Nurse Prescribing In New Zealand: Professional Gain Or Political Loss?   

Abstract
Change in the work of nurses is currently being driven by two main developments.  Some nurses can now be legally mandated to undertake the traditional medical task of prescribing, while at the same time the delegation of routine nursing work to unregistered care workers has become more common. An optimistic reading of these changes might suggest they illustrate the successful professionalisation of nursing, by and for nurses. However, by locating changes to nursing’s scope of practice within the historical context of the Health Reforms, an alternative reading is possible. With particular reference to nurse prescribing, we argue that changes in nursing work are often politically driven, rather than being simply outcomes of nurse-led developments towards extending autonomous nursing practice.   

Keywords
Nurse prescribing, health reforms, professional autonomy, commodification   

Introduction
Several commentators have argued that in general nurses react to health policy rather than determine the direction such policy should take (Lange & Cheek, 1997; McCartney, Tyrer, Brazier & Prayle, 1999). In New Zealand, for example, nursing as a profession was largely invisible in setting the direction of the Health Reforms of the early 1990s (White, 1995). However the work of nurses was crucial to the implementation of the reforms, and as the policy environment driving the health sector changed so too did the scope of nursing practice.  Continued