Abstract: This article examines a growing number of cases in New Zealand in which parents and guardians are required to make life and death ethical decisions on behalf of their seriously ill child. Increasingly, nurses and other practitioners are expected to more closely inform, involve and support the rights of parents or guardians in such situations. Differing moral and ethical values between the medical team and parents or guardians can lead to difficult decision making situations. The article analyses the moral parameters, processes, outcomes and ethical responses that must be considered when life and death ethical decisions involving children are made. It concludes with a recommendation that nurses should be recognised as perhaps the most suitable of all health care personnel when careful mediation is needed to produce an acceptable moral outcome in difficult ethical situations.

Abstract: Aims to understand the factors that encourage motivation and engagement of caregivers who are relatively poorly paid, with limited training, but who are required to provide personal care to an increasingly frail population. Undertakes an initial exploratory study, with participants from four rural aged-residential care (ARC) facilities, to identify three key themes that influence caregiver motivation. Subsequently develops these initial themes, within a 42-bed facility, to explore how to encourage caregiver motivation. Bases the four-step process on Lewin’s cycle: plan, act, observe, and reflect. Establishes an advisory group of caregivers who develop a nine-point action plan, accepted by management and implemented in the facility.

Abstract: Examines the experiences of parents and nurses in caring for a child following invasive Slipped Upper Femoral Epiphysis (SUFE) repair. Conducts semi-structured interviews with parents of five children, predominantly Māori or Pacific, who underwent SUFE repair, and five paediatric nurses caring for the children and their families in the hospital ward. Offers two perspectives of the journey for these parents following such an injury, from the child's hospitalisation to caring for these children once they are home. Presents and contrasts these perspectives, revealing insights into the parents' ongoing need for support, information and planning for care, and nurses' efforts to meet these needs. Presents implications for nursing practice.

Abstract: The aim of this study was to explore with a small number of Maori families their experiences of accessing health care when their children were unwell with a respiratory condition. A qualitative research methodology was used in the study. Participating families were among those experiencing an admission to a children's ward between July and December 2003. Four families were interviewed. They discussed in depth their experience of accessing health care for their unwell children. Data were analysed using thematic analysis, and three common themes were evident: family resources, choice of health service provider and parents' feelings of vulnerability. The findings highlight that while socio-economic status plays a large part in determining the ease with which families can access the needed health care, there are other barriers within the health system which also pose difficulties for Maori.

Abstract: In this article the authors introduce an alternative way that nurses can be with families, using a relational process that can enhance nurses' responses when working with those transitioning to parenthood. Seasons of Life, a framework adapted from the Maori health model He Korowai Oranga, emerged from practice to offer a compassionate and encouraging stance, while at the same time respecting each family's realities and wishes. The model allows the exploration of the transition to parenthood within a wellness model, and takes a strengths-based approach to emotional distress. This approach provides a sense of “normality”, rather than of pathology, for the emotions experienced by new parents. The specific issues men may face are discussed, where despite recent culture change that allows men a more nurturing parental role, there is still no clear understanding of how men articulate their sense of pleasure or distress at this time. Practitioners are encouraged to examine their own assumptions, values and beliefs, and utilise tools such as reflective listening, respect, insight and understanding. The most significant aspect of relationship between nurse and parents is not the outcome, but how nurses engage with families. Examples from practice will demonstrate some of the differing ways this relational process framework has been effective.

Abstract: This exploratory descriptive study informed by grounded theory examines the experience of mothers in managing their pre-school child's acute asthma attack at home. The study reveals that mothers perceive that they are responsible for the management of their pre-school child during an acute asthma episode, a process they described as 'managing it'. This process involves mother in 'working on treatment', 'making the call', 'watching' and 'calming', while the husband/partner, family, friends and health professionals are 'supporting treatment'. This study suggests that nurses and doctors need to move away from the current paternalistic view of health care delivery in acute settings and embrace the concepts of support and partnership in the care of the pre-school child with asthma and their family.

Abstract: Reports a study exploring family experiences of stroke during the first six months following a stroke. Performs a hermeneutic phenomenological study in which four participants from two Auckland families are interviewed in 2011 and 2012, at three time-intervals within the first six months post-stroke. Identifies three themes of the families' experiences: loss of a life once lived; navigation of an unfamiliar path; re-creation of a sense of normality. Stresses the importance of contact with the health-care team in facilitating the transition to post-stroke life.