Advanced nursing practice: a review of scopes of practice in cancer care
The establishment of advanced nurse practitioners (ANPs) has expanded considerably in recent years and shown to result in substantial contributions to numerous fields of health care. Due to advancements in treatments and innovations in medicine, patients with cancer are living longer, requiring a multifactorial holistic approach in which ANPs, due to their skills and knowledge, can be best utilised, as they are able to provide the expert care required at various stages of the patient journey. This article explores scopes of practice from ANPs working with oncology patients in a tertiary cancer centre, making explicit their roles, in addition to highlighting experienced challenges and future directions of care.
Since the birth of the NHS in 1948 the health needs of the UK population have continued to become increasingly complex, partly due to an ageing population (Barnett et al, 2012), higher healthcare costs and, more recently, increased pressures due to the COVID-19 pandemic (Hooks and Walker, 2020). Consequently, and in response to population needs, over the past few decades the NHS has seen the introduction of new roles, such as that of advanced nurse practitioners (ANPs), to improve standards of care and optimise service delivery (NHS England/NHS Improvement, 2019).
Advanced practice is recognised by the Royal College of Nursing (RCN) as a distinctive level of practice encompassing direct care provision, education, research and leadership – seen as the four pillars of advanced practice (RCN, 2018a). Practising at advanced clinical level involves autonomy and decision-making against a background of complexity, uncertainty and unpredictable risk, while taking accountability for actions undertaken (Health Education England, 2017; International Council of Nurses, 2020).
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