Abstract: An emergent theoretical perspective in the nursing literature relates to nursing as a human science and the application of critical social science and feminist frameworks to nursing research. This research adds to the discipline's knowledge base in that it is at the leading edge of exploring how critical case study illuminates critical issues in the practice of nursing.My interest in the research question came from hearing colleagues espouse the view that other than a legal one, there were no differences in practice between enrolled and registered nurses. How accurate was this perception? Without answers to this question, members of the nursing profession in New Zealand were likely to make some major decisions about the future of enrolled nursing which history will show were ill founded. Since I “walk the talk” of both the world of practice and the corridors of nursing power relationships, I sought answers by incorporating the viewpoints of both groups into the research design.Five registered nurses who had previously been enrolled nurses were asked to consider what was different about their present practice compared to their experiences as an enrolled nurse.Through critically reflexive discourse and journalling, Liz, Emma, Kathy, Helen and myself came to reflect on our nursing worlds in order to transform them.Writing about these transformations in a way that kept our voices alive was more difficult. The cases were written as stories, using storytelling as a legitimate academic activity to link the methodology with the theoretical perspectives. This ensured our individual voices were heard rather than silenced by the research process. It also left a clear decision trail for the reader to follow related to issues of rigor. Paradoxically, the identification of patterns across the case studies was facilitated.Two main patterns emerged in answer to the question “what's different in your practice now from when you were an enrolled nurse?” The differences were explicated in the pattern “Becoming a registered nurse” while “She was one of us” exposed the underlying power and control issues. This study found that the enrolled nurse controls practice at the bedside.The nursing profession's stance on the future of enrolled nurses was also explored through case study. Key nursing stakeholders were interviewed using a proposed legislative change to the Nurses' Act, 1977, that would lead to the demise of the enrolled nurses as a category of nurse, as a focus point. These different perspectives expose for critique the socio-political forces that silence the voice of enrolled nurses in determining their own future. At a legislative level, the stakeholders' voices are dominant. The future of enrolled nurses looks increasingly bleak in New Zealand as the nursing profession positions itself legislatively for the 21st century

Abstract: In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing.