dc.contributor.author |
Adams, Sue |
|
dc.contributor.author |
Carryer, Jenny |
|
dc.coverage.spatial |
United States |
|
dc.date.accessioned |
2022-05-10T21:32:17Z |
|
dc.date.available |
2022-05-10T21:32:17Z |
|
dc.date.issued |
2021-02 |
|
dc.identifier.citation |
(2021). Policy Politics and Nursing Practice, 22(1), 17-27. |
|
dc.identifier.issn |
1527-1544 |
|
dc.identifier.uri |
https://hdl.handle.net/2292/59157 |
|
dc.description.abstract |
The implementation of the nurse practitioner (NP) workforce in primary health care (PHC) in New Zealand has been slow, despite ongoing concerns over persisting health inequalities and a crisis in the primary care physician workforce. This article, as part of a wider institutional ethnography, draws on the experiences of one NP and two NP candidates, as they struggle to establish and deliver PHC services in areas of high need, rural, and Indigenous Māori communities in New Zealand. Using information gathered initially by interview, we develop an analysis of how the institutional and policy context is shaping their experiences and limiting opportunities for the informants to provide meaningful comprehensive PHC. Their work (time and effort), with various health organizations, was halted with little rationale, and seemingly contrary to New Zealand's strategic direction for PHC stipulated in the Primary Health Care Strategy 2001. The tension between the extant biomedical model, known as primary care, and the broader principles of PHC was evident. Our analysis explored how the perpetuation of the neoliberal health policy environment through a "hands-off" approach from central government and district health boards resulted in a highly fragmented and complex health sector. Ongoing policy and sector perseverance to support privately owned physician-led general practice; a competitive contractual environment; and significant structural health sector changes, all restricted the establishment of NP services. Instead, commitment across the health sector is needed to ensure implementation of the NP workforce as autonomous mainstream providers of comprehensive PHC services. |
|
dc.format.medium |
Print-Electronic |
|
dc.language |
eng |
|
dc.publisher |
SAGE Publications |
|
dc.relation.ispartofseries |
Policy, politics & nursing practice |
|
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.subject |
Humans |
|
dc.subject |
Health Policy |
|
dc.subject |
Health Care Sector |
|
dc.subject |
Nurse Practitioners |
|
dc.subject |
Health Services Needs and Demand |
|
dc.subject |
Professional Practice |
|
dc.subject |
Primary Health Care |
|
dc.subject |
Delivery of Health Care |
|
dc.subject |
New Zealand |
|
dc.subject |
Female |
|
dc.subject |
Workforce |
|
dc.subject |
anthropology |
|
dc.subject |
cultural |
|
dc.subject |
health status disparities |
|
dc.subject |
physicians |
|
dc.subject |
primary care |
|
dc.subject |
Health Services |
|
dc.subject |
Clinical Research |
|
dc.subject |
Generic health relevance |
|
dc.subject |
10 Reduced Inequalities |
|
dc.subject |
1110 Nursing |
|
dc.title |
How the Institutional and Policy Context Shapes the Establishment of Nurse Practitioner Roles and Practice in New Zealand's Primary Health Care Sector. |
|
dc.type |
Journal Article |
|
dc.identifier.doi |
10.1177/1527154420965534 |
|
pubs.issue |
1 |
|
pubs.begin-page |
17 |
|
pubs.volume |
22 |
|
dc.date.updated |
2022-04-11T06:34:22Z |
|
dc.rights.holder |
Copyright: The author |
en |
dc.identifier.pmid |
33054593 (pubmed) |
|
pubs.author-url |
https://www.ncbi.nlm.nih.gov/pubmed/33054593 |
|
pubs.end-page |
27 |
|
pubs.publication-status |
Published |
|
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Journal Article |
|
pubs.elements-id |
837294 |
|
pubs.org-id |
Medical and Health Sciences |
|
pubs.org-id |
Nursing |
|
dc.identifier.eissn |
1552-7468 |
|
pubs.record-created-at-source-date |
2022-04-11 |
|
pubs.online-publication-date |
2020-10-14 |
|