It was in the 1990s that the NHS incorporated the Advanced Nurse Practitioner (ANP) role and today in hospital settings as well as general practise, ANPs form an established component of the healthcare team. Let us look at the role in detail.
ANPs are commonly known as nursing practitioners or advanced practitioners and these nurses have an education to Masters level with significant post-registration experience. ANPs can function in the capacity of primary healthcare provider and also diagnose disease with the help of history taking, conducting physical examination, ordering or diagnostic tests and the subsequent interpretation of the results and issue treatment and medication prescription. They are also qualified to make onward referrals.
With the traditional start of the ANPs in A & E or general practise, increasingly they are making their mark in the hospital settings with their employability from neurology, ENT to cardiac wards. According to study, their success in General Practise is evident in 65% of patients who prefer visiting a nurse-led clinic and minimal referrals to a GP.
The origin of the role can be seen in the gap stemming from the legal restrictions, curtailing the working hours of the junior doctors. The need for better patient care, better staffing levels also contributed to the rise of the ANP role. This role provides ambitious, dedicated and experienced nurses an further opportunity of career development. It improves the general efficiency in general practice by allowing the ANPS to conduct certain procedures which previously only a GP would have performed.
For a nurse who wants to develop her expertise as an ANP, according to the Royal College of Nursing, recommends ‘to start young’ and suggests that staff nurses who are keen on this role should spend time with an ANP to better understand the role and associated responsibilities. A key requirement for the ANP programme is a three year post registration experience prior to completion of the Independent Prescribing qualification. These three years can be suitably utilised by the nurses to develop their knowledge, skills and expertise. On completion of the three-year-practise, nurses are eligible to put in an application to the university programme.
Masters Degree is essential for the ANP qualification and several universities offer MSc courses. These part time courses in advanced nursing practise usually extend over 2 -5 years. This part-time structure ensures that the nurses have the financial flexibility and also enjoy benefit of continuous nursing practise. NHS with the conception of the role, has given full recognition to this role and extends traineeships to nurses, which offer combined work and study.
As the course nears completion, the nurses can experience a pay escalation and as per NHS scales the ANPs nursing salaries fit in the broad range of £26,302 to £41,373 per annum.
However, despite the increasing recognition to the necessary nature of the ANP role in the healthcare delivery set up, the low profile of the role and lack of clarity are the main issues identified by the RCN. Therefore, RCN is now trialling for the ANPs a credentialing process which shall be implemented from 2017. In it the ANPs would be able to register their credentials with RCN. This will thus generate a registry of Credentialed ANPs with the RCN and these credentials would be revalidated every three years. The credentialing will be based on the factors of competence, qualifications and experience.
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