From nurse education, clinical, or workforce issues through to healthy living, Nursing Review has it covered.

About 15 registered nurse prescribers have now been authorised since the new prescribing pathway came into affect last September. But numbers are expected to grow soon with the first graduates of the new postgraduate diplomas in RN prescribing due this winter. 

Nearly 70 primary health and family planning nurses from Invercargill to Whangarei are trialling a third level of nurse prescribing. The new limited level of prescribing rights – to be known as registered nurse prescribing in community health – is aimed at nurses currently using standing orders and is a step below the registered nurse prescribing in primary health and specialty teams which got underway in September last year.

After a decade in the making the bill that removes legal barriers that have hindered nurse practitioner and nurse practice was finally passed by parliament this week.

Her first script was for paracetamol but writing it herself was "still an awesome feeling", says the country's first registered nurse prescriber.

The coming into force this week of regulations allowing suitably qualified registered nurses to prescribe for straightforward conditions is "absolutely fantastic", says chief nursing officer Dr Jane O'Malley.

The new right for registered nurses to prescribe is welcomed by Professor Jenny Carryer but she also questions whether training funding is enough to meet the "huge education commitment" required.

The right for registered nurses to prescribe comes into force on September 20 and just days later applications open for nurses seeking to be the first RN prescribers.

From next week nurse practitioners will be able to join doctors and dentists in being able to issue standing orders – removing one more barrier to NP practice.

Nurses keen to be the first registered nurse prescribers are approaching Nursing Council with the first RN prescriber now likely to be authorised in October.

The first registered nurse prescriber could be signing their first script on 20 September when long-awaited RN prescribing regulations come into force.

The long-awaited 'barriers' bill is being revised after the select committee hearings proposed new amendments allowing NPs to supervise registered nurse prescribers.

Nurses have a key role in reducing the threat of antibiotic resistance that could cause 10 million deaths annually by 2050, says the new Kiwi leader of the International Council of Nurses Dr Frances Hughes.

As registered nurse prescribing inches closer, MARK JONES and JILL WILKINSON argue that prescribing innovations could be better and faster in the future if the Queen wasn't involved. They are calling for the proposed new Medicines Act to see a handover in power for deciding nursing's prescriptive authority from the Queen (i.e. the Crown) to the Nursing Council.

A second attempt to get nurse endoscopy training underway – to help boost the colonoscopy workforce prior to introducing  national bowel cancer screening – is set to start in 2016. An attempt at fast tracking nurse endoscopist training was announced in mid-2014 by then Health Minister Tony Ryall. Training was due to start early 2015 but was stalled and recently a second start date was set for 2016.

The long awaited go-ahead has been given to piloting a dedicated training programme for 20 would-be nurse practitioners in 2016.

Nursing leaders are angry and frustrated at moves to exclude nurse practitioner-led services from being eligible for general practice-only funding.

The lifting of restrictions on nurse practitioners prescribing controlled drugs like morphine and ritalin is being warmly welcomed.

Nurse practitioners could better evolve their practice to meet community needs if a proposed generic scope of practice goes ahead, says Nurse Practitioners New Zealand chair Jane Jeffcoat.

Both Treasury and the Ministry of Health are advising the new health minister to push ahead with the long awaited bill to remove barriers to health workforce flexibility.

New Health Minister Jonathan Coleman has confirmed he's following in his predecessor's footsteps in being supportive of expanded nursing roles.

More nurses could be getting the right to prescribing from early next year – if the current Nursing Council application is given Cabinet approval.

Opening up prescribing to suitably qualified nurses in primary health and other specialties is a step closer with a formal application being lodged by the Nursing Council with the Ministry of Health.

Nurses nationwide are invited to take part in a major online survey hoping to pinpoint the real differences between a staff nurse and a specialist nurse’s daily work.

Rolling out the physician assistant role based on the “sweeping conclusions” of a flawed evaluation of a flawed trial was not wise or safe, says a damning critique by nurses’ organisation NZNO.

“Get a master’s degree” is the single most important piece of career advice, believes clinical nurse specialist KATRINA O’LEARY, who discovered her love of study on arriving in New Zealand and is now contemplating her PhD.

MARIANNE TE TAU’s career to date is being guided by the philosophy of reflective practice, pursuing professional development and being patient/whānau-centred.

Can nurse-led titration of heart failure medicine make a difference? Check out this edition’s Clinically Appraised Topic (CAT).

Michele King shares a day of juggling finding respite beds, ward visits lunchtime meetings and working with frail older people and their sometimes tearful but grateful children.

