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The journey from nurse to advanced nurse practitioner: applying concepts of role transitioning

28 May 2020
7 min read
Volume 29 · Issue 10

Abstract

The advanced nurse practitioner (ANP) role was established in Ireland in 2001 and represents an important nursing role development within Irish healthcare. Currently there are 336 ANPs registered with the Nursing and Midwifery Board of Ireland, working across 40 specialties. This number is increasing exponentially in response to emerging and anticipated future service needs and population demand projecting to a critical mass of 750 by 2021. Health service provision is enhanced by advanced practice performance outcomes. This article explores nurse to advanced nurse practitioner transitional journeys, a concept that has not previously been researched in depth from an Irish perspective. The theories of Benner, Woods, and Bourdieu are reviewed to explore whether an advance practice career trajectory results in unique nurse-to-ANP role transitioning. Contextualising possible personal, professional and educational transitions may enable the promotion of effective career ‘scaffolding’ to enhance a smooth transition for aspiring ANPs into advanced nursing practice roles.

Ireland has a government-funded healthcare system with means-tested access. Around 37% of the population has free access and the rest pay subsidised fees for elements of care, while some aspects are free for all. In addition, private costed healthcare services are available. There are special access systems for those with long-term conditions, to cover pregnancy, childbirth, children under 6 years, and those on long-term medications. There is an agenda of continuous improvement to the service. For example, the Report of the Commission on Nursing: a blueprint for the future (Government of Ireland, 1998) championed a complete revision of the structure of Irish nursing that included a recommendation for the establishment of advanced practice roles. The registered advanced nurse practitioner (ANP) role represents an important development within healthcare in Ireland. Currently 336 advanced practitioners are registered with the Nursing and Midwifery Board of Ireland (NMBI), working across more than 40 specialties (DoH, 2019). Significantly, the Health Service Executive (HSE), as provider of public health services in Ireland, has pledged to increase the number of ANPs in response to population demand and emerging service needs. Current integrated care service delivery is focused on addressing critical areas including older persons, chronic diseases, and unscheduled/scheduled care. The current planned workforce projection is in line with the current Irish Sláintecare strategy (a health reform plan) (DoH, 2017) and by 2021 it is proposed that there will be a total of 750 practising advanced practitioners in Ireland addressing population-based service needs (DoH, 2019).

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