October 2017 December 2013 | Page 18

Te Puawai
we would still be in our shelters and caves
somewhere in Africa.
Rising to the Challenge (MoH) suggests
that services need to think again about
how they can be creative and improve
effectiveness and efficiencies. These
words may sound old and clichéd but that
is only because they have been used
again and again but not yet actually
implemented. Nurse practitioners have
years of experience, advanced training
and the ability to apply their skills and
knowledge in a practical if not user friendly
way to improve health outcomes. That is
what we are designed to do; the NP scope
of practice embodies clinical integration. It
is not that anyone wishes to undermine
medical officers or be tall poppies with our
colleagues. The fact is we have skills and
knowledge that can be better utilised in
ways other than just “filling the gap” or
worse still qualified but not employed as
NPs. As the evidence demosnstrates for
health administrators and regulators over
and over again NPs especially are a
highly flexible and very cost effective
solution to workforce challenges.

publications.
A
highly
significant
observation about the breadth of
comparative studies in this area is the
absence of any studies that reach a
contrary conclusion. Of more than 100
published, post- OTA reports on the
quality of care provided by both nurse
practitioners and physicians, not a single
study has found that nurse practitioners
provide inferior services within the
overlapping scopes of licensed practice.
My final statement to readers of this article
and in particular to decision makers who
influence health service development in
the New Zealand health sector is to
please read the evidence and incorporate
the roles of advanced practice nurses/NPs
into your service delivery plans. In regard
to the MoH base document that I have
referred to in this article “Rising to the
Challenge”, Nurse Practitioners have
already risen to the challenge! “Gizza job”
we are ready and able. It is time for the
furniture to be re-arranged to allow us into
the room.

1.

Jeffrey Bauer (2010), an internationally
recognised medical economist and health
futurist, states:
Consistent findings about comparable and
acceptable quality have been reported in
studies focused on different institutional
settings,
including
emergency
departments,1

2.

3.

Carter, M. W., & Porell, F. W. (2005). Cited in Bauer
J (2010). Nurse Practitioners as an underutilised
resource for health reform. Evidence base
demonstrations of cost-effectiveness. American
Academy of Nurse Practitioners.
Lemley, K. B., & Marks, B. (2009). Cited in Bauer J
(2010). Nurse Practitioners as an underutilised
resource for health reform. Evidence base
demonstrations of cost-effectiveness. American
Academy of Nurse Practitioners.
Aigner, M. J., Drew, S., & Phipps, J. (2004). Cited in
Bauer J (2010). Nurse Practitioners as an
underutilised resource for health reform. Evidence
base demonstrations of cost-effectiveness.
American Academy of Nurse Practitioners.

Nurse practitioners as an underutilized
resource for health reform, rural clinics,2
and nursing homes.3 Many more studies
that reach the same conclusion are
identified in the footnotes of these
© Te Puawai

College of Nurses Aotearoa (NZ) Inc
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