Abstract: In light of the current challenges facing the nursing workforce, the author proposes a way forward to capture and utilise the challenges to bring about positive change.

Abstract: This study aimed to articulate how sexual identity impacts on the therapeutic relationship between the client and the lesbian nurse in psychiatric mental health nursing. There is little consideration given in the literature or in research as to how sexuality of the nurse impacts on nursing practice. Most attitudes held by the public and nursing staff are based on the assumption that everyone is heterosexual, including nurses. Fifteen lesbian psychiatric mental health nurses from throughout New Zealand volunteered for two interviews and shared their experiences of becoming and being a lesbian psychiatric mental health nurse. The stories they told give new insights into how these nurses negotiate and position their lesbian identity in the therapeutic relationship. To work therapeutically with people in mental distress the nurse uses personal information about themselves to gain rapport with the client through appropriate self-disclosure. Being real, honest and authentic are also key concepts in this relationship so the negotiation of reveal/conceal of the nurse's identity is central to ongoing therapeutic engagement. One of the most significant things arising from the research is that participants are able to maintain their honesty and authenticity in the therapeutic relationship whether they self-disclose their lesbian identity or not. This is because the experiences in their personal lives have influenced how the participants 'know themselves' and therefore guide how they 'use self' in their therapeutic nursing. The concept of a 'licensed narrative' has also been developed during this research reflecting the negotiated understandings between the researcher and the participants. Further, the use of NVivo a qualitative software package helps to track and make transparent the research processes. These two aspects make a unique contribution to the field of narrative inquiry.

Abstract: The author presents her experience investigating the incidence of post-anaesthetic shaking in the recovery room ward, and develops a clinical tool for its treatment. Several theories about post-anaesthetic shaking are examined. The cases of 1296 patients who had major regional or general anaesthetics over four consecutive months in the previous year are studied. The incidence of post-anaesthetic shaking and correlating core body temperature readings with post-anaesthetic shaking are examined. A protocol for reducing/treating post-anaesthetic shaking is developed on the basis of the findings of the study.

Abstract: Reports the smoking prevalence of nursing students, comparing this with other relevant group and changes in smoking behaviour since this was last reported in 2013. Administers a national online survey of nursing students. Notes rates of smoking for both Maori and non-Maori students.

Abstract: In this report, the New Zealand Nurses Organisation (NZNO) releases the findings from its first-ever members' employment survey. The questionnaire, based on the United Kingdom?s Royal College of Nurse?s annual survey (which has been running for 21 years) covered core employment issues: employment agreements, hours, pay, job change, along with demographic details, as well as questions around plans for and perceptions of working life for over 800 NZNO members.

Abstract: This study aimed to identify how graduates perceived their clinical performance during their first year of practice. A convenience sample of 30 graduates was surveyed after 3 months and 7 months in practice, using an adapted form of a questionnaire devised by Ryan and Hodson (1992). The results showed that over time, graduates generally required less direction in all areas of clinical competence. After 7 months in practice, the majority of the graduates rated their performance in nursing skills, communication skills, and professionalism at the expected level or above. However, some still required direction with using theory and research in practice, with meeting client's psychosocial needs and with teaching clients. In the leadership competency, after 7 months, most graduates saw themselves functioning at the expected level related to client care and needed less direction in unit management skills. However, many of the unit management skills were rated as 'not applicable' indicating that new graduates are not initially placed in a management role. Implications for nursing education and limitations of the research are discussed.

Abstract: This modified action research inquiry focused on the everyday, palliative care practice experiences of a group of district nurses. The intent was to develop an understanding of common issues of concern for this group of district nurses when providing palliative home care in a specific community context and to implement practical, achievable strategies in response to these local issues. Five district nurses identified four broad areas for action through four praxis group meetings and comprising one full cycle. These four areas have been named as methods of enhancing support for people and families, possibilities for creatively managing workloads, mechanisms to enrich working partnership with other palliative care providers and possible vehicles for supporting nurses' self care. Implementation of action from this action research project focused on enhancing care and outcomes for people and family served by this group of district nurses in their local community. This study illuminates everyday essences of the district nurse role and the elements articulated by this group in supporting their practice in one New Zealand community. This study also reveals some of the tensions and messiness when employing an action research methodology with nurses in the workplace. The author notes that this research focused on a little known area (palliative care delivered by district nurses in New Zealand) in a local community (a culturally vibrant and ethnically diverse yet with poor health and socioeconomic statistics). She goes on to say that it has resonance with other nurses, particularly those working in community settings who may experience similar issues and concerns. This research also offers important insights for nurses working in any practice setting.

Abstract: This clinical case study takes an integrated approach to investigation and critical analysis of the complex physiological and pathophysiological treatment modalities instigated when a patient presents following acute traumatic head injury. A broad overview of the developmental physiology of the brain and an explanation of the mechanism of traumatic brain injury as it relates to alterations in cerebral blood flow, intracranial pressure and cerebral metabolism is presented. The author describes in narrative form the clinical presentation of a patient, her symptoms and initial treatment rationale. It concludes with analysis of the patients initial treatment priorities and symptom management during the first 48 hours of her care.