ABSTRACT
Advanced Nurse Practitioners comprise one solution to current health system challenges. However, confusion about their contribution results in their role being underutilised. This situation gives rise to three central questions addressed in the chapter by applying a systems and discourse analytic perspective to a range of texts: What do the discourses circulating in the healthcare system tell us about medicine and nursing? How do the relationships and processes that characterise healthcare systems constrain and enable Advanced Nurse Practitioners? Are other ways of being, doing, knowing and relating possible? Findings suggest that advanced nursing practice is defined with reference to medicine and is constructed as ‘inferior’, not advanced, underpinned by a knowledge base with less influence and impact than medical knowledge(s). Discursive monopolising of caring is evident, while medical doctors are positioned as authority figures whose relationships with Advanced Nurse Practitioners are based on control and characterised by perceptions of a threat to doctors’ influence and professional identity. Advanced Nurse Practitioners should be sensitive to language-in-use, how it shapes them and how they can shape it to better represent their role, the value that it adds to the healthcare system and how it complements the roles of other healthcare professionals.
