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Do you know your clinical nurse specialist from your nurse practitioner?

Move to tighten definition of advanced nursing practice aims to end confusion about roles

Move to tighten definition of advanced nursing practice aims to end confusion about roles


Proliferation of nursing titles had led to uncertainty about who can claim advanced
practice status. ​​​​​Picture: Mike Wilkinson

The internationally recognised definition of advanced practice status could be tightened up to eliminate confusion about nursing roles.

Nurses who are clinical nurse specialists or nurses practitioners would be eligible to be called an advanced practitioner, under changes being considered.

However, the Interntional Council of Nurses says this proposal does not exclude other roles such as nurse consultant, nurse midwife and nurse anaesthesia.

Another proposal is that nurses would need a master's degree to claim advanced status. 

The ICN definition was last updated in 2002.

‘Title protection is vital’

Melanie Rogers, chair of the ICN's nurse practitioner/advanced practice nurse network, explained the update.

‘It’s about transparency,' said Dr Rogers, a primary care nurse practitioner who teaches at the University of Huddersfield. ‘Title protection is absolutely vital. Clinical nurse specialists tend to provide specialist advanced clinical practice and nurse practitioners tend to be general. Hopefully this will reduce the amount of confusion around.'

About 2-3% of the UK nursing workforce is thought to hold advanced practice status, compared to 2% in the Republic of Ireland and 6% in the United States.

Research in 2017 led by London South Bank University nurse academic Alison Leary found there were 595 different titles being used by people claiming advanced practice status.

Dr Rogers outlined the proposed changes in a speech at ICN congress in Singapore, where the advanced nurse practitioner title is protected.

Signifier of necessary skills

On the proposals for a master's degree requirement, she added: 'This is to ensure the advanced practitioner has the necessary skills of critical thinking, leadership and understanding of research and policy issues.'

The new definition, contained in a 40-page document currently out for consultation.

The ICN will host an advanced practice nursing conference next year in Canada.


Further information

ICN nurse practitioner/advanced practice nurse nursing network conference


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