The genesis of advanced nursing practice in New Zealand: Policy, politics and education
Susan H. Jacobs, RN, PhD, FCNA(NZ), Dean, Faculty of Health & Sport Science, Eastern Institute of Technology, Taradale
Julie M. Boddy, RN, PhD, FCNA(NZ), Professor of Nursing, School of Health and Social Services, Massey University, Palmerston North
Reference: Jacobs, S. H., & Boddy, J. M. (2008). The genesis of advanced nursing practice in New Zealand: Policy, politics and education. Nursing Praxis in New Zealand, 24(1), 11-22.
When New Zealand’s first Nurse Practitioner was approved by the Nursing Council of New Zealand in December 2001, it was the centenary year of New Zealand nursing registration, but less than a decade after the commencement of New Zealand’s first pre-registration nursing degrees. What were the conditions and forces in play that saw nursing achieve a new emphasis on advanced clinical education and practice, culminating in the development of an advanced, expanded scope of nursing practice? This contemporary historical study examines the professional and sectoral milieu of the 1990s and the turn of the 21st century, together with the policy initiatives undertaken to advance nursing in New Zealand during that period.
Advanced nursing practice, Nurse Practitioner, nurse prescribing, policy
In the late 1990s, as an era of public sector reform settled, conditions were ripe for the development of the Nurse Practitioner (NP) in New Zealand. The Nursing Council of New Zealand (the Nursing Council), the statutory body governing the practice of nursing for the protection of the public, had confirmed the undergraduate degree in nursing as the requirement for entry-to-practice. A Ministerial Taskforce on Nursing (1998) had determined that there were systemic barriers to nursing’s ability to deliver on its potential. While health had become “overtly politicised” from 1972 onwards (Dow, 1995, p. 214), the 1980s and 1990s brought an intense political focus to improve efficacy and efficiency in the health system (Finlayson, 1996). Nevertheless, in the late 1990s serious concerns persisted regarding delivery of primary health care, fragmentation of health services and the burden of chronic disease (Ministry of Health (MOH), 1996). In response to these issues, two successive Ministers of Health had demonstrated support for legislative and policy initiatives that could enable nurses to more effectively deliver primary health care …..cont.