The nursing sector has its collective fingers crossed that it is only months away from nurse prescribing being opened up to more than just nurse practitioners and diabetes nurse specialists, including nurses working in other long-term conditions. Nursing Review reports.

Dr ANECITA GIGI LIM looks at how NSAIDs work and in particular how using NSAIDs can increase the risk of acute kidney injury.

Venous leg ulcers (VLU) are an ‘orphan disease’ in which nurse researcher Dr Andrew Jull has a longstanding interest. He talks to Nursing Review about his team’s latest VLU research project – Asprin4VLU – his first, and one of New Zealand’s first ever nurse-led, randomised, controlled trials of a drug treatment.

New Zealand’s ageing population is experiencing an upsurge in common age-related eye diseases. Clinical nurse specialist VICKY MIYEONG YOU reports on an innovation at Greenlane Eye Centre that has seen nurses trained to deliver collaborative specialist treatment for one of these diseases – wet macular degeneration.

Nursing Review asked Health Workforce New Zealand for an opinion piece on HWNZ’s recent and future plans and on nursing’s role in that work and vision. Chair DES GORMAN and acting director RUTH ANDERSON responded.

As registered nurse prescribing inches closer, MARK JONES and JILL WILKINSON argue that prescribing innovations could be better and faster in the future if the Queen wasn’t involved. They are calling for the proposed new Medicines Act to see a handover in power for deciding nursing’s prescriptive authority from the Queen (ie, the Crown) to the Nursing Council.

Follow Cardiac NP Annette Rief as she cycles and ferries her way to a day's work helping adults manage and live with congenital heart disease.

Nursing Review updates the next steps towards widened registered nurse prescribing in, hopefully, 2016.

If I’ve learned anything from reporting on nursing over the years, it’s that many nurses are multitaskers extraordinaire. They juggle demanding workloads: raising kids and completing postgraduate study; and emerge with new skills to enhance their nursing practice and the letters PGDip, MN or even PhD after their names.

The eye is small and should be ‘pretty easy to learn’ thought ELISSA McDONALD but, an ophthalmology PhD later, the now nursing school lecturer knows how wrong she was.

Nursing mentors have been instrumental in helping clinical nurse specialist JESSICA ONGLEY along her career path towards her ultimate goal of becoming a nurse practitioner.

A positive evaluation of a Health Workforce New Zealand-funded physician assistant (PA) pilot in primary health has been released. HWNZ has no plans to take further steps to initiate a PA training programme but more US-trained PAs are being sought by practices and an application for regulation of the role is in the pipeline. FIONA CASSIE reports.

That patient with the persistent cough or wheeze may be mislabelled asthmatic. And that COPD patient prescribed a steroid inhaler may only be increasing their risk of pneumonia. Nursing Review talks to respiratory physician associate professor Jeff Garrett about misdiagnoses and misclassifications that can result in misprescribing for some airway disorders.

’Tough customers’ are now turning up for appointments more and more often since primary health care NP Jane Dutton joined Whanganui’s Castlecliff Health nearly six months ago.

Dunedin’s criminal courts are home turf for Patsy-Jane Tarrant, who recently gained a doctorate in her specialty field of forensic mental health.

A pre-diabetes education programme successfully preventing diabetes in the community is one initiative that helped lead to Palmerston North clinical nurse specialist and diabetes prescriber Tracey McNeur being nominated as a nursing hero.

More clients than ever before can consult with a nurse by phone following a new initiative that Family Planning nursing leader Rose Stewart helped develop.

Nurses nationwide are invited to take part in a major online survey hoping to pinpoint the real differences between a staff nurse and a specialist nurse’s daily work.

For a decade now, New Zealand nurses have had to declare each year that they continue to be competent to practise safely. DR RACHAEL VERNON, a leading researcher into New Zealand and other nations’ continuing competence frameworks, says such frameworks can predict and imply a nurse is safe to practise, but never guarantee.

PROFESSOR JENNY CARRYER is alarmed that after 10 years of battling barriers hindering nurse practitioners, a new contract currently being negotiated for primary health providers could create yet another barrier.

Nursing leaders are angry and frustrated at moves to exclude nurse practitioner-led services from being eligible for general practice-only funding.

The end of the year has swung around very fast.

By the end of 2014, the aim is for every New Zealander to be able to electronically access their core personal health information. This prompts new challenges and new privacy issues. FIONA CASSIE talks to nursing leaders about increasing moves to shared electronic health information, about protecting privacy and why it is important for nurses – even the IT shy – to be involved every step of the way.By the end of 2014, the aim is for every New Zealander to be able to electronically access their core personal health information. This prompts new challenges and new privacy issues. FIONA CASSIE talks to nursing leaders about increasing moves to shared electronic health information, about protecting privacy and why it is important for nurses – even the IT shy – to be involved every step of the way.

