For me, it is all about what I
want to be doing, and what my
community needs me to be
doing. I don’t work in an
organisation that has service
barriers in access to diagnosis,
investigation or prescribing
activity. The community and
people we work with tell us
this. However, what our
community does tell us is that
they experience issues around
the planning, coordination and
provision of older persons
services,
advanced
care
planning, long term condition
education
and
support,
screening and preventative
healthcare, and hands on
palliative care services. For
these issues, the RN is often
the clinical expert in the right
place at the right time and is
why these activities are where
my colleagues and I focus our
expertise and time. To do this, I
utilise Standing Orders and
work within a model of care
that facilitates and does not
hinder or limit my practice in
any way. For me right now, the
personal and organisational
investment in the years of
further
education
and
supervised practice that it
would take to register as an NP
makes neither strategic or
financial
sense
for
my
community, myself or my
organisation. Especially when it
won’t improve the current
efficiency and effectiveness of
June 2018 L.O.G.I.C
the way I deliver services within
an integrated team to meet my
community’s needs.
Besides, becoming an NP is not
as simple as myself or any
other individual nurse making
the decision to be an NP
anyway. This journey requires
workforce
and
employer
structures, support, funding
and system wide commitment
that still is not (and has never
been) adequately in place. NP
candidates need employment
security, a large amount of
personal
and
financial
resourcing, and at least one
supportive
long-term
relationship with a medical or
NP colleague before they even
begin! Not a situation to be
underestimated or embarked
upon unless the benefits
significantly outweigh the costs
and risks. Costs and risks that
are not just about individual
nurses, but about what our
communities,
DHB’s
and
country require from its
workforce and are prepared to
resource. In your area, perhaps
there are issues around access
to the kinds of services an NP
can provide. In which case, I
fully support the development
and implementation of these
roles. But like any other health
discipline; none of us can
provide 100% of what every
patient requires, including an
NP. We are all, or should be,
one big team. Made up of
diverse professions, scopes of
practice and roles, with a wide
range of strengths and skills.
New Zealand needs all of us
and more of us.
Thinking about my future as I
approach the last third of my
working life, I see that it is in
fact a sound decision that I not
pursue NP registration. After
all, not being an NP hasn’t
stopped me from owning a
general practice, participating
at a regional and national level
in various groups, teaching,
mentoring, leading, working
overseas for many years, or
anything else I have done
during my nursing career.
Instead of being an NP, what I
would love for my future is to
continue to be part of making
positive change around the
systems and infrastructures of
health, beyond my own general
practice, and through this
facilitate
better
practice
environments for my RN
colleagues.
What I would also like for the
future is to hear the nursing
profession start talking about
“nursing” being an answer to
the issues within the health,
disability and social systems;
rather than focussing on any
specific nursing scope and role
as the workforce solution. I
think we need more than ever
to
minimise
any
intra-
professional divisions and false
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