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This work needs to continue, as the reality is that one cannot do without the other as the majority of New Zealand nurses, including CNLs, work within a DHB setting. They therefore cannot develop in isolation from each other. White (2004) recommends:

Nurses need to be assisted to reframe their understanding of the expression of the nurse-patient relationship and nursing practice in the contemporary healthcare system and to see themselves as caring and connected knowledge workers who bring humanity to an otherwise often dehumanising technically focused illness-cure system. (p. 207)

The DHB would benefit from such reframing in order to understand how nurses are prepared at undergraduate level. This is where their CNLs develop from. This, in part, explains why the CNLs through nine meetings and an interview maintained the importance of the patient. Not the budget, roster, quality and risk accountabilities, but the patient and their nursing staff. They are a nurse, a nurse, a nurse and, as White (2004) suggests: “The focus on nurse-patient relationship, to the virtual exclusion of other relationships, has left nurses in a position of vulnerability” (p. 208). This position of vulnerability can be altered by such collaborative work as suggested. The CNL would benefit from a deeper understanding of the DHB as a crown agent, the DHB’s responsibility to its population and how that responsibility is translated to various roles in this market model. Then, as White goes on to suggest, New Zealand nurses would do well to continue to develop their understanding of the political processes that influences health care delivery, such as the nineties health reforms and she states: “to work with governments and opinion-makers persuasively with a rich blend of evidence and story” (p. 216).


Directorate and Nurse Educators

The professional development model that is based on individual learning needs assessment by the CNL and extension of knowledge to their nursing staff and the role of a mentor, was indicated as important by the group. This is of relevance to the DHB’s executive nursing officer, senior nurses and education team as well as nursing degree programmes. The undergraduate nursing curriculum needs to prepare the nurse for the reality of the health


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