Spheres of influence or autonomy? A discourse analysis of the introduction of Nurse Practitioners in rural and remote Australia
被引:31
|
作者:
Turner, Clare
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机构:
Flinders Univ S Australia, Sch Nursing & Midwifery, Fac Hlth Sci, Adelaide, SA 5001, AustraliaFlinders Univ S Australia, Sch Nursing & Midwifery, Fac Hlth Sci, Adelaide, SA 5001, Australia
Turner, Clare
[1
]
Keyzer, Dirk
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机构:
Flinders Univ S Australia, Sch Nursing & Midwifery, Fac Hlth Sci, Adelaide, SA 5001, AustraliaFlinders Univ S Australia, Sch Nursing & Midwifery, Fac Hlth Sci, Adelaide, SA 5001, Australia
Keyzer, Dirk
[1
]
Rudge, Trudy
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Flinders Univ S Australia, Sch Nursing & Midwifery, Fac Hlth Sci, Adelaide, SA 5001, AustraliaFlinders Univ S Australia, Sch Nursing & Midwifery, Fac Hlth Sci, Adelaide, SA 5001, Australia
Rudge, Trudy
[1
]
机构:
[1] Flinders Univ S Australia, Sch Nursing & Midwifery, Fac Hlth Sci, Adelaide, SA 5001, Australia
advanced nursing practice;
critical discourse analysis;
Nurse Practitioner;
professional autonomy;
rural and remote nursing;
D O I:
10.1111/j.1365-2648.2007.04275.x
中图分类号:
R47 [护理学];
学科分类号:
1011 ;
摘要:
Aim. This paper is a report of a study to examine the social discourses of nursing within health care as these produce understandings about autonomy for Nurse Practitioners, where autonomy refers to the ability of Nurse Practitioners to practise as professionals in their own right. Background. Nurse Practitioners were recently introduced to the nursing career pathways in Australia. Despite a plethora of international information, the role implementation in rural and remote Australia is slow with a number of influences emerging to hinder progress. Method. Critical discourse analysis was used to examine the differences between policy and the reality of implementation. The notion of autonomy was used to explore texts in policy documents relating to Nurse Practitioner authorization and published between 1995 and 2006, and these were compared with the experiences of nurses working in Nurse Practitioner positions. Findings. Policy texts indicate support for advanced practice and the autonomy of Nurse Practitioners. The process for authorization; however, has constraints which support nurses' progress but also hinder it. Subsequent acceptance of Nurse Practitioners has also been problematic as colleagues struggle to understand the role within the current healthcare system. Conclusions. There is a significant gap between the rhetoric of policy and the implementation of Nurse Practitioner roles in rural and remote Australia. Whilst policy supports the notion of autonomy, the experiences of nurses indicate a mere shift in the traditionally-accepted boundaries of nurses' roles. Evidence from the United Kingdom and United States of America suggests that the findings in this study are relevant internationally as well as nationally.
机构:
James Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia
Charite Univ Med Berlin, CCM, Emergency & Acute Med CVK, Augustenburger Pl 1, D-13353 Berlin, GermanyJames Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia
Slagman, Anna
Harriss, Linton
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James Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, AustraliaJames Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia
Harriss, Linton
Campbell, Sandra
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机构:
James Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia
Cent Queensland Univ, Ctr Indigenous Hlth Equ Res, Cairns, AustraliaJames Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia
Campbell, Sandra
Muller, Reinhold
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James Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, AustraliaJames Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia
Muller, Reinhold
McDermott, Robyn
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机构:
James Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia
Univ South Australia, Sch Hlth Sci, Publ Hlth, Adelaide, SA, AustraliaJames Cook Univ, Ctr Chron Dis Prevent, Australian Inst Trop Hlth & Med, Coll Publ Hlth Med & Vet Sci, Cairns, Australia