Navigating professional and prescribing boundaries: Implementing nurse prescribing in New Zealand

Non-medical prescribing is now well established in a number of countries. Because prescribing has traditionally been viewed as a medical role, there are inevitable interprofessional boundary tensions when non-medical prescribing is introduced. In New Zealand, enabling legislation has allowed nurse practitioners to apply for prescriptive authority after undertaking appropriate educational preparation. This study explored the experiences and perspectives of one of the first cohorts of nurse prescribers and their strategies in establishing the role and negotiating the associated professional boundaries. Semi-structured interviews were undertaken with ten newly registered nurse-prescribers. Two broad categories, each comprising three themes, were identified: 'shifting professional boundaries' and 'navigating boundaries of practice'. Participants described how they were faced with the challenge of an unprepared environment as they began to prescribe and how they built trust in their prescribing practice among their colleagues and patients. They also related how they determined their personal prescribing boundaries in this new environment. They described the new professional relationship between nurse prescribers and doctors as collaborative, but with the crucial difference of it being interdependent, not dependent. The study offers insights into the challenges associated with the establishment of new professional roles such as prescribing.