Patricia M. Schwirian
(Modified Keynote Speech presented in the 14th Annual Nursing Conference: "Advanced
Nursing Practice")
Abstract
Developments in modern health care have created the demand for expanded and enhanced roles for nurses. Part of this evolution has been the emergence of the need for advanced nursing practice. Around the world, nursing is facing the challenge of shaping this role in ways that will maximally contribute to the health and welfare of their clients, their communities and the profession of nursing. Discussions of the development of advanced nursing practice have focused on several basic concepts and issues. These include: (1) What specific roles will advanced nursing practitioners play in health care systems? (2) What type of education and training is essential for the successful enactment of these roles? (3) How should advanced nursing practice be effectively regulated? (4) What strategies can nursing leaders use to most effectively establish the place of advanced nursing practice in the health care system? In this paper each of these questions with special reference to the manner(s) in which they have been addressed in the U.S. are discussed. Finally, some practical advice for those committed to moving advanced nursing practice further within the healthcare system is presented.
Key words: Advanced Practice Nurse Case Managers (APNCMs), case management, United States