Abstract: This clinical case study takes an integrated approach to investigation and critical analysis of the complex physiological and pathophysiological treatment modalities instigated when a patient presents following acute traumatic head injury. A broad overview of the developmental physiology of the brain and an explanation of the mechanism of traumatic brain injury as it relates to alterations in cerebral blood flow, intracranial pressure and cerebral metabolism is presented. The author describes in narrative form the clinical presentation of a patient, her symptoms and initial treatment rationale. It concludes with analysis of the patients initial treatment priorities and symptom management during the first 48 hours of her care.

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: Investigates programmes to facilitate the transition to home for babies who have had lengthy admission to Neonatal Intensive Care Units. Provides an overview of the transition services at four sites visited in the US and Canada. Highlights the common elements among all four programmes and identifies the components of quality transition services. Evaluates their clinical effectiveness. Part of the Margaret May Blackwell Scholarship Reports series.

Abstract: This thesis explores the issues surrounding the elderly remaining in their own environment and why remaining 'at home' becomes so essential for them. There are many elderly people who have moved to residential care settings on the advice of others. The author explores the implications of such moves through the stories of several elderly persons, and her own experiences as a nurse working with the elderly in institutional care.

Abstract: This thesis explores three Muslim women's experience of childbirth, in a setting surrounded by health professionals who largely have little understanding of their culture. Various forms of narrative such as a letter, excerpts from conversations, and interviews, have been used in presenting this research. The women's stories reveal that giving birth in a cross-cultural setting is stressful. The women had to adjust to an environment which challenged their beliefs and values, in one case with no extended family or cultural support. This stress is long lasting as evidenced in the women's stories. Given the opportunity to tell their story, all the women highlighted both the positive and negative aspects of their birth experiences. This thesis identifies situations that heightened the vulnerability of the women, and highlights the uniqueness of each woman. It concludes by identifying recommendations and reading material for nurses and midwives in education or practice.

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.

Abstract: Nursing in New Zealand has been a recognised profession for one hundred years. Throughout this time the profession has made a significant contribution to the health of communities, nationally and internationally. Despite the obvious effort and achievement, the author suggests that the evidence of this contribution is not well known. She goes on to say that nurses, now as never before, are challenged to show how they 'add value' and to explain why nursing expertise is essential to safe service delivery. Finding a way to communicate this contribution has been identified as one of the most important issues facing the profession. This thesis explores the concept of contribution and presents a model, the 'Contribution Model', to show how nursing can articulate the action and achievements that show how nursing professionals have and will continue to contribute to health gain in New Zealand. Through the application of the 'Contribution Model' and framework presented in this thesis, nursing is shown to have made a contribution to health gain by using the broad range of knowledge, skills and experiences in a wide range of settings, to provide care wherever and whenever required. Case studies and scenarios from history, observation and prediction are used to show how the actions and achievements of nursing meet the expectations of individuals, the community and society: past, present and future.