Abstract: The author, an occupational health nurse, examines rationale for and effectiveness of the pre-employment assessment, which has become an accepted practice. Reasons for doing assessments include the reduction of risk to the employer from lower accident rates and absenteeism, compliance with legislative requirements and the provision of baseline health measures for general health surveillance. The costs of the screening process, along with the benefits are weighed up, in conjunction with international research in the area. The author found little research on the process in New Zealand. The opportunity for primary health care and health promotion practice as an aspect of this screening is highlighted as an important, though underestimated, benefit. Regular auditing is recommended to ensure that the outcomes of the process meet the criteria required.

Abstract: An overview of the model of nursing practice and nurse roles derived through a programme of nursing research in the context of the changing New Zealand health system. The emphasis is on the complementary nature of the practice of family nurses taking a generic integrative service delivery hub role and the practice of other nurses advancing in specialist roles. Nursing care is presented as a professional, collective practice of registered nurses spread across all health service sectors and employment settings. Nurse roles are differentiated according to the interplay of two factors influencing the extent of practice autonomy the nurses assume (educationally supported) in responding to health need. A diagram depicts the interrelationship of competency and scope for the inclusive three different career trajectories of nurses advancing in practice. NOTE: This paper was published with an error in the title of the article (stated correctly on the journal contents page). An apology from the journal editor with an explanation of the importance of the use of the term ?advancing? and not ?advanced? was published in the subsequent issue (Nursing Praxis in NZ,14(1)).

Abstract: Outpatient nurses are often seen as nurses who are less important or skilled and can no longer physically cope with working in busy wards. This report is aimed to challenge this presumption and show that there are many educated and highly skilled nurses working in these departments. The diversity of the role of the nurse within the continued advancement of nursing practice in the outpatient department is evidence to disprove the perceptions other nurses have of the outpatient nurse. The purpose of this report was to discuss the changing role of the outpatient nurse from 'handmaiden' to 'autonomous practitioner', and secondly, to discuss nurse-led services and what experience and/or skills these nurses are expected to have to fulfill these roles. Literature was gathered to inform this report from the academic circles, policy from the Ministry of Health, the District Health Board website, and in relation to the author's own role with the outpatient department.

Abstract: New Zealand's ageing population is predicted to have increasing degenerative musculoskeletal changes affecting both mobility and morbidity. In response, the New Zealand government is supporting a one hundred per cent increase in the number of elective joint replacements performed across the country from 2004 to 2008. However, like other specialties, orthopaedic nursing is experiencing shortages. In order to improve the recruitment and retention of orthopaedic nurses, as with other nursing specialties, childcare is offered as a strategy for consideration. In 2005, New Zealand parents indicated in an online survey, that in order for them to work, they needed affordable, quality and conveniently located childcare. Nurses have similarly indicated the importance of childcare when considering and managing a balance between their work and home lives. This paper explores contextual work and home life balance dialogues in relationship to nursing recruitment and retention issues and New Zealand nursing. Childcare as a recruitment and retention strategy, is explored in the context of New Zealand nursing and compared with the childcare strategies employed for nurses by Britain and Australia – New Zealand's major competitors for New Zealand nurses. The author concludes that, in light of the international shortage of nurses, childcare is an important recruitment and retention strategy which is currently absent in many of New Zealand's district health boards. Recommendations are offered to support the balance between work and home life for nurses and reconcile orthopaedic nurses to the clinical setting in order to provide the quality and efficient care that is needed for New Zealand's ageing society.

