Our findings related to the practice domain of professional
efficacy speak to the centrality of a nursing model of NP
practice enhanced by the facility for autonomous decision
making in clinical care. Nursing in Australasia has for a long
time expressed concerns that development of the NP role
extends nursing along a continuum towards medicine (see
Litchfield 2002). Certainly, in Australasia, sectors of the
medical profession have expressed concern on this issue. Such
a view presupposes that the knowledge continuum is hierarchical,
with medical ability as a pinnacle of achievement and
secured at the expense of nursing ability. Carryer (2002)
argued that tasks do not define a discipline; instead, it is the
philosophical approach guiding practice which determines
the nature of the discipline. This latter view is borne out by
participants’ responses to questions about the nature of their
role. Almost all participants made a clear distinction between
their approach and attitude to practice and the incorporation
of tasks previously outside the scope of nursing practice.