The New Zealand nurse practitioner polemic : a discourse analysis : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, Massey University, Wellington, New Zealand

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dc.contributor.authorWilkinson, Jillian Ann
dc.date.accessioned2008-01-27T20:43:34Z
dc.date.available2008-01-27T20:43:34Z
dc.date.issued2007
dc.description.abstractThe purpose of this research has been to trace the development of the nurse practitioner role in New Zealand. Established in 2001, this advanced nursing practice role was birthed amid controversy as historical forces at play both inside and outside nursing struggled for power to control the future of the profession. Using a discourse analytical approach informed by the work of Michel Foucault, the study foregrounds the discourses that have constructed the nurse practitioner role within the New Zealand social and political context. Discourses, as explained by Foucault, are bodies of knowledge construed to be ‘truth’ and connected to power by reason of this assumption, serving to fix norms and making it virtually impossible to think outside them. Discourses of nursing and of medicine have established systems of disciplinary practices that produce nurses and physicians within defined role boundaries, not because of legislation, but because discourse has constructed certain rules. The nurse practitioner role transcends those boundaries and offers the possibility of a new and potentially more liberating identity for nurses and nursing. A plural approach of both textuality and discursivity was used to guide the analysis of texts chosen from published literature and from nine interviews conducted with individuals who have been influential in the unfolding of the nurse practitioner role. Both professionally and industrially and in academic and regulatory terms dating back to the Nurses Registration Act, 1901, the political discourses and disciplinary practices serving to position nurses in the health care sector and to represent nursing are examined. The play of these forces has created an interstice from which the nurse practitioner role in New Zealand could emerge. In combination with a new state regime of primary health care, the notion of an autonomous nursing profession in both practice and regulation has challenged medicine’s traditional right to surveillance of nursing practice. Through a kind of regulated freedom, the availability of assessment, diagnostic and prescribing practices within a nursing discourse signals a radical shift in how nursing can be represented. The nurse practitioner polemic has revolutionised the nursing subject, and may in turn lead to a qualitatively different health service.en_US
dc.identifier.urihttp://hdl.handle.net/10179/533
dc.language.isoenen_US
dc.publisherMassey Universityen_US
dc.rightsThe Authoren_US
dc.subjectNurse practitioneren_US
dc.subjectNursing practiceen_US
dc.subjectDiscourse analysisen_US
dc.subjectFoucaulten_US
dc.subjectPrimary health careen_US
dc.subject.otherFields of Research::320000 Medical and Health Sciences::321100 Nursingen_US
dc.titleThe New Zealand nurse practitioner polemic : a discourse analysis : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, Massey University, Wellington, New Zealanden_US
dc.typeThesisen_US
massey.contributor.authorWilkinson, Jillian Ann
thesis.degree.disciplineNursingen_US
thesis.degree.grantorMassey Universityen_US
thesis.degree.levelDoctoralen_US
thesis.degree.nameDoctor of Philosophy (Ph.D.)en_US
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