Abstract: Since 1995 we have provided a bereavement follow-up service but the benefits of this to clinical care have not previously been reported . We reviewed the 1995 results, documentation methods, system design, discussed with reviewers their data collection, interview process and its effect on them and their practice. Next-of-kin of only 99/151 patients ( M87 age 14-88) were contacted 16-149 median 34 days after the death. Sleep disturbance (55/99) were the most common problems. We now give next-of- kin literature including a pamphlet which introduces our service and discusses these problems. Most next-of-kin (77/99) commented favorably on DCCM care, but 16/99 identified inadequate facilities and communication problems as service deficiencies. We have improved facilities (paint, furniture, telephone, drinks machine). We now notify patients general practitioners of every death and bring families back for meetings with staff when necessary. We changed systems of case identification and recording of next-of-kin information. Nurse interviewers (8) identified their needs for improved telephone skills, education about grief and research, debriefing after calls and their need for acknowledgement of participation in this service. Study days now address these issues. Interviewers difficulties with interview content have lead to changes. They suggested peer review of data forms to improve completeness which now occurs. Some found the interview process personally disturbing, but all reported positive changes in their practice with bereaved families.Within two years a bereavement service has led to improvements in facilities, communication, and staff expertise, it is now part of our holistic care

Abstract: An emergent theoretical perspective in the nursing literature relates to nursing as a human science and the application of critical social science and feminist frameworks to nursing research. This research adds to the discipline's knowledge base in that it is at the leading edge of exploring how critical case study illuminates critical issues in the practice of nursing.My interest in the research question came from hearing colleagues espouse the view that other than a legal one, there were no differences in practice between enrolled and registered nurses. How accurate was this perception? Without answers to this question, members of the nursing profession in New Zealand were likely to make some major decisions about the future of enrolled nursing which history will show were ill founded. Since I “walk the talk” of both the world of practice and the corridors of nursing power relationships, I sought answers by incorporating the viewpoints of both groups into the research design.Five registered nurses who had previously been enrolled nurses were asked to consider what was different about their present practice compared to their experiences as an enrolled nurse.Through critically reflexive discourse and journalling, Liz, Emma, Kathy, Helen and myself came to reflect on our nursing worlds in order to transform them.Writing about these transformations in a way that kept our voices alive was more difficult. The cases were written as stories, using storytelling as a legitimate academic activity to link the methodology with the theoretical perspectives. This ensured our individual voices were heard rather than silenced by the research process. It also left a clear decision trail for the reader to follow related to issues of rigor. Paradoxically, the identification of patterns across the case studies was facilitated.Two main patterns emerged in answer to the question “what's different in your practice now from when you were an enrolled nurse?” The differences were explicated in the pattern “Becoming a registered nurse” while “She was one of us” exposed the underlying power and control issues. This study found that the enrolled nurse controls practice at the bedside.The nursing profession's stance on the future of enrolled nurses was also explored through case study. Key nursing stakeholders were interviewed using a proposed legislative change to the Nurses' Act, 1977, that would lead to the demise of the enrolled nurses as a category of nurse, as a focus point. These different perspectives expose for critique the socio-political forces that silence the voice of enrolled nurses in determining their own future. At a legislative level, the stakeholders' voices are dominant. The future of enrolled nurses looks increasingly bleak in New Zealand as the nursing profession positions itself legislatively for the 21st century

Abstract: High stress and staff turnover in a multi-specialty paediatric area prompted this study that aimed to :1) measure the burnout level of nurses in a multi-specialty paediatric area2) identify and validate causes of stress3) identify new ways of preventing stress on the wardFifty four percent (n=14) of the paediatric nurses completed the questionnaire booklet that included demographic data, the Maslach Burnout Inventory, the Nursing Situations Questionnaire the Hopkins Symptom Checklist-21 the Ways of Coping Checklist and open ended questions about sources of stress and satisfaction at work. Results indicated levelsof burnout and distress comparable with larger studies. Conflict with doctors was the major source of stress followed by workload, inadequate preparation in dealing with the emotional needs of patients and their families and death and dying. Conflict with doctors has not previously been identified as the major source of stress. However workload and death and dying are commonly identified as sources in the literature. Suggestions for further research and the low response rate are discussed

Abstract: Grounded theory was used to investigate the lives of quadriplegic people living in the community. The model indicates that people move between dependence and independence according to several factors