Neonatal Nurse Practitioners - A Model for Expanding the Boundaries of Nursing Culture in New Zealand  

Abstract
The development and terminology of what constitutes advanced practice nursing roles in New Zealand has been the subject of recent debate within nursing. This article outlines the development of the neonatal nurse practitioner role in New Zealand as an example of one advanced practice nursing role. A model of how nursing culture changes to include roles that incorporate components that historically have been considered the domain of other health professionals is proposed. This article outlines some of the issues surrounding the neonatal nurse practitioner role, including the educational requirements for this role in New Zealand.  

Keywords
Neonatal nurse practitioner, advanced practice, nursing culture  

Background to Nurse Practitioner Roles
According to Roberts (1983) the historical roots of what is now considered to be the domain of nurse practitioners can be found in situations which predate the move from community to hospital based care. Accounts from those earlier times suggest that nurses practised in ways which were similar to what is now considered to be the advanced nurse practitioner or nurse practitioner role. A current definition of this role given by the Nurse Executives of New Zealand (1998) reads: nurses work as nurse practitioners to undertake care management over a longer period of time with individuals and groups of patients requiring care and services across the inpatient-community care continuum eg neonatal nurse practitioner, family health nurse practitioner (p.2), and The nurse undertakes comprehensive assessment, diagnosis, care planning, care delivery, care coordination and monitoring of patient/client progress (p.4).  Continued