Self-declared ‘BC’ (before computers) nurse Jodie Healey, once daunted by IT, is now the e-Medication clinical liaison nurse for Southern District Health Board. FIONA CASSIE talks to her about bringing her fellow ‘BC’ nurses over to the advantages of electronic medication management at the bedside.

Dr Anecita Gigi Lim backgrounds adverse drug events for the elderly and how to avoid them.

The nursing sector’s patience has finally been rewarded with the passing of a bill that grants nurse practitioners equal prescribing status to GPs, midwives, and dentists.

Surgery can be traumatic enough for a patient without an infection setting them back weeks, months, or even disabling them for a lifetime. LINLEY BONIFACE* of the Health Quality & Safety Commission backgrounds the national campaign to prevent surgical site infections and the role that nursing plays.

Disaster veteran and nurse leader Frances Hughes shares the findings of her Fulbright research into post-disaster responses and building resilient RNs.

JO ANN WALTON* argues that the public ­­– and some health colleagues – still need to be educated on the vital role of both “essential” and “inessential” nursing care.

We look to nurses as learners, educators, and leaders in this edition. Read on about teaching fledgling nurses in the classroom and on the ward, fostering leadership skills, nurses sharing their career tales, and milestones past and future in the recognition of competence and professional development.

Some call it the biggest revolution for New Zealand nursing since training left hospitals. A decade since the first Kiwi nurse practitioner was authorised to prescribe, the Nursing Council is proposing the long-awaited widening of prescribing to registered nurses. Prescribing is the buzz. Along with cries of “at last” and “fantastic”, there is a desire to get it right from the outset if the country wants more RNs to leave the protection of standing orders and become prescribers in their own right. FIONA CASSIE reports.

Far North nurse practitioner Adrianne Murray is the pragmatic but passionate face of nurse prescribing. FIONA CASSIE talks to the country’s second ever-prescribing NP about doing the groundwork to be a prescriber.

Paula Renouf became the country’s first nurse prescriber in June 2003. Nursing Review caught up with her on travelling sabbatical in the United States’ Pacific North West and asked her to reflect back on the decade that’s followed.

Diabetes nursing managed to ‘jump the gun’ to RN prescribing with a successful demonstration site. Next off the starting blocks is expected to be respiratory nursing. FIONA CASSIE looks at some specialist areas and their likely prescribing ambitions.

One issue that prescribing reform will hopefully improve is the current grey area over when a nurse is ‘advising’ or ‘prescribing’ an over-the-counter (OTC) medicine like paracetamol.

To celebrate International Nurses Day this year Nursing Review invited district health boards across the country to contribute stories on nursing ‘heroes’ in their region. We got stories back on just some of the unsung, innovative, compassionate, high achievers and dedicated nurses that make up the New Zealand nursing workforce.

We look at a day in the life of Sue Glover - one of the country's new Registered Nurse First Surgical Assistants working with mostly children before, during and after their heart surgery.

NICOLA RUSSELL vents some frustration that in 2013 general practice is still largely “business as usual” despite the optimistic rhetoric of the 2001 Primary Health Care Strategy. She also calls for input into an upcoming College of Nurses workshop for nurses keen to explore developing primary health care nursing services.

Des Gorman rejects nursing criticism that HWNZ’s innovations have been poorly planned and taken a fragmented approach.

The first primary health nurse to gain formal recognition for her mental health nursing skills has been credentialed and others are due to follow.

A nurse practitioner survey found five of the country’s NPs are still hunting for NP positions.

All non-prescribing nurse practitioners may have to upskill to be prescribers within two years to align with new legislation.

Understand the Trans-Pacific Partnership Agreement (TPPA) FIONA CASSIE finds out more from public health campaigner Deborah Gleeson on why she believes nurses should know more.

Sonia Gamblen talked to 13 clinical nurse managers about the often ad hoc and haphazard path from bedside nurse to ward leader. Her research findings prompted a call for improved leadership and management training for nurses and her own local solution.

Nursing opposition to the proposed delegated prescriber role has been tempered by amendments proposed by the Health Select Committee to the Medicines Amendment Bill.

Sharon Myoji Schnare, a United States-based family and women’s health nurse practitioner addressed the recent primary health care nurses' conference* about the brave new world opening up to nursing.

