Advanced Nurse Practitioners - What they can and can't do.

Can somebody please clarify what ANP's are actually allowed to do. I know this will depend on years of experience and area of practice but is there a clear set of boundaries within which these nurses practice? I know they need to practice within their scope of competence but this can vary from one nurse to another and so is not clear cut, is it down to the trust/employer. Also, the role is unregulated which clouds things more, when if ever will this be rectified?
Given the training and responsibilities that come once qualified, I've heard them described as doctors on the cheap. Is this the case, are ANP's working there butts off for little financial reward?

Any clarification on the above is much appreciated.

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Reply 1

paulbarlow

yup they are being used to fill in for missing doctors. that thou is not what they are meant to be. they are meant to examine and treat simple none complex conditions and then hand off more complex cases to the doctors when its being run properly its safe and saves time for the doctor quickens the patients visit. research shows patients are just as well off being seen by a nurse than a doctor. the main rule the nurse must know when to hand off. it will become a masters course and will be a recognized nmc role similar to district nursing and health visiting. obviously the nurse really needs alot of experience before doing the course.

Reply 2

Charlotte's Web

Original post by rescueme

There are certain boundaries, but no defined ANP role as the skills required will vary by trust and department. In some areas the ANP is more of an advisory role, whereas in others they act more like an autonomous practitioner prescribing, running clinics etc. but this really just depends what is needed in that particular area. Some of the appeal of the role is the flexibility and autonomy it allows.

All nurses are registered with the NMC so they are effectively regulated and accountable for their actions and omissions. Logically they should be regulated by the NMC rather than the GMC as they are still nurses. They are still bound by the NMC code of conduct and this would cover the additional aspects of their role.

Whether the role exists to extend the capabilities of nurses or to fill gaps that were once filled by doctors is a bit of a contentious issue. In all likelihood it is probably a mixture of the two.

Reply 3

Speed1987

The ANP role can really differ from diagnosis to prescribing, some even carry out simple surgery. However it's very difficult to get these roles, they are very limited and doctors now prefer to use Psychian assistants to complete other tasks to free them up.

However some doctors don't like this because PAs are not accountable, the doctor who directs them is. Where a nurse is accountable for their actions, so any problem rests squarely with them.

I know one nurse who trained alongside me in a trust as a ANP and it caused her a lot of stress, the doctor didn't really want to train her. She was left to do it all her self basically, he just signed her off, he wasn't interested and it's taking his job... of course he doesn't want that. Then there are other problems such as who is responsible for that individual, this is normally the consultant however once a nurse takes over their care suddenly theirs a problem and they are not keen on being responsible anymore. It's creates a lot of politics, I personally think the governor should intervene doctors how to much power over other professions in health care.

Often ANP jobs are roles doctors don't want to do, for example Anesthetics, doctors know this is a high risk area and a lot of patients are making claims... stating they weren't under in their operation etc... so of course doctors are happy for nurses to do this role, however surgery itself they will fight tooth and nail to stop nurses doing this.

I would suggest if your honestly interested in this area, become a doctor, honestly you'll be much better paid and respected. There's are 1 year access courses into medicine now, I knew a HCA completing the course. Dunno what they are doing now though, the nurse I trained with runs her own medication reviews, like a SHO.

Reply 4

paulbarlow

the wifes on her second year of 3 training its interesting training. four modules in the first year clinical leadership, clinical history taking and examination skills, pathophysiology investigations and immediate management and minor illness management. this coming year none medical prescribing and another module. more skill are fun. never stop learning.

Reply 5

PandaRawanda

Original post by Speed1987

Hey Speed, could you send me a link to the access course you mentioned? That's the first I've heard of it.

Thanks. =]

Reply 6

paulbarlow

you need to qualify as a rgn gain clinical experience and then apply. its not a role for a newly qualified nurse. no access course can get you on to a anp course.

Reply 7

moonkatt

Original post by paulbarlow

you need to qualify as a rgn gain clinical experience and then apply. its not a role for a newly qualified nurse. no access course can get you on to a anp course.

