Specialist and Advanced Specialist Nursing and Midwifery Practice

Abstract

Ambiguities and role confusion exist with regard to specialist and clinically advanced nursing/midwifery practice globally and in most healthcare settings. This confusion requires clarification in such a way that specialist/clinical advanced nursing and midwifery practice (as a category of the clinical specialist) are clearly delineated. In South Africa, this is further complicated by the introduction of the Occupation Specific Dispensation (OSD) of the Department of Health (2007) which makes provision for a grade called Professional Nurse (Specialty Nursing) and also for a further grade called Clinical Nurse Specialist (Level 3 Hospitals). The Specialty Nursing category has been implemented in most health services and nurses who have qualifications at post-basic and postgraduate diploma level in the areas described in Regulation 212 can benefit from this progression. The higher level of Clinical Nurse Specialist (OSD term for advanced specialist) has not yet been implemented. The OSD document indicates that appointments to these posts will require significant clinical experience and a clinical master's degree. This is in line with the ICN stance that clinical advanced specialist nursing and midwifery practice require masters and PhD-level education linked to significant clinical practice experience. This chapter presents a differentiation between the two levels of specialist practice − the advanced nurse/midwife practitioner and the specialist nurse/midwife from a South African perspective and in line with the International Council of Nurses (ICN) framework.

Perceptions of midwives on shortage and retention of staff at a public hospital in Tshwane District

“…According to the International Confederation of Midwives, the scope of practice for midwives must support and enable autonomous midwifery practice and should therefore include prescribing rights, access to laboratory/screening services and admitting and discharge rights (Oyetunde & Nkwonta 2014:43). The South African Nursing Council has, meanwhile, been criticised over not recognising midwifery as a profession in its own right (Duma et al 2012:6). This is perhaps the reason why midwifery as an independent function is still undervalued.…”

Use of scenarios to explore conflict management practices of nurse unit managers in public hospitals

“…These nurses have to manage relations between team members under their supervision, without having been practically evaluated on their ability to manage interpersonal relations. At postgraduate level, nurses are exposed to nursing management by enrolling for speciality programmes in either clinical or non-clinical postgraduate diploma or degree (Duma et al 2012:07). A clinical programme is a specialist area in nursing science covering specific knowledge and skills required for nurses to perform in a particular field, such as intensive care, trauma nursing, childcare nursing and many others.…”

The essence, opportunities and threats to Advanced Practice Nursing in Sub-Saharan Africa: A scoping review

“…Nurses constitute about 70–80% of the human resource for health in SSA (Duma et al., 2012; Rispel et al., 2014; Sietio, 2000). This means that nurses form the foundation of the healthcare system and by extension, the foundation of the child healthcare in SSA (Davis et al., 2014).…”

“…Nursing councils lack the resources and autonomy to expand the scope of practice of APN to reflect their extended roles. This creates role confusion among nurses and other healthcare professionals, placing a restriction on the Advanced Practice Nurses (Duma et al., 2012; East et al., 2014; Kleinpell et al., 2014). For example, the nurse practitioner programme in Ghana started in the year 1999 but could not be regulated until 2014 partly due to the fact that the Nursing and Midwifery Council thought the medical council is best suited to regulate their practice while the medical council demanded to change the name of the programme for them to regulate (Nursing and Midwifery Council, 2014).…”

“…There is difficulty with nurse practitioner private practice. Laws permitting NP private practice, acceptability by patients as care provider, and financial reimbursement.5.(Doodhnath, 2013), South Africa “Experiences of advanced psychiatric nurses on their practice in an Occupational Specific Dispensation hospital setting” To describe how the experiences of psychiatric nurses practicing at an OSD clinic was used to develop guidelines to support nurses practicing in OSD wardsQualitative, exploratory, descriptive and contextual design.In-depth interviews were conductedThe guidelines recommends the APN practice according to their scope of practice and enable the adoption of advanced practice nurse roles to allow the APN to practice advanced nursing skills.6.(Duma et al, 2012), South Africa “Specialist and advanced specialist nursing and midwifery practice” To differentiate between the two levels of Advanced Practice Nursing in South Africa in line with ICN perspectivesThere is much ambiguity in terms of roles and practice across the world. This ambiguity needs clarification in order to delineate scopes of practice.In South Africa, a “nurse/midwife specialist” is trained at the Advanced diploma level and is authorised to practice in a specialist field.…”