title: Advanced or advancing nursing practice: what is the future direction for nursing?
abstract: Advanced nursing practice roles have emerged over the last 25 years in response to two major challenges: first, the significant reduction in available doctors; and, second, the rise in numbers of patients with complex health needs. It is suggested that, with a major drive to respond to the first problem, with its emphasis on the development of medical skills, the development of advanced nursing practice (which has the potential to have a significant impact on the second challenge of the rise in long-term conditions) has very much taken second place. Moreover, advanced nursing practice roles have become so medically focused that not only is advanced nursing practice not evident, but neither are the recognised sub-roles that are fundamental to advancing practice. These include innovation, education, research and clinical leadership. This article argues that in the current climate it is essential that advanced nurse practitioners not only demonstrate advanced practice, but also actively embrace the concept of 'advancing' nursing practice as the dominant feature of new roles.
authors.affiliation: Senior Lecturer (Emergency & Advancing Practice), Department of Nursing, Midwifery & Healthcare Practice, Faculty of Health and Life Sciences, Coventry University.
authors.forename: Alastair
authors.initials: A
authors.lastname: Gray
mesh_terms: D057179:Advanced Practice Nursing / Q000639:trends*; D005544:Forecasting; D006801:Humans; D009722:Nurse Practitioners; D024802:Nurse's Role; D006113:United Kingdom
keywords: Advanced nursing practice; Advancing nursing practice; Clinical leadership; Innovation; Medical replacement