Abstract: The aim of this study was to explore the practice of flexible learning for postgraduate nurses. Flexible learning is a contemporary approach to learning that utilises the benefits of technology. Flexible learning can be understood as a continuum, from fully on-line or web-based courses, to those that are on-campus and supported by technology. Internationally, the rise of flexible learning has been influenced by increased demand for higher education and competition among providers within the context of reduced education funding. The study population, New Zealand postgraduate nurses, are accessing higher education in increasing numbers to advance their practice and to position themselves for new roles and opportunities. These are often experienced nurses yet inexperienced in higher university education, who combine study, work and other commitments. The study employed a qualitative case study design because it enabled multiple perspectives to be gained. Data included documentation, participant observation, survey, students' assessed work and interviews with key stakeholders: student, teacher and the organisation. Thematic analysis was conducted on reviewed documentation, participant observation and interviews. The study identifies the elements that contribute to flexible learning and the interconnectedness between the elements within the dynamic context of a university to illustrate that effective flexible learning can be provided by using a student centred approach to ensure the learning needs of postgraduate nurses are met. The author concludes that flexible learning improved access, choice, and provided an emphasis on the student as central to learning. In response to these findings the weighting of recommendations are toward the organisation as, the author suggests, it is at this level where greater change can be made to improve support for flexible learning provision.

Abstract: The particular, contemporary meanings ascribed to “advanced nursing practice” in New Zealand have been debated and delineated in the 1990s, culminating in the launch of the nurse practitioner role at a conference sponsored by the Ministry of Health and the Nursing Council of New Zealand in August, 2001. Drawing on archival materials, documents, other texts and voices, this article explores the evolution of connotations and meanings of the word “advanced” as applied to nursing in New Zealand. The focus is on clinical practice, research, teaching, consulting, higher education, and advancement of the profession. Historical aspects of advancement in New Zealand nursing are examined, including registration, unsupervised practice, technical specialisation, and career development.

Abstract: This thesis describes an exploratory study of registered nurses within a local district health board which pursued 'if' and 'how' professional practice frameworks assisted nurses in their individual professional practice. Self assessment and performance appraisal are identified as critical elements of professional development by the Nursing Council of New Zealand, and this became the focus of the author's research. A qualitative descriptive framework was utilised to explore the research question, where experiences of registered nurses employed within inpatient adult medical and surgical settings were collected through questionnaire. Analysis of the data was through general inductive thematic approach. Eight themes arose, of which, two have sub-themes. The first four themes relate to self assessment and performance appraisal and the second four themes relate to professional practice. The findings from the participant's perspective provide an understanding of how participants' utilised self assessment and performance appraisal to inform their professional practice. There are significant implications for professional practice within the findings of this study, which are presented along with recommendations for future practice, and future avenues for research.

Abstract: Cultural safety is taught in all undergraduate nursing programmes in Aotearoa/New Zealand. There is a predominance of Pakeha nurse educators in teaching this content. There is little explanation of what being Pakeha entails. This perpetuates a silence and continues the dominant hegemonic position of Pakeha in Aotearoa/New Zealand. This study suggests that as Pakeha cultural safety nurse educators we examine our dominance and critique the delivery of cultural safety education. This autobiographical study undertakes to explore the Pakeha identity of a cultural safety nurse educator. The author discusses identity in the context of a globalised world, and challenges the idea of a definitive Pakeha identity. There are multiple descriptions of Pakeha, all underdeveloped and inadequate for the purposes of cultural safety education. In this study, the author uses the heuristic process of Moustakas (1990) and Maalouf's (2000) ideas of vertical and horizontal heritage to locate and present the essence of the self. In keeping with the purpose of cultural safety education, the author considers her ethnic cultural self as described by Bloch (1983) and explores Helms' (1990) theory of White racial identity development. This thesis describes the position of one Pakeha in the context of teaching cultural safety in an undergraduate nursing degree programme in Aotearoa/New Zealand. For Pakeha cultural safety nurse educators the author argues that exploration of one's heritages and location of a personal Pakeha identity is pivotal to progressing the enactment of cultural safety in Aotearoa /New Zealand.

Abstract: This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support.

Abstract: Practice development, situated at the nurse-patient interface, is a crucial aspect of professional development as a whole. The Nursing Development Unit (NDU) is one model of structured clinical practice development. NDU have their origin in a desire to provide the best possible care for patient through the support and development of autonomous therapeutic nurses. All possible sources of NDU-related literature from 1983-1999 were reviewed to determine the effectiveness of the NDU model. The purpose of the research was to establish the role of the parent organisation in supporting the ongoing viability of NDU; to describe the key processes and activities of NDU that are instrumental in the development of nursing practice; to clarify the role of the NDU in contributing to improved patient outcome; and finally to identify the critical indicator of successful NDUs for their application in the New Zealand context. The study found that British nursing journals have played a large part in promoting the NDU model. The pioneering units were given positive coverage and this has by and large continued. Accreditation systems have been important in maintaining standards and providing a generic framework for implementation. The trend is now towards internal funding from the parent organisation. The review identified a number of key features for the successful establishment of NDUs. NDUs appear to have under emphasised the development of socio-political acumen in the nursing staff. However, the NDU does offer a model for the development of confident, assertive, autonomous professionals. The NDU model values nursing as professional practice. The author concludes that the NDU model has stood the test of time, and demonstrated the ability to be at the vanguard of contemporary practice development. The model is flexible and its potential is maximised when it is tailored to meet the need of the parent organisation. The model has been successfully established in Australia, and has the potential to be adapted and refined for the New Zealand context.

Abstract: This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities.