Wright, J., & Honey, M. (2016). New Zealand nurses' experience of tele-consultation within secondary and tertiary services to provide care at a distance. Nursing Praxis in New Zealand, 32(2).
Abstract: Aims to explore NZ registered nurses' experience of using tele-consultation to provide care at a distance. Using a general inductive approach, single semi-structured interviews were undertaken with nine experienced nurses who provide secondary and tertiary services to patients and healthcare teams. Identifies five themes relating to nurses' role in tele-consultation.
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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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Vernon, R. A., Jacobs, S., & Papps, E. (2007). An innovative initiative for advanced nursing practice roles. Available online from Eastern Institute of Technology, 14(2), 16–17.
Abstract: This paper reports an initiative which is an example of partnership between education and health organisations resulting in the implementation of a jointly funded advanced nursing practice role. The model is for community based Nurse Practitioner-managed health care for primary health and disease management. The key partners in this project are the Eastern Institute of Technology, Hawke's Bay District Health Board, and a Primary Health Organisation (Tu Meke – First Choice). This article summarises the objectives, implementation, evaluation and benefits of the programme.
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Sue, K., Lee, T. W., & Kim, G. S. and others. (2021). Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study. Human Resources for Health, 19(1). Retrieved May 18, 2024, from http://dx.doi.org/https://doi.org/10.1186/s12960-021-00555-6
Abstract: Investigates current responsibilities of nurses in advanced roles (NAR) in the Western Pacific. Uses a Delphi survey to identify key barriers and challenges for enhancing role development within the country and the region. Conducts semi-structured individual interviews with 55 national experts from clinical, academic and/or governmental backgrounds in 18 countries, to identify strategies for establishing nurses in advanced roles to improve equitable access to healthcare in the region.
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Spence, D., & Smythe, E. (2007). Courage as integral to advancing nursing practice. Nursing Praxis in New Zealand, 23(2), 43–55.
Abstract: This paper focuses on the illumination of courage in nursing. The authors suggest it is a fundamental component of nursing, yet it is seldom mentioned or recognised in the literature, or supported in practice. Data from a hermeneutic analysis of nurses' practice stories is integrated with literature to assist deeper understanding of the meaning of courage in contemporary nursing practice. The purpose is to make visible a phenomenon that needs to be actively fostered if nursing is to effectively contribute to an improved health service.
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Spence, D., & Anderson, M. (2007). Implementing a prescribing practicum within a Master's degree in advanced nursing practice. Nursing Praxis in New Zealand, 23(2), 27–42.
Abstract: This article reports the implementation of a collaborative project undertaken to monitor and improve the effectiveness of the prescribing practicum papers delivered within two Master's degree programmes in advanced nursing practice. The recent introduction of Nurse Practitioner registration in New Zealand has resulted in the development of a number of Master's degree programmes in which students can complete a Nursing Council of New Zealand approved programme for prescribing. For the study, a developmental action research approach was used. Data were collected through interviews with practicum students, their medical supervisors and academic staff. Formative findings were progressively used to refine delivery of the practicum papers and a thematic analysis of summative findings identified areas for further improvement. The findings suggest that the processes being implemented are developing well. The researchers recommend that further education is required to clearly differentiate medical and advanced nursing roles. They recommend that greater attention needs to be paid to the preparation of medical supervisors and, most significantly, revision of funding is required to more equitably support the ongoing development of nurses for advanced practice roles.
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Spence, D., & Anderson, M. (2006). Implementing a prescribing practicum within a Masters programme in advanced nursing practice. A pilot study. [Auckland; Hawkes Bay]: [The authors].
Abstract: This report presents the findings and recommendations derived from a collaborative action research pilot project undertaken alongside the implementation of two nurse prescribing practicum courses. The students, teachers and supervisors participating in year long Masters' level prescribing practica at Auckland University of Technology (AUT) and Eastern Institute of Technology (EIT) were interviewed about their perceptions, concerns and actions relating the first time implementation of their respective practicum papers. Research findings suggest that the practicum implementation has been successful overall, however there is a need to refine delivery, and to review current funding arrangements.
