I am very near completion of my masters in advanced nursing practice. Over the last few years, the advanced nurse practitioner (ANP) role has brought about confusion about what the role entails compared with specialty nursing. This made me ask myself: ‘Will my title change again once I gain my qualification?’ ‘Will this alter my professional identity?’ ‘Should I be using it now?’
I also started to wonder if this advanced role will take away specialism. Can I really be both? How can I make this role work within outpatient parenteral antimicrobial therapy (OPAT)/intravenous (IV) therapy and vascular access?
There are position papers about ANP roles and a lot of articles examining the changes and differences with speciality nursing. Cooper et al (2019) reiterated that there is a lot of overlap within the roles. They stated that the ANP role is more general than specialist and level of education was found to be a key descriptor in the definition.
Advanced practice is a level of practice, rather than a type of practice. ANPs are educated at masters level and have been assessed as competent in practice using their expert clinical knowledge and skills. They have the freedom and authority to act, making autonomous decisions in the assessment, diagnosis and treatment of patients (Health Education England, 2017; Royal College of Nursing (RCN), 2018).
The differentiation centres on the focus of the role. ANPs focus on managing whole episodes of clinical care, whereas specialist practitioners focus on discrete aspects of a patient's care.
The following criteria underline the importance of the educational preparation for the role, if negligence claims and law suits are to be avoided:
This poses the question: how can we keep our clinical nurse specialty, especially in IV therapy? Clinical nurse specialists (CNSs) are expert clinicians with advanced education and training in a specialised area of nursing practice who work in a wide variety of healthcare settings. A CNS's specialty may be defined by the area of work.
The majority of CNSs are able to gain a qualification within their specialty field, eg oncology, tissue viability, urology—giving accreditation to their expert knowledge and professional status. Unfortunately, in the UK, OPAT/IV therapy/vascular access do not have any recognised educational programmes that clinicians can access. Training courses are often only provided by the company. This training does not have the academic standing that is often required to accredit a job role. However, in the USA, CNSs have access to a couple of accredited qualifications to help distinguish a specialism in vascular access and infusion therapy.
The vascular access board certification and certification in infusion therapy are both available and highly regarded accreditations. This type of qualification might help define the IV specialty and understand our roles within advanced practice. We need to look towards boards such as NIVAS to help in developing these accredited courses for us like minded enthusiasts in IV-related therapies.
With regard to my initial questions, the position papers are quite clear about the level of education required: the ANP title should not be used until a masters is acquired. My best guess so far for my title once I gain my qualification: Advanced Nurse Practitioner (ANP) with an OPAT/IV therapy/access specialty.