Abstract: The focus of this thesis is the practice of the nurses employed in the Native Health Nursing Scheme in New Zealand from 1911 to 1930. These nurses were a vanguard movement for change in community nursing services as they established a new role and developed innovative ways of practicing nursing while claiming greater autonomy and accountability for nurses who worked in community settings. Consequently they contributed to an increase in status for nurses in New Zealand.The Native Health Nursing Scheme was established by the Health Department to replace the Maori Health Nursing Scheme, an initiative by Maori leaders for Maori nurses to provide nursing care for their own people. The original scheme had foundered amid under-resourcing, a lack of support from hospital boards and administrative chaos. Government policy for Maori health was openly assimilationist and the mainly non-Maori Native Health nurses carried out this policy, yet paradoxically adapting their practice in order to be culturally acceptable to Maori.Their work with the Maori people placed the Native Health nurses in a unique position to claim professional territory in a new area of practice. As they took up the opportunities for an expanded nursing role, they practiced in a manner which would develop the scope and status of nursing. The geographical isolation of their practice setting provided the nurses with the challenge of practicing in an environment of minimal administrative and professional support, while also offering them the opportunity for independence and relative autonomy. Obedience, duty and virtue, qualities highly valued in women of the day, were expected especially in nurses. These expectations were in direct contrast to the qualities necessary to perform the duties of the Native Health nurse. The conditions under which these nurses worked and lived, the decisions they were required to make, and the partnerships they needed to establish to be effective in the communities in which they worked, required courage, strength, organizational ability and commitment

Abstract: The diagnosis of childhood cancer has a profound impact on the family. How nurses understand family affects their practice with families facing the diagnosis of childhood cancerShaped by Heideggerian phenomenology, van Manens methodology for hermeneutic phenomenology was used to construct an understanding of family from the experiences of family members facing the diagnosis of childhood cancer. Seven family members from two families, one mother, two fathers, two siblings, and two grandparents were interviewed about their experience of facing the diagnosis of childhood cancer.From the participants experience the meaning of family was interpreted as being-with-others, for-the-sake-of-others, who one might not distinguish from oneself. This understanding of family is recognisable, yet different from traditional definitions of family and may help nurses and family members to act more thoughtfully and tactfully with each other

Abstract: Since 1991, nursing profession in New Zealand has primarily been through a three year programme. The purpose of this study was to explore the issues faced by a group of degree graduates in their first year of registered nurse practice and to identify if the degree graduatesoutcomes (such as critical thinking, problem solving, reflection on practice, research, independent learning, and using cultural safety knowledge) had mediated this transposition process. Purpose sampling was used to invite five female graduates to take part in two focusgroups, one held at months and the other at 9 months after starting work. Qualitative data were collected using semi-structured questions and the taped interviews were analysed for themes. Five themes were identified: accepting responsibility, accepting their level of knowledge, becoming a team member, professional standards, and workplace conditions. Graduates were using their cultural safety knowledge but they perceived their knowledge of research was linked to further academic. Their ability to critique their own practice was evident but they found it difficult to challenge their colleagues' practice and the wider agency culture. Implications of the study are discussed in relation to nursing education and preceptor programmes and areas for further research are indicated

Abstract: There has been a great deal written about the efforts of the nursing profession to achieve full professional status but little about individual nurses' aspirations in seeking this goal. A group of 6 co-researchers, myself included, looked at this perceived gap in nurses' dreams for the profession.The philosophical underpinnings of the research were feminist and reflected postmodern feminist and some radical feminist concepts. This philosophical positions guided our research to uncover the knowledge of how we actively construct ourselves into dominant social values. This means we were searching for how our dreams were constructed and how we reflected the values of society in the way we produced our dreams. Peace and Power (Chinn & Wheeler, 1989) was used to guide the group interaction and Memory-Work (Hague, 1987) for data collecting and analysis. The co-researchers wrote individual stories about their dreams for the nursing profession. Collective analysis of the stories occurred in order to uncover the was in which the dreams were constructed. From this collective analysis the individual co-researchers redrafted their stories. Each redraft contained new insights, motives and actions of ourselves and others, forgotten experiences and inconsistencies, as a means of identifying and questioning dominant ideologies. The aim was to move towards empowerment through making the unconscious conscious.Four common dreams emerged from analysis of the stories: the first was that individual nurses want full professional status and autonomy; the second asked the nurses to care and support each other; a high standard of patient and nursing-focussed care was the third dream; and the fourth was for continuing education and knowledge to be shared between nurses. Although the dreams were common across the group it was found that the dreams varied in their construction. The dreams for each group member reflected multiple realities that emerged from different contexts, influenced by historical and socially dominant cultural values.Through studying and theorising our dreams for the nursing profession, we increased our understanding of how they were shaped so that we were able to initiate change and make our dreams become a reality. This has implications for the nursing profession. We live our lives collectively, as nurses and women, as others influence our being and reality. Although others influence us, it is each individual nurse who contributes to actively construct her/himself in to the dominant cultural values held by society and therefore up to each individual to initiate change. If nurses are able to make dreams a reality then positive changes will occur within the profession; I.e. decreased staff turnover, increased morale and increased quality in patient care