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Spence, D. (2004). Advanced nursing practice through postgraduate education, part one. Nursing Praxis in New Zealand, 20(2), 46–55.
Abstract: In New Zealand the clinically focused postgraduate papers and programmes, available through universities and polytechnics, are evaluated from an educational perspective but little evaluation of the implications for practice has been undertaken. This paper is Part One of a report on a study that sought to illuminate the impact of clinically focused postgraduate education on advancing nursing practice. Hermeneutic methodology provided a framework for analysing both the perspectives of nurses who had undergone such education and those who had directly employed and worked alongside these nurses. Emerging themes are described here. In a second article the findings will be discussed in relation to literature. Constraining factors will be identified and strategies designed to maximise the benefits of education for advancing nursing practice will be recommended.
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Spence, D. (2004). Advancing nursing practice through postgraduate education, part two. Nursing Praxis in New Zealand, 20(3), 21–30.
Abstract: This paper continues presentation of the findings of a North Island based research project that explored the impact of clinically focused postgraduate education on advancing nursing practice. Like their international counterparts, increasing numbers of New Zealand nurses are enrolling in advanced practice programmes. Yet, despite international evidence supporting the usefulness of Masters level preparation for advancing clinical practice, questions about the need for such development persist. This paper argues that postgraduate education contributes to the development of courage and that this, in turn, is essential to overcoming the barriers that currently constrain the advancement of nursing practice.
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Speed, G. (2003). Advanced nurse practice. Nursing dialogue: A Professional Journal for nurses, 10, 6–12.
Abstract: The concept and characteristics of advanced nursing practice in New Zealand and overseas is compared with the nurse practitioner role. There is an international debate over definitions of advanced nursing and the range of roles that have developed. The rationale for the nurse practitioner role in New Zealand is examined, along with the associated legislation currently before Parliament. Job titles and roles of nurses within the Waikato Hospital intensive care unit are discussed and ways of developing the role of nurse practitioner are presented.
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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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Ross, J. (1999). International perspective: The development of the advanced role of rural nurses in New Zealand. Australian Journal of Rural Health, 7(4), 253–257.
Abstract: This paper offers an insight into the development of the advanced role of rural nursing practice in New Zealand. The concept of advanced nursing practice is discussed within the context of the interdisciplinary healthcare team. It is argued that as nurses take on advanced practice, it is essential they receive appropriate clinical and theoretical skills to ensure they are in a position to provide competent and clinically safe, effective health care in an ethical, efficient manner. A description of a survey, undertaken by the author, studying rural nurses' skills provides the recommendation for the development of an appropriate postgraduate course at Masters level, designed specifically for primary rural nurses for the advanced role.
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Ross, J. (2001). Perspectives on developing the advanced role of rural nursing in New Zealand. Health Manager, 8(1), 19–21.
Abstract: The author traces the development of rural nursing, which began as an assistant role for general practitioners, to the present role which incorporates advanced nursing practice. She reports the results of two surveys of nurses' roles and skills, from 1996 and 1999-2000. Specific rural competencies are identified, in managing isolation, professionalism in a small community, nurse/patient relationships in a small community, and independence.
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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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Rook, H., Hales, C., Milligan, K., & Jones, M. (2021). Dr Jill Wilkinson's discourse analysis of the sources of power and agency for nursing. Nursing Praxis in New Zealand, 37(1). Retrieved May 18, 2024, from http://dx.doi.org/https://doi.org/10.36951/27034542.2021.012
Abstract: Highlights two articles written by Jill Wilkinson in 2008 pertaining to the Ministerial Taskforce on Nursing in 1998, in which she discusses the conflict between autonomy and unionism in nursing and the development of the nurse practitioner (NP) role. Considers the ongoing challenges to establish NP toles in mainstream health services.
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