Abstract: This thesis explores the customary kaupapa of Matauranga Maori or Maori knowledge, which the author identifies as the appropriate technique to determine how health care should be maintained by and for Maori. The research highlights the need to meld these kaupapa with that of a contemporary Maori viewpoint, to focus more on a deeper enhancement of these kaupapa, and develop an understanding of the social, cultural, educational, political and economic contexts these concepts have on Maori as a people. This research identified six Maori registered women nurses, who shared their experiences regarding Matauranga Maori and its importance to their nursing practice. Over a period of one year, in-depth conversations unfolded and produced data on what Matauranga Maori involves and how the six participants in the study believe it influences their nursing practices. All were currently practicing nurses within various health settings such as psychiatric and comprehensive nursing. From the inception of this study, the focus was to introduce Matauranga Maori as the epistemological framework of choice. The author notes that the findings of this research indicate that a collection of key kaupapa, namely whakapapa, whanaungatanga, te reo Maori, wairuatanga, tuurangawaewae, manaakitanga and rangatiratanga are crucial to the health and wellbeing of Maori as a people. These kaupapa enable Maori to determine and strengthen their worldview, which in turn reflects the concept of being Maori thereby contributing to the health and status of their whanau, hapu and iwi. She goes on to say that the findings support the view that there is a substantial collection of kaupapa, which are inherent in Matauranga Maori as being able to provide a framework for theoretical research. These kaupapa will provide a framework for nursing practice and educational curricula that will develop and maintain nursing standards to meet the needs of Maori.

Abstract: This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how individual autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted.

Abstract: The aim of this study was to explore with a small number of Maori families their experiences of accessing health care when their children were unwell with a respiratory condition. A qualitative research methodology was used in the study. Participating families were among those experiencing an admission to a children's ward between July and December 2003. Four families were interviewed. They discussed in depth their experience of accessing health care for their unwell children. Data were analysed using thematic analysis, and three common themes were evident: family resources, choice of health service provider and parents' feelings of vulnerability. The findings highlight that while socio-economic status plays a large part in determining the ease with which families can access the needed health care, there are other barriers within the health system which also pose difficulties for Maori.

Abstract: The author describes and discusses the main barriers to practice nurses achieving their potential as a profession. She identifies key obstacles as the funding model, GP attitudes and the current employment model. Shared governance, the development of a patient-centred services, and new employment models are proposed as the basis of a new model of primary care delivery.

Abstract: This article examines historical events within one hospital and compares them with contemporary risk management practices. The examples involve a nurse sustaining injury in the course of her work, a fire in the hospital and two instances of patient complaints – one concerning nursing care and the other relating to a time lag between admission to hospital and receiving medical attention. Analysis of the processes followed in investigating these occurrences reveals that these historic investigations were small in scale and less bureaucratic than contemporary practice, and were based on a culture of blame. This is contrasted with modern risk management practices which are more focused on understanding what can be learned from the incident with respect to preventing recurrence.

Abstract: A clinical audit was undertaken to assess the diagnostic skills of the nurse colposcopist measuring colposcopy: histology: cytology correlation. At National Women's Health the first New Zealand nurse colposcopist training programme was developed in 2000. A retrospective audit of the colposcopy clinical records was performed during the nurse's training programme between July 2000 and March 2002. An 82% (82/100) histology: cytology: colposcopy correlation was achieved by the nurse in the third phase of her training programme. The results are comparable with other reported studies involving medical and nurse colposcopists. Expertise in colposcopy examination can be incorporated into the broader role of a Nurse Practitioner working in the area of women's health.

Abstract: This article details how an individual family planning nurse's practice concerning opportunistic testing for sexually transmitted chlamydia was improved through an audit of her testing rates and reflection on the outcome. The leading curable sexually transmitted infection in New Zealand, chlamydia, (including the incidence and spread of the infection and why it is a public health issue) is discussed, and the audit examined. The first audit of fifty consecutive client visits exposed a lack of opportunistic testing. The second looking at a similar but more recent group of client visits, made after the results of the first (zero opportunistic testing) were known, shows an increase in testing and education about chlamydia. Important clinical issues concerning chlamydia testing and treatment are considered. In conclusion the article challenges other nurses in the community to take a lead in raising awareness of the consequences of undiagnosed chlamydial infection and find ways of increasing opportunistic testing for chlamydia within their practice.

Abstract: This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours.