Jenny Carryer

Massey University · School of Nursing

Background For more than a century, Māori have experienced poorer health than non-Māori. In 2019 an independent Tribunal found the Government had breached Te Tiriti o Waitangi by “failing to design and administer the current primary health care system to actively address persistent Māori health inequities”. Many Māori (44%) have unmet needs for pri...

Aim To develop a framework to guide the successful integration of nurse practitioners (NPs) into practice settings and, working from a social justice lens, deliver comprehensive primary healthcare which advances health equity. Design Integrative review. Methods The integrative review was informed by the Whittemore and Knafl's framework and follow...

Background For more than a century, Māori have experienced poorer health than non-Māori. In 2019 an independent Tribunal found the Government had breached Te Tiriti o Waitangi by “failing to design and administer the current primary health care system to actively address persistent Māori health inequities”. Many Māori (44%) have unmet need for prim...

Ongoing advocacy and action over the past two decades have resulted in a broad and permissive scope of NP practice in New Zealand. As numbers of NPs rise, the potential of the NP role is being realized in national workforce policy, acknowledging the contribution NPs make to healthcare delivery, particularly in the face of burgeoning long-term condi...

Background Primary care in Aotearoa New Zealand is largely delivered by general practices which are heavily subsidised by government. At least seven models of primary care have evolved: Traditional, Corporate, Health Care Home, Māori practices, Pacific practices, and practices owned by Primary Health Organisations/District Health Boards and Trust/N...

Background Māori are over-represented in Aotearoa New Zealand morbidity and mortality statistics. Other populations with high health needs include Pacific peoples and those living with material deprivation. General practice has evolved into different models of primary care. We describe nurse work in relation to these models of care; populations wit...

Little is known about the working conditions of nurse practitioners (NPs) in primary health care in New Zealand. Data were collected using an online organizational climate questionnaire from NPs and managers who employed NPs. Nearly two-thirds of all primary health care NPs in the country (n ¼ 136) responded together with a purposive sample of 58 m...

INTRODUCTIONEstablishing the nurse practitioner (NP) workforce in New Zealand is a viable solution to health and workforce challenges in primary health care. General practices have been slow to implement NP services. Managers of general practices are central to the employment and development of NP roles. AIMTo explore the perspectives of managers o...

The implementation of the nurse practitioner (NP) workforce in primary health care (PHC) in New Zealand has been slow, despite ongoing concerns over persisting health inequalities and a crisis in the primary care physician workforce. This article, as part of a wider institutional ethnography, draws on the experiences of one NP and two NP candidates...

AIM: The aim of the survey was to describe the demographics, distribution, clinical settings and employment arrangements of the New Zealand nurse practitioner workforce in primary healthcare settings; and organisational factors limiting their practice. METHOD: An online survey was developed and sent to all NPs in mid-2019. RESULTS: The survey was c...

Using a convenience sampling, nurse educators representing 10 countries were surveyed to describe required clinical education for advanced practice beyond basic traditional nursing education. This article explores the many factors currently influencing the structure and diversity of these clinical experiences worldwide.

Nursing has long articulated our advocacy role, our closeness to people's life experiences , our commitment to holism , our desire to have greater autonomy over our practice, to be free of medical dominance and managerial ignorance and above all to be at the table where decisions are made (Clendon, 2019; Daly, Jackson, Anders, & Davidson, 2020; Sal...

Nurse practitioners in New Zealand are regulated as advanced practitioners who are fully authorized prescribers working independently or in collaborative teams. The NP role carries no requirements for oversight, supervision, protocols, enforced or formal collaboration nor limits to prescribing. In this regard, NPs have an enviable amount of freedom...

Understanding the lived realities of Māori patients with long-term health conditions (LTCs) is essential if the health system in Aotearoa New Zealand is to eliminate current Māori health disparities and support Māori patients appropriately. Culturally responsive researchers can gain insights by ensuring the inclusion of Māori participants in resear...

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...

INTRODUCTION The prevalence of long-term health conditions (LTCs) continues to increase and it is normal for people to have several. Lifestyle is a core feature of the self-management support given to people with LTCs, yet it seems to fail to meet their needs. From a larger study exploring the experiences of this group, this paper reports on the ro...

Objectives: The study aimed to explore how people with complex, established co-morbidities experience long-term condition care in New Zealand. Despite the original conception as appropriate for people with early stage disease, in New Zealand the self-management approach dominates the care provided to people at all stages of diagnosis with long-ter...

Background There is a wealth of international evidence concerning the contribution post‐registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional...

Objectives The aim of this study was to describe the experience of people with multiple long-term conditions with particular reference to the notion of the ‘expert patient’ in the context of self-management. Methods A multiple case study of 16 people with several long-term conditions, included interviews and contacts over an 18-month period and an...

