Abstract: The author notes that it is widely accepted that there is a global shortage of nurses, and there are many studies in the health workforce literature about the negative aspects of nurse work environments, nursing workloads, decreased job satisfaction of nurses and the impact these have on patient health outcomes. In the past five years there has also been international and New Zealand-specific research into the effects of health restructuring on nursing leadership, retention of nurses, and on patient care. Much of this research has shown that countries with very different health care systems have similar problems, not only with retention of qualified nursing staff due to high levels of job dissatisfaction, but also with work design and the provision of good quality patient care in hospitals. This dissertation explores the many detrimental effects on nurses and nursing leadership, of extensive, and continuing, public health restructuring in New Zealand. The context of this dissertation is New Zealand public hospitals, with references pertaining to medical and surgical areas of nursing practice. Health reforms have negatively impacted on patient care delivery systems, patient health outcomes, and retention of educated nurses in the workforce. In order to resolve these issues, coordinated efforts are required in New Zealand district health boards to develop and sustain effective nursing leaders, who will promote and assist in the development of strong, healthy organisational cultures to retain and support professional nurses and the ways in which they wish to practise.

Abstract: Interviews 14 participants, 10 older and experienced health professionals, and four managers. Describes the lived experience of health professionals ageing at work, and of the managers interacting with them. Demonstrates that the ability of older practitioners to adapt to meet the ongoing physical demands of practice and their shifting workplace environment determines whether they will be valued at work and remain in their roles.

Abstract: Critically examines the work required to establish nurse practitioner (NP) services in rural primary health care in NZ, using the institutional ethnography approach to the inquiry. Explores the work and experiences that nurses undertook to become NPs delivering rural primary health care services. Considers how these were institutionally-shaped and coordinated. Conducts interviews with a total of 13 NPs and four NP candidates.

Abstract: Examines the experiences of the patient, their family and healthcare professionals during the trajectory of a prolonged critical illness in an Intensive Care Unit (ICU). Conducts a qualitative, instrumental, multi-case study informed by the Chronic Illness Trajectory Framework. Analyses data from six linked cases (patient, family and clinicians) in four ICUs over a two-year period. Argues that identifying the sub-phases of a prolonged critical illness trajectory allows targeted interventions for each sub-phase.

Abstract: Identifies key factors senior perioperative nurses consider when making decisions about nurse staffing and skill mix in the operating room (OR). Uses a qualitative descriptive approach in undertaking semi-structured interviews with 7 senior nurses tasked with decision-making about OR staffing. Analyses the data using Braun and Clarke's thematic analysis process.

Abstract: Describes and explores how nursing leadership practices occur in contemporary hospital wards in NZ. Utilises 18 months of episodic fieldwork observations in four wards of a hospital and individual discussions with nurses, to conduct a focussed ethnography from the perspective of leadership-as-practice. Uses qualitative analysis to identify the nature of leadership practices at all levels of the nursing team.