Abstract: Home Based Treatment in acute mental health care is a relatively new phenomenon in New Zealand, although it has been utilised successfully overseas for many years. This paper considers factors that are integral elements of its successful implementation, specifically considering the relationship of nursing care to crisis intervention methodology. It describes how Home Based Treatment fits with contemporary crisis services and how the adherence to crisis intervention models can enable nurses to create a clearly defined recovery perspective in their practice. The author notes that service users in New Zealand and overseas have openly voiced their concerns around the discrepancies between how services have traditionally been delivered and how they wish services to be. He suggests that, as an alternative to inpatient care, Home Based Treatment is an option that promotes recovery and self determination. It is also an arena in which nurses can deconstruct the traditional power relationships between themselves and clients to create a new and invigorating way of practicing.

Abstract: People working in aged care settings in New Zealand spend approximately 30% of their lives in their workplace. There is a challenge for workplaces to support people to maintain and improve their health status. This project investigated the question: How can workplaces support staff to maintain health in an aged care environment? The project concerned two considerations: primarily what people can do for themselves and how the organisation can assist their interest and maintain their investment in health based activities and secondly what workplaces can do to make the organisations more healthy. The philosophy and the realities of the workplace were reviewed and the project addressed the strategies that could be adopted by the workplace. The study identifies a series of practical activities and outcomes that aged care facilities can undertake for nurses/caregivers or other members of staff working in the workplace. The findings lead to recommendations about healthy outcomes and managing health and creating a positive climate for health within the workplace.

Abstract: The author describes the purpose of her writing as exploring the journeys that Maori have experienced within the nursing profession of Aotearoa/New Zealand. It presents the reader with insight into these journeys by examining a broad range of events and experiences from pre European contact up to contemporary times. The intention of providing these insights is for the reader to be made aware of not only the “uniqueness” that Maori nurses bring to the profession in New Zealand but to give voice to the many untold experiences of Maori nurses. The Nursing Council of New Zealand (NCNZ), numerous Maori and non- Maori academics have long acknowledged the uniqueness of Maori health perspectives and needs. However, the author notes there is limited literature which specifically discusses experiences of Maori consumers of health services and until recently, exploration of the experiences of Maori nurses has been limited. The Ministerial Taskforce of Nursing (1998) identified the paucity of research related to Maori nursing and acknowledges the need for Maori nurses to develop a body of knowledge specifically focused in this area. To this end, the author intended that this work would contribute to the increasing body of knowledge regarding this unique group within the nursing profession of Aotearoa/New Zealand.The discussion includes revisiting the history of nursing in Aotearoa/New Zealand and critiquing the participation of Maori nurses. The experiences of Maori nurses and students from within the education sector is detailed with a particular focus on their experiences of Kawa Whakaruruhau / Cultural safety. Contemporary issues for Maori nurses are critiqued and possible solutions offered along with details of the writer's vision for the future direction of Maori within the wider nursing profession in Aotearoa/New Zealand.

Abstract: This paper presents an exploration of a foundational goal of palliative care nursing which is to help patients die with dignity. The paper presents this practice exploration as a journey to gain understanding of the concept of dignity; the author notes that it does not avoid the difficulties encountered in practice situations because dying with dignity is unique and curiously also invisible and different for everyone. Much of human life is conducted through stories and much of nursing involves telling and listening to stories. Many of our social institutions are comprised almost entirely of opportunities for telling and retelling stories. Nurses are constantly listening to patients telling them what is going on in their lives and because of this the stories related here are written bold and raw. The three stories explore and reveal in-depth details of nursing practice that evolved and changed after reflection. The paper also reveals and explores the untold and often painful stories that challenge nurses' capacity to offer dignified care. To deepen the exploration towards discovering ways to articulate the complexity of dignity, the author reflected on the nature of the practice changes documented in the stories and then used a range of diverse literature and her love of the paintings and philosophy of a New Zealander, Ralph Hotere, to support her ideas that dignity is indeed a complex phenomenon.

Abstract: Grounded theory methodology has guided the grounded theory methods used to explore the acute care paediatric nurses' perspective of what they do when a child has had a severe accident. The research was initiated from the experience of nursing children in the context of a rehabilitation centre and wondering how acute care nurses promoted a child's recovery after a severe unintentional injury. Many avenues were used to search international and New Zealand literature but the scarcity of literature related to what acute care paediatric nurses do was evident. Nursing children in the acute care ward after a severe accident is complex. It encompasses nursing the family when they are experiencing a crisis. It is critical that the acute care nurse monitors and ensures the child's physiological needs are met, and the nurse “works with” the child to maintain and advance medical stability. Nursing interactions are an important part of “working with”, communication is the essence of nursing. This research has focussed on the nurses' social processes whilst caring for the physical needs of the child and interacting with the family and multidisciplinary team when appropriate. An effective working-relationship with a nurse and family is founded on trust. Grounded theory methods supported the process of exploring the social processes of “building trust” whilst “working with” families in a vulnerable position. Nurses rely on rapport to be invited into a family's space to “work with” and support the re-establishment of the parenting role. The “stepping in and out” of an effective working-relationship with a family is reliant on trust. Nurses build trust by spending time to “be with”, using chat to get to know each other, involving and supporting the family to parent a “different” child and reassuring and giving realistic hope to help the child and parents cope with their changed future. A substantive theory of the concept of “building trust to work with” has been developed using grounded theory methods. The theory has been conceptualised using the perspective of seven registered nurses working in paediatric acute care wards that admit children who have had a severe traumatic accident.

Abstract: This dissertation came out of the author's wondering why there are still so few men going into nursing especially when the history of nursing reveals that men have been a part of nursing for a long time. In New Zealand it is only since the mid seventies that men have been able to gain the exact same nursing qualifications as their women colleagues. The author notes that men in nursing are still seen as unusual in that they work in a predominantly female occupation and have had their masculinity questioned by the myth that all men in nursing must be gay. There is also the notion that caring is a difficult task for men and is seen by society as a uniquely feminine ability. Both issues are related to dominant notions of masculinity. In addition to this there is currently a crisis in terms of a nursing shortage and it has been suggested that one way to resolve this crisis is to encourage more men into nursing. Thus this exploration as to why there are so few men in nursing is timely. Men who choose nursing as a career risk challenging the traditional roles of their gender stereotype. A comprehensive search of the literature from different disciplines reveals deeper issues than just the commonly held assumption that nursing is not masculine. Exploring the issues of gender with a particular focus on masculinity has uncovered the concept of hegemonic masculinity. This describes how gender is practiced in a way that legitimises patriarchy, reinforcing the dominant position of men over women as well as over other groups of men. It is these patriarchal attitudes that have seen men marginalised within nursing. On the one hand men in nursing could be seen as challenging the current dominant masculine ideal. However, on the other hand men in nursing may not challenge this hegemonic masculinity; instead often supporting the status quo in an effort to maintain their own masculinity. The author suggests that the implication for nursing, if it is to increase the numbers of men in the profession, is to challenge this notion of hegemonic masculinity. This needs to be done appropriately by critically examining this concept rather than by merely replacing one hegemony with another. He goes on to say that it is now time for nursing education to include a critical exploration of gender issues and how it relates to men as part of undergraduate nursing education for both men and women students.