Background: A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The la...

AIM This exploratory qualitative study provides insight into E-portal use in rural primary care. INTRODUCTION As of February 2017, almost 300,000 New Zealanders were using E-portals, offered in over 455 general practices. Patient portals are intended to give patients convenient and secure electronic access to their health information and increase t...

Pressure injuries, incontinence, malnutrition, and falls are important indicators of the quality of care in healthcare settings, particularly among older people, but there is limited information on their prevalence in New Zealand (NZ). The aim of this study was to establish the prevalence of these four problems among older people in nursing home fa...

Aims: To outline the way in which the culture of austerity arising from the Global Financial Crisis has been used by Australian and New Zealand governments to maintain and extend health care budget cuts, through new public management strategies leading to missed nursing care. Background: Ten years on the cost of the Global Financial Crisis conti...

In 2012, the lead author, Sue, commenced doctoral study to critically examine the establishment of nurse practitioner services in rural primary health care in New Zealand using institutional ethnography, under the supervision of Jenny. There is an identifiable need for a nurse practitioner workforce, yet the growth has been slow. The research proje...

Objective: To consider the alignment of the Nurse Practitioner (NP) role in NZ with the goals and aspirations of the many countries facing challenges to maintaining health service delivery and reducing health disparities. Methods: Data was collected as a component of a larger institutional ethnography but for this paper was thematically analysed to...

INTRODUCTION: Chronic care Model (CCM) aims to make the care of people with long term conditions (LTC) planned, proactive and patient-centred. The patient assessment of chronic care (PACIC) and our recently developed modified PACIC (MPACIC) allow patient and provider views to be compared. AIM: To explore the use of measures of care provision and re...

In crisis situations, the authority of the nurse is legitimised by legal powers and professional knowledge. Crisis stakeholders include those who directly use services and their families, and a wide range of health, social service and justice agencies. Alternative strategies such as therapeutic risk taking from the perspective of socially inclusive...

The nurse practitioner role is transformative in primary health care delivery, addressing unmet health care needs worldwide. The lack of role standardization inhibits the nurse practitioner's ability to cross borders for meaningful practice and scholarly exchanges, to conduct transnational research, and transform health care. This lack of standardi...

To analyse the reporting structures of nursing leaders of publicly funded hospitals and seek both the views of nurse leaders and Chief Executive Officers/Chief Operating Officers on the structural positioning of nurse leaders in the organisation. Concern that the continuing restructuring within hospital structures and focus on economic outputs in h...

In New Zealand, as in many other countries, the demand for health services is escalating as chronic disease, population ageing and health disparities increase. It has been argued that a more comprehensive primary health care approach is needed combining biomedical approaches with a social determinants and social justice based approach. The contempo...

This article introduces institutional ethnography as a valuable approach to sociological inquiry for health and nursing research in New Zealand. Institutional ethnography has gained increasing prominence across the world because of the potential transformative nature of the research. Institutional ethnography explores how everyday activities and ex...

In New Zealand, as in many other countries, the demand for health services is escalating as chronic disease, population ageing and health disparities increase. It has been argued that a more comprehensive primary health care approach is needed combining biomedical approaches with a social determinants and social justice based approach. The contempo...

Rationalised economic cultures are characterized by a preoccupation with production efficiency and control of business practices through scientific management techniques. Nursing practice is profoundly affected by these techniques and rationalised nurse work environments threaten the well-being of nurses and patients. Healthcare managers pursue cos...

Purpose - Care coordination for patients with chronic conditions is one aim of an integrated health care delivery system. This article compares findings from two separate New Zealand studies and discusses the implications of the results. Design/methodology/approach - We describe and discuss use of the Patient Assessment of Chronic Illness Care Mea...

To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes n...

The Diabetes Get Checked programme provided a free annual diabetes check to people diagnosed with diabetes. The aim of the present study was to ascertain the impact this programme had on the practice of nurses; identify factors that nurses consider contributed to the success or failure of the programme in their work setting; and to elicit nurses' s...

To determine if carbon dioxide (CO2), insufflated during colonoscopy reduces pain experienced by patients post colonoscopy compared to air. A randomised, double-blinded, controlled trial with 205 consecutive consented patients referred for elective colonoscopy was undertaken at MidCentral Health Gastroenterology Department. Patients were randomised...

Numerous studies report high levels of stigma and discrimination experienced by obese/overweight women within the health care system and society at large. Despite general practice being the most utilised point of access for health care services, there is very little international or national exploration of the experiences of large-bodied women (LBW...

