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Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing
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Professor Andrew Cashin, Southern Cross University - Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing

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Prof Andrew Cashin, Professor of Nursing, Southern Cross University delivered the presentation at the 2014 Developing the Role of the Nurse Practitioner Conference. …

Prof Andrew Cashin, Professor of Nursing, Southern Cross University delivered the presentation at the 2014 Developing the Role of the Nurse Practitioner Conference.

The Developing the Role of the Nurse Practitioner Conference 2014 is for organisations and managers looking to better understand, utilise and grow the role of the nurse practitioner in their health service.

For more information about the event, please visit: http://www.healthcareconferences.com.au/npconference14

Published in: Health & Medicine
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  • 1. Saying What We Mean and Doing What We Say: The Evolving Case of Clarity in Australian Advanced Practice in Nursing Andrew Cashin
  • 2. Objectives • Discuss Scenario Based Modelling • Consider the existing nursing language crimes • Outline the potential of the new Nursing and Midwifery Board of Australia Nurse Practitioner Standards in terms of their contribution to clarity • Critique other assorted tasty titbits
  • 3. Thing one and thing two revisited The patient lay dreaming of frustrated screaming All he had asked was who is doing my care and two nurses stood preening I am a APN, a Nurse Practitioner said nurse one, and I am an APN too announced nurse two Oh two NPs thought the patient this all makes sense But then came the explanation and it was way to dense I am a NP said nurse one, and I am a consultant said nurse 2 The patient was so frustrated they begun to turn blue Please said the patient, just do it now, What will you do, just tell me how. Nurse one glared down, but it all should be clear Two things can be one, and we are both here I can order tests, prescribe and refer Nurse two said I can’t do these things, consult I prefer
  • 4. Nurse one said I can lead your episode of care Nurse tow opened their mouth but the patient was in despair If we just talk of scope, what can be done is clear The patients will know that which is dear Who will do what the patient at last shouted Nurse one and two their advancedness had flouted I am a registered nurse at last said nurse two I am a NP said nurse one so you know what I do The patient relaxed as will planners of services too When it is clear what worker will do the do Unlike the sneetches teach us stars and beaches It is important to know what is in each workers reaches
  • 5. The word advance fits into one of the foundational metaphors of our age, the directional metaphor (Lakoff and Johson, 1980.). Advance signifying the flowing nature of reality and movement in a forward direction. The Australian Oxford dictionary defines advanced as, “far on in progress” (Australian Oxford dictionary, 2004, p.18).
  • 6. “Nursing is responsible for articulating and disseminating clear definitions of the roles nurses engage in and the professions scope of practice”.(International Council of Nurses, 2004.).
  • 7. scenario modelling that attempts to match work to be done with those capable and credentialed to do it As Health Workforce Australia moves to scenario planning, incremental cost benefit of differing approaches (involving different roles) to meet health system needs will occur. Data on efficacy and efficiency is needed for this modelling and sensitivity analysis.
  • 8. • it is estimated that at least 70 countries either have, or are considering introducing advanced practice roles (International Council of Nurses ICN Nurse Practitioner/Advanced Practice Nursing Network, 2012). • Pulcini, Jelic, Gul& Loke (2010) identified that only 23 of 32 countries surveyed formally recognised the NP/APN role. Of these, 48% (11 countries) have licensure maintenance/registration or renewal requirements. While 71% of countries had some form of NP/APN education, only 15 identified the Masters Degree or equivalent as the most prevalent credential. Further, even within individual countries there can be variability. • Huge variably
  • 9. Circularity Many definitions conflate advanced practice nursing and advanced nursing practice and use interchangeably Many definitions rely on extension and expansion Side bar conversation registration standard
  • 10. Quick examples USA Advanced Practice = particular scope Advanced Practice Nurse CRNA; CNM; or CNP=Registered Nurse + Extended Scope of Practice Nurse Practitioner One type of Advanced Practice Nurse Regulation —all Advanced Practice Nurse titles legislatively protected Qualifications required —accredited graduate level course; passed national certification exam and obtained license to practice
  • 11. Uk Advanced Practice = a level of practice Relationship between EP; APN; ANP; NP = not stipulated Regulation—titles are not regulated or protected Qualifications required—no specific qualifications required:
  • 12. Canada Advanced Practice = Level of practice Advanced Practice = Registered Nurse Scope of Practice OR Registered Nurse and Extended Scope of Practice Nurse Practitioners = Registered Nurse Scope of Practice OR Registered Nurse and Extended Scope of Practice Regulation = Nurse Practitioner title regulated Qualifications —master degree recommended:
  • 13. New Zealand Advanced Practice = level of practice Advanced Practice = Registered Nurse Scope of Practice or Registered Nurse and Extended Scope of Practice Nurse Practitioner Nurse Practitioner = Registered Nurse and Extended Scope of Practice Regulation —Nurse Practitioner title regulated Qualifications —a master degree recommended:
  • 14. Advanced nursing practice (ANP): ANP is a continuum along which nurses develop their professional knowledge, clinical reasoning and judgement, skills and behaviours to higher levels of capability (that is recognisable). Nurses practising at an advanced level incorporate professional leadership, education and research into their clinically based practice. Their practice is effective and safe. They work within a generalist or specialist context and they are responsible and accountable in managing people who have complex health care requirements. Advanced nursing practice is a level of practice and not a role. It is acknowledged that advanced nursing practice is individually attributed within a regulated nursing scope (Enrolled Nurse, Registered Nurse or Nurse Practitioner). Advanced practice nursing (APN): APN in the Australian nursing context identifies the additional legislative functions of an endorsed Nurse Practitioner that are outside the contemporary Registered Nurse scope of practice. Advanced practice nursing as a Nurse Practitioner is a qualitatively different level of advanced nursing practice to that of the Registered Nurse due to the additional legislative functions and the regulatory requirements. The requirements include a prescribed educational level, a specified advanced nursing practice experience; and continuing professional development. NMBA (2013). Australian Nurse Practitoner Standards for Practice http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines- Statements/Codes-Guidelines/nurse-practitioner-standards-of-practice.aspx
  • 15. Further Nurse Practitioner: A Nurse Practitioner is an Advanced Practice Nurse endorsed by the Nursing and Midwifery Board of Australia to practise within their scope under the legislatively protected title ‘Nurse Practitioner’ AND UNDER THE APN Definition [Advanced practice nursing should not be confused with the term ‘practice nurse’ that is used colloquially to describe nurses working in the general practice setting.]
  • 16. The patient said phew I know who is nurse one and nurse two What is more the planner knew too We all know what is done by nurse one and nurse two The two lovely nurses who certainly do the do
  • 17. References Australian National Dictionary Centre (2004). The Australian Oxford Dictionary (2nd ed). Melbourne:Oxford University Press. International Council of Nurses ICN Nurse Practitioner/Advanced Practice NursingNetwork, 2012. Frequently Asked Questions. Lakoff and Johnson.(1980). Metaphors we live by. Chicago: The University of Chicago Press. Pulcini, J., Jelic, M., Gul, R., & Loke, A. Y. (2010). An international survey on advanced practice nursing education, practice, and regulation. Journal of Nursing Scholarship, 42(1), 31-39. Scanlon, A., Cashin, A., Watson, N., & Bryce, J. (2012). Advanced nursing practice hours as part of endorsement requirements for nurse practitioners in Australia: A definitional conundrum. Journal of the American Academy of Nurse Practitioners, 24(11), 649-659. Stasa, H., Cashin, A., Buckley, T., & Donoghue, J. (2014). Advancing advanced practice—Clarifying the conceptual confusion. Nurse education today, 34, 356-361.

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