Abstract: This thesis describes the journey of a practicing independent nurse practitioner and naturopath through the stories of five clients. The thesis is presented as a narrative and begins with an account of the events in the practitioner's life that lead to the specific study of natural therapies and the development of a cohesive practice using holistic health practices from a nursing perspective. The text essentially describes the process of establishing a private practice combining two disciplines of nursing and naturopathy in New Zealand. The study reveals how a nurse and naturopath's practice is based on the premise that it is crucial to recognise that the personal life and professional life of the nurse inform and influence each other and are always part of the process of care in such a practice. Three healing modalities that are central to the practice are described in detail. The description is informed by theory and research from nursing, the social sciences and the natural sciences. The study reveals the practical value of postmodern nurse theorists, Jean Watson and Margaret Newman to this practice. This study also briefly discusses the concepts from quantum theory, evolutionary theory and psychoneuroirnmunology that are used in the practice.

Abstract: Expresses concern that inconsistent specialist nursing workforce planning and pathways for nursing practice development will adversely affect needed service provision for the population. Reports the outcomes of research, which suggests an alternate approach through the development of a single unified capability framework for specialist nursing practice in NZ. Uses a qualitative descriptive and exploratory multi-method enquiry approach to review extant understandings and develop a consensus framework, identifying the essential elements required for a single national framework for specialist nursing in NZ. Widens the understanding of a more holistic approach to specialist nursing development, which holds great promise for the specialist nursing workforce in NZ and internationally.

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.

Abstract: Maintains that the Nurse Practitioner (NP) role has the potential to achieve more equitable outcomes for rural populations, particularly for older adults in their transition from hospital to the rural setting. Examines how NPs can reduce readmissions, from a thematic analysis of the literature using a realist synthesis approach, focusing on the Thames Coromandel rural community. Derives three themes from the analysis: self-efficacy, holistic care, and care grounded in nursing philosophy.

Abstract: The objective of this study was to conduct research to inform the development of standards for nurse practitioner education in Australia and New Zealand and to contribute to the international debate on nurse practitioner practice. The research was conducted in all states of Australia where the nurse practitioner is authorised, and in New Zealand. The research was informed by multiple data sources including nurse practitioner programme curricula documents from relevant universities in Australia and New Zealand, interviews with academic convenors of these programmes and interviews with nurse practitioners. Findings include support for masters level of education as preparation for the nurse practitioner. These programs need to have a strong clinical learning component and in-depth education for the sciences of specialty practice. Additionally an important aspect of education for the nurse practitioner is the centrality of student directed and flexible learning models. This approach is well supported by the literature on capability.

Abstract: The author traces the development of the nurse practitioner role in New Zealand, which was finally introduced in 2001. It traces the key events, from early debates on the issue, the influence of the Centre for Rural Health, and a series of government investigations into nursing which noted the untapped potential of the nursing workforce and the lack of ongoing clinical career pathways. Barriers to rural nurses becoming endorsed as primary health care nurse practitioners are examined, and some of the solutions to this issue are explored. Relationships between nurse practitioners and the local general practitioners, and community resistance are areas that need management. Education is seen as a key response to many of these issues.

Abstract: This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners.

Abstract: The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.