Position paper on advanced nursing practice

Table of Content

Before the general elections on May 2013. Senator Cynthia Villar’s statement on “room nurses” drew anger from many Filipinos. particularly those associated to the nursing profession. In a senatorial argument. she stated that Filipino nursing pupils do non necessitate to complete a BSN grade since they are directed to going room nurses or health professionals in America or other states. The Philippine Nursing Association was speedy to bang Senator Villar’s label by stating that “patient attention or place attention is merely one facet of [ the ] nursing profession. ” ( Calonzo. 2013 )

The mentioned incident may be declarative of the developing nursing profession in the Philippines. Harmonizing to the American Academy of Nurse Practitioners ( 2011 ) . there are 33 states which pattern advanced nursing functions. This includes adjacent states in Asia such as South Korea. Hong Kong. Japan. Thailand. and Singapore among others. Conversely. the Philippine’s current nursing jurisprudence does non supply implementing guidelines for the pattern of Advanced Practice Nursing.

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Statement of the place

However. the proposed amendments to the Philippine Nursing Act of 2002. ot herwise known as RA 9173. includes coverage of Advanced Practice Nursing. The National Nursing Career Progression Program ( NNCPP ) . as stipulated in Article VII. Section 31 of the said amendments. shall be implemented by the Board of Nursing along with the Department of Health and accredited professional organisations.

This plan will supply chances for nursing forte plans and extra wages for Advanced Practice Nurses ( APNs ) . We view this as a good alteration of the current nursing jurisprudence as this paves the manner for the on-going patterned advance of Philippine nursing and how it may do in footings of planetary nursing criterions in the hereafter.

Background information

Mosby’s Medical Dictionary ( 2009 ) defines an Advanced Practice Nurse as a registered nurse holding instruction beyond the basic nursing instruction and certified by a nationally recognized professional organisation in a nursing forte. or run intoing other standards established by a Board of Nursing. Advanced Practice Nurses demonstrate a “greater deepness and comprehensiveness of cognition. a greater synthesis of informations. increased complexness of accomplishments and intercessions. and important function liberty. ”

( O’Grady. 2004 ) Furthermore. APNs encompass certified nurse-midwife ( CNM ) . certified registered nurse anesthesist ( CRNA ) . clinical nurse specializer ( CNS ) . and nurse practician ( NP ) .

In Article VI. Section 27 of the amended version of RA 9173. the functions of a nurse practician are mentioned every bit good as the demands to go one in the Philippines. Outstanding points include the demand of a master’s grade for entry degree. and enfranchisement based on the Board of Nursing protocol.

Discussion of both sides of the issue

Harmonizing to Blais. Hayes. Kozier. & A ; Erb ( 2002 ) . “Nursing instruction and advanced pattern functions will necessitate to develop in tandem if nursing is to be effectual in continuing the best of what nursing has been and to take the profession into the hereafter of wellness attention. ” Through the execution of Advanced Practice Nursing. the nursing profession in the Philippines may play a bigger function in the health care system of Filipinos.

Furthermore. the quintessential stereotype of nurses being the “doctor’s assistant” can be curtailed. Harmonizing to the American Nurse’s Association. “APNs can supply 60 % to 80 % of primary attention services every bit good as or better than doctors. and at a lower cost. ” ( as cited in Huston. 2006. p. 413 )

Nurse practicians can supply complete physical scrutinies. diagnose and dainty many common ague and chronic jobs. interpret research lab consequences and X raies. prescribe and manage medicines and other therapies. among others ( O’Grady. 2004 ) . In the Philippines where there is a scarceness of physicians in the rural countries. nurse practicians may besides be able to make full in the spread with their ability to supply primary attention to different age groups.

Harmonizing to Edwards & A ; Davis ( 2006 ) . because there are differences in educational readying and clinical pattern worldwide among nurses. it is indispensable to derive an apprehension of nurses’ perceptual experience of their clinical competency. Through advanced nursing functions. an overall addition in the morale and assurance of Filipino nurses may therefore follow.

Last. chances for continued development in the nursing profession may supply a solution to the excess of registered nurses in the Philippines. Harmonizing to Julito Vitriolo. CHED Executive Director. there are around 400. 000 unemployed nurses in the Philippines today ( Dioquino. 2013 ) . The Department of Labor and Employment has even urged idle nurses to seek for alternate employment alternatively of waiting for occupation vacancies in medical installations ( Jaymalin. 2013 ) . By actuating freshly registered nurses to prosecute alumnus schooling. they may hold a greater opportunity for well-paying occupations in the hereafter under the same profession.

However. there are some hindrances and disengagements that may be encountered with the execution of the proposed amendment on Advanced Practice Nursing. The difference in nursing patterns across the Earth can take to uneffective acceptance of advanced nursing functions. Harmonizing to Sherman & A ; Eggenberger ( 2008 ) . the “autonomy of the nurse and the degree of coaction between nurses and doctors are different across civilizations. ”

In the Philippines where nurses are mostly dependent on doctors for a patient’s medical direction. the attitude towards a widened range of pattern may be met with some opposition by a figure citizens. This can be made worse with the fact that “payers insist on ‘paying for performance’” in footings of physician-delivered attention ( O’Grady. 2004 ) .

