Concurrent sessions offer participants rich variety.

Conference's second day featured five concurrent streams--collaborative practice; Maori and primary health care (PHC) initiatives; health promotion, education and new initiatives. There were five 25-minute sessions in each stream, with a rich and varied range of topics. Kai Tioki Nursing New Zealand sampled just a few.

Assessing mental health risks for nurses

Hamilton independent nurse consultant Jacquie Kidd described her PhD research into nurses who have experienced mental illness in clinical practice. Through her private practice Hineira Health, Kidd has cared for a number of nurses. What has struck her is how secret her care has had to be. "Nurses can't always access the same kind of services as other patients and sometimes a nurse will be sent to another area to get help. This secretiveness is not helpful to nurses becoming well again."

Among nurses, more than 21,000 could expect to become mentally unwell at some time in their lives. Nurses needed to be aware that burnout was not the same as depression, but it could develop into a mental illness if not dealt with properly.

Primary health care not a soft option

"Primary health care nursing is a mindset and not a career choice," said Whitireia Community Polytechnic nurse lecturers Kerri Arcus and George Orsborn during their presentation, Creating a culture of primary health care in an undergraduate nursing programme.

In 2002, the curriculum for nursing undergraduate studies at the polytechnic was revised, with PHC a central focus. "We need to expose nursing students to innovative models of practice and to prepare them to work autonomously outside institutional settings. It is folklore that nurses need to work in secondary care before working in PHC," Arcus said.

Exploiting the ceil phone

Using the cell phone for chlamydia tracing is proving very effective at Wanganui's Youth Services Trust. In her presentation, clinical nurse specialist Beverley Herbert said New Zealand had the third highest chlamydia rate in the world. The PHC nurse was ideally positioned to address this epidemic by exploiting, in a positive way, tools or toys to interact with young people in their practice. "Chlamydia is a very insidious disease. Complications include ectopic pregnancy and infertility."

In order to reduce chlamydia rates, nurses needed to target the under 20s, those who changed partners frequently, people who had unprotected sex and those who had had previous positive results. Using mobile phones and text messaging enabled nurses to text back appointment times, offer advice and counselling, notify when test results were available, and assist with contact tracing. "Nearly 75 percent of 12-19 year olds regularly use a mobile phone. Health professionals haven't even begun to tap into the potential of the mobile phone as far as assisting young people with their health," she said.

Encouraging men to have regular check-ups

A "warrant of fitness" approach to men's health is proving successful at the Golden Bay Medical Centre in Takaka, according to practice nurse Brenda Bruning. A men's health clinic was started in February 2004, in response to the fact men access health services at a much lower rate than women, yet their life expectancy is significantly lower, with higher morbidity and mortality rates. "I offer men a half-hour appointment for $35. Lunch hour and some early evening appointments are also offered, as men are often reluctant to attend during work hours." Of the 68 men seen recently, 60 percent had abnormal cholesterol levels and between 10 and 15 percent had a moderate risk of cardiovascular problems.

Defining health promotion

A challenging session, Contextualising health promotion, contrasted health education and health promotion. Presenter, senior lecturer at Massey University's School of Health Sciences, Dean Whitehead, said that, by definition, health promotion was an inherently political process--"If you are not politically active it is doubtful you can call yourself health promotionalists."

Health promotion focused on community-based empowerment and socio-political activity. Whitehead lamented the fact there were no "political" placements, eg shadowing MPs, in undergraduate nursing education.

He urged nurses to clarify what their practice was. Health promotion was sustained, planned, resourced, long-term and evaluated. He urged nurses to avoid health education that was ad hoc, unplanned, opportunistic, individual, behavioural, Lifestyle-focused, with unevaluated interventions.

Integrating palliative and primary care

Nurse educator at Palmerston North's Arohanui Hospice, Bridget Marshall, outlined new partnerships developed in their service to ensure the best possible care to the community. The hospice was working with GPs, the Manawatu Independent Practice Association and allied services, including district nurses, to provide palliative care services. The keys to success were communication, teamwork among the different providers, respect for each other's skills and knowledge; the increasing palliative care knowledge of those involved; and funding to develop the project.

The hospice had also introduced the liverpool care of the dying pathway in both community and residential care. This had improved documentation at the hospice and staff felt it had also improved the standard of care.

Research shows how nursing care differs

A research project carded out between the Independent Nursing Practice (INP) in Nelson and the School of Health at Nelson Marlborough Institute of Technology found that the nature and quality of services provided by the INP differed from that of other PHC providers. Two groups of clients, one of women under 21 and the other of women over 30, were interviewed for the research, commissioned by the INP.

Themes from the findings of the qualitative, interpretive research, presented by senior academic staff member David Mitchell, were: towards reciprocity and moving beyond the therapeutic relationship; responding to the transitional needs of clients; recognising and responding to the client's life stage; and a service that was available, acceptable, accessible and affordable.

Increasing nursing's profile at ACC 

A programme manager with the Accident Compensation Corporation (ACC), Alison Randall, outlined a range of areas in which ACC was working to increase the profile of and support to nursing. These included scholarships to five rural nurse practitioner students; the rural nursing contract; the community nursing contract, which was mostly for wound care and intravenous therapy and was paid on a per visit basis; the compression therapy pilot project; and the rural GP contract, a practice-based payment. She said the sky was the limit for nursing opportunities within ACC.