Journal of Professional Nursing

Advanced Nursing Practice:  Time and Meaning 

Susan Jacobs, RCpN, BScN, M.A., PhD candidate  Dean, Faculty of Health & Sport Science  Eastern Institute of Technology, Hawke’s Bay 

Jacobs, S. (2003). Advanced nursing practice: Time  and meaning. Nursing Praxis in New Zealand, 19(3),  29-39.   



The particular, contemporary meanings ascribed to “advanced nursing practice” in  New Zealand have been debated and delineated in the 1990s, culminating in the  launch of the Nurse Practitioner™ at a conference sponsored by the Ministry of  Health and the Nursing Council of New Zealand in August, 2001.  Drawing on archival materials, documents, other texts and voices, this article  explores the evolution of connotations and meanings of the word “advanced” as  applied to nursing in New Zealand. This exploration of time present, and time  past, facilitates a perspective of the future.   

Key Words: Advanced nursing practice, meanings over time, nursing history     


Connotations of the word “advanced”  as applied to nurse, the practice of  nursing and the profession of nursing  have evolved over time. The particular  meanings ascribed to “advanced  nursing practice” in New Zealand at  the turn of the 21st century were  drawn together in the late 1990s. As  defined by the Nursing Council of New  Zealand (NCNZ) in 2001, advanced  nursing practice,  has a clinical or therapeutic focus.  It is the integration of researchbased  theory and expert nursing  in a clinical practice area, and  combines the roles of practitioner,  teacher, consultant, and  researcher to advance the  professional practice of nursing  (Canadian Nurses’ Association,  1997). Advanced nursing  practice reflects a range of highly  Jacobs, S. (2003). Advanced nursing practice: Time  and meaning. Nursing Praxis in New Zealand, 19(3),  29-39.  developed clinical skills and  judgements acquired through a  combination of nursing experience  and education. Essentially,  advanced nursing practice  requires the application of  advanced nursing knowledge,  with practitioners drawing not  only from their clinical experience,  but also on the experience and  research of the profession as a  whole (NCNZ, 2001, p. 28).  Drawing on the Canadian Nurses’  Association’s definition of advanced  nursing practice, this New Zealand  statement reflects movements which  originated in the United States, and  have spread throughout North  America, Australia, and the United  Kingdom.

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