Nursing levels: update on what counts as advanced practice
Posted 14 May 2024 - 11:56
New definitions in professional framework aim to end ambiguity that can limit careers, with clear interpretation of advanced, enhanced and consultant nursing levels
New definitions of advanced, enhanced and consultant nursing levels are being issued by the RCN to provide a consistent interpretation of the roles.
Although advanced-level nursing is widely recognised, it has lacked a consistent definition from employers, covers a wide range of roles and titles, and remains unregulated. By updating the definitions in the RCN professional framework (see box below), the college hopes to bring ‘clarity and consistency’ to nursing practice and remove ambiguity that it says can limit nursing staff in their career.
Increased complexity of nursing ‘poorly recognised by employers, policymakers and the public’
The Nursing and Midwifery Council (NMC) passed a motion in March to develop an approach to regulate advanced practice, following recommendations from health think tank the Nuffield Trust. A public consultation will be launched later.
RCN professional nursing committee chair Rachel Hollis said: ‘Beyond the point of registration, the work of the registered nurse increases in its complexity. This is inconsistently and poorly recognised by employers, policymakers and the public.
‘We set out to change this, and a working group, made up of expert members and staff from the RCN nursing department, has come together to clarify and bring consistency to the levels of nursing practice.’
Spelling out the levels of nursing practice beyond registration
Enhanced
- Enhanced-level nursing can only be delivered by registered nurses who have gained additional post-registration education and experiential learning in a relevant subject area
- This level is differentiated by a registered nurse’s expertise in applying specific knowledge and skills to a designated area, such as a client group, skill set or in an organisational context. Nurses working at the enhanced level should know how to manage discrete activities in complex, challenging and changing situations, seeking further guidance when needed
Advanced
- Advanced-level nursing is delivered by registered nurses with substantial experience and expertise
- The advanced level is differentiated by a registered nurse’s expertise in applying highly developed theoretical and practical knowledge to complex, unpredictable and sometimes unfamiliar situations. This involves use of critical thinking, high-level decision-making and exercising professional judgement
Consultant
- Consultant-level nursing describes a level of nursing delivered by registered nurses who have progressed from an advanced level in their field or specialty
- It is differentiated from other levels by a registered nurse’s expertise and credibility; strategic and enabling leadership; learning, developing and improving across the system; research and innovation as an embedded researcher; and underpinning consultancy as the foundations of putting expertise in place to sustain quality
Source: RCN – Levels of nursing
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