Abstract: This review provides an overview of the health issues for adolescents, and the implications for nursing practice, particularly around health promotion. It looks at the social context of adolescents including peer pressure, along with health issues such as suicide, mental health, sexual health, and smoking.

Abstract: This inquiry is an in-depth exploration of one middle aged woman's experience of strife in chronic illness and her nursing care involving four nurses (including the author) in a community context over a three-year period. The study is praxiological in that the understanding achieved is derived from practice within a 'research as praxis' methodology positioned in the disciplinary perspective of nursing as a practical human science. Five methodological premises inform the research processes: reflexivity, dialogue, moral comportment, re-presentation in narrative and critique. They emanate from an eclectic ontological praxiology based on the research framework constructed from Gadamerian philosophical hermeneutics, components of other philosophical praxiologies evolved from an exploration of the practical discourse in philosophy and my preferred health and nursing assumptions. The research processes include researcher journalling, a summary of Sarah's nursing record and dialogical meetings with Sarah and the nurse co-participants. Using the research material a narrative is then co-constructed. The narrative is structured around what Sarah viewed as the overall nursing contribution to her care; the 'sharing of her burden of illness'. This, she maintained, enabled her to live safely in the community. Finally there occurs a critique of the narrative within a discursive framework. Three themes, embedded in particular discourses, emerged from the narrative both in Sarah's and the nurses' experience; paradox, moral meaning and metaphor. Sarah's experience is interpreted as taking place in the 'in-between space' of the disease and health-illness discourses. Two main concepts which depict the tension experienced in this space are the 'the ontological assault of illness' and 'entrapment in the disease discourse'. The nurses, in this instance, 'pushed the boundaries' to create a space for the nursing as a caring practice discourse on the margins of nursing as a functional service discourse. The author notes that, within the nursing as a caring practice space, many 'fine lines' were walked with Sarah. Walking the 'fine line' of an 'intense relationship' was seen as advanced nursing practice. The research highlights important implications for a person and/or families who live with chronic illness and practice and educational issues for advanced nurse practitioners. Further, it promotes praxiological methodologies as advantageous for expanding nursing knowledge.

Abstract: This action research inquiry explores communication and nursing practice in an effort to improve practice and enhance patient care. Action research is a critical reflective process that involves spirals or cycles of planning, acting, reflecting/evaluating and replanning the next cycle. Using ear syringing as a procedure, in the general practice setting and at two separate surgeries, the author and another practice nurse co-researched this study during working hours. Twelve people consented to participate in the research that involved the audiotaping of each ear syringing interaction. Following each transcription of the recording, the researchers read their own and then each other's transcripts, and listened to the recordings. They discussed and reflected on their findings and planned the next cycle. Throughout the process, the researchers found a number of areas of practice to change or enhance. Changes included the use of technical language such as “contraindications” and “auditory meatus”, the side effects of syringing, improvements in communicating situations where ear syringing is not recommended and the options available, and post procedure information. These changes became a significant challenge, for example when both researchers forgot the changes, thus repeating previous errors and omissions. This factor highlighted the need to practise any changes prior to interactions, and to have a cue card on hand to facilitate recollection and to cement improvements into practice. Although time constraints limited this inquiry to three cycles, at the final meeting the researchers agreed to continue the reflective process they had begun to explore their practice.

Abstract: This literature review discusses the history of the inclusion of culture into nursing studies. There is a small sample of overseas literature for critique with a focus on the inclusion of cultural safety in New Zealand. The concept of cultural safety was first introduced into New Zealand in the late 1980s. It was adopted by the New Zealand Nursing Council for nurses and midwives in 1992 and became part of the basic curriculum for nursing and midwifery education.

Abstract: The research on which this thesis is based involves both a private narrative and a public narrative, with the story of cultural safety, and the history, theory and the future direction gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced cultural safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety Theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of cultural safety is undertaken. The role and application of the Treaty of Waitangi to the theory of cultural safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of cultural safety into the nursing education system and its implementation. The public and media reaction to the inclusion of cultural safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of cultural safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The author notes that the story of cultural safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, she points out that, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients.

Abstract: This paper reports the results of a survey to determine how much genetics is taught in the bioscience component of the three-year Bachelor of Nursing degree offered by 16 tertiary education institutes in New Zealand. A questionnaire was mailed to the bioscience lecturers seeking information on the bioscience and genetics content of current programmes. They were also asked to indicate their perception of the impact and relevance of new genetic knowledge on health care and nursing education. Results indicated that on average 250-350 hours are devoted to the teaching of biosciences. Less than 10 hours are devoted to genetics at 66% of institutes, one institute did not teach any aspect of genetics. None of the institutes taught more than 20 hours of genetics in the programme, although 47% of lecturers said they would like to teach more genetics if there were more time available in the curriculum. Lecturers teaching bioscience to Bachelor of Nursing students are aware of the importance of genetics in health care and to nursing in particular, and the majority are of the opinion that more genetics should be included in undergraduate programmes, however 'curriculum crowding' is a problem.