Abstract: This thesis focuses on the experience of being human as process in order to reveal being. Illness and health are seen as reflections of this process of revelation. This work argues that health and illness are physical expressions of consciousness and therefore an outcome of what a human being has thought. In this way, this work shows how thought/intent serves to create life in the moment. In this understanding lies the potential to change reality, to change life. The thesis identifies self-responsibility as the key to changing consciousness. Taking responsibility for the creation of one's reality eliminates the human tendency to blame another for what is experienced in life. To that end, this work argues, we are each free to choose what is felt in response to life. In so doing, we can become conscious that life is a choice, that is to be approached from either the position of perfection, or excellence. The author proposes that, in the understanding that human beings are the creators of their reality, it is possible to conceive of care in nursing that is directed at changing thinking/thought. Such change would be to focus on the excellence of life, and in that way enact care in nursing that is an enabling through a process of being that is an emotional allowance in response to life. To this end, this work is titled Nursing as an Aesthetic Praxis. The aesthetic is emotion and feeling. Praxis, is presented in its dialectical relationship of thought and action that is then bound to emotion and feeling in such a way that it illuminates the nature of thinking. This way of thinking, this work shows, is transformatory. Where transformation is a process of being that as a state of excellence is one of incremental human freedom accompanied by incremental responsibility.

Abstract: The role of storytelling in any society fulfils multiple functions such as maintaining culture, holding history, teaching genealogical lessons, imparting wisdom, entertaining, passing on knowledge. The author suggests that nursing, historically described as a craft with an oral tradition, could be seen to be quietly moving away from the practice of storytelling. Or has it? She asked this question and began to realise that her practice and relationships with colleagues had always been based on stories and storying. To explore this phenomenon, she began to describe her day to day practice in story form, and began to position stories she had previously written. In her work of oncology palliative care nursing within a community setting in New Zealand, the stories proved crucial to her role as an educator, and companion of patients and their families. In this paper she examines how she uses story for her benefit, the patients' benefit, but mainly for the benefit of nursing. She examines from her own perspective, some underlying themes that reinforce the need to continue this ancient tradition and explore the role, value and function of storytelling within nursing.

Abstract: This is the first New Zealand study to use the Maslach Burnout Inventory (MBI) and the Phase Model of Burnout to determine the extent and severity of burnout in a population of 1134 nurses. Burnout is conceptualised as a syndrome consisting of three components-emotional exhaustion, reduced personal accomplishment and depersonalisation of clients or patients that occurs in individuals who work in the human service professions, particularly nursing. It has been observed that nurses are at a high risk of burnout and burnout has been described as the 'professional cancer' of nursing. Results revealed an overall 'low to average' level of burnout, suggesting that New Zealand nurses, apart from those in the 41-45 age group, are doing better than expected insofar as they are managing to avoid or not progress to the advanced phases of burnout. Possible explanations and directions for future research are presented.

Abstract: This article discusses the importance of physical activity in the health of older people, in the context of holistic perspectives of elder adulthood and theories of ageing and recent research. The wide ranging role of the gerontologic nurse specialist is explored.

Abstract: This thesis examines Pacific women's experiences of becoming a nurse and their first year of practice post-registration, within the New Zealand context. The participants' stories of being students and beginning practitioners are inter-woven with the author's own reflections as a nurse and nurse educator who also claims a Pacific cultural heritage. To create the space in which the stories can be laid down, the thesis includes a description of the migration and settlement of Pacific peoples in Aotearoa/New Zealand. This description shows how Pacific people have been systematically stigmatised and locked into marginalised positions by mainstream dominant culture. The thesis deconstructs, what the author describes as, taken-for-granted and self perpetuating conceptualisations of marginality that currently underpin most theoretical explanations and proposes a reconstructed map of marginality. This deconstructed/reconstructed map of marginality is used as a template through which the experiences of the participants are filtered and interpreted. Radical Hermeneutics provides a philosophical underpinning for this project that has as one of its objectives the desire to resist reducing complexity to simplistic explanation and superficial solutions. The thesis challenges nursing to examine its role in reproducing the hegemonic power of dominant culture by applying unexamined cultural normative values that create binary boundaries between 'them' and 'us'. At the same time the thesis challenges Pacific people to move past hegemonically induced states of alienation and learn how to walk in multiple worlds with confidence and power.

Abstract: The aim of this research was to explore surveillance discourses within New Zealand child health nursing and to identify whether surveillance practices have implications in this context for power relations. Five experienced and practising Plunket nurses were each interviewed twice. The texts generated by these semi-structured interviews were analysed using a Foucauldian approach to critical discourse analysis. In contrast with the conventional view of power as held and wielded by one party, this study revealed that, in the Plunket nursing context, power is exercised in various and unexpected ways. Although the relationship between the mother and the nurse cannot be said to operate as a partnership, it is constituted in the nurses' discourses as a dynamic relationship in which the mother is actively engaged on her own terms. The effect of this is that it is presented by the nurses as a precarious relationship that has significant implications for the success of their work.

Abstract: The delivery of palliative care within contemporary New Zealand society is discussed, in the light of the recent publication of The New Zealand Palliative Care Strategy (2001). The viewpoint taken is largely descriptive rather than prescriptive, being based on a literature survey of international research and academic theory, which is also informed by the author's professionally gained knowledge. Four different perspectives, comprising a mix of providers and recipients of care are investigated: those of central government planning; specialist palliative care units; aged-care complexes; and patients, family and whanau. As an area of healthcare which current demographic projections indicate will become increasingly significant, the provision of palliative care to residents of and patients within aged-care complexes receives special attention. A metaphor of “parallel travellers” on “parallel journeys” is used to provide a thematic basis to the paper. The lived experiences and perceptions of each group of “parallel travellers” are explored. Difficulties in defining and evaluating palliative care, the implications of main-streaming, the scope of palliative care provision, the educative role of specialist palliative care providers and the current focus on mechanistic outcome measures are discussed. It is contended that the values and goals, both explicit and implicit, of the four specified groups may not at present be sufficiently congruent to optimise the effective provision of palliative care from the point of view of all concerned. While adequate resourcing and a genuinely collaborative approach among healthcare providers are both acknowledged to be critical, the potential for palliative care nurse practitioners to be appointed to the role of “care co-ordinator” alluded to within The New Zealand Palliative Care Strategy (2001), is also seen as pivotal. Insights from a postmodern perspective are offered as one possible way of achieving greater congruence.