Anxious patients with chest pain who used to wait up to 100 days for review at Counties Manukau District Health Board are now being seen in less than 20 days.Nearly half of heart attack patients who used to wait up to six months for a cardiologist review are now seeing a nurse practitioner or CNS instead. FIONA CASSIE talks to cardiac nurse practitioner Andy McLachlan about the difference nurse-led clinics are making.

If your car is your home, it’s tough getting diabetes under control. FIONA CASSIE looks at a whānau ora approach to chronic conditions at one of the country’s first whānau ora centres.

Lyvia Marsden brings 50 years of nursing to the ‘non-nursing’ whānau ora model she developed for North Shore’s Te Puna Hauora. FIONA CASSIE talks to the president of the National Council of Māori Nurses and other Te Puna nurses about their approach to chronic conditions and whānau ora. And how nurses can't be all things to all people.

Sue Schroder walks to work knowing her twin pre-schoolers are in her husband's good hands.  She then sets to work with the mostly young women clientele providing information and support on contraception to STIs...

After more than two decades of nursing, enrolled nurse Kay Bone has recently stepped up into a new time-saving role for West Coast capsule endoscopy patients and has been endorsed at an “accomplished” level of practice. FIONA CASSIE finds out more.

RRR PROFESSIONAL DEVELOPMENT ARTICLE: The rhetoric around self-management for people with long-term conditions recognises that they themselves are the most concerned and constant contributor to their own care and that what they know is an untapped resource. At the same time, professionals are being advised to share decision-making, but does this go far enough? For the person living with a long-term condition, part of their work is to manage relationships and interactions with an array of health professionals and other helpers – amongst them, nurses. Just as professionals look for interest and engagement from those they care for – whether identified as patients, clients, consumers, or service-users – that expectation is mutual. In this learning activity, we’ll look at what shared decision-making means, especially for people with long-term conditions*.*

Creative nursing approach to improving medication safety: Wairarapa DHB

RRR PROFESSIONAL DEVELOPMENT ARTICLE: There’s a rather wonderful and instructive irony in the celebration of International Nurses Day – the anniversary of Florence Nightingale’s birth – with the theme for 2012 of ‘Closing the gap: From evidence to action(1). Nightingale represents anything but a gap between evidence and action. Described by her first biographer as a ‘passionate statistician' (2), she was not only a researcher and research user but also a designer of research graphics (3). Her successes in reforming military health services and standardising hospital statistics (3) are exemplars of how to use evidence to drive improvements in practice. In this learning activity, we’ll explore our contemporary responsibilities and opportunities for bringing evidence to everyday nursing decision-making and actions.

Prison nurse LOUISE CHA reports on the challenge of helping an estimated 80 per cent of prisoners quit when smoking was officially banned in prisons last winter.

It has taken a decade of hard work, lobbying, frustration and personal sacrifice to build a critical mass of 100 NPs.Nursing Review marks the milestone by asking nursing leaders to reflect on the role’s past and future and by profiling the work of some NPs.

Night duty on the PAR team sees Sarah Imray wake to the sound of her children back from school and return home to wave them off to school.  In between she is called out across Wellington Hospital to patients recently discharged from ICU to patients with alarmingly high EWS (early warning scores).

By Taima Campbell, co-chair (Maori Caucus) of College of Nurses Aotearoa and former Auckland DHB director of nursing

Nursing organisations are giving a firm thumbs-down to the new delegated prescriber role proposed in the Medicines Amendment Bill.

Patch protection a barrier to physician assistants by Fiona Cassie

News briefs including: More nurses in schools/ Oz aged care package get nurses’ backing/  Innovative RNFSA and HCA training underway/ NZ hospital productivity ‘bucks trend’/ Toolkit to improve elective patient flow/  New ACC patient handling guidelines/ Strong cultural life enhances Māori elders

FIONA CASSIE talks to recent Florence Nightingale medal winner Andrew Cameron about the momentous and mundane of being a Red Cross nurse.

A pilot of prescribing by diabetes nurse specialists was safe, effective, and popular with patients according to a newly-released evaluation report

*Kathy Holloway’s timely PhD research has helped shape New Zealand’s first national process for endorsing specialty standards. Fiona Cassie reports.*

Final sign-offs are close for both a new registered nurse scope of practice and the profession’s new process for endorsing specialty standards.

A trial of diabetes nurse specialists with prescribing rights is a step closer with a special regulation proposal now on the agenda. The fate of the proposed pilot hung in the balance late last year as ways forward appeared hampered by legislative barriers under the Medicines Act.

American-trained physician assistants are to be recruited for a pilot of the role at Counties Manukau District Health Board in early 2010.