Development of nurse specialists/advanced practitioners in Ireland

An Bord Altranais (Irish Nursing Board) published "Report of the Commission on Nursing: A Blueprint for the Future" in 1998. This report was the result of collaborative work among those involved in nursing in Ireland. It recommended the establishment of clinical career pathways, which would allow a nurse with extensive experience and advanced expertise, as well as an appropriate course, to be recognized as a clinical nurse specialist. Further advancement along this pathway could possibly enable the nurse to progress to an advanced practitioner grade. The report acknowledged that there are "various and differing interpretations" of the title "practitioner". This article explores the growth and development of the roles of the clinical nurse specialist and advanced nurse practitioners in Ireland over the past number of years. The literature reflects elements of confusion that exist in some areas about the role of a clinical nurse specialist and an advanced nurse practitioner. The "Review of the Scope of Nursing and Midwifery Practice" (An Board Altranais, 2000) recognized a lack of clear differentiation between the role of the clinical nurse specialist and the advanced nurse practitioner. Overall, some clear roles are identified for the nurse who advances or wishes to advance along clinical career pathways in nursing. However, there still appears to be a certain degree of confusion about the use of titles such as "nurse specialist" and/or "nurse practitioner". The guidelines about the level of practice and education/training required for the nurse moving along the pathways of clinical nurse specialism and/or advanced nursing practice is somewhat obscure and is interpreted in different ways in the literature.