In this paper, the limitations associated with current research approaches to the study of clinical decision-making are discussed. Research examining the clinical decision-making of nurses and doctors, and associated work in information procession, is reviewed. It is concluded that although the research is valuable in furthering the understanding of clinical decision-making, there are limitations associated with the current research approaches. The limitations are primarily related to the research approaches employed and the concentration on experienced nurses. The research fails to examine the development of clinical decision-making ability and the learning that occurs in practice. Phenomenography is proposed as an alternative approach. The aim of phenomenography is to describe an individual's perception of a phenomenon. Phenomenography is relevant to the study of clinical decision-making as it is concerned with variation in experience. When applied to the study of new graduate nurses, phenomenography can provide valuable information in relation to individual differences in learning that arise from experience, what factors influence learning and how they affect clinical decision-making ability.

Individualised care will help in reducing discomfort and improving life experiences following surgery. Patients who are prepared for the postoperative recovery at home, have adequate analgesia and do not experience delayed wound healing are more likely to manage activities of living.

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The current global nursing shortage challenges the provision of a well qualified and sustainable health workforce to meet future population health needs. An identified area of concern for New Zealand reaching health policy targets in chronic conditions management and primary health care is an adequate specialist nurse workforce supply. This article explores the New Zealand context underpinning this concern and contends that effective workforce planning would be supported by the development of a single unified framework for specialist nursing practice in New Zealand. A consistent national framework has the potential to support accurate data collection and enable service providers to identify and plan transparent and transferable pathways for specialist nursing service provision and development. Advanced practice nursing frameworks assist in increasing productivity through building an evidence base about advanced practice, enhancing consistency and equity of expertise; supporting a reduction in role duplication; and enabling succession planning and sustainability.