A clinical internship model for the nurse practitioner programme
Introduction
Nurse practitioners (NPs) have been working in Canada, the United States of America (USA), and United Kingdom (UK) hospitals for a considerable length of time. The numbers of NPs in Canada is approaching 1000 (Canadian Institute for Health Information, 2006). In the UK, the number is close to 38,000 (NMC, 2006) and in the USA, there are 106,000 NPs (American Academy of Nurse Practitioners, 2006).
The role of the NP in Australia is relatively new but the numbers are increasing with approximately 140 NPs. These numbers are expected to increase as health service providers acknowledge the benefits of NPs. In the state of Victoria there are to date only 36 nurses NPs endorsed by the Nurses Board of Victoria (NBV website, 2006). In Victoria a nurse practitioner is defined as “… a registered nurse educated for advanced practice who is an essential member of an interdependent health care team and whose role is determined by the context in which s/he practices” (NBV website, 2006). An important issue from a curriculum development aspect is: what is the most appropriate method for preparing nurses for these types of advanced clinical practice roles? One approach is to develop a curriculum that incorporates clinical internship that will best prepare nurses for these advanced roles.
Section snippets
Literature
The introduction of the NP was a specific strategy aimed at increasing the number of health care providers who could provide a quality service that was able to meet the increasing healthcare delivery needs of the community in a cost-effective manner (McMullan et al., 2001). NPs provide a unique blend of nursing and medical care. In Australia, the main areas that health service providers have employed NPs are primary healthcare, emergency and more recently acute care. In one study, NPs have
Nurses board requirements
Those who wish to become NPs must fulfil certain criteria. In most instances nurses enrol in a Master’s degree programme and also seek employment as a nurse practitioner candidate (NPC). As the NP title is protected, a nurse cannot use the title without formal endorsement with the relevant Nurses’ Boards in Australia. The focus of the NP role is on health promotion, education, and the complementary nature of the advanced nursing role with five extended practice areas: limited prescribing,
The clinical internship model
The description of the internship programme will be presented followed by the students’ comments on the model. For the clinical internship to succeed, it is of paramount importance that the mentor has a clear understanding of the NP role within the clinical specialty. The role of the mentor will be outlined before the students’ evaluation of the model is presented. The role of the mentor is to assist the NPC to develop and apply advanced assessment, diagnostic and pharmacological skills to
Initial student evaluations
The overall feedback on the clinical internship programme that incorporates mentorship from NPCs has been positive. In total, four students have been enrolled in the internship: three from Emergency Departments (ED) and one midwife from an antenatal clinic. Three students provided feedback on the internship. The students were asked to give their opinions on the internship, in terms of did it work for them, any issues they had, what they would change about the model, did having one mentor work
Discussion
This discussion paper highlights the importance in developing and delivering a programme that meets the academic and clinical requirements for NPCs. We have highlighted the importance of a mentorship programme and have demonstrated the importance of NPCs keeping a clinical log and presenting clinical cases within the clinical environment. Secondly, the feedback from NPCs has been positive. There is no doubt that for the mentorship experience to be successful and productive, a collaborative
Conclusion
The clinical internship model appears to be a suitable method of assessment and allows NPCs to develop their scope of practice whilst integrating the theory with their specialist clinical practice. Important to the success of such a programme of clinical learning is the establishment of a flexible mentor–mentee relation that enables NP role development that is role specific. Equally, the benefits of a clinical internship within a Master degree course that focuses specifically on the acquisition
References (29)
- et al.
Patient satisfaction with a new nurse practitioner service
Accident and Emergency Nursing
(2000) - et al.
Nurse practitioner competency standards: findings from collaborative Australian and New Zealand research
International Journal of Nursing Studies
(2006) - et al.
Mentoring for nurses in general practice: national issues and challenges
Collegian
(2005) - et al.
Care of minor injuries by emergency nurse practitioners or junior doctors: a randomised controlled trial
Lancet
(1999) Mentoring opens doors
British Journal of Perioperative Nursing
(2005)- et al.
Cultivating APNs for the future; a hospital-based advanced practice nursing internship program
Canadian Journal of Nursing Leadership
(2003) - American Academy of Nurse Practitioners, 2006. Spotlight on Healthcare....
- Australian Nursing and Midwifery Council, 2006. National Competency Standards for the Nurse Practitioner....
Mentoring – a complex relationship
Journal of the American Academy of Nurses Practitioners
(2006)- et al.
Do advanced practice nurses and physicians assistants benefit small rural hospitals
Journal of Rural Health
(1999)
Advanced practice nurses: a study of client satisfaction
Journal of American Academic Nurse Practitioners
Patient satisfaction with emergency nurse practitioners in A and E
Journal of Clinical Nursing
Evaluating emergency nurse practitioner services: a randomized controlled trial
Journal of Advanced Nursing
Cited by (30)
Construction of an Index System for Assessing Competences of Transplant Coordinators in China: A Delphi Survey
2022, Transplantation ProceedingsMidwifery students' experiences of their clinical internship: A qualitative descriptive study
2018, Nurse Education TodayImaging appropriateness in an academic emergency medicine program
2018, International Emergency NursingCitation Excerpt :Nevertheless, studies show that most of the students, physicians, nurses and medical house staff are not familiar with it, so its use may lead to better outcomes and resource management [20,26,27]. As we honestly acknowledge, most of imaging requests in emergency department are ordered without radiologic consultation and by still-learning emergency medicine residents [24,28]. Concerning the absence of organized radiology teaching for emergency residents, we measured emergency medicine residents’ knowledge of choosing proper initial imaging in some common pre-defined clinical scenarios, mainly to ascertain its improvement through their residency training.
The accuracy of adult limb radiograph interpretation by emergency nurse practitioners: A prospective comparative study
2014, International Journal of Nursing StudiesCitation Excerpt :We did not undertake individual analyses between the clinicians in each group to preserve staff anonymity. On-going clinical education and regular auditing is standard practice in the ED and is an important quality control measure (Hardy and Barrett, 2004; Lee and Fitzgerald, 2008; Swaby-Larsen, 2009). Emergency nurse practitioners participate in both formal and informal education.
Advanced practice registered nurses: Addressing emerging needs in emergency care
2014, African Journal of Emergency MedicineCitation Excerpt :Depending on the plan of study, a third area of coursework that provides information about a more specialized population such as geriatrics may be included. In addition to coursework all APRN education has a formalized mentorship experience, also called an internship,8 in the clinical arena. Students are paired with experienced APRNs or physicians who provide direct mentorship, helping their mentees teach health promotion, develop assessment and diagnostic skills and learn specialty-specific procedures.
Nurse Practitioner Special Interest Groups: Effective or Not?
2011, Journal for Nurse PractitionersCitation Excerpt :Upon meeting the board's requirements, an “endorsement” is placed on the nurse's registration. In the state of Victoria, Australia, the term “NP candidate” is used to describe a nurse who has completed or is working toward an accredited master's program13 and is working in a NP model of practice while receiving appropriate clinical supervision.26 In other states of Australia, the term “transitional” NP, as opposed to candidate, is used.