Obstacles that prevent nurse practitioners in New Zealand fulfilling their roles

Harvey, Clare; Papps, Elaine; Roberts, Jennifer

doi:10.7748/phc.25.5.24.e935

Cited by 5 publications

(3 citation statements)

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“…He emphasizes that we need to consider new professionals 'carving' out their 'place' in the healthcare system rather than replacing. While the comparison of the practices for ANPs and doctors will continue to be the cornerstone of any discourse relating to ANP practice, research such as that carried out by Scanlon et al (2018) and Harvey et al (2015) recognize the significant role ANPs play in any health system.…”

Section: Discussionmentioning

confidence: 99%

Constructing the advanced nurse practitioner identity in the healthcare system: A discourse analysis

Thompson

McNamara

2021

Journal of Advanced Nursing

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Section: Discussionmentioning

confidence: 99%

Constructing the advanced nurse practitioner identity in the healthcare system: A discourse analysis

Thompson

McNamara

2021

Journal of Advanced Nursing

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“…Findings from earlier New Zealand research indicate that advanced practitioners may have yet to reach a critical mass and that there is a general perception of limited strategic direction related to these roles [ 48 , 49 ]. The New Zealand NP role has recently seen rapidly increasing numbers after years of low registration [ 50 ], although numbers remain lower than early government predictions [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Perceptions of underlying practice hierarchies: Who is managing my care?

Officer

McBride‐Henry

2021

BMC Health Serv Res

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Background The introduction of new health professional roles, such as that of the nurse practitioner and pharmacist prescriber in primary health care can lead to changes in health service delivery. Consumers, having used these roles, often report high satisfaction. However, there is limited knowledge of how these individuals position nurse practitioner and pharmacist prescriber roles within existing practice structures. Methods Semi-structured interviews were conducted with 21 individuals receiving services from these practitioners in New Zealand primary health care. Interviews were recorded and transcribed verbatim for thematic analysis. Results Participant views reflect established practice hierarchies, placing advanced practitioners ‘below’ general practitioners. Participants are unable to articulate what it was about these practitioners that meant they operated at lower tiers and often considered practitioners to act as ‘their doctor’. They also highlight structural barriers impairing the ability of these providers to operate within their full scope of practice. Conclusions While seeing value in the services they receive, consumers are often unable to position nurse practitioner and pharmacist prescriber roles within health system contexts or to articulate how they value their practitioner’s skills. Embedded structural barriers may be more visible to consumers than their interactions with the health system suggest. This may influence peoples’ ability to receive intended or optimal health services. Consumer ‘health professional literacy’ around the functions of distinct health practitioners should be supported so that they may make informed service provision choices.

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“…Primary Health Organisations were originally intended to be organisations that brought together multiple professions, that were governed (at least in part) by community representatives, and were expected to use some of their funding for planning to address population health needs through primary care [ 47 ]. Around the same time as the introduction of the Primary Health Care Strategy, regulatory changes also provided significant scope for registered nurses and nurse practitioners to play a larger role in primary care, but the growth and uptake of nurse practitioner roles in primary care has been very slow [ 48 ].…”

Section: Jurisdictional Features – Ontario Québec and New Zealandmentioning

confidence: 99%

How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand

Tenbensel¹,

Miller²,

Bréton³

et al. 2017

International Journal of Integrated Care

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Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions. This paper seeks to compare the key institutional and policy features of Ontario, Québec and New Zealand that shape the ‘space available’ for models of community-based primary health care to take root and develop. Our analysis suggests that two key conditions are the integration of relevant health and social sector organisations, and the range of policy levers that are available and used by governments. New Zealand has the most favourable conditions, and Ontario the least favourable. All jurisdictions, however, share a crucial barrier, namely the ‘barbed-wire fence’ that separates funding of medical and ‘non-medical’ primary care services, and the clear interests primary care doctors have in maintaining this fence. Moves in the direction of system-wide community-based primary health care require a gradual dismantling of this fence.

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Obstacles that prevent nurse practitioners in New Zealand fulfilling their roles

Cited by 5 publications

References 0 publications

Constructing the advanced nurse practitioner identity in the healthcare system: A discourse analysis

Constructing the advanced nurse practitioner identity in the healthcare system: A discourse analysis

Perceptions of underlying practice hierarchies: Who is managing my care?

How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand

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