Conclusion
It is clear that there is a definitional conundrum for
advanced nursing practice. Registered nurse practice in
Australia is not confined to a role, but rather can include
any practice that is based on nursing knowledge where
the link between this knowledge and practice can be
clearly articulated. This is not the case for advanced nursing
practice. In Australia, the definition utilized by the
national nursing and midwifery regulatory authority, the
NMBA, embeds extended practice in advanced practice.
The only regulated title for nurses in Australia with a
legislated extension to scope is “nurse practitioner.” The
entanglement of extended and advanced practice within
the NMBA definition inhibits clarity of what is meant
by advanced practice and interferes with the process
of endorsement of NPs in Australia. If advanced is tied
to extended it would follow logically that only NPs are
legally able to practice in extended “advanced practice”
roles. Surely all NP practice incorporates the registered
nurse scope. No NP would claim to practice only within
the domains of the extension. As NP practice is based on
the foundation of a registered nurse scope, NPs practice
fully within this scope as well as within the legislated
extended scope. The essential question remains, who
determines when the registered nurse commences
work in the so-called advanced nursing practice role,
to start counting the hours toward NP endorsement?
Advanced nursing practice is the ability to fully express
the designated nurse scope.
The NMBA Endorsement as an NP registration standard
needs to be revised. Removing the reference to ”extended”
practice in the definition and acknowledging
time spent in advanced nursing practice more broadly,
not just an advanced nursing practice role, are important
steps toward achieving a clearly articulated pathway to
NP endorsement in Australia.