ADVANCED PRACTICE NURSING
SANC íS POSITION PAPER/STATEMENT
INTRODUCTION AND CONTEXT
Nurses and midwives in South Africa are educated and trained to function at both entry level and higher level in specific fields of practice. For the purposes of nursing practice, existing nursing education provides for diplomas and advanced diplomas (additional qualifications) that culminate in professional registration with the Nursing Council . For purpose of professional registration, the Council currently does not distinguish between a nurse who obtained the qualification through an advanced diploma qualification and the one who obtained it from a masterís degree. Registration of an additional qualification for a professional nurse is currently dependent on the focus of the additional/specialized discipline, regardless of whether this was obtained through a diploma, a bachelorís degree, masterís degree or any other qualification. This has resulted in uncertainty about the status and classification of advanced practice nurses in South Africa, and has many implications, some of which impact on remuneration and clinical career-pathing of the advanced practice nurse.
This position statement attempts to address the above uncertainty, changes in the nursing and higher education legislation as well as calls for clarification of the status of nurses practising at an advanced level in the country. This position statement was informed by exploratory and in-depth literature review, both at national and international level as well as focus group discussions with stakeholders.
Evidence has shown that international variations and preferences exist in respect of the title for nurses in this category. These variations are influenced mainly by national context, health needs and legislative framework of different countries. Most of the countries researched subscribe to the International Council of Nurses(ICN) terminology and definition which is explained below. The determining factor that influence the discussion is the fact that professional nurses move from an entry level into the profession, to an advanced level in a specialised field.
TERMINOLOGY AND DEFINITIONS
The umbrella term is ďAdvanced Practice Nurse?(APN), defined by the ICN as follows:
ĎíThe (APN) is a registered nurse who has acquired the expert knowledge base, complex decision-making skills and competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A masterís degree is recommended for entry level (ICN 2002).
Two predominant categories of the APN are identified:
The view of the International Council for Nurses is that each country should credential nurse categories according to its own context, taking into cognizance its health care system as well as available resources in order to enable the country to model its own level/s of specialisation.
SANC recognizes that beyond a general nurse/midwife practitioner, there is need for the Advanced Practice Nurse.
Within advanced practice nursing should be two levels namely:
The South African Nursing Council approved the position paper on Advanced Practice Nursing at its meeting in March 2012.