Carryer, J. B., & Boyd, M. (2003). The myth of medical liability for nursing practice. Nursing Praxis in New Zealand, 19(4-12), 4–12.
Abstract: This article explores the complex nature of liability in the case of standing orders and vicarious liability by employers, and also when nurses and doctors are in management roles. The authors address misconceptions about medico-legal responsibility for nursing practice with the advent of nurse prescribers and nurse practitioners. They refer to the submission made by the College of Nurses Aotearoa (NZ) on the Health Practitioners Competence Assurance Act (2003), and discuss practice liability and nurse-physician collaboration.
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Wilkinson, J. A. (2007). The New Zealand nurse practitioner polemic : a discourse analysis : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, Massey University, Wellington, New Zealand. Doctoral thesis, Massey University, Wellington.
Abstract: Traces the development of the nurse practitioner role in NZ since its establishment in 2001, using a discourse analytical approach to examine those discourses that have defined the role. Employs both textual and discursive analysis of texts from published literature and from nine interviews with individuals influential in the evolution of the role. Examines political perspectives and disciplinary practices dating back to the Nurses Registration Act of 1901. Considers the implications of an autonomous nursing profession in both practice and regulation.
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Holloway, K. (2012). The New Zealand nurse specialist framework: Clarifying the contribution of the nurse specialist. Policy, Politics, & Nursing Practice, 13(3), 147–153.
Abstract: Presents an overview of the NZ Nurse Specialist Framework (NZNSF), developed through a consensus approach as part of a doctoral study, and which provides an over-arching structure to support coherence, clarity and consistency for nurse specialists. Maintains that the framework supports workforce policy makers in planning effective utlisation of the nurse specialist in health care delivery.
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Smythe, E. (2003). Uncovering the meaning of 'being safe' in practice. Contemporary Nurse, 14(2), 196–204.
Abstract: This paper moves away from the prevalent discourse of competence to consider the meaning of the experience of 'being safe' within the context of childbirth. It offers findings from a doctoral study, informed by the philosophies of Heidegger and Gadamer. Following ethical approval, the data was collected in New Zealand by tape-recorded interviews of 5 midwives, 4 obstetricians, 1 general practitioner and 10 women. The method was informed by van Manen. The findings reveal that in seeking the meaning of being safe one needs to be aware that the unsafety may already be present in the situation. Practitioners may be able to do little to rectify the unsafeness. There is, however, a spirit of safe practice, explicated in this paper, that is likely to make practice as safe as it can possibly be. Wise practitioners are ever mindful that a situation may be or become unsafe, and are always aware of their own limitations.
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Rose, L., Nelson, S., Johnston, L., & Presneill, J. J. (2008). Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units. Journal of Clinical Nursing, 17(8), 1035–1043.
Abstract: The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU.
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