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RCN Annual Nurse Practitioner Conference

Nurse practitioners love their work and are much more satisfied with their jobs compared with other nurses of similar grade, according to a study presented at the Royal College of Nursing (RCN) Annual Nurse Practitioner Conference held in Harrogate recently. There was an air of celebration as more than 200 nurse practitioners gathered for the event, marking the 20th anniversary of the first published research on nurse practitioners in the UK.  Some of the original pioneers of the role attended, as well as those more recently qualified and many student nurse practitioners. While the majority of delegates worked in primary care settings, it was notable that a significant minority this year were acute care nurse practitioners, reflecting the growth of advanced practice in this area and the commonality of underlying principles that distinguishes this type of nursing.
The conference is the key annual event in the nurse practitioner calendar, drawing together practitioners and educators for networking and updating of professional and clinical issues. This year's event highlighted the progress and achievements of the preceding 20 years, hopes and ambitions for the future, as well as a few frustrations. Some of the greatest changes in healthcare have occurred in the last few years, with nursing advancing more than any other profession.

The role of nurse practitioners
Ghislaine Young, nurse practitioner, and Katrina Maclaine, RCN nurse practitioner adviser, presented the results of a large survey of more than 1,200 nurse practitioners, commissioned by the Nurse Practitioner Association (NPA), into the role, function and experiences of nurse practitioners across all clinical settings. Although job satisfaction is high, one in four feel that their role is not being used to its full potential, perhaps suggesting that their true value is not recognised. Core activities include assessment, making new diagnoses and treatment, including prescribing and referrals. A key feature of the role is its considerable flexibility depending on the patient group and setting in which the nurse practitioner practises.
Nursing skill is seen as important, with nurse practitioners seeing themselves as maxi-nurses, not mini-doctors. The role has allowed nurses to advance their career while remaining clinically focused. Yet, despite the success of the role, barriers to practice remain.
Jenny Aston, a nurse practitioner from Norfolk, described the work in progress to enable clinical imaging requests from nonmedically qualified professionals. Jenny has worked with radiologists, radiographers, physiotherapists and osteopaths to establish a national collaborative guideline. She explained the local variations in requesting X-rays, which tied in with the NPA survey finding that 44% of nurse practitioners had had X-ray requests refused. The guideline, which is due to be published in the next few months, should be an invaluable tool to help nurse practitioners, by removing one of the barriers to their practice.

Definition of a nurse practitioner
One of the key challenges for nurse practitioners in recent years has been the issue of  regulation of the title. Susan Aitkenhead, professional adviser in support of policy and strategy at the Nursing and Midwifery Council (NMC) gave an update on the NMC position on advanced nursing practice, and progress towards regulation of title. It was agreed in 2005, following consultation, that this level of practice should be recognised and registered. A definition of advanced nurse practitioner has been agreed, and competencies have been matched against the Knowledge and Skills Framework.(1) The next step is to seek approval from the Privy Council to open a subpart of the register; although information was sent to them in January 2006, a response is still outstanding, as the Privy Council is currently awaiting the views of the Department of Health. Ms Aitkenhead explained that, without making assumptions of a positive response, the NMC were using the waiting time proactively by working with the Association of Advanced Nurse Practice Educators to develop draft guidance for approval of education programmes and guidance for individuals who want to register.
Delegates expressed their frustrations at this delay. Concern was voiced about the plethora of nursing titles in use, and the issue of public protection when the title is used by those without appropriate education. There was an overwhelming feeling that standardisation of the education and qualifications of those using the title nurse practitioner should be enforced. It was suggested that lobbying the chief nursing officer might assist in speeding through the legislation. Updates on this issue can be found at the NMC website - www.nmc-uk.org

The value of nurse practitioner practice
A series of popular clinical skills development workshops ran throughout the conference, as well as sessions with themes including education, research, innovation and international perspectives.
Dr Alison Crumbie, a nurse practitioner and partner in general practice in Cumbria, presented her fascinating research exploring the values of nurse practitioner practice. Personal development, achievement and autonomy were found to be key. Nurse practitioners are very positive about their work, the goal of which they see as using the skills of doctors within a nursing model.
The conference was concluded by Professor David Colin-Thomé, National Clinical Director for Primary Care at the Department of Health, who gave an inspiring address on the current primary care agenda. Discussing the principles of the white paper Our Health, Our Care, Our Say,(2) he spoke of the increased potential for nursing in the community and a vision of the roles that could be developed. He urged nurse practitioners, as those who have pioneered new ways of working, to seize opportunities and find their own destiny.  
Next year's RCN event will be held on 7-8 September 2007 in Daventry. For further details visit www.rcn.org.uk/events

References

  1. Department of Health. Knowledge and skills framework. London: DH; 2006.
  2. Department of Health. Our health, our care, our say. London:DH; 2006.

Resources
NMC W:www.nmc-uk.org

Association of Advanced Nurse Practice Educators 
W:www.aanpe.org

RCN Nurse Practitioner A
W: www.rcn.org.uk/pcph/forums/nurse_practitioner_association

Department of Health W: www.dh.gov.uk