When Ros Rowarth began as a nurse four decades ago, she never imagined she would one day be treating patients and prescribing drugs independently.
But now, after 40 years of practising as a nurse and five years of study, the Rotorua woman has qualified as a nurse practitioner and is the first one working in general practice in Rotorua. It is the highest clinical level at which a nurse can work.
It now means Ms Rowarth can prescribe a range of medication and treat acute and long-term conditions as she sees fit. While she still has doctors to go to for advice if she needs it, she no longer has to get them to sign off on prescriptions.
Ms Rowarth said that as a hospital-trained nurse, she started postgraduate study to prove to herself she was still able to think and learn. After completing her postgraduate certificate, diploma and masters, she then decided she was so close to completing the nurse practitioner qualification that she might as well do it.
The benefits of her new qualification were varied, she said.
"From a personal perspective it allows me to complete a consultation without always having a doctor involved. It doesn't mean I have to do everything by myself but I can prescribe for certain conditions."
With 27 years at Ranolf Medical Centre, Ms Rowarth said she knew her patient base well and some found it easier to talk to nurses. For the practice it meant she could step in and take acute clinics, which would be a "huge time-saver" for the doctors and improve access for patients.
Completing the qualification also allowed her to show others it was "never too late".
"I am finishing my clinical career at the highest level and that is hugely satisfying. It's a lot of extra knowledge and responsibility."
She said that had the nurse practitioner qualification been available when she started, she would probably have done it.
"When I started nursing I hadn't seen all the options and hadn't quite realised there would be a ceiling as to how far you could go."