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Nurse education in Germany

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					                                                     Issue 3            September 2004



1. ICN INP/APN Network Bulletin                    The Education Subgroup has posted the
Chair Update, Madrean Schober                      position papers on the role of the NP/APN in
                                                   different countries, and has listed informative
                                                   links for programmes and courses on offer in
Resources and representation for the ICN
                                                   several nations. The Communication
International Nurse Practitioner/Advanced
                                                   Subgroup has successfully launched the
Practice Nursing Network continue to increase
                                                   second issue of the bulletin, which spotlights
as we approach the end of 2004:
                                                   countries of the Middle East. Articles of
                                                   interest continue to be solicited. The
        International scope, standards and
                                                   conference report of the Geneva meeting was
         competency guidelines for advanced
                                                   published at Medscape Nursing and the
         practice nursing roles are in the final
                                                   Network was represented at the National
         stage of development. It is hoped
                                                   Organization of Nurse Practitioner Faculties
         that these documents will be
                                                   held in the USA in April 2004.
         available for worldwide access within
         the next six to twelve months.
                                                   The Conference Subgroup has finalized the
                                                   template and time-line for host countries
        A Network Resource Bank (NRB) is
                                                   interested in sponsoring conferences. Once
         now in place with plans to increase
                                                   the logo was selected, a banner with photos
         utilisation of this resource of experts
                                                   was developed and will be available for use at
         in the field. Those interested in
                                                   the booth display in Taiwan in 2005. Petrie
         becoming a member of NRB can
                                                   Roodbol of the Research Subgroup reported
         access the application on the web
                                                   on the website survey which received
         site at www.icn-apnetwork.org under
                                                   responses from 68 countries on the role of
         the membership tab.
                                                   Nurse Practitioners, familiarity with the role,
                                                   education and practice. The Policy
        The 2006 ICN INP/APNN
                                                   /Standards/Regulation Subgroup has
         Conference will be hosted by                                              th
                                                   completed and submitted the 7 draft of the
         DENOSA in the Republic of South
                                                   Scope of Practice and Standards for the
         Africa and the 2008 conference will
                                                   NP/APN. This was presented to the
         be held in Toronto, Canada.
                                                   conference participants in Groningen and has
                                                   also been posted on the website for additional
The term of this chair will end in December
                                                   feedback from members as well as NNA
2004 with a vision of network expansion that
                                                   members of ICN.
continues to include far-reaching global
representation and increased opportunities for
the international community to contribute to
and access information on trends and growth
for advanced nursing practice.                               Table of contents
                                                      Update from Chair                   1
2. Network Committee Update                           Committee Update                    1
                                                       rd
Subgroup activities for 2003-2004                     3 ICN INP/APN Conference            2
Rosemary Goodyear, Core Steering Group                INP Membership                      2
                                                      Nursing Around the World            2
The subgroups of the INP/APN Network have             Featured Member Activities          3
been working toward moving the network                Featured Organisation               4
forward in the global community of nurse              Meeting News                        4
practitioners and advanced practice nurses.



