Abstract: The purpose of this research has been to trace the development of the nurse practitioner role in New Zealand. Using a discourse analytical approach informed by the work of Michel Foucault, the study foregrounds the discourses that have constructed the nurse practitioner role within the New Zealand social and political context. The author suggests that discourses of nursing and of medicine have established systems of disciplinary practices that produce nurses and physicians within defined role boundaries, not because of legislation, but because discourse has constructed certain rules. The nurse practitioner role transcends those boundaries and offers the possibility of a new and potentially more liberating identity for nurses and nursing. A plural approach of both textuality and discursivity was used to guide the analysis of texts chosen from published literature and from nine interviews conducted with individuals who have been influential in the unfolding of the nurse practitioner role. Both professionally and industrially and in academic and regulatory terms dating back to the Nurses Registration Act, 1901, the political discourses and disciplinary practices serving to position nurses in the health care sector and to represent nursing are examined. The play of these forces has created an interstice from which the nurse practitioner role in New Zealand could emerge. In combination with a new state regime of primary health care, the notion of an autonomous nursing profession in both practice and regulation has challenged medicine's traditional right to surveillance of nursing practice. Through a kind of regulated freedom, the availability of assessment, diagnostic and prescribing practices within a nursing discourse signals a radical shift in how nursing can be represented. The author concludes that the nurse practitioner polemic has revolutionised the nursing subject, and may in turn lead to a qualitatively different health service.

Abstract: This thesis presents a study of the every-day moral decision making of experienced nurses. Eight experienced registered nurses participated in the completed research that is based on data gathered through interviews, document audit and literature review. A grounded theory approach was used to analyse the extensive data gathered for the study. This methodology generated a theoretical description involving the antecedents, processes and consequences of nursing moral decision making.Nursing practice has moral content, if not an entirely moral purpose, and moral decision making is the central component of this practice, yet the ethical aspects of nursing practice remain a comparatively recent field of study. It is therefore essential to nurses and their patients that this process is adequately studied and theorised. To date, very few studies have been undertaken in this area in New Zealand. This study aims to at least partially redress this situation by offering insights through conceptualisation and theoretical description of nursing moral decision making.The findings of the study reveal that antecedents such as personal moral development, upbringing and social experiences, contribute to a 'nursing ethic' in the moral decision making of experienced nurses. Furthermore, the study shows that the context and individual and shared perceptions of moral events influence the degree of nursing involvement in ethical situations. Finally, the study maintains that an intrinsic and persistent nursing ethic guides ethical decision making in nursing. This ethic is an undeniable phenomenon of considerable significance to nursing practice and education