Abstract: The purpose of this study was to provide a partial theoretical description of the phenomenon of caring in nursing practice. Three practice settings involving cancer patients were selected: hospital, hospice, and community with thirty patients and thirty-two nurses participating in the study. A research design combining a phenomenological perspective and grounded theory strategies was implemented. Data were collected by interview, participant observation and records. The data were analysed by the method of constant comparative analysis.A number of concepts were developed from the data and the theoretical framework of “The Actualized Caring Moment” was formulated to explain how the actual caring process occurs in nursing practice. This caring moment is the moment at which the nurse and the patient realise their intersubjective connectedness in transforming healing-growing as human beings in a specific-dynamic changing situation. The actualized caring moment is a gestalt configuration of three carting moments. The pre-conditions, The on-going interaction, and The situated context.The Pre-conditions, which consist of the nurse, personally and professionally prepared to care, and the patient, a person with compromised health and wellbeing, are pre-requisites for the occurrence of the caring process. The nurses has the qualities of benevolence, commitment, and clinical competency to be ready to care. The patient is a unique person in a vulnerable state and requires assistance from the nurse to meet personal health needs.The on-going interaction, the actual caring process, is the continuity of the nurse-patient interaction moment by moment which brings together six caring elements: Being there, Being mindfully present, A relationship of trust Participation in meeting needs, Empathetic communication, and Balancing knowledge-energy-time. The Situated Context is the situation and environment where the actual caring process is taking place, and this is comprised of circumstances of the nurse-patient meeting and care-facilitating working conditions.The conceptual framework of “The Actualised Caring Moment” offers nurses an opportunity to understand their practice more fully in providing effective nursing service. Consequently, its implications are valuable for education, research, and the development of knowledge focussed on the discipline of nursing

Abstract: Historical facts from 1881 pertaining to Wellington Hospital, and the training of nurses, commencing with the employment of unpaid Lady Nurses, the conditions of employment for probationers (circa 1883), the formal teaching of probationers 1888, progressing to a three year training, and, with Miss Ellen Dougherty a Wellington trainee being the first registered nurse in the world in 1901. Management of the 1880's and 90's appears a little strange, not employing their own trainees, nor appointing Miss Dougherty as matron, when she had been acting matron.Extrapolation of historical facts to give a probable characterisation of the unpaid Lady nurses and the day in the life of a probationer nurse of these times.Inferences suggest that nursing in New Zealand had military rather than religious origins and, perhaps Misses Selena Sutherland and Dougherty were not lady like enough to be employed by Wellington Hospital!

Abstract: This text begins with a discourse analysis of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, 1994 – DSM -IV- to illustrate the discursive construction of mental disorder. The analysis identifies how productivity, moderation, entariness and rationality are constructed by this psychiatric discourse as the fundamental attributes of normality. It is argued that this discursive construction of normality has particular implications for the subject positions available to women.The text explores how those subject positions are constituted by analysing the narratives of women who have been diagnosed as having a mental disorder. Its object is to explore how the categories 'mental disorder' and 'women' are constituted; the effect this has on some women's experiences; and to offer a feminist interpretation of those experiences. The text explores the meaning of these women's experiences and proposes that their responses can be regarded as tactical responses to the non-recognition, or disconfirming recognition, accorded to the subject positions available to them.The women's tactical responses although taking different forms, reveal some commonalities in their responses to a lack of recognition for their performances: shame regarding the body which marks them as women; a sense of meaningless and emptiness in the available performances; a sense of themselves as objects for the use of others; passive performances as self-protective tactics; a need to suppress anger; and a tension between cultural expectations of normality and their own subjective experiences. The tactical responses that these women had employed take the form of over-conformity, withdrawal and resistance. They reflect that Sass (1992:58) describes as attempts to escape the 'form of the real'. It is the women's body which establishes her engendered subjectivity and it is through the body that the tensions related to her expected performances emerge. Each women's tactical response is imbued with multiple and sometimes contradictory meanings that may represent their ambivalence in relational to the cultural expectations for productive, moderate, unitary and rational performances. To enable the meaning of the women's distress to emerge it is necessary that it be recognised by interpretations that reflect their multiple and contradictory form.Alternative readings of these women's tactical responses position the desire for recognition as central. It proposes that it is necessary to pay attention to both the literal and figurative functions of language. The possibility of 'advancing our understanding of social life' (Gergen, women constructed as mentally disordered. These readings of the narratives require an understanding of the context and construction of the narrator's life and opens up the possibility for multiple understandings that do not necessarily privilege productivity, moderation, unitariness and rationality.By attending to the significance of the women's narratives this text proposes that the DSM-IV's (1994) construction of mental disorder of effectively marginalises women's experiences of their culturally determined subject positions. It acknowledges the need to understand how women symbolize their distress in a way that creates and communicates meaning