What is nursing in advanced nursing practice? Applying theories and models to advanced nursing practice—A discursive review

Abstract

AimThis article appraises models and theories related to advanced nursing practice. It argues that while the role of the advanced nurse practitioner builds on and extends beyond traditional nursing, it remains firmly grounded in ‘caring’.BackgroundThe stereotype that nurses ‘care’ and doctors ‘cure’ is fading. Increasingly, nurses have crossed boundaries and conducted independent assessment, diagnosis, prescribing and consultation, which used to be the doctor's role. Confusion and argument have arisen due to the higher‐level practice of the advanced nurse practitioner, as many questions where these ‘doctor nurses’ stand.DesignA literature review.Data SourcesDatabases, including CINAHL, Medline and Google Scholar, were searched.MethodDatabases were searched, and relevant studies and review articles from 1970 to 2023 were identified using the following keywords: ‘advanced nurse practitioner’, ‘nurse practitioner’, ‘advanced nursing’, ‘advance practice’, ‘nurse practitioner’, ‘nursing theory’ and ‘nursing model’.ResultsAlthough advanced nurse practitioners identify themselves as nurses, there is limited use of nursing theory to conceptualize this new level of practice and to define their contribution to the multi‐disciplinary team. It is noted that a holistic approach to personalized patient care, based on therapeutic relationships and effective communication, may help us identify the unique contribution of the advanced nurse practitioner.ConclusionsThe development of advanced nursing theory needs to capture this holistic approach and its caring element to recognize the value and strengthen the identity allegiance of this hybrid role.Implications for the Profession and/or Patient CareHolistic approach and patient‐centred care, effective communication and the therapeutic relationship are strong characteristics relating to ANP practice, the latter of which is yet to be clearly defined and captured in nursing theories. Conceptualizing ANP practice and capturing their valuable nursing care will enable better understanding and clarity for the role to realize its full potential.