Untie my hands: the nurse practitioner, the restriction-freedom paradigm and legal implications of practice

Untie my hands: the nurse practitioner, the restriction-freedom paradigm and legal implications of practice

The role of the nurse practitioner has been established in Australia since 1996 (Driscoll et al. 2005). During this time it has also been established that nurse practitioners provide a service that fills a gap in service provision (Gardner 2004). Nurse practitioners in Australia have proved themselves to be clinical experts in their chosen nursing field (Gardner 2004).

In 2006 (RCNA 2006), an article stated that in order to fulfil their role nurse practitioners argued that their hands were tied due to the need for strict adherence to clinical practice guidelines and protocols. They argued that a nurse practitioner's ability to use clinical judgement was inhibited by the need for strict adherence to clinical practice guidelines and protocols.

The above statements going to press provided the roots of this study, beginning with an historical-comparative examination of the emergence of the nurse practitioner role in five countries: USA, Canada, United Kingdom, New Zealand and Australia. These findings were compared using analytical comparison in relation to education, registration, regulation, legal and professional issues and future possibilities.

Field research examined the world of the nurse practitioner as seen through the eyes of four nurse practitioner participants in order to gain insight into this world, assisted by a qualitative interpretative approach and methodological theory. Data was collected from structured in-depth interviews using open ended questions.

Thematic analysis of the data, alongside nurse practitioner research, revealed that to allow less stringent adherence to clinical practice guidelines would seem unlikely at the present time. Important issues that are apparent in preventing this less stringent approach include the need to ensure that nurse practitioners are fully aware of the Ipp Reforms enacted into Civil Liabilities legislation in 2005 and the relevance of other Torts in the daily clinical practice of the nurse practitioner. This would ensure that all nurse practitioners are more knowledgeable about these important areas of law.