New Zealand has more people living with long-term health conditions, an increasing older population and health inequalities that continue to persist, particularly for Māori and poorer communities. But despite the declining rural medical workforce, New Zealand has been slow to develop nurse practitioner services.
In her thesis, Dr Sue Adams, a senior lecturer at Massey University's School of Nursing, explored the experiences of rural nurses on their journey to becoming nurse practitioners.
Dr Adams, who graduated with her Doctor of Philosophy last week, researched how the development of nurse practitioners in rural communities was restricted by the structure and organisation of health services, including general practice.
Internationally, it has been demonstrated that nurse practitioners are an effective and appropriate health workforce delivering primary health care services to underserved and rural populations.
Dr Adams' research identified that fragmented health service organisations, and the ongoing policy commitment to doctor-led care, limited the opportunity to improve primary health care services through using nurse practitioners to meet the health needs of rural communities.
Dr Adams was surprised by how much frequent policy changes, both nationally and locally, derailed the development of the nurse practitioner workforce.
"Much time, energy and money is wasted endeavouring to maintain the status quo of doctor-led health services, rather than embracing a nursing workforce that has the enormous potential to transform primary health care services, increasing both access and health outcomes.
"The findings challenge health policy makers and funders to incorporate clear plans to develop the nurse practitioner workforce as a cost-effective solution for New Zealand and an obvious solution to the current crisis around rural and small town services as the GP workforce disappears."
Dr Adams holds an honours degree with registered nurse training and completed a Master in Science in Nursing at Kings College London, United Kingdom. She has also completed further postgraduate study at Oxford Brookes University, United Kingdom, the University of Auckland, and AUT. She lives with her husband in Albany on Auckland's North Shore, and has three adult children and two grandchildren.