Opinion: advanced nurse practitioners are set to become a more common sight in Irish healthcare settings

By Emily Lockwood, Mary Rose Sweeney and Daniela Lehwaldt, DCU

Nursing is a trusted profession, but they are often not acknowledged as professionals working in shifting healthcare and delivering innovative ways of bringing healthcare to the patient. For example, nursing roles such as the advanced nurse practitioner has been in the Irish health services since 2002, but little is known about them.

The Department of Health recently realised the impact advanced nurse practitioners could have due to being less costly than the traditional nurse and doctor role. They could also give rapid access to patient care innovation and provide healthcare for all.

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What is an advanced nurse practitioner?

These nurses have many years of prior training as a nurse or midwife to prepare for the role, as well as an advanced practice master's degree. They can prescribe medications and request many diagnostic tests, such as x-rays, ultrasounds, CTs and MRIs.

They can order and interpret many diagnostic investigations, make a patient diagnosis and refer, discharge, and access services previously only the remit of a medical doctor. Importantly, they independently practice within their own professional right. In many healthcare places in Ireland, you may be seen by an advanced nurse practitioner or a doctor in the community or hospital. Nurses with advanced skills in Ireland provide access to care that otherwise might be difficult to get.

The importance of advanced nurse practitioners was clearly seen during thge pandemic when they were required them to take up significant levels of independent practice. This period also saw these nurses stepping into different roles within their specialist areas to keep patients away from the acute hospital environment. They also provided access to services in primary care, and virtual clinics led by these nurses were quickly developed in response to the pandemic.

From the Department of Health, what is an advanced nurse practitioner?

The last two years has seen more reliance on and a more open acceptance of the advanced nurse practitioner role with virtual consultations and independently discharging people with virtual follow up plans instead of bringing them back into crowded hospitals. They also carried out many risk assessments, organised screening and provided professional advice about Covid-19 concerns. They remotely monitored and provided wellness checks for patients to avoid hospital admission.

The future for advanced nurse practitioners

Advanced practice in nursing can enhance people’s journeys in healthcare and meet the demands of a growing population profile with limited healthcare providers. The familiar narratives of the doctor and the nurse are changing to meet the supply and demand of healthcare. This change has shifted from traditional workings to innovative sustainable goals.

Advanced nurse practitioners need public support and awareness of their position to reduce cultural constraints they often face in their practice. They can be constrained by an old style of thinking often due to a lack of understanding of the role. Open conversations and media coverage tocanshow the positive impact they bring to a changing world of healthcare in Ireland and globally. Perhaps now is the time to encourage these nurses to fulfil their role and fully utilise their expertise in clinical practice.

Dr Emily Lockwood recently completed her PhD at DCU and is a Registered Advanced Nurse Practitioner Emergency at University Hospital Waterford. Her research explored the levels of clinical autonomy amongst advanced nurse practitioners in Ireland. Dr Daniela Lehwaldt is Assistant Professor and Academic Lead in Nursing at the School of Nursing, Psychotherapy and Community Health at DCU. Dr Mary Rose Sweeney is an Associate Professor and Head of the School of Nursing, Psychotherapy and Community Health at DCU.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