A large number of people live with chronic, non-malignant pain, which impacts on their work, social activity and quality of life. For many people pain appears to be inadequately treated and controlled, in part due to a reluctance to take appropriate medication. The aim of this study was to learn more about people's experience of pain in the context...

This qualitative study was focused on the landscape of nursing policy and political leadership in New Zealand. A volunteer sample (N = 18) of nurse leaders (Fellows of the College of Nurses Aotearoa (NZ) Inc) drawn from across the country was interviewed with respect to issues that affect their interest in participating in political action and poli...

Caesarean section in the absence of need: a pathologising paradox for public health? This qualitative study explored the discourses constructing women's choice for a caesarean section, in the absence of clinical indication. The research was informed from the theoretical ideas of poststructuralism that presumes people's reality is shaped discursivel...

Despite a 10-year history of nurse practitioner (NP) development in New Zealand (NZ) there is no formalised or universal process for ensuring the transition of willing nurses to NP status. This unmet need is of particular interest in the rural context where workforce issues are paramount. The aim of this study was to explore the transition from rur...

This viewpoint is written from the dual perspectives of a metabolic biochemist and a nurse academic who met at the Oxford University Round Table Forum on Obesity in 2008. Forty invited participants from around the world spent a week presenting and debating research and practice in the area of obesity. A unique feature of this forum was that it was...

Health policy reforms in New Zealand during the 1990s impacted on hospital operations, on the nursing workforce, and on patients. This study analyses changes in rates of 20 adverse patient outcomes that are potentially sensitive to nursing (OPSNs) before (1989-1993), during (1993-2000), and after (2000-2006) the policy reforms, using all New Zealan...

This article reports research reviewing the configuration of nursing leadership in New Zealand public hospitals. It represents an analysis of Phase 1 of a larger study. Leadership in nursing is critical if the profession is to meet the challenges of health services in the 21st century. The research focuses on how leadership in public hospitals is s...

The Patient Assessment of Chronic Illness Care (PACIC) is a widely used 20-item measure consisting of five subscales. Published factor analyses of PACIC scores have produced conflicting results on the measure's factorial validity, and therefore some confusion as to the utility of its subscales. We aim to reduce this confusion by reviewing the evide...

Rationale, aims and objectives The Patient Assessment of Chronic Illness Care (PACIC) is a widely used 20-item measure consisting of five subscales. Published factor analyses of PACIC scores have produced conflicting results on the measure's factorial validity, and therefore some confusion as to the utility of its subscales. We aim to reduce this c...

In line with Wagner's Chronic Care Model, the Patient Assessment of Chronic Illness Care (PACIC) has been developed to evaluate chronic illness care delivery from the patient's perspective. Modification of the instrument to assess the same aspects of care delivery from the health practitioner's perspective would enable individual practitioners to e...

Providing care for people with chronic illness is a major issue for health practitioners around the world, especially as populations age. Encouraging self-management is beneficial in terms of relieving the burden on the health system and promoting better health and adherence to medication and advice amongst this group. To measure the level of self-...

Over the last 20 years significant advances in the management of pain have been made. Specifically, establishment during the 1990s of Acute Pain Services (APS) within hospitals both nationally and internationally resulted in improved awareness and management of pain. However there has been little research into staff satisfaction with the service, a...

To examine issues related to the working life of registered nurses in residential care for older people in New Zealand, 48 registered nurses completed surveys (n = 28) or participated in discussions (n = 26) regarding their work roles, continuing education and interactions with specialist nurse services when providing care for older people living w...

The professional practice environment of hospital-based nurses has been the focus of considerable attention over the last few decades. More recently, attention has been paid to the community nursing environment, and this study considers the context of public health nursing in New Zealand. Aim: The purpose of the study was to identify the organizati...

Effective nursing practice requires the ability to recognise emotions and handle responses in relationships with clients and their families. This emotional competence includes nurses managing their own emotional life along with the skill to relate effectively to the multiple colleagues and agencies that nurses work alongside. The research was desig...

This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing...

Body size has come to be regarded as a major problem facing many countries in the 21st century. Whereas variations in height, hair colour and other bodily differences are simply accepted as normal human diversity; variations in body size are considered differently. Large body size is now firmly identified and labeled as overweight or obese and we a...

Professional Development and Recognition Programmes (PDRP) for nurses have developed out of the Clinical Career Pathways (CCP) of the 1990s. The Health Practitioners Competence Assurance Act (2003) has now required all health professionals to provide evidence that their practice meets criteria set by the individual regulatory body, which, for nursi...

To date nursing research exploring the relevance of the practice environment has focused substantially on the experiences of hospital-based nurses. More recently greater attention has been paid to the community nursing environment and nurses involved in primary health care. This study considers the context of public health nursing in New Zealand, f...

