Abstract: Sense-Making, a qualitative research method, was used to obtain and analyse data from interviews with 10 registered nurses, in order to study reflective thinking in actual nursing practice. Ten non-routine nursing situations were analysed for the presence of reflective thinking. Reflective thinking was extensively manifest, especially in moments of doubt and perplexity, and consisted of such cognitive activities as comparing and contrasting phenomena, recognising patterns, categorising perceptions, framing, and self-questioning in order to create meaning and understanding. Self-questioning was identified as a significant process within reflective thinking. By exploring and analysing the type of questions respondents were asking themselves, the study uncovered three hierarchical levels of reflective thinking, focussed on action, evaluation and critical enquiry. The findings of this study resulted in the development of a model of reflective thinking, which is discussed in terms of the implications for learning in nursing practice.

Abstract: A preceptorship programme of 100 hours duration was developed and delivered by a nurse education institute, in consultation with a health care organisation. The purpose of the study was to examine preceptors, preceptees, and nurse managers' preceptions of the preceptor role and factors which influenced the performance of preceptors. Using focus groups, participants were each asked to identify the outcomes of the programme in practice. Study findings highlighted the importance of formal preceptor preparation, personal and professional development of the preceptors, and the promotion of positive partnerships between nurse educators and nurse practitioners. The need for formal recognition of the preceptor role in practice, particularly in relation to the provision of adequate time and resources, emerged from the study. The research findings enabled the development of an evaluative model of preceptorship, which highlights the intrinsic and extrinsic factors impacting on the preceptor role

Abstract: This article describes a study conducted on the internal medicine, general surgical, and vascular wards of a large metropolitan hospital to assess the impact of a networked monitoring system and portable patient monitors. This pilot study was developed to address the needs of hospital patients who require continuous non-invasive vital signs monitoring (including heart rate, non-invasive blood pressure, pulse oximetry, cardiac waveform monitoring) with the addition of surveillance from a cardiac intensive care area. Data were collected from 114 patients over a three-month period to identify a patient group that could be managed appropriately under the new system and to determine the effect that flexible monitoring had on patient care management. Findings include identification of a specific patient group that can be managed successfully outside the cardiac intensive care area using this system. Other findings suggest a way to improve the management of patient monitoring in the general ward areas.

Abstract: This article discusses ways in which relaxation, when used as an adjunct to medical therapies, can be a useful nursing management tool for effectively relieving cardiac pain. The available literature suggests that although nurses place a lot of importance on cardiac patients being pain free, it is apparent this is often not achieved. Research and documented case studies suggest that relaxation can play an important role in the treatment and prevention of this distressing symptom. The author advocates for nurses to challenge nursing practice and help patients deal effectively with chest pain in a way that meets each individual's needs.

Abstract: This paper addresses the concept of truth, and debates who should tell it and how it should be told. It explores the cultural aspects of knowing the truth about dying. The question of whether nurses have a moral obligation to tell the truth is explored, and suggests the lack of New Zealand research in this area should be addressed.

Abstract: This paper looks broadly at issues to do with quality monitoring in higher education and considers the role and focus of the Nursing Council of New Zealand in the approval of and ongoing monitoring of undergraduate nursing degree programmes. It is suggested that the approach taken by the Nursing Council is accountability led where minimal attention is given to teaching and learning and actual graduate outcomes. This may lead to a mistaken belief that Nursing Council's monitoring focuses on quality or that the outcomes of their monitoring might contribute to programme enhancement. A shift to emphasise learning processes, students and continual improvement in order to enhance programme quality is proposed.

Abstract: The author examines the concept of informed consent as it applies to patients and as it is obtained by nurses. The principles of autonomy, beneficence and non-maleficence are discussed. How these principles inform critical care nursing is explored and five inappropriate uses of technology in resuscitation are used as examples.

Abstract: The author investigates the premises that form the basis of nursing practice in acute care. Assumptions about patients and caregiving are often at odds with each other. The origins of these tenets are mapped from Florence Nightingale through to present nursing theorists. Overlapping areas of nursing and medical care in the acute care setting are examined, and the conflict that can arise between traditional nursing care and the expected medical nursing role is examined. He argues that the challenge for acute care nurses is to find a balance between normative nursing and the medical model.