A task-based approach to defining the role of the nurse practitioner: the views of UK acute and primary sector nurses

There exists within the United Kingdom considerable confusion relating to t he definition and occupational boundaries of the nurse practitioner (NP). I n consequence, the clinical practice and training of the Nf remain unregula ted, unstandardized and heavily dependent on local forces. Such a situation is regrettable, particularly in view of the potential value the nurse prac titioner has for health care provision and also for influencing national po licy decisions. It is conceivable that one reason for the current failure t o reach agreement over the role definition of the nurse practitioner relate s to the fact that their essential job functions depend upon the context in which the nurse practitioner operates, with primary-based practice differi ng from acute sector service delivery in sufficient critical ways as to mak e a generic, inclusive definition impossible. To investigate the veracity o f this view, two cohorts of United Kingdom nurses were sampled, one of whic h worked within the acute sector (n = 49) and the other in the community (n = 420). These groups were surveyed using a unique training needs analysis instrument that had been developed along formal psychometric principles. Bo th groups perceived advanced clinical activities, including examination and diagnosis, and a range of research activities to be central to the role of the nurse practitioner. The primary sample, however, reported business and management activities as essential tasks, while the acute sector nurses re garded high levels of communication skills, autonomy and risk management to be more important. The implications of the similarities and differences be tween the two data sets are discussed with reference to different clinical domains.