The roles of the APRN are continuously evolving. From the early 1960s to present day, advanced practice nurses continue to rise to meet the needs of our communities and abroad. As the number of nurse practitioner-advanced practice nurses (NP-APNs) on a steady incline, the various barriers in defining their roles in the US as well as internationally has limited their ability to function at their full potential. As discussed in An International Survey on Advanced Practice Nursing Education, Practice, and Regulation (Pulcini, Jelic, Gul & Loke, 2009), NP-APN nomenclature, scope of practice and education are factors in the development of the roles of APRNs internationally.
The United States and United Kingdom both utilize the title of nurse practitioner; however, other countries, such as South Korea, Singapore, and Switzerland continue to use the title advanced practice nurse (Pulcini, Jelic, Gul & Loke, 2009). This can lead to confusion on the part of the patient and family member who may not be familiar with the role of the advanced practice nurse in the clinical setting. Also, the authors state that the United Kingdom uses the terms specialist and NP interchangeably. According to Pulcini et al (2009), This interchange of terms most often occurs when the nurse who has specialized knowledge in a certain area has a advanced practice title (p. 32).
Scope of Practice
As mentioned by Joel (2009), The degree of autonomy afforded to APNs varies from country to country, and even within the country (p.76). The NP-APN scope of practice includes advanced health assessment, diagnosis, disease management, health education and promotion, referral ability, prescribing diagnostic procedures, medications and treatment plans, admitting and discharging privileges, patient caseload management, collaborative practice, evaluation of healthcare services, and research (Pulcini, Jelic, Gul & Loke, 2009). The United Kingdom and United States have similarities in their origins.
Both were established to help meet the needs of the rural and underserved areas as well as the overall population. In the United Kingdom, NPs were utilized as the first level of care for patient triage and in primary care (Pulcini, Jelic, Gul & Loke, 2009). Another similarity is their prescriptive rights in both the US and the UK. According to Joel, The move, originating in England, to enable nurses to undergo a specified nonmedical prescribing program has resulted in over 10,000 nurses who are now classed as independent prescribers, and as a consequence, can prescribe almost everything from the British National Formulary (p.90).
As in many professions, education is the key element to being successful and productive. The standard educational requirement for NPs in the United States in a masters level degree; however in the United Kingdom is still trying to adopt a masters level program. According to Pulcini et al (2009), While the Royal College of nursing in the United Kingdom has developed a masters curriculum for NP education, universities are not obliged to adopt it (p.33). Furthermore, NP courses are both offered at the baccalaureate and masters level in the UK.
The United States and United Kingdom have numerous similarities and differences in the roles of the APRNs. In the future, these roles will continue to evolve to meet the needs of the community.