“Noses and eyes”: Nurse practitioners in New Zealand

Abstract
Principles for understanding and evolving nurse practitioner practice, politics and policy are distilled from 40 years of experience in the United States and Australia. The issues in all countries are remarkably similar. Some historical and conceptual grounding may assist the continuing development of this expanded role for nursing in New Zealand.   

Keywords
Nurse practitioners, advanced nursing practice, nursing and policy

Introduction
Not long ago, I took a tour of the Parliament buildings in Wellington. In the well of the House, the guide said something about how they tally the “noses and eyes.” I had this Harry Potter vision of guys in black morning suits dashing about counting noses and eyes. “No’s” and “ayes,” of course. My American ears heard something different. This experience reminded me never to take anything for granted in international understanding. Nevertheless having been in the company of nurse practitioners (NPs) since the very first of them emerged in the United States (US) in the late 1960s, I offer a few principles that might transcend national borders, political systems and accents.