Furthermore. there may non be dependable preparation establishments in the state to shoulder Advanced Practice Nursing. Today. there is no school in the Philippines that offers the deepness and comprehensiveness of cognition and accomplishments required for advanced pattern ( Domocmat. 2012 ) . This can badly impact the efficaciousness of Filipino nurse practicians as they do non acquire the same quality of instruction and preparation compared to their foreign opposite numbers. In this respect. function outlooks may besides non be clear to them as work scenes will be far from states considered as precursors of Advanced Practice Nursing such as the United States.

Last. O’Grady ( 2008 ) references that “the rapid growing and success of the APN motion has been described as a riotous innovation—in that APNs can in many ways provide the same attention or better attention than doctors. at a lower cost in a more convenient scene. ” This may take to professional sod conflicts that may altogether affect quality of attention and patient’s safety. Harmonizing to Safriet ( 2002 ) . doctors have “prevented the creative activity of Scopess of pattern that accurately define the type of attention being provided by new groups of wellness attention providers” such as advanced pattern nurses ( as cited in Huston. 2006. p. 422 ) .


Thailand. which can be seen as holding similar health care demands and restrictions as the Philippines. has greatly benefited from their execution of Advanced Practice Nursing. A survey in 2007 concluded that bulk of APNs in Thailand are in the primary scene and that advanced functions has led to Thai nurses experiencing “more useful” as their assurance is enhanced ( Hanucharurnkul. Suwisith. Piasue. & A ; Therathongkum. 2007 ) .

The demand to progress pattern can be seen as a necessary measure to better the function of the nursing profession in the country’s health care system. We believe that chances for go oning instruction and preparation for nurses can merely take to a more competent work force that may be able to accommodate better to the demands of the Filipino people. The Philippines may follow suit with Singapore where APNs undergo a period of clinical internship as an APN-intern under the mentorship of a medical adviser in a peculiar country ( Singapore Nursing Board. 2011 ) .

Although much remains to be seen for the hereafter of Advanced Nursing Practice. its execution can be seen as a motion towards bettering the nursing profession as a whole in the Philippines.


American Academy of Nurse Practitioners ( 2011 ) . NP Fact Sheet. Retrieved from American Academy of Nurse Practitioner database hypertext transfer protocol: //aanp. org/

Blais. K. . Hayes. J. . Kozier. B. . & A ; Erb. G. ( 2002 ) . Professional nursing pattern. New Jersey: Pearson Education. Inc.

Calonzo A. ( 2013 ) . Nurses’ group slams Cynthia Villar’s ‘room nurse’ ticket. [ ONLINE ] Available at: hypertext transfer protocol: //www. gmanetwork. com/news/story/298011/news/nation/nurses-group-slams-cynthia-villar-s-room-nurse-tag. [ Last Accessed 02 September 13 ] .

Dioquino R. ( 2012 ) . Nursing profession plagued by unemployment. poor-quality schools. [ ONLINE ] Available at: hypertext transfer protocol: //www. gmanetwork. com/news/story/248540/news/nation/nursing-profession-plagued-by-unemployment-poor-quality-schools. [ Last Accessed 2 September 13 ] .

Edwards. P. & A ; Davis. C. ( 2006. November 01 ) . Internationally Educated Nurses’ Perceptions of Their Clinical Competence. Journal of Continuing Education in Nursing. ( 6 ) . 265. Retrieved from hypertext transfer protocol: //elibrary. bigchalk. com

Huston. C. J. ( 2006 ) . Professional issues in nursing. Philadelphia: Lippincott Williams & A ; Wilkins

Hanucharurnkul. S. . Suwisith N. . Piasue N. . & A ; Terathongkum S. ( 2007 ) . Characteristics and working state of affairss of nurse practicians in Thailand. Retrieved September 1. 2013 from International Council of Nurses database hypertext transfer protocol: //www. icn. ch. /

Jaymalin M. ( 2013 ) . DOLE advises nurses to seek alternate occupations. [ ONLINE ] Available at: hypertext transfer protocol: //www. philstar. com/headlines/2013/02/26/913217/dole-advises-nurses-seek-alternative-jobs. [ Last Accessed 2 September 13 ] .

Mosby’s Medical Dictionary ( 2009 ) . 8th erectile dysfunction. Elsevier.

O’Grady. E. ( 2004 ) Advanced Practice Registered Nurses: The Impact on Patient Safety and Quality. Retrieved 2 October 2013 from hypertext transfer protocol: //www. ahrq. gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/OGradyE_APRN. pdf

Sherman. R. & A ; Eggenberger. T. ( 2008. December 01 ) . Transitioning Internationally Recruited Nurses Into Clinical Settings. Journal of Continuing Education in Nursing. ( 12 ) . 535. Retrieved from hypertext transfer protocol: //elibrary. bigchalk. com

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Position paper on advanced nursing practice. (2017, Jul 06). Retrieved from


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