You can't qualify as an RGN anymore :wink:

Reply 8

paulbarlow

you need to be a Registered Nurse - Adult .

Reply 9

paulbarlow

im still a rgn no matter what some pen pusher say. grumble mutter im ancient and achy

Reply 10

rescueme

The access course which speed1987 mentioned is an access course for medicine not for ANP.

Reply 11

paulbarlow

Original post by rescueme

The access course which speed1987 mentioned is an access course for medicine not for ANP.

have you considered that role. that would be a serious step. 3/4 years extra studying. then the junior doctors years thats nasty hours.

Reply 12

rescueme

Original post by paulbarlow

have you considered that role. that would be a serious step. 3/4 years extra studying. then the junior doctors years thats nasty hours.

No I had not.

'then the junior doctors years that's nasty hours.' -

you are not selling it very well!

Studying for medicine is a huge commitment with a heavy focus on exams for at least 10 years, one doctor said to me. There is also the financial stress.

I don't have the desire to get myself bogged down in that now.

It seems if you want to go down the ANP route you are better of if you can studying medicine.

Reply 13

paulbarlow

its not me im just a plain old nurse. my wife is training to be one. her plan is to be a mixed district and anp nurse. its a role that her gps would like. and it fits in with doing extended roles. it will save a lot of gp visits.an will insure quicker treatment for patients. there is no desire for my wife to become a gp. to be honest she hates studying. in fact a few years back the community manager wanted every community nurse to be one.

Reply 14

rescueme

Original post by paulbarlow

Good luck to her, I hope she has a happy future in the role.

Reply 15

comebackseason

There has been a recent change in nursing education which will allow new registrants to prescribe medications faster. Rather than doing the v300 course 3 years post graduation it can be done in 1 year.

Also there are new master's degree programs for NPs in the works similar to those in North America

Reply 16

paulbarlow

i hope not. a newly qualified needs experience. it could be a serious error to speed it up. the experience is really needed. the wifes on a masters for her anp. again its not suitable for new nurses.
experience is not a negative thing. its really not something that education can replace. in fact to think a new nurse could be prescribing serious medications scares me.

Reply 17

rescueme

Original post by comebackseason

The v300 can be done once the nurse has gained a years experience after graduating? If they choose to do it after a year of experience on an oncology ward for example does that limit them to prescribe in an oncology setting or if they moved to ED can they prescribe there? I'm just wondering if the training is a general prescribing or more focused on the area in which you are employed?

Which universities offer the nurse practitioner masters and how much experience do you need before you can apply?

Reply 18

paulbarlow

rgu 3 years need to do the clinical assessment unit before you ca do the v300.
southampton

The entry requirements for the MSc in Advanced Clinical Practice (Advanced Nurse Practitioner and Advanced Practitioner) are:

•

A first degree (2:2 Hons or above) or an equivalent standard in other qualifications approved by the University in a relevant subject from an approved institution of higher education.

•

A current professional registration with a relevant UK professional/statutory body e.g. Nursing and Midwifery Council, Health Professions Council.

•

A current job contract in a clinical or clinically related area. (You will also need the support of a clinical mentor who is able to assess your practice competency and support your learning).

•

At least two years relevant post registration clinical experience (three before commencing V300 non-medical prescribing)

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At least one satisfactory reference (given the practice related requirements this should be from your current employer and include confirmation of the required practice experience and mentor support; on some occasions a second reference will be required)

university of london

Applicants should hold at least a lower second-class honours degree or the equivalent from an international institution.
Applicants without a degree may be considered on the basis of professional experience and/or at the discretion of the programme director.
Applicants should be registered with the Nursing and Midwifery Council or a similar professional/statutory body with two years' relevant clinical experience and currently working in a healthcare setting.
Students with relevant work experience, combined with a demonstrable ability to study at degree level, will also be considered.
Applicants must be in permanent employment in appropriate clinical setting and must have full support from their employer to undertake programme at City, University of London.
Applicants must have access to a designated practice supervisor in practice who is a doctor (registrar and above) or ANP.