Abstract: This article investigates the process where nurses attempt to understand the experience of patients. The author argues that this transcends particular models of ill-health. Gadamerian hermeneutics, which has been used in nursing research to articulate the process of understanding, is elaborated on. Gadamer's exposition of understanding shows that practitioners need to be aware that understanding of other people is developed through a fusion of one's own history, language and culture with that of the other person. This occurs through a hermeneutic question-answer dialogue in which practitioners put their ideas at risk of being modified or rejected in the process. Understanding then, is a perceptual and conceptual process. In this way, the experience of nurses seeking to understanding those they nurse increases self-awareness, as well as enhancing their ability to further understand others.

Abstract: A clinical research practicum.

Abstract: This paper describes an attempt at effecting change with specific relevance to the discharge planning of clients from a New Zealand inpatient mental health unit to a community setting. It explores how a team of community mental health nurses, practising in an urban/rural area, used the concepts of practice development to endeavour to bring about change while still retaining a client-centred focus. It describes how, in their enthusiasm, they embarked on the road to practice change without undertaking some of the essential ground work, Although they did not achieve all they set out to achieve, much was learnt in the process. In this paper, the authors outline their key learning points concerning the importance of engagement, communication, consistency and cooperation to the process and outcomes of practice change.

Abstract: Investigates the requirements for documentation by nurses. Research by Millar & Araquiza (1999) suggests that nurses spend an estimated 30% of their time documenting patient care.

Abstract: The authors review the contemporary notion of obesity and suggest that the nursing approach, with an emphasis on treatment, are shaped by a culture located within “western” views of ideal body shape. The biomedical framework regards obesity as disease and obese people as the cause of their own health problems. The authors note varying cultural interpretations of obesity, and suggest that by viewing obesity as a disease, the cultural, social or economic determinants of obesity are not acknowledged. Nursing needs to broaden the concept of the categories of difference to respond in a culturally safe way to obesity. Cultural safety asks that nurses care for people “regardful” of difference. This means nurses must reflect on the care given, so that the biomedical model is not just replicated. Nurse-led clinics offer an opportunity for practices based on nursing values of care and cultural safety. Such clinics are based on nursing's social model of health, rather than a biomedical, disease-focused model.

Abstract: In this article the authors introduce an alternative way that nurses can be with families, using a relational process that can enhance nurses' responses when working with those transitioning to parenthood. Seasons of Life, a framework adapted from the Maori health model He Korowai Oranga, emerged from practice to offer a compassionate and encouraging stance, while at the same time respecting each family's realities and wishes. The model allows the exploration of the transition to parenthood within a wellness model, and takes a strengths-based approach to emotional distress. This approach provides a sense of “normality”, rather than of pathology, for the emotions experienced by new parents. The specific issues men may face are discussed, where despite recent culture change that allows men a more nurturing parental role, there is still no clear understanding of how men articulate their sense of pleasure or distress at this time. Practitioners are encouraged to examine their own assumptions, values and beliefs, and utilise tools such as reflective listening, respect, insight and understanding. The most significant aspect of relationship between nurse and parents is not the outcome, but how nurses engage with families. Examples from practice will demonstrate some of the differing ways this relational process framework has been effective.