Greetings, Kia ora, from New Zealand, Aotearoa, a group of vibrant
volcanic islands thrust up from the depths of the southern Pacific Ocean some millennia ago. Dense native bush abounds as does widely rolling farmland. In pristine silence tussock-clad foothills sweep toward soaring mountain ranges. Everywhere lakes and rivers sparkle as they burble and rush to the sea.
Around the 13th century the islands were settled by Polynesian people who, over time,developed their distinctive Māori culture. European explorers arrived in the 17th century heralding the arrival of European settlers. In 1840 the islands were formally appropriated by the British government in an agreement of sorts with the Māori people, called the Treaty of Waitangi.
Today the country is self-governing with a diverse population of around 4.5 million people. In 1902 New Zealand became the first country in the world to register professional nurses. Professional nurses currently comprise about 65% of the health service workforce and make a significant contribution to public health in a range of community and hospital settings.
Careful Nursing in New Zealand
Victoria University of Wellington. In 2013 the Graduate School of Nursing, Midwifery and Health, under the leadership of a former Head of School, Professor Jo Walton, introduced the Careful Nursing Philosophy and Professional Practice Model into the academic paper that is embedded in the Nurse Entry to Practice (NetP) Programme. This district health board-funded programme supports and further prepares new graduate nurses in their first year of practice. The Careful
Nursing content, taught by lecturers Natalie Lindsay, Caz Hales and Helen Rook has proved very popular with students and the School's district health board partners, which employ the students.
During a recent class Wellington students reflected on Careful Nursing and how they 
were using it in their practice. One reported that she found the idea of trustworthy collaboration very useful in developing her own style of leadership and observed that overall Careful Nursing merged easily with Māori and Pacific Island cultural approaches to health care. Another student raised interesting questions about Careful Nursing language, questioning whether terms such as caritas and Infinite Transcendent Reality were creating a Careful Nursing jargon. Another
student reported that Careful Nursing had helped strengthen her professional self-confidence, describing how she had been able to question a senior colleague appropriately and firmly about what she judged to be an unsafe practice.
In mid-August a number of past and present NetP students along with
senior nursing leadership from a number of district health board areas came together for a morning workshop review of Careful Nursing. They discussed with enthusiasm how they were using aspects of it in their practice and their plans for sharing it with colleagues who had not taken the NetP programme.
Visits to clinical settings provided opportunities to discuss the influence of students' exposure to Careful Nursing in their practice areas. At Eldon Lodge, Paraparaumu, which specialises in care of the elderly, nurses observed that their students found Careful Nursing a very useful framework for understanding the special needs of elderly persons. It enhanced students' sensitivity to their limitations and disabilities and emphasised the importance of encouraging them to participate in their care. They also found the concept of
participative-authoritive management very useful in working with health care assistants. The Practice Nurses at Newlands Medical Centre in suburban Wellington, who work collaboratively with doctors to provide a wide range of primary health care services, observed that Careful Nursing provided a good structure and rationale for nursing practice and were impressed by students' use of concepts such as contagious calmness.
Claire Renor, a clinical co-ordinator for the programme, thinks of Careful Nursing as "a conscious, considered, deliberate and purposeful act requiring the combination of knowledge, skills and attitudes of the careful nurse". She delights in describing "carefully nursed moments" and observes that it enables graduates to name what they are doing and gives them a deep sense of satisfaction with their practice.
Wanganui Hospital: NetP students' use of Careful Nursing has so impressed the nursing leadership at this hospital that in the near future they plan to formerly implement Careful Nursing as the hospital's model of nursing. Located in the coastal city of Whanganui, 200 kilometres north of Wellington, the hospital serves the Whanganui District Health Board with a wide range of acute and primary health care services. The proactive nursing leadership and committed and imaginative nursing workforce will provide a great opportunity to further explore the effectiveness of Careful Nursing.
New Zealand College of Primary Health Care Nurses Conference Features Careful Nursing
This dynamic college of the New Zealand Nurses Organisation bought together 260
nurses from around the country for its annual conference in Wellington at Te Papa, New Zealand's national museum, from August 15th – 17th. The Nelson-based organising committee (photo) titled the conference 'Nurses Live Better, Laugh Sooner, Care More', and surely the wit and imaginativeness of the organising committee was everywhere evident: Te Papa rang with laughter.
The range of invited papers included one on 'The Careful Nursing Philosophy and Professional Practice Model'. It was well received and participants responded with questions about the practicalities of implementing the model, its inclusion of standardised nursing languages and evidence of its effectiveness. A paper related to the Careful Nursing concept of nurses' care for themselves and one another was also presented, 'The Virtue of Friendship: Nurses' Care for Themselves and One Another'. In this paper it was suggested that the virtue theories of Aristotle and Thomas Aquinas could be drawn upon to help nurses care for themselves and one another.
New Zealand Nurses and Careful Nursing
Many nurses in New Zealand take an interest in Careful Nursing and their interest is as vibrant as their country. They have already contributed much to the development of Careful Nursing and surely will continue to do so.
Well done, Ka pai i meatia
Therese Meehan