Establishing the nurse practitioner workforce in rural New Zealand: barriers and facilitators

被引:20
|
作者
Adams, Sue [1 ]
Carryer, Jenny [2 ]
机构
[1] Univ Auckland, Sch Populat Hlth, Fac Med & Hlth Sci, Private Bag 92019, Auckland, New Zealand
[2] Coll Hlth Massey Univ, Sch Nursing, Tennent Dr, Palmerston North 4474, New Zealand
关键词
Rural health; primary health care; nursing roles; workforce; equity; PRIMARY-CARE;
D O I
10.1071/HC18089
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
INTRODUCTIONThe health sector is facing considerable challenges to meet the health needs of rural communities. Nurse practitioners (NPs) deliver primary health care (PHC) services similar to general practitioner (GP) services, within a health equity and social justice paradigm. Despite GP workforce deficits, New Zealand has been slow to effectively utilise NPs. AIMFrom a larger study exploring the establishment of NP services, this paper reports on the barriers and facilitators to becoming a NP in rural PHC. METHODSOverall, 13 NPs and 4 NP candidates participated in individual or group interviews. Participants were employed in a variety of PHC settings from six district health boards across New Zealand. Using a scaffold map constructed to show the stages of the pathway from nurse to NP, data were analysed to identify experiences and events that facilitated or were barriers to progress. RESULTSExperiences varied considerably between participants. Commitment to the development of the NP role in their local areas, including support, advanced clinical opportunities, supervision, funding and NP job opportunities, were critical to progression and success. Existing GP shortages and the desire to improve health outcomes for communities drove nurses to become NPs. DISCUSSIONImplementation of the NP workforce across New Zealand remains ad hoc and inconsistent. While there are pockets of great progress, overall, the health sector has failed to embrace the contribution that NPs can make to PHC service delivery. A national approach is required to develop the NP workforce as a mainstream PHC provider.
引用
收藏
页码:152 / 158
页数:7
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