Abstract: This thesis is about caring for males, especially those males who could be considered “difficult” to care for through their use of behaviours such as silence, anger or defensive humour. This thesis is positioned in the view that these behaviours are often expressions of distress, which typically distance males from those who attempt to care for them. The author suggests that the word “distress” more accurately reflects the theme of the thesis, and it is used throughout the work. This thesis explores the interface between gender issues, nursing practice and caring for males. It is informed by a review of relevant literature and data gathered from a focus group of nine registered nurses. The analysis is framed by questions that are developed from a series of reflections on my personal and professional life. Critical social theory, with its emphases on dominant dialogue, power and emancipation is used to inform and guide this analysis. What is most obvious is the contrast between themes arising from the literature and those arising from the focus group. It appears that the literature, in the main, is critical of males in regard to concepts of masculinity, issues related to gender, and men's health. Males are portrayed as arbitrators of their own misfortune, as deliberately choosing a lifestyle that reflects poorly on their health, their self-expression, and communication with others. Concepts such as power and control over others, both at a societal and individual level, often feature. Conversely, the literature is noticeably lacking in regard to information about the health related experiences of males and about caring for males. In contrast, the participants of the focus group frame their discussion in the positive. For example, they suggest that males are interested in their health but require an environment that supports this expression of interest. They support this by identifying a range of behaviours they believe are effective in caring for males. The participants also suggest that it is the registered nurse rather than the male who manages issues to do with power and control. The thesis concludes that creating and sustaining an environment supportive of, and sensitive to the needs of males, is an activity that requires considerable thought, skill and experience. These areas are not adequately addressed in academic dialogue, research activity, or in the education of registered nurses. The thesis suggests that this situation is inconsistent with an ethic of care and that nursing should make a priority of broadening its research and knowledge base to better understand and care for males.

Abstract: This study originates from the author's practice experience working for the New Zealand Fire Service back in the late 1980's and early 1990's as an Occupational Health Nurse where she piloted a Critical Incident Stress Peer Support programme in the No.4 Region. The author identified work-related stress and related it to Critical Incident Stress (CIS) from firefighters exposure to critical incidents. This study explores four firefighters experience of Critical Incident Stress Debriefing (CISD) within a Region of the New Zealand Fire Service. It explores the application of CISD as one component of Critical Incident Stress Management (CISM), and the Nurse Researcher's philosophy of Clinical Nurse practice in relation to the application of CISD. The knowledge gained from the analysis of the data has the potential to influence professionals understanding of their experience and affect future practice and that of others working in the field of CISM. Much of the literature that supported CISD appeared to offer a rather superficial understanding of the firefighters experience in relation to CISD. A narrative approache was chosed as the methodology, utilising four individual case studies as a method of social inquiry in order to explore the experience of CISD. The narratives were able to creatively capture the complexity and the dynamic practice of CISD. An overall pattern of the formalised process was uncovered through the participants' narratives. Eight dominant themes were highlighted from the narratives which included safe environment; ventilating the stress reaction; similar feelings; getting the whole picture; peer support; bonding and resolution. While these themes were common to all the participants, each participant had a particular theme/s which was unique to their experience.

Abstract: This article describes the use of a model that has been developed to assist students in tackling the complex issues surrounding mental health nursing. The Workbook Portfolio has identifiable components that encourage the development of reflective and analytical skills, which allow nurses to practice within an environment that is influenced and determined by a complex, and sometimes contradictory, range of external influences. The article explains the workings of this model so it can be used by educators to for students in the mental health setting.

Abstract: This paper explores the relationship between evidence, decision tools, and the effectiveness of the nursing contribution to health services. It examines a continuum of decision-making within the international trend of the Effectiveness Movement, drawing on international literature and local experience. It draws on the concept of explicit evidence-based decision-making, the guideline development movement as exemplified through the New Zealand Guidelines Group, information technology in decision support, and the challenges of an evidential approach to nursing. This article is based on a paper given at 'The Pride and Passion of Professional Nursing Practice' College of Nurses' Aotearoa (NZ) Conference, Rotorua, 8-9 October 1998.

Abstract: This paper reviews currently identified issues concerning emergency department attendance, and examines the core question of the role of primary care in the emergency department. Asks whether this is an appropriate use of emergency department resources, and if so, what the implications are for the role of the emergency nurse. Suggests the establishment of Minor Injury Units in New Zealand like those in the UK.

Abstract: The author presents a case study of a joint appointment between a nurse lecturer and a staff nurse in an acute forensic psychiatry unit. He explores the advantages, disadvantages and reasons for success in relation to the findings of a survey of the literature on joint appointments. This technique is seen as a means of narrowing the gap between theory and practice which resulted when nurse training was transferred from hospitals to polytechnics. He highlights the need to develop research methodology to clarify potential benefits of this approach.

Abstract: This article presents discussion on some of the main findings of a recently completed study on nursing ethics in New Zealand. An interpretation of a nurse's story taken from the study is offered and suggestions are made for nursing ethics education.