Advanced Practice Nursing in New Zealand

Carryer, Jenny; Adams, Sue

doi:10.1007/978-3-030-20550-8_11

Cited by 3 publications

(4 citation statements)

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“…The need for the development of advanced nursing, career frameworks, and employment arrangements were stipulated (King, 2001). In the same year as the launch of the Strategy, the first NP was registered in New Zealand (Carryer & Adams, 2020). Since that time there have been various changes to the legislation, regulation (including NP scope of practice), and education of NPs to facilitate NPs working in PHC settings (Carryer & Adams, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…In New Zealand, NPs are advanced practice nurses with a clinical master’s degree and are authorized prescribers, with a prescribing range limited only by their clinical judgment (Carryer & Adams, 2020). They are regulated by the Nursing Council of New Zealand, under the Health Practitioners Competence Assurance Act (2003) with a separate title to practice within the NP scope of practice (Nursing Council of New Zealand, 2017).…”

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confidence: 99%

“…They are regulated by the Nursing Council of New Zealand, under the Health Practitioners Competence Assurance Act (2003) with a separate title to practice within the NP scope of practice (Nursing Council of New Zealand, 2017). The prime objective of establishing the NP workforce was to increase access to health services and reduce health inequalities (Carryer & Adams, 2020; Hughes & Carryer, 2002). Since 2001, over 450 NPs have registered and just over half work in PHC settings (Adams et al., 2020; Nursing Council of New Zealand, 2019).…”

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confidence: 99%

“…Since 2001, over 450 NPs have registered and just over half work in PHC settings (Adams et al., 2020; Nursing Council of New Zealand, 2019). NPs may provide first-contact primary care, prescribe, and receive public subsidized funding in the same way as do primary care physicians (Carryer & Adams, 2020). However, in a recent survey in New Zealand of PHC NPs, just 39% identified their main clinical setting as being primary care physician-led general practice (Adams et al., 2020).…”

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confidence: 99%

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How the Institutional and Policy Context Shapes the Establishment of Nurse Practitioner Roles and Practice in New Zealand’s Primary Health Care Sector

Adams

Carryer

2020

Policy, Politics, & Nursing Practice

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The implementation of the nurse practitioner (NP) workforce in primary health care (PHC) in New Zealand has been slow, despite ongoing concerns over persisting health inequalities and a crisis in the primary care physician workforce. This article, as part of a wider institutional ethnography, draws on the experiences of one NP and two NP candidates, as they struggle to establish and deliver PHC services in areas of high need, rural, and Indigenous Māori communities in New Zealand. Using information gathered initially by interview, we develop an analysis of how the institutional and policy context is shaping their experiences and limiting opportunities for the informants to provide meaningful comprehensive PHC. Their work (time and effort), with various health organizations, was halted with little rationale, and seemingly contrary to New Zealand’s strategic direction for PHC stipulated in the Primary Health Care Strategy 2001. The tension between the extant biomedical model, known as primary care, and the broader principles of PHC was evident. Our analysis explored how the perpetuation of the neoliberal health policy environment through a “hands-off” approach from central government and district health boards resulted in a highly fragmented and complex health sector. Ongoing policy and sector perseverance to support privately owned physician-led general practice; a competitive contractual environment; and significant structural health sector changes, all restricted the establishment of NP services. Instead, commitment across the health sector is needed to ensure implementation of the NP workforce as autonomous mainstream providers of comprehensive PHC services.

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Section: Introductionmentioning

confidence: 99%

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