Abstract: As has been the case internationally, deinstitutionalisation of dual diagnosis (intellectual disability and mental illness) services has also occurred in New Zealand. Inpatient services have been redefined to respond to the more acute focus that has arisen out of this deinstitutionalisation process and nurses are having to redefine their roles in response. This study was undertaken to explore and describe the culture of nursing practice in a dual diagnosis inpatient unit in one psychiatric hospital. A focused ethnographic approach was used to triangulate data gathered from fieldwork observations, review of documents and semi-structured interviews. Schein's (1985) levels of culture model, was used to identify and explore the artifacts, values and assumptions evident in this nursing practice. Analysis presents three key themes categorised as 'communication', 'assessment' and 'safety'. While these key themes are shown to be evident in the everyday practice of the nurses, how these relate to the notion of 'dual diagnosis nursing' is not clear. Therefore, the author describes the major finding of this study as revealing a nursing culture holding tight to traditional psychiatric and psychopaedic nursing practices and struggling to develop a distinctive culture in the absence of a defined dual diagnosis knowledge base. The author concludes that these findings suggest an urgent need to provide nurses with support in gaining contemporary knowledge regarding dual diagnosis nursing. Support for nurses in advancing these areas then impacts on support for the patients. It is suggested that additional research is undertaken to assess the learning needs of the nurses in order to develop clinical practice guidelines for this area. Further recommendations are made to address system issues which are contributing to the gap in knowledge.

Abstract: A research portfolio submitted in partial fulfilment of the requirements for the degree of Master of Nursing, the University of Auckland, 2010.
Sustained weight loss maintenance is a constant challenge, especially for morbidly obese individuals who have tried and failed repeatedly. Why is it then, that some individuals are successful whilst others are not so successful? This two-phase sequential, mixed methods study sought to identify and gain insight into the factors associated with successful weight loss maintenance for participants in an adult weight management programme in the Waikato. Success appeared to be independent of age, gender, ethnicity, domicile, employment status and the presence of co-morbities.
Four major themes emerged:
- “Actions speak louder than words – just do it” (Following a lower energy diet, having higher levels of physical activity, regular self weighing, and vigilance in adjusting their behaviours based on the results)
- Routines were also important in supporting the changed behaviours
- What's it worth to me
- Valuing the achievements associated with lesser weight was seen as another important factor of success

Abstract: The author has taken a broad approach to this research to explore the views of Generation Y New Zealand Registered Nurses towards the nursing profession, the work itself and their career plans. This study arose out of the author?s interest in health care workforce planning for nursing and in particular the retention of young nurses given the current national and global shortage of nurses. Because of the broad and descriptive nature of the research, a wide variety of topics are included in the literature reviewed.
Chapter one provides background to the study and an overview of generational cohorts.
Chapter two explores selected literature relevant to the concept of work and the characteristics of the Generation Y workforce.
Other topics included in this chapter include Herzberg?s work motivation hygiene/maintenance theory and a selection of literature about key workforce recruitment and retention issues.
A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Health Sciences

Abstract: Examines the lived experiences of adults with myasthenia gravis(MG). Uses an interpretive phenomenological approach applying the research methodology of van Manen (1990). Interviews seven people living with MG and records their experiences of the disease. Poses broadly-worded questions about various topics related to MG, that include diagnosis, symptoms, treatments and coping strategies, guided by individual experiences. Reveals by means of thematic analysis that MG affects every aspect of a person?s ?lifeworld?: their sense of time, body, and space and their relationships with others. Highlights three main themes embedded in the data experienced by a person with MG: living with uncertainty, living with weakness and living with change.

Abstract: Reports a five-week study tour of nurse-led child health practices in the US, Scandinavia and the UK to determine what effect such clinics have on child health, and how they differ from NZ practice. Visits nurse clinics in San Francisco, Denver and New York in the US, Copenhagen in Denmark, and Norfolk in England; visits collaborative practices in these locations as well as in London, England and in Stockholm, Sweden. Examines health promotion opportunities in these same places. Part of the Margaret May Blackwell Scholarship Reports series.

Abstract: This study explores the phenomenon of dilemma in paediatric practice. Using a hermeneutic phenomenological method informed by the writings of Heidegger [1889-1976] and Gadamer [1900-2002] this study provides an understanding of the meaning of 'being in dilemma' from the perspective of predominantly paediatric health care professionals but also families in New Zealand. Study participants include four families who had a child requiring health care and fifteen health care practitioners from the disciplines of medicine, nursing, physiotherapy, play specialist and occupational therapy who work with families and children requiring health care. Participants' narratives of their experiences of 'being in dilemma' were captured via audio taped interviewing. These stories uncover the everyday realities facing health professionals and families and provide an ontological understanding for the notion of dilemma. The findings of this study suggest that experience of dilemma for health professionals reveals a world that is uncertain and questionable where they are thrown into having to make uncomfortable choices and must live with the painful consequences of their actions. The consequences of being in such dilemma are having to find ways of living with the angst, or risk becoming too sensitive or desensitizing. For families the experience of dilemma reveals a similar phenomenon most evident in circumstances where they feel totalized by the impact of heath care encounters. This study has uncovered that the perspectives that health professionals and families bring to the experience of dilemma reveal different concerns and commitments and may be hidden from each other. This thesis proposes that health professionals and families need support in living with their own personal encounters of enduring experiences of dilemma.

Abstract: A paper presented at the annual conference of Nursing Informatics New Zealand (subsequently incorporated into the collective organisation, Health Informatics NZ).

Abstract: The original aim of the study was to find out through a questionnaire what child health/paediatric nurses in New Zealand/Aotearoa saw as their needs for post-registration education. Nurses were completing courses in the United Kingdom and returning to New Zealand/Aotearoa and realising that their nursing capabilities had improved. They became senior nurses with education responsibilities and exhibited political leadership among their colleagues in the field of child health/paediatric nursing. They were becoming increasingly concerned at the lack of any clinical courses in the specialty of child health/paediatric nursing to promote an appropriate standard of practice. It was intended that a research project about post-registration child health/paediatric education would assist concerned nurses to develop a programme. The time needed for such a project did not fit with a limited research paper. It was decided to reduce the project to a review of the literature on competence in nursing, with some comment on the specialty of child health/paediatric nursing. In order for nurses to find what they need to learn and know, an understanding of competence in nursing practice is required. Competence is defined as the ability of the nurse to carry out specific work in a designated area at a predetermined standard. Issues around competence, defining a scope of practice, development and assessment of competence, and regulation of nursing, are part of the context in which accountability for the practice of nurses sits.