Advancing change in advanced practice nursing

School of Nursing faculty members are spreading the word when it comes to the role of advanced practice nursing. 

Nancy Carter, associate professor and assistant dean of the graduate nursing programs, and Denise Bryant-Lukosius, professor and inaugural holder of the Alba DiCenso Chair in Advanced Practice Nursing, have been travelling around the world sharing and gathering information on the importance of advanced practice nursing and the need for further research and advancement within healthcare systems. 

An advanced practice nurse (APN) is a registered nurse who has completed advanced education and training in nursing. They are equipped with higher knowledge, skills, and scope of practice in nursing, and are prepared to work in either a specialist or generalist capacity. There are two types of APNs: a clinical nurse specialist (CNS) and a nurse practitioner (NP). A CNS is a registered nurse who has completed a master’s or doctoral degree in nursing with expertise in a clinical nursing specialty. A NP is a registered nurse with additional education and experience who can diagnose, order and interpret diagnostic tests, prescribe pharmaceuticals, and perform specific procedures within their specific scope of practice. 

APNs play a crucial role in meeting the complex health needs in a wide variety of settings and contribute to the development of sustainable, efficient, and effective health systems. They are often primary care providers and are at the forefront of providing preventive care services to the public. APNs treat and diagnose illnesses, advise the public on health issues, manage chronic disease, and engage in continuous education to remain ahead of any advancements in technology or methods in the field. APNs are an essential part of the healthcare system, and their contributions are invaluable. Carter and Bryant-Lukosius are advocating for APNs not only in Canada, but around the world. 

Carter spent a few days in Switzerland in November 2023. She attended conferences, visited multiple hospitals, and organized and presented at lectures and discussions at t Berne University of Applied Health Sciences with health care leaders within the school. Carter and Christoph von Dach, a professor within the Berne University of Applied Health Sciences, organized a virtual global exchange class where McMaster students back in Hamilton and students from Berne shared information about advanced practice nursing in each country and worked in groups over Zoom. “I think my biggest take away is that the nursing profession has the same challenges across the globe. It was definitely interesting to learn about the APN role in Switzerland” says Melissa Spadafora, a MSc McMaster School of Nursing student who attended the virtual global exchange.

Bryant-Lukosius also experienced a fair share of travelling last year. An international project that came to light at the end of December 2022 led to numerous national and international presentations and meetings, all culminating to a symposium presentation and policy cafe at the International Council of Nurses (ICN) Congress in Montreal in July 2023. The project examined the speciality certification of APNs and the importance of the role not only nationally, but internationally. The project engaged 75 stakeholders from 26 countries across the world. With a wide network and the ability to engage international stakeholders, the results are informing policies and practices worldwide.

Bryant-Lukosius was also asked by many to travel to places such as Washington, Singapore, and Hong Kong. She spread knowledge and evidence on why it is necessary for healthcare systems to continue to develop for APNs and how to implement these roles in primary care, long-term care, home nursing, and speciality practice in their respective countries.

Bryant-Lukosius and Carter are both heavily involved in the Canadian Centre for Advanced Practice Nursing Research (CCAPNR) which is made up of faculty across Canada from all different universities. The aim is to create new solutions for problems that challenge health and social services. There are also many doctoral students and post-doc fellows that have joined the centre as well. All of which are focusing on APN research. 

One of the students involved with CCAPNR is Samantha Horvath. She is in the CCAPNR trainee group and is currently completely her PhD with the School of Nursing and is also a part time registered nurse. The CCAPNR trainee group focuses on building international research capacity in APN for the doctoral student group. The trainee group is a subgroup of the senior CCAPNR members, and they receive education and mentoring from the senior CCAPNR researchers and faculty members. “My experience with the group has certainly been robust so far. Various opportunities for work are always available to those of us who have the capacity to contribute. I and another trainee were recently able to work on the creation, and submission of a proposal for the CIHR Team Grant: Strengthening the Health Workforce for System Transformation with the senior members, including nursing leaders Leigh Chapman, Karima Velji, and the Canadian Nurses Association. Overall, it is an amazing group to work with, and learn from” says Horvath. 

Carter and Bryant-Lukosius are driving change when it comes to the role of advanced practice nursing. Their efforts to expand advanced practice nursing roles and develop new models of care are improving patient outcomes, increasing access to care, and reducing healthcare costs. Their work is a testament to the importance of advanced practice nursing in healthcare systems around the world.