Nurse Practitioners: The Future of Nursing Practice.

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“The Nurse Practitioners (Nps) have not come on the scene to take over the job of the Physician, but they have come to enhance and extend health care practice”.

Health care advances as technology advances and research is made. Medical practice is a field that vehemently forbids stagnation. The wheels are always moving, changes occur, procedures and practices become obsolete, policies arise, new branches of medicine regularly grow out of the big stem and it’s all for the advancement and development.

The advent of Nurse Practitioners is a product of this wave of development sweeping the medical shores in this 21st century, and we all must embrace it. Nps are an important and vital part of the health-care system. They combine diagnostic skills and nursing care into one whole capsule for the patient to swallow, marrying these two aspects of health-care to provide optimal health services to patients, clients and the society.

According to the International Council Of Nurses, an advance practice registered nurse (APRN) is “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A masters degree is recommended for entry level (ICN, 2018).

The beauty of the Nurse practitioner is the ability to concentrate on a holistic approach to patient care, emphasising on health promotion, patient education/counseling and disease prevention.

From the inception of the Nurse practitioner (Np) role in the 1960s, Nps have been identified as health care providers who can serve a combination of needs. Combining primary care medical services with advanced practice nursing skills. (The Online Journal of Issues In Nursing, 2015).

Where did the initiative come from to start this branch of health care practice?

“In 1965, assistant professor of nursing Loretta Ford and paediatrician Henry Silver envisioned a nursing role that could bridge the gap between health care needs of children and families abilities to access and afford primary health care” (The Online Journal of Issues In Nursing, 2015).

Scope of Practice.
According to the International Council of Nurses, the Nurse practitioners practice spans the following :
•Integrates research, education, practice and management
•High degree of professional autonomy and independent practice.
Case management/own case load.
•Advanced health assessment skills, decision-making skills and diagnostic reasoning skills.
•Recognised advanced clinical competencies.
•Provision of consultant services to health providers.
•Plans, implements & evaluates programmes.
•Recognised first point of contact for clients.

It is also important that one understands the regulatory mechanism, which is country specific for Nursing Practitioners.

According to the International Council of Nurses, below are the regulatory mechanism -country specific regulations underpin NP/APN:

•Right to diagnose.

•Authority to prescribe medication.

•Authority to prescribe treatment.

•Authority to refer clients to other professionals.

•Authority to admit patients to hospital.

•Legislation to confer and protect the title “Nurse Practitioner/Advanced Practice Nurse”.

•Legislation or some other form of regulatory mechanism specific to advanced practice nurses.

•Officially recognised titles for nurses working in advanced practice roles.

The idea of the Nurse Practitioners role is a very brilliant piece. With the rise in health care cost, the introduction of Nursing Practitioners (NPs) will provide efficient health care with affordable cost for health care services (cost-effective services). NPs do not replace the physicians, but work with them and the whole health team, each working to achieve a single goal. They are part of a collaborative team, putting skill and knowledge together.

It is important that health care systems in Africa, and West Africa in focus should embrace this development. We must think beyond the boundaries of “trying to protect my practice “, and embrace development and advancement. It is pathetic seeing the petty feud that goes on amongst health care workers in Nigeria.
The Nurse Practitioner is the future of Nursing Practice and a great contribution to the Medico/Nursing field. Nursing practitioners will do developing countries a lot of good, as the cost of health care will be reduced (cost-effective), and services rendered are also effective and efficient.

Ayinla Daniel (R.N)

(Chief Editor Care City)


•”Definition and characteristics of role”. International Council Of Nurses (ICN) International Nurse Practitioners/Advanced Practice Nursing Network. International Council Of Nurses (ICN). Retrieved 21st February 2018.

•Keeling, A. (May 31st, 2015) “Historical Perspectives on am expanded role for Nursing”. OJIN. The Online Journal of Issues In Nursing Vol. 20, No 2 Manuscript 2. Retrieved 21st February 2018.

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