I have been an advanced nurse practitioner for over 20 years. After being in post for a while it dawned on me that the role was invisible. It seemed a profound silent revolution had taken place and that we were taking on increasingly autonomous and responsible roles and no one blinked an eye. In fact the NMC steadfastly refuses to recognise us and the role is to this day, unregulated. In 2005 I wrote a very contentious article in the BMJ1 on advanced nursing and doctors were outraged because a nurse was daring to suggest that research showed that nurses were not only good communicators but safe and effective practitioners in roles previously only undertaken by physicians. Some nurses were outraged because I was forsaking my own profession and pretending to be something that I wasn't. But then nothing: ANPs sunk back into oblivion and no one was interested.
Physician associates are the new kids on the block and suddenly they are causing a clamour of interest, and hospitals and general practices all want to employ them.
Hang on a minute, what about advanced nurse practitioners who have been in the clinical arena for a quarter of a century in the UK? Advanced nurse practitioners are two for the price of one, the alchemy of nursing and medicine bound into a new professional role, all the richer because of the symbiosis of the two parent disciplines.
Physician associates undergo much shorter training in bio-medicine than doctors, cost less to train and employ but cannot prescribe or work autonomously. I was dismayed to see in a recent article in Independent Nurse2 that a physician associates was quoted as saying that whereas advanced nurse practitioners can only do certain things physician associates can see patients with 'almost anything'. The arrogance and ignorance of this comment has left me deeply troubled.
I remain uncertain about the future of advanced nursing. I hope that one fine day the NMC will see the light that is blindingly obvious to all but them, and in the meantime it may be that medical bodies such as the RCGP will have to take a lead in setting standards for advanced nursing and giving our role its mandate and infrastructure of professional development.
1. The Nursing Profession's Coming of Age. Young G. BMJ 2005; 331:1415
2. Physician Assistants Plough the Same Furrow as ANPs. Bhardwa S IN 2015