Abstract: Investigates the impact of workplace factors on burnout in NZ RNs. Conducts a cross-sectional survey among 480 RNs in which burnout, practice environment and negative acts in the workplace were self-reported by means of the Copenhagen Burnout Inventory (CBI), the Practice Environment Scale (PES), and the Negative Acts Questionnaire (NAQ).

Abstract: The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates.

Abstract: The author reviews the diagnosis, treatment, and management of intermittent claudation. She uses a case study to illustrate successful management of the condition.

Abstract: Extensive treatment requirements for patients in I.C.U. frequently result in interruption of their sleep. Sleep interruption can become sleep deprivation with physiological and psychological effects. To determine the amount of sleep patients in the I.C.U. received, a brief study was done in the form of a questionnaire to nursing staff. Noise levels in the I.C.U. were recorded over a period of time. From the study it was concluded the majority of patients were sleep deprived

Abstract: A thesis submitted in fulfilment of the requirements for the Degree
of DOCTOR OF PHILOSOPHY IN EDUCATION, UNIVERSITY OF CANTERBURY 2003.
This thesis highlights the ways in which the practices of contemporary midwives in
Aotearoa/New Zealand are caught within the intersection of an array of competing discourses. The context for this is the reconstruction of midwifery in Aotearoa/New Zealand as an autonomous feminist profession founded on partnership with women. Interviews and participant observation with midwives, based mainly in one New Zealand city, are the basis of an analysis of the complexity of midwives? praxis as professionals. The analysis draws on insights from critical and feminist approaches to Foucault?s theories of discourse, power and the subject. It includes discussion of the conditions which came to produce and authorise the concept of ?partnership?. Which subjects can speak about partnership, and when? What claims
are made about it? What challenges it?

Abstract: Investigates current responsibilities of nurses in advanced roles (NAR) in the Western Pacific. Uses a Delphi survey to identify key barriers and challenges for enhancing role development within the country and the region. Conducts semi-structured individual interviews with 55 national experts from clinical, academic and/or governmental backgrounds in 18 countries, to identify strategies for establishing nurses in advanced roles to improve equitable access to healthcare in the region.

Abstract: Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient.