Abstract: The subject of nursing leadership is approached by reviewing the literature of two prominent nursing theorists, Patricia Benner and Jean Watson, and the literature of transformational leadership. Common themes are identified. An exhortation is offered to nurses to consider that the caring characteristics of nurses are what is required in the corporate world of management. Chapter 1, questions whether nursing and management are different worlds or shared realities. It outlines the author's experience of practising as a manager in a complex organisation and the seeming barriers that exist between managers and nurses and management and nursing. A questioning of those barriers became the impetus for the review. Chapter 2, outlines the work of Patricia Benner and Jean Watson. Caring is identified as a core concept which is said to differ significantly from a conventional understanding of helping and is inextricably linked to a profound understanding of what it means to be human. Chapter 3, reviews the literature of contemporary managers who are exploring a transformed approach to leadership and management. Six themes are identified that are common to nursing theory and transformational leadership theory. Chapter 4, acknowledges that despite the similarities between nursing and contemporary management thought, there remains a gap between nurses and management. Rather than feeling optimistic about the future, and confident in assuming leadership roles, many nurses feel defeated and fearful about the future. It is suggested that this may be a consequence of bad experience of leadership, of loss of joy of caring and of failure to value the strength residing in the collective community of nurses. Nurses are encouraged to recognise that their knowledge and experience of caring and wholeness, healing, sharing and enabling, are the attributes that equip them to be leaders of the future health and corporate world.

Abstract: The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline.

Abstract: A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home.

Abstract: This research is about preceptorship in nursing. There is considerable emphasis placed on health care organisations to support newly appointed graduate nurses, and preceptorship is a recommended model. Despite this emphasis, the author suggests that little is known about how preceptorship partnerships work in practice. The primary focus of this exploratory descriptive qualitative study was to explore the perspectives that preceptors and preceptees, who had worked in partnership, had about how they established and sustained their respective roles. Three sets of registered nurses who had recently completed a preceptorship experience were interviewed about their partnership. Content and thematic analysis of this descriptive data revealed four main themes. The preceptorship relationship grows out of respect for each another and develops as a result of honest and open communication. Preceptees who have an initial positive experience into their new work area settle quickly and efficiently into their new role. Preceptees appreciate preceptors who are welcoming, supportive and willing to undertake the role, while preceptors are happy to undertake the role if the graduate displays an interest in learning and are willing to be guided. The preceptee learns what it means to be a registered nurse in the particular working context, while the preceptor learns how to support learning processes and evidence-based practices. The author goes on to say that further exploration and investigation of these themes and of the relationships that evolve during preceptorship partnerships is needed. By understanding these findings, organisations can prepare both the preceptor and preceptee as they begin to undertake their role to ensure future partnerships will be successful.

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 was an evaluative study of the Day Stay services to patients with particular regard to patient information and teaching. Data was collected via questionnaires from 143 patients who had attended Day stay. 95% of patients were satisfied with explanations about their surgery. 22% of patients wanted more information about the Day stay routine. 93& of patients said information given on discharge was adequate. After discharge home 16.9% of patients developed problems with care which are discussed with suggestions for improving Day stay service

Abstract: The purpose of this study was to gain insight into the possible factors [precipitating back injury in Nurses who had injured their backs during 1985. 23 Nurses were interviewed and factors such as age, years of Nursing, circumstances of injury, why nurses thought the injury had occurred, were examined. Treatment and the effects of the injury on the Nurse were explored. Significant findings were delay in seeking medical assessment when back injury was suspected, and the changes in lifestyle and home and work habits which followed injury. Findings from this study were used to initiate an action study of Nurses lifting patients