Advanced practice in children and young people's nursing

The authors of this chapter have deliberately adopted a controversial stance that we hope will engage the reader in some critical and reflective debate regarding children’s nursing and the nature of advanced nursing practice. To this end we have put forward different perspectives on how nurses, particularly those working with children and young people, may advance their practice. In doing so we have recognised that the boundary between nurses’ initial registrant field of practice and others is becomingly increasingly blurred, and may even be deemed as irrelevant by some. Likewise, we also recognise and discuss the arguments put forward that the aspiring Advanced Nurse Practitioner, regardless of their initial registrant specialist field, needs to attain a generic and generalist standard of practice for Advanced Practice. A central intent of this chapter is to explore and illuminate the role(s) and activities of Advanced Nurse Practitioners who are working with Children and Young People. Our stance will be that such Advanced Nurse Practitioners may arise from any of the current four UK ‘fields’ or ‘branches’ of nursing practice to which new registrants are assigned at successful completion of their pre-registration studies (Child, Mental Health, Learning Disability, Adult).The development of Advanced Nurse Practitioners, their role, activity, scope of practice, education and regulation presents a complex history and is currently an unfinished story. It is fair to say that few areas of nursing activity have been so closely scrutinised and researched (Svensson 1996 Carnwell and Daly 2003 Horrocks et al 2002) and yet it remains controversial and challenging. In the light of that uncertainty, and in consideration of this chapter’s central intent, it will be necessary to ground discussion on Advanced Nurse Practitioners in their historical context, and then apply these fundamental concepts to the activities of Children and Young People’s Nursing. This chapter will review and explore the definitions, history and development of Advance Nursing Practice and Advanced Nurse Practitioners in the general sense and in the widest context. The concepts and principles outlined will then be applied and discussed in relation to Children and Young People’s Nursing and to the development and status of Advanced Nurse Practitioners in the care of children and younger people. There is discussion on current issues; the relation of child field competencies to Advanced Practice competencies, and the modernisation of career pathways, and how education must adapt to meet the needs of the future children’s nursing. We will then consider specifically the role of the Advanced Nurse Practitioner in the key areas of child response to healthcare, developmental knowledge and child protection. The chapter will conclude with a resume of the current status of children’s nursing and advanced nursing practice in the UK