To draw on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. Enacted legislation provides for mutual recognition of qualifications, including nursing, between New Zealand and Australia. As the nurse practitioner role is relatively new in both countries, there is no consistency in role expectation an...

Nurse practitioners will become a vital component of the health workforce because of the growing need to manage chronic illness, to deliver effective primary health services, and to manage workforce challenges effectively. In addition, the role of nurse practitioner is an excellent example of increased workforce flexibility and changes to occupatio...

The objective of this study was to conduct research to inform the development of standards for nurse practitioner education in Australia and New Zealand and to contribute to the international debate on nurse practitioner practice. The research was conducted in all states of Australia where the nurse practitioner is authorised and in New Zealand. Th...

The title, Nurse Practitioner, is protected in most jurisdictions in Australia and New Zealand and the number of nurse practitioners is increasing in health services in both countries. Despite this expansion of the role, there is scant national or international research to inform development of nurse practitioner competency standards. The aim of th...

This exploratory/descriptive study describes the memories of former ICU (Intensive Care Unit) patients after discharge. Six patients described their memories of ICU and discharge to the ward and home. Memories for the former ICU patients varied, and there were multiple layers of awareness, with periods of unreal experiences and nightmares. In the m...

Health benefits associated with being active are well recognised and yet for many, particularly women at midlife, how this activity is maintained is both complex and poorly understood. This paper describes a qualitative feminist study in which 10 midlife women participated in two semi-structured interviews to explore factors influencing their abili...

Cultural safety education is a concept unique to nursing in New Zealand. It involves teaching nursing students to recognize and understand the dynamics of cultural, personal, and professional power and how these shape nursing and health care relationships. This article describes the findings of a research study on the experience of teaching cultura...

To determine whether hospital-based, home care, and district nurses identify a core set of organizational attributes in the nursing work environment that they value as important to the support of professional practice. Survey data, collected in 2002-2003 from 403 home care nurses in the United States (US) and 320 district nurses in New Zealand (NZ)...

Using 'social cognitive' frameworks, attitudes to HRT have been examined as if they were stable entities located within individuals. However, qualitative studies have revealed variations and contradictions in women's 'attitudes'. We seek to explain these apparent contradictions by using a social constructionist approach to the analysis of qualitati...

The ANMC Nurse Practitioner Standards Project History of the project The advent of the nurse practitioner role in Australia signifies an historic development with the extension to the scope of professional nursing practice that has been long awaited. The nurse practitioner will fulfil a pivotal role in contemporary health service teams in varied c...

The myth of medical liability for nursing practice is widespread among doctors, nurses and the public at large. This myth is promulgated by the medical profession in various forums and is an artefact of the lingering stereotype of nurse as “handmaiden”. In fact, nurses are autonomous practitioners who do not require supervision by other health prof...

Health correlates of autonomy, control and professional relationships in the nursing work environment Background. Internationally, nursing is facing a variety of challenges including changes in health systems, an ageing workforce and escalating shortages of Regis-tered Nurses. New Zealand is no exception. Here as elsewhere these challenges are taki...

Background. Internationally, nursing is facing a variety of challenges including changes in health systems, an ageing workforce and escalating shortages of Registered Nurses. New Zealand is no exception. Here as elsewhere these challenges are taking their toll on the resources and demands of hospital environments, on the health and well-being of nu...

Clinical Career Pathways (CCPs) for nurses were introduced in the 1970s and they were first established in New Zealand during the late 1980s. The implementation of CCP programmes has met with mixed response; many nurses view it negatively as an extra and unnecessary demand from their employers while others perceive it to be a valuable form of profe...

The use of hormone replacement therapy (HRT) involves complex decisions for mid-aged women owing to controversy about the meaning of menopause and uncertainty regarding risks and benefits. Qualitative studies show that women can hold apparently contradictory beliefs, for example, both resisting and relying on medicalization. Focus group data (48 pa...

This paper describes a three-year long research project in which nine large-bodied women have engaged in a prolonged dialogue with the researcher about the experience of being ‘obese’. The study involved an extensive review of the multidisciplinary literature that informs our understandings of body size. The literature review was shared with partic...

This article focuses on trafficking of young Nepalese girls and women. Trafficking is an integral part of the social and economic fabric of Nepal, as in other parts of the world. The practice causes intolerable degradation and suffering for the girls and young women involved, who are treated as a commodity. It presents a risk to their physical and...

Infertility is an issue for men and women but it is women who experience the majority of the diagnostic and treatment procedures. Nurses and midwives care for women in a variety of settings in which infertility is managed. This management is currently characterised by an escalation in related technologies and there is the potential for prolonged an...