Advances in nursing practice

Advanced nurse practitioners make an important contribution to the NHS by assessing and managing seriously sick and injured people every day.

Their role is distinct from that of emergency nurse practitioners, and national guidance from the Royal College of Nursing and the Royal College of Emergency Medicine provides definitions of advanced practice to meet NHS service needs.

Advanced nurse practitioners’ scope of practice is wide-ranging and their proficiency is underpinned by in-depth theoretical knowledge and lengthy practice-based training.

Night duty brings specific challenges to advanced practitioners who work alongside fewer staff and may develop a sense of professional isolation. This is compounded by patients’ challenging behaviours, such as alcohol or substance use, suicide and para-suicide, and aggressive outbursts.

The article by Jennifer Jenkins explains the sequence of events during one night shift when she was required to assess, manage and care for a range of patient presentations.

She had to make critical, informed decisions about patients’ conditions and welfare to avoid long delays in treatment, transfer and discharge.

As Ms Jenkins makes clear, the advanced nurse practitioner role is of enormous value to the nursing profession, and can be immensely satisfying to those who achieve it.