Nurse Practitioners in New Zealand

Case Studies

Picture of Adrianne Murray.

Working life as a Nurse Practitioner in Primary Health Care Māori Health
Adrianne Murray

Background and training

I grew up in same region I practice in, the uppermost part of New Zealand known as Te Tai Tokerau (Northland). I have a deep affiliation with my Māori ancestry and come from the tribe (Iwi) of Ngapuhi and the multiple subtribes (hapu) of Muriwhenua Tika.

In 1985 I left college to start a career in nursing. I trained at Northland Polytechnic and became a registered nurse in 1987. My speciality interests were in medicine with a focus on heart disease and associated conditions. My choice was not surprising as my family has a history of early death due to heart disease, stroke and diabetes. I specialised in this field for ten years working in secondary hospital settings.

New opportunities

After this period radical changes in rural hospitals saw reconfigurations and staff redundancies. This resulted in an opportunity for me to work in primary care and allowed me to extend my specialist skills into preventative medicine having already had first-hand experience of what could befall clients. Working for four General Practitioners enabled me to explore a new context of nursing, working independently, but in a collaborative manner with medical colleagues to provide holistic care.
Picture of Adrianne by her van.

Moving into Māori Health

In 2001 I moved into Māori Health Provider services because they were looking to establish nurse led services in primary care. I recall MHPs were new, inexperienced, and greatly in need of registered health professionals to provide structure and credibility to their services. My background as a clinician and manager allowed me to establish a nursing service without too much difficulty. However during the process two challenges presented themselves: firstly, how to ensure safe clinical practice for nurses in this setting as we had no medical authority within the team; secondly, it was important to validate the work of kaupapa Māori (practices of Māori) nursing as a significant contributing factor for improving Māori health as these were the types of nursing services we offered.

Post-graduate training and Nurse Practitioner (NP) role

So, in 2002 I re-entered postgraduate studies to achieve a Clinical Masters of Nursing with a research paper in Kaupapa Māori Nursing. I then gained Nurse Practitioner status with prescribing rights in 2005. This pathway provided solutions to both challenges identified earlier. With my newfound title I began independent collaborative practice as a NP in primary care, Whānau Ora. This title describes the advanced clinical expertise of the nurse working in primary care with predominantly Māori individuals, families, or communities. I see clients in general practice collaborating in equal partnership with medical colleagues, and I also manage independent NP outreach clinics in remote rural settings. This work environment provides exposure to a range of primary care diseases as the work covers the entire aged life span. I utilise prescribing as one would a clinical tool, i.e. only when needed and only when clinically indicated. In this context prescriptive care is part of the holistic nursing paradigm. Finally, I collaborate closely with medical, nursing, community and allied health agencies because these colleagues provide clinical support for my role, as well as offering necessary referral options for the client.
Picture of Marae.

Hard work but rewarding

In closing I can only say this work is hard, but most rewarding, in little ways you see your community’s health improve for the better, and that’s got to be worth it!

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Nurse Practitioners in New Zealand

Case Studies

Working life as a Nurse Practitioner in Primary Health Care Māori Health Adrianne Murray

Background and training

New opportunities

Moving into Māori Health

Post-graduate training and Nurse Practitioner (NP) role

Hard work but rewarding

Working life as a Nurse Practitioner in Primary Health Care Māori Health
Adrianne Murray