professional context of nursing in New Zealand. Nursing as a profession has seen not only the cost corporate model being introduced to health in the nineties but has encompassed changes to how nurses are trained.
The CNL Within the New Zealand Nursing Environment
The role of CNL has and will continue to develop in response to change. The health reforms of the early 1990s resulted in a tension developing between the humanism of nursing and the managerialism expected with these changes (Bamford & Porter-O’Grady, 2000). The notable changes to the preparation to practise as a nurse in New Zealand can be traced back to the release of the Carpenter Report (1971). This report recommended transferring training of Registered Nurses from a hospital base to a polytechnic education. This resulted in the closure of the last hospital based nursing school in 1992 (Keith, Peat, & Marwick, 2001). As these authors further describe, the 1990s ushered in more rapid changes with a degree programme replacing the diploma qualification. As of 2001, all New Zealand nursing programmes leading to registration as a Registered Nurse were at degree level.
The settings and how the students of such programmes work alongside existing registered nurses have changed in response to internal and external political forces. The transfer of internal politics into policy can be exemplified by strategies such as health of older people (Ministry of Health, 2002), Maori health (Ministry of Health, 2002), and primary health care (Ministry of Health, 2001). The commitment to cultural safety and the Treaty of Waitangi as the nation’s founding document explained within the Nursing Council of New Zealand (2002) guidelines for cultural safety also direct the preparation to nurse and present practise. The Health Practitioners Competence Assurance [HPCA] Act 2003 was introduced to protect the safety of the public by providing mechanisms that ensure the life long competence of health practitioners, including nurses (HPCA Update, 2003). The Nursing Council of New Zealand, the licensing body of New Zealand nurses, released a set of competencies that Registered Nurses must satisfy in order to continue to practise. In addition to satisfying these competencies, the nurse seeking renewal of an annual practising certificate must declare hours practised and professional development.