Opportunities for resistance may lie outside public and private health organizations in civil society, in the nurse union movements and other health and nursing professional associations.

This article draws on the free-text commentaries from trans-Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self-effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms.

Purpose The purpose of this paper is to explore how nurses make decisions to ration care or leave it undone within a clinical environment that is controlled by systems level cost containment. The authors wanted to find out what professional, personal and organisational factors contribute to that decision-making process. This work follows previous international research that explored missed nursing care using Kalisch and Williams' MISSCARE survey. Design/methodology/approach The authors drew on the care elements used by Kalisch and Williams, asking nurses to tell us how they decided what care to leave out, the conduits for which could include delaying care during a shift, delegating care to another health professional on the same shift, handing care over to staff on the next shift or leaving care undone. Findings The findings suggest that nurses do not readily consider their accountability when deciding what care to leave or delay, instead their priorities focus on the patient and the organisation, the outcomes for which are frequently achieved by completing work after a shift. Originality/value The actions of nurses implicitly rationing care is largely hidden from view, the consequences for which potentially have far reaching effects to the nurses and the patients. This paper raised awareness to hidden issues facing nurses within a cycle of implicitly rationing care, caught between wanting to provide care to their patients, meeting the organisation's directives and ensuring professional safety. Rethinking how care is measured to reflect its unpredictable nature is essential.

The PATU™ Aotearoa Hinu Wero (Fat Challenge) is a group exercise initiative that promotes physical activity and focuses on fat loss in order to reduce obesity in Māori. This study evaluated the effectiveness of the pilot nine-week Hinu Wero (August–October 2014) involving 66 participants (males n = 26, females n = 40, ages 17–63 years) using a mixed-methods approach. Pre-and post-Hinu Wero anthropometric data revealed whether changes in body fat percentage, body mass index, and weight occurred. Mean reductions in all these measurements were observed. An online focus group with 13 of the participants, and a trainer interview (n = 1, male, 28 years) was undertaken in June 2015 to obtain various perspectives of the Hinu Wero. The online focus group participants were very enthusiastic about the PATU™ Hinu Wero and the results being achieved. It was acknowledged that the Māori practice of whanaungatanga (connectedness, support) was of paramount importance. The PATU™ Hinu Wero functioned as an effective health intervention for reducing obesity in local Māori and working towards reducing health inequities in New Zealand.

This article examines nurses' commentaries from a survey conducted in New Zealand that studied contradictions between quality assurance and work intensification in nursing care. Nurse managers were blamed for either avoiding or not recognizing work intensification affecting quality care delivery. However, the data illustrate key structural issues resulting in missed care that impact on patient safety, rather than a problem directly attributable to managers. Until these structural issues are addressed, missed care and adverse events will continue to affect the quality of care.

This paper describes the decision-making processes of nurses to take leave or not. These discoveries were unanticipated and gained during the analysis of data from a larger New Zealand study examining the decision-making process around what care to ration on a shift by nurses. What these findings revealed was that nurses seek a balance that places work as first priority, followed by family and then lastly themselves. The analysis highlights work intensification

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