Abstract: The purpose of this literature review is to generate a picture of what is known and what needs to be investigated further about anaesthetic nursing in the perioperative nursing role in New Zealand, and to examine this in relation to international trends. Nurse anaesthetists in the United States are described in American nursing literature, and recognised as one of the four advanced nurse practitioner roles. In New Zealand, recent efforts to provide appropriate post-graduate education for the perioperative nurse have been challenged by other inter-professional interests, thus restricting the development of an expanded role. The author notes that this has caused concern for New Zealand's perioperative nurses who consider anaesthetic nursing is an integral part of perioperative practice. Anaesthetic nursing forms a substantial component of the basic competencies required of a registered nurse working in the operating theatres. Orientation programmes and ongoing education at all levels of professional development incorporate anaesthetic nursing competencies to provide continuity of patient care and support perioperative practice. Care of the patient undergoing anaesthesia is an area where nurses demonstrate their advanced assessment skills and clinical judgement and is included in perioperative specialist or nurse practitioner job descriptions. The Perioperative Nurses Association in New Zealand is concerned to develop postgraduate education in their area of speciality to support their application for 'College' status within the New Zealand Nurses Organisation. For this to happen in a cogent fashion, information and knowledge generated from research, are required to clarify perioperative nursing's current position and determine how practice can be shaped to best care for patients undergoing surgical interventions. Evidence from research supports nurses in the anaesthetic role by demonstrating that the preoperative visits and assessments they undertake can reduce patients' anxieties, decrease the need for pain relief and shorten hospital stays. This review includes literature sources that explore disparities between the development of New Zealand anaesthetic nursing and international models. The author suggests that information and understanding gained from conducting this review will allow future developments in anaesthetic nursing practice to be informed by previous initiatives and projects and identifies areas for further research.

Abstract: This study explores the experience of being an orthopaedic nurse. As an orthopaedic nurse the author had concerns that the validity of orthopaedic nursing as a unique scope of practice was being questioned. In this thesis, the case for orthopaedic nursing is argued, by showing it as a specialty in its own right. A qualitative approach informed by the author's interpretation of philosophical hermeneutics as articulated by Heidegger (1927/1962) and Gadamer (1976; 1989) was undertaken. Phenomenology seeks to uncover 'taken-for granted' meanings in everyday experience and hermeneutic research recognises that the historical and cultural horizons of participants and researcher influence the interpretation. Eight nurses working in various orthopaedic settings were interviewed. Data was analysed using the interpretive thematic approach described by van Manen (1990). The nurses' stories from practice yielded two essential themes, 'being part', and 'gaining and maintaining integrity'. The author concludes that these themes interrelate and together reveal meanings and insights about being an orthopaedic nurse. 'Being part', shows the essential nature of relationships between orthopaedic nurses and others. 'Gaining and maintaining integrity' describes the embodied nature of the phenomenon. The overall thematic finding 'seeing the world through orthopaedic eyes' reveals the nature of orthopaedic nursing as a unique scope of practice.

Abstract: This literature review is an exploration of nurse case management and it will provide the background for the introduction of a nursing case management model in the acute surgical environment at Western Bay Health. Case management is a collaborative process which assesses, plans, implements, co-ordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost-effective outcomes (Newell, 1996:.3). In undertaking this review it was the author's intention to include the findings as background to a business case seeking the introduction of a surgical nurse case management model within the surgical service.

Abstract: This feminist study is an exploration of the subjectivity of women working as nurses within the gynaecological ward. Gynaecology has a long history as a unique area of concern to the health practitioners of any given period. However, the author suggests, recently with the development of modern gynaecology, this specialty has become based on male knowledge and male texts, women either as patients or nurses appear voiceless within this canon. Major tests within nursing mirror a medical construction of gynaecology, with the women involved in the discourse again absent from the literature. To explore the nurses' reality within the gynaecological ward, the author has undertaken a feminist interpretive study. To contribute to this debate the author drew on certain specific notions from feminist and postmodern epistemologies. These notions of the Other, difference, the body and discourse provided a unique way of viewing the practice of the nurses in this gynaecological setting. These epistemological concepts were then interwoven with feminist strategies to undertake the research. Through the process of feminist praxis, which included the author working alongside the nurses and conducting in-depth interviews, three areas of general concern to the nurses emerged. Firstly the relationships, that is their relationships with each other as nurses and with their women patients. Secondly, the difficulties inherent in nurses' practice in this setting due to the nature of the experiences of the women they were nursing. These difficulties arose in relation to two particular situations, nursing women experiencing a mid-trimester termination and nursing women with cancer. Thirdly, the relationship with/in the medical discourse and individual doctors which, according to nurses, had a major impact on their work. This study contributes to nursing knowledge by providing a forum for the voices of women as nurses, who nurse women in the gynaecological ward, to be heard. The author concludes that nursing and feminism have much to offer each other and share an emancipatory goal of positive action to support and assist people in their lives.