude is seen by the nurse participants as critical in the care of the young person. Having Attitude is about the nurse balancing the dependence/independence needs of the young person with their family and peers, and about being acceptable to the client. This results from the work of the nurse which is characterised by the nurse being competent' and 'being supportive whilst taking into account all of the socio-political factors that effect the nurses working situation. The socio-political context impacts upon the young persons life in terms of the types of health issues they have, and the availability and affordability of appropriate health services. It also impacts on the environment in which the nurse works, in terms of the complexity of the concerns with which young people present, current health reforms and funding issues. The nurse needs to have a broad knowledge base and ability to work within a complex situation. Nurses believe they can make a difference to the young persons health experience when they are supportive, competent and have attitude

Abstract: Maternal child care in New Zealand has traditionally been given by a variety of providers from the private and public sector. The reorganisation of the health services has effected all forms of health delivery including maternal and well child care or well child care services. Contracting of services in a competitive environment has been an important feature of the reorganisation process. Ashton (1995) notes that the system of contracting has facilitated the introduction of new approaches to health from new provider groups, which are not necessarily based on primary health care principles. This has led to confusion for providers and consumers alike. In 1996 a new national schedule which described the services recommended for maternal and child care was introduced called WellChild/Tamariki Ora. A questionnaire based on this schedule was administered to a sample of 125 parents of children under five years of age in Hawkes Bay to investigate issues relating to the provision and receipt of well care services.Descriptive data showed that the major providers in the present study were doctors. There were significant differences found in the number of services received by the less educated, the unemployed, single parent families, and Maori and Pacific Island people.Perceptions about the helpfulness of services received were not related to ratings of the child's health. Parents who received a greater number of Family/Whanau support services rated their children's health more highly. Findings are discussed in relation to the previous literature and recommendations are presented with particular emphasis on the implications for nursing and the role of nurses in providing well child care services

Abstract: The focus of this thesis is the practice of the nurses employed in the Native Health Nursing Scheme in New Zealand from 1911 to 1930. These nurses were a vanguard movement for change in community nursing services as they established a new role and developed innovative ways of practicing nursing while claiming greater autonomy and accountability for nurses who worked in community settings. Consequently they contributed to an increase in status for nurses in New Zealand.The Native Health Nursing Scheme was established by the Health Department to replace the Maori Health Nursing Scheme, an initiative by Maori leaders for Maori nurses to provide nursing care for their own people. The original scheme had foundered amid under-resourcing, a lack of support from hospital boards and administrative chaos. Government policy for Maori health was openly assimilationist and the mainly non-Maori Native Health nurses carried out this policy, yet paradoxically adapting their practice in order to be culturally acceptable to Maori.Their work with the Maori people placed the Native Health nurses in a unique position to claim professional territory in a new area of practice. As they took up the opportunities for an expanded nursing role, they practiced in a manner which would develop the scope and status of nursing. The geographical isolation of their practice setting provided the nurses with the challenge of practicing in an environment of minimal administrative and professional support, while also offering them the opportunity for independence and relative autonomy. Obedience, duty and virtue, qualities highly valued in women of the day, were expected especially in nurses. These expectations were in direct contrast to the qualities necessary to perform the duties of the Native Health nurse. The conditions under which these nurses worked and lived, the decisions they were required to make, and the partnerships they needed to establish to be effective in the communities in which they worked, required courage, strength, organizational ability and commitment