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Diers, D. (2008). “Noses and eyes”: Nurse practitioners in New Zealand. Nursing Praxis in New Zealand, 24(1 (Mar)), 4–10.
Abstract: Principles for understanding and evolving nurse practitioner practice, politics and policy are distilled from 40 years of experience in the United States and Australia. The issues in all countries are remarkably similar. The author suggests that some historical and conceptual grounding may assist the continuing development of this expanded role for nursing in New Zealand.
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Papps, E. (2001). (Re)positioning nursing: Watch this space. Nursing Praxis in New Zealand, 17(2), 4–12.
Abstract: This paper traces the emergence of categories of nurse over the last hundred years from the time that the Nurses Registration Act became law in 1901. Insights from the work of Michel Foucault are utilised to show how nurses and nursing have been historically shaped and positioned. It is suggested that the recent endorsement by the Nursing Council of New Zealand of the concept and title of 'nurse practitioner' represents an opportunity for nurses to imagine what might be constructed for their roles.
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McPherson, G., Horsburgh, M., & Tracy, C. (2005). A clinical audit of a nurse colposcopist: Colposcopy, cytology, histology correlation. Nursing Praxis in New Zealand, 21(3), 13–23.
Abstract: A clinical audit was undertaken to assess the diagnostic skills of the nurse colposcopist measuring colposcopy: histology: cytology correlation. At National Women's Health the first New Zealand nurse colposcopist training programme was developed in 2000. A retrospective audit of the colposcopy clinical records was performed during the nurse's training programme between July 2000 and March 2002. An 82% (82/100) histology: cytology: colposcopy correlation was achieved by the nurse in the third phase of her training programme. The results are comparable with other reported studies involving medical and nurse colposcopists. Expertise in colposcopy examination can be incorporated into the broader role of a Nurse Practitioner working in the area of women's health.
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Huntington, A. D., & Gilmour, J. A. (2005). A life shaped by pain: Women and endometriosis. Journal of Clinical Nursing, 14(9), 1124–1132.
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.
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Adams, S., Boyd, M., Carryer, J., Bareham, C., & Tenbensel, T. (2020). A survey of the NP workforce in primary healthcare settings in New Zealand. New Zealand Medical Journal, 133(1523). Retrieved May 4, 2024, from https://hdl.handle.net/2292/54716
Abstract: Describes the demographics, distribution, clinical settings and employment arrangements of the NZ nurse practitioner (NP) workforce in primary healthcare settings, and organisational factors limiting their practice. Surveys 160 NPs and finds that general practice and aged residential care were the most common clinical settings.
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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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Jacobs, S. (2005). Advanced nursing practice and the nurse practitioner: New Zealand nursing's professional project in the late 20th century. Ph.D. thesis, , .
Abstract: This thesis examines the forces influencing the development of contemporary advanced nursing practice in New Zealand. It begins with an historical approach to explore the various meanings of advanced nursing practice from the late 1800s through the first years of the 21st century. Seven historical understandings of the meaning of 'advanced' nursing practice emerge. The author's analysis of the broad scope of New Zealand nursing history, including a case study of the development and implementation of the nurse practitioner, draws on theoretical perspectives from sociology, political science, and nursing. She develops a “framework of critical factors for nursing to take into account when considering how to ensure the profession is able to deliver on its great potential to improve the health of New Zealand communities”. Examining the work of a range of nursing leaders, past and present, and drawing on the work of political scientist, John Kingdon, the author describes the work of several nurses as “policy entrepreneurship.”
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Jacobs, S. (2003). Advanced nursing practice: Time and meaning. Nursing Praxis in New Zealand, 19(3), 29–39.
Abstract: The particular, contemporary meanings ascribed to “advanced nursing practice” in New Zealand have been debated and delineated in the 1990s, culminating in the launch of the nurse practitioner role at a conference sponsored by the Ministry of Health and the Nursing Council of New Zealand in August, 2001. Drawing on archival materials, documents, other texts and voices, this article explores the evolution of connotations and meanings of the word “advanced” as applied to nursing in New Zealand. The focus is on clinical practice, research, teaching, consulting, higher education, and advancement of the profession. Historical aspects of advancement in New Zealand nursing are examined, including registration, unsupervised practice, technical specialisation, and career development.
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Mackay, B. (2004). An analysis of innovative roles in primary health care nursing. Ph.D. thesis, , .
Abstract: An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process.
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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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Gardner, G., Dunn, S., Carryer, J. B., & Gardner, A. (2006). Competency and capability: Imperative for nurse practitioner education. The author-version of article, available online from Queensland University of Technology ePrints arc, 24(1), 8–14.
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.
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Mearns, G. (2005). Developing autonomous ownership: A grounded theory study of how registered nurses working in aged care are advancing their nursing practice. Ph.D. thesis, , .
Abstract: The introduction of nurse practitioner registration into New Zealand in 2001 was heralded as a move that would open up a wealth of opportunities for registered nurses to extend their practice into more independent roles and to provide a client-centred health service. It was also seen as a way to retain experienced registered nurses in the clinical practice area by providing a credible clinical career pathway. If nurse practitioner's are to meet these expectations, then, the author suggests, it is important to understand the processes that encourage or discourage nurses from advancing their practice. One of the early scopes of practice to be introduced was nurse practitioner with an endorsement in aged care scope of practice. Grounded theory was the method used to generate an explanation of how registered nurses working in aged care were preparing for the introduction of nurse practitioner roles. An analysis of early data highlighted codes around registered nurses in aged care extending and advancing their practice rather than preparing specifically for the nurse practitioner role. The research question for this study was: 'How are registered nurses in aged care advancing their nursing practice?' Semi-structured interviews were used to collect data from ten experienced registered nurses working in aged care clinical practice settings ranging from secondary hospital facilities, to community settings and residential care villages. Dimensional analysis of the data eventually generated three major conceptual categories: 'ownership of nursing', 'extending practice', and 'moving out of a comfort zone'. Of these, 'ownership of nursing' was identified as the core construct that linked the other categories together. The substantive theory that explains how registered nurses in aged care advance their clinical practice is 'developing autonomous ownership'. Nurses who develop autonomous ownership of nursing are more likely than other nurses to move out of a current comfort zone and advance their practice into more independent roles that suit their autonomous ownership of nursing. This study identified important contextual factors and conditions that support the development of an autonomous ownership of nursing and that subsequently facilitate advancing nursing practice. These include creating supportive environments, organisational commitment to advanced nursing practice roles, visible nursing leadership, congruence between organisational and nursing philosophies, interdisciplinary collaboration and participating in postgraduate education. The author suggests that the significance of this study is that it generated a theory about the processes that encourage or discourage nurses from preparing for, and progressing into, advanced nursing practice roles such as nurse practitioner.
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Holloway, K. T. (2011). Development of a specialist nursing framework for New Zealand. Doctoral thesis, University of Technology Sydney, Sydney, Australia. Retrieved May 4, 2024, from http://hdl.handle.net/10453/20322
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.
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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 4, 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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Mustafa, M., Adams, S., Bareham, C., & Carryer, J. (2021). Employing nurse practitioners in general practice: an exploratory survey of the perspectives of managers. Journal of Primary Health Care, 13(3). Retrieved May 4, 2024, from http://dx.doi.org/10.1071/hc21036
Abstract: Explores the perspectives of practice managers on employing nurse practitioners (NP) in general practice. Uses an electronic survey to collect demographic and numerical data, which were analysed descriptively and analytically using SPSS (version 26). Written answers to open-ended questions were analysed qualitatively.
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