Abstract: The purpose of the research was an evaluation of practice exemplars as a reflective process in teaching and learning about cultural safety. Six Maori, two Pacific and five Pakeha students, ranging in age from 30 to 40, took part in the research. The research findings revealed five sub themes: personal safety, power/ powerlessness, reflection, teaching and learning and cultural safety. The presentation, while acknowledging that cultural safety shared some commonalities with culture care theory, highlighted differences between the two. These included that cultural safety was explicit in identifying the inherent power of the nurse in health care relationships; related to the experience of the recipient of nursing care, and extended beyond cultural awareness and sensitivity; provided consumers of nursing services with the power to comment on practices; and contributed to the achievement of positive outcomes and experiences for them. It outlined the characteristics of a culturally safe nurse as a nurse who had undertaken a process of reflection on her/his own cultural identity and who recognised the impact their personal culture had on client care.

Abstract: This interpretive inquiry explores the lived experience of 3 undergraduate nursing students and one midwifery student who have panic attacks. The aim of the research is to give voice to these students and to raise awareness among nurse educators about the impact that panic attacks may have for them. The research question asks, “what is the lived experience of panic attack in undergraduate nursing students?” A semi structured interview was conducted with each student in order to gain significant data. The research identified four key themes implicit to the lived experience of panic attack analysis: Listen to the beat of my heart (embodiedness), fearfulness, shamefulness, and holding one's own (coping). The findings suggest that the lived experience of panic attack is embedded in the lifeworld of lived body, lived time, lived relation, and lived space. Panic attack affects students physically and emotionally and interpersonally. The significant finding is that nurse educators need be aware of the coping or non-coping strategies used by students and, most importantly, recognise the impact that panic attacks have on their study.

Abstract: The objective of this paper is to establish if there is any documented research and literature evidence that describe what the presenting clinical symptoms of Mai Aitu is, and also to explore an alternative frame-work to assess Pacific Islanders who present to mental health in crisis. As a community mental health nurse in the Crisis Assessment and Treatment Team (CATT), the author reports being confronted almost every day with an increasing number of Pacific Islanders presenting in crisis with symptoms consistent with the well documented signs of psychosis. For instance, symptoms like hallucinations, delusion and paranoid ideation which are also well known for describing schizophrenia. Her concern is that mental health nurses may be compromising their practice, the safety of the Pacific Island population and possibly the credibility of the profession with what appears like a lack of knowledge and awareness regarding the clinical symptoms of some Pacific Island mental illness. In Tonga it is called Avea Avanga, in Fiji it is referred to as Lialia, in Samoa it is known as Mai Aitu. The author notes that the issue becomes apparent when Samoan clients present in crisis with what appears to be psychosis but the fanau believe their love one is not mentally unwell, that he or she is simply suffering a traditional Samoan illness. Therefore they insist he or she be treated at home, instead of through admission to the psychiatric hospital, and also that they be seen by a Samoan healer instead of a psychiatrist.

Abstract: This social-cultural history explores the changing context, culture, and identity of psychiatric nurses working in New Zealand public mental hospitals between 1939 and 1972. Primary documentary sources and oral history interviews provided the data for analysis. The thesis is divided into two periods: 1939 to 1959 when asylum-type conditions shaped the culture of the institutional workforce, and 1960 to 1972 when mental health reform and nursing professionalisation challenged the isolation and distinct identity of mental hospital nurses. Between 1939 and 1959 the introduction of somatic treatments did not substantially change nursing practice in mental hospitals. Overcrowding, understaffing and poor resources necessitated the continuance of custodial care. The asylum-type institutions were dependent on a male attendant workforce to ensure the safety of disturbed male patients, and the maintenance of hospital farms, gardens, and buildings. Although female nurses provided all the care and domestic work on the female side, the belief that psychiatric nursing was physically demanding, potentially dangerous, and morally questionable, characterised the work as generally unsuitable for women. Introduction of psychiatric nursing registration which was a move toward professionalisation did little to change the dominance of a male, working-class culture. From 1960 to 1972 psychiatric nurses' identity was contested. New therapeutic roles created the possibility of the nurses becoming health professionals. Their economic security and occupational power, however, was tied to an identity as unionised, male workers. As psychiatric nurses were drawn closer to the female-dominated nursing profession through health service changes and nursing education reform, both men and women acted to protect both their working conditions and their patients' welfare. To achieve these ends, they employed working-class means of industrial action. By accepting the notion that psychiatric nurses' identity was socially constructed, this thesis provides an interpretation that goes beyond the assumption that nursing is a woman's profession. Instead, it presents psychiatric nursing as a changing phenomenon shaped by contested discourses of gender, class and professionalisation. Nursing in public mental hospitals attracted ordinary men and uncommon women whose collective identity was forged from the experience of working in a stigmatised role.

Abstract: This thesis traces the journey of the author's inquiry into family members' experience of the relinquishment of the personhood of a loved one with a dementia; a journey in which she reports that her own prior understandings were significantly challenged. The study was prompted by her experience of working in the area of dementia care and hearing, in the course of the working day, comments such as 'there's nobody there' made in relation to someone suffering from severe dementia. Such comments appear to imply that the person of the dementia sufferer in some way is no longer present. They are comments which relate to the very nature of personhood. The study takes impetus from the fact that the ways in which nurses view the personhood of dementia sufferers has significant consequences for the ways in which they respond to dementia sufferers and their families. This thesis, which retells the stories of four family members who each have a loved one with a dementia illness, reveals that rather than there being a unified concept of personhood in dementia, and in spite of the fact that particular understandings of dementia and personhood dominate our cultural conversations, in their day to day lives these four family members managed and made sense of their experience through particular and different ways of looking at the impact dementia has on the personhood of dementia sufferers. Not all did, in fact, relinquish the personhood of their family member. In their lived lives, the four research participants had recourse, each in different ways, to multiple discourses of personhood. For some, in addition to loss, there was also unexpected gain. This finding necessitated and shaped further inquiry into discourse and the role of discourse in shaping, constraining and opening up possibilities for meaning, and into the two substantive areas of dementia and personhood. Nurses work closely alongside the family of dementia sufferers who are daily faced with the challenge of managing and making meaning of that situation. It is critically important that they are able to recognise, validate and support the variety of needs that family members have. Nurses, whose education is traditionally based on a biomedical framework, are nevertheless often required to mediate between different understandings. Not only do they need currency of knowledge in the rapidly changing biomedical field of dementia, but they need also an understanding of the role and the power of discursive constructions of both dementia and personhood. Such understanding will provide insight into alternate ways of understanding these concepts. However, although such understanding is critical for nurses working in this area, the author suggests that nursing literature has not brought these discussions to the fore.