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Advanced Nursing Practice - Evolution or Revolution?

Sandra Richardson, BA, Dip.Soc.Sci., Dip.Heal.Sci.(PG) Nurse Researcher, Christchurch Hospital Emergency Department
Richardson, S. (2002). Advanced nursing practice - evolution or revolution? Nursing Praxis in New Zealand, 18(2), 33-41. 


This article has been written to challenge the seemingly unquestioning acceptance of changing roles in New Zealand nursing. It is evident in nursing history that a number of issues, such as community versus hospital services and generalist versus specialist practice, tend to resurface in a cyclic manner. Characteristics that are currently associated with ‘advanced’ nursing roles can be recognised when the origins and development of nursing in New Zealand are traced. This gives rise to speculation that changes to nursing scope of practice are not so much revolutionary as evolutionary, and can perhaps be viewed as a reclaiming rather than a redefining of nursing roles. 

Key Words: advanced practice, nursing boundaries, New Zealand nursing history.  


There is considerable interest in the area of 'advanced' practice roles for nurses, both nationally and internationally. A number of descriptors have been applied to these projected nursing roles often, in their multiplicity, more confusing than enlightening. The phrase 'advanced practice' tends to be used as an umbrella term encompassing many of the sometimes conflicting definitions associated with the concept. New Zealand (NZ) nursing appears to be embracing the re-conceptualisation of the scope and practice of nursing that these roles imply.