Abstract: A Heideggerian Hermeneutical Analysis (HHA) approach was used for a study of returning registered nurse students (RRNS) from a nursing/health management context. In essence a descriptive interpretive study the intent has been to unveil the common meanings embedded in the lived experience of RRNS return to formal (advanced) studies. The phenomenon or issue of interest was pursued in the form of a question: What is meaningful and significant for participant RRNS in their everyday world on re-engaging in formal (advanced) nursing studies?Research from the RRNS viewpoint is scarce, so the focus of the study was to understand what RRNS themselves found to be the highlights of the experience. Participants included RRNS coming from a management background and, therefore, very much at the cutting edge of rapid and continuing change in health care provision. In addition to personal and professional reasons for returning to study, what the narratives disclosed was the compelling need experienced by the RRNS to increase understanding of changing requirements in the workplace. They looked for new possibilities to transform management of nursing/health services and for learning experiences favorable to that purpose. A key aspect of their concern related to the interactive nature of their lived experience as a RRNS with the entire context of their everyday world, that is, with the connections and relations between the study-work-homespace.Fourteen RRNS from an established university nursing programme participated in an expended non-structured interviews lasting 60 – 90 minutes. The interviews were held during 1993 in places selected by participants, some in the home but mostly in the work setting. With the consent of the participants interviews were audiotaped and then transcribed. The texts (transcriptions) were analysed hermeneutically using Heideggerian phenomenology, a particular tradition of philosophy whose concern is the meaning of Being. The concern is to make visible participants' experience of their 'world'. In this instance, it was the everyday 'world' of the participant RRNS and the lived meanings of what they experienced on return to formal (advanced) studies. Hence everyday lived experience is the focus of attention in Heiedeggerian phenomenology. In this research approach what is sought is understanding not explanation. It is a premise of phenemenology that, in general, an understanding of the meaning and significance of the lived experience can be required from the 'things' (the phenomena under study) themselves. Approaching a participant as an expert by virtue of directly experiencing the phenomenon, is basic to phenomenology. Hermeneutic analysis of the texts of the participant RRNS affirmed the authenticity of those assumptions.The study revealed several common or major themes, two relational themes and one constitutive pattern were identified through the process of textual interpretation. The constitutive pattern expressing the full complexity of the relations and connections between the themes, was found to be present in all fourteen texts; the nature of a constitutive pattern being 'that it's always there'. The constitutive pattern 'Nursing is Dwelling in Thoughtful Concern as Context Calls Forth', emerged as the major finding of the study. This pattern witnesses to the pragmatism that is inherent in nursing and commonly found in nurses' responses to the challenges presented by continuing and rapid change. For the participant RRNS nursing had become a way of engaging their energies in the workplace as appropriate to a given place, time and culture. The two relational themes accent particular aspects of the constitutive pattern. 'Nursing' is a whole pile of things'; and 'Curriculum: Reflective Openness' reveal the inherent meanings of the constitutive pattern. Firstly, that nursing is diverse in practice and has many dimensions; and,, secondly, that a curriculum befitting the diversity of nursing requires us to constantly challenge ad test the learning experiences we provide for RRNS.The fourteen participants traversed diverse pathways to acquire the understanding and skills required for altered health care structures. Adopting new relationships and 'leaping-ahead' (Heidegger, 1962), to be able to see the whole picture of what was being experienced in nursing/health care, reveals the RRNS becoming-as interpreters for both colleagues and clients. Leaping-ahead is reflective of thoughtful concern as the pattern of responding to presenting need. This way of living a life transforms work. The participant RRNS disclose that, dwelling in such a way in nursing/health work opens up a future of possibilities which brings all the presenting needs into focus. Sharing the story of their lifeworld as RRNS, the participants have exemplified the ' reflective openness' Senge(1990) advocates, as being a pre-requisite for 'learning organisations'. Contemporary oganisations require us to challenge our own thinking as well as being free to speak our minds ('participant openness'). Since, however much we value our daily life practices and understandings, they need to be 'always subject to test and improvement'. In effect, what the participants have bestowed on us is that, within the framework of a curriculum for RRNS and the content learning of a given course, we must generate a process of learning amenable to both individual and group requirements