                                                                                                 1
3. Report of 3rd ICN INP/APN                       apnetwork.org and a conference report was
Network Conference                                 published at Medscape Nursing and can be
                                                   accessed at http://www.medscape.com.
Barbara Sheer, Communications Chair
                                                   (posted 7/21/04).
“Critical Pathways in a Global Context” was
                  rd
the theme of the 3 ICN INP/APN Network             4. Current Membership
Conference held in Groningen, the
Netherlands on June 29- July 3, 2004. The          Current Membership of the INP/APNN totals
Conference Chair, Mrs. Petri Roodbol, and the      548, and the Resource Bank has 50
capable staff welcomed delegates                   members. If you would like to become a
representing 27 countries.                         member, please consult the website, or, if you
                                                   have expertise to share, please join the
Some European countries were represented           Network Resource Bank. Together we can
with delegates and speakers for the first time     make a difference in global health care.
at a network conference. Switzerland and
Belgium are moving in the direction of
advanced practice nursing, while Germany is        5. Nursing Around the World
facing changes in health care and nursing
education with mixed results.                      Advanced Nursing Practice in Switzerland
                                                   Lyn Lindpaintner, Institute of Nursing Science,
There were diverse presentations from around       University of Basel
the world including, Australia, Canada, Hong
Kong, Malaysia, New Zealand, South Africa,         The history of advanced practice nursing in
Sweden and Thailand. The most poster               Switzerland is very recent, but very dynamic.
presentations were from representatives from       The Institute of Nursing Science (INS) at the
Japan.                                             University of Basel was founded in 2000, and
                                                   is the first university-level nursing programme
The changes in the European union were             in Switzerland. Furthermore, the INS
highlighted in keynotes by drs Ria von             articulated a clinically oriented mission: to
Bonninghausen tot Herinkhave-Visser, chair         improve health outcomes in the Swiss
of the Permanent Committee of Nurses in the        population, especially those living with chronic
Netherlands and Philip C. Berman, Director of      illness, through the development of advanced
the European Healthcare Management                 nursing practice. This has required innovative
Association. In particular, the freedom of         curricular developments since, until the INS
movement for people and services within the        Master’s programme was established,
European Market has significant implications       physical assessment skills had not been
for nursing and health care.                       systematically taught, even in advanced
                                                   clinical education. The challenges posed by
Dr Stephanie Ferguson, ICN consultant,             the growing epidemic of chronic illness have
offered a leadership pre-conference workshop       raised awareness of the important contribution
for the network committee members and, in a        of advanced nursing practice in this arena. In
keynote session, discussed the Leadership for      particular, in the areas of geriatric, cardiac and
Change programme developed by ICN. Her             transplant nursing, as well as HIV/AIDS care,
inspiring presentation highlighted the need for    new roles are evolving rapidly. The INS’
countries to develop nursing leadership within     efforts in clinical field development, research
the country to move health forward. Nurses         and teaching will surely stimulate important
need support and inspiration to be actively        change.
involved in the health care changes that all
nations face.                                      Nurse Education in Germany
                                                   Gertrud Leser
Fadwa Affara, representing ICN and the             Bielefeld, Germany
network policy/standards/ regulation
subgroup, presented the latest draft of the        Nurse education in Germany is comparable to
international scope and standards of practice.     international programmes in content; however,
             th
This is the 7 draft and is now available on the    most nursing schools are private hospital-
network website for international comment.         based schools and come under the Ministry of
After the comment period, it will go back to the   Health. This applies particularly to
committee for the final version.                   programmes in adult nursing, newborn and
                                                   children nursing, midwifery and nursing
Petie Roodbol presented the results of the         assistance.
2003-2004 network survey. The 637
respondents, representing 68 countries,            There is also a programme leading to the
responded positively to the concept of the         qualification of care of the elderly nurse, under
nurse practitioner. Educational programmes         the Ministry of Social Affairs, and a
were reported in 42 of the countries with over     programme in handicapped/disabled nursing,
half at the masters level. A press release is      under the Ministry of Education.
posted on the website http://www.icn-


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Recent changes in some nursing laws and            areas. These roles continue to evolve and
programmes aim towards a common                    future directions are emerging.
foundation in newborn/child nursing and
general nursing. There are also pilot              The Challenges of Developing the Nurse
programmes that include care of the elderly in     Practitioner Role in Puerto Rico
the common foundation phase.                       Janet Rodríguez, University of Puerto Rico
                                                   Lenore Resick, Duquesne University-School
Overall, although recent changes try to bring      of Nursing
nurse education into line with general health
care moves that include shorter hospital stays     Historically, initiating the role of the nurse
and more community-based health facilities,        practitioner worldwide has not been without
the nursing profession in Germany continues        struggle. Puerto Rico, like many countries,
to be split into different professional groups.    has encountered various challenges and
Nurses and politicians continue the debate to      oppositions to gaining recognition for this role.
establish Bsc courses as a first step into the     In 1997, the University of Puerto Rico, Medical
profession, but progress is hampered by            Sciences Campus, School of Nursing initiated
financial constraints.                             an ongoing collaboration with Duquesne
                                                   University in Pittsburgh, Pennsylvania. By
                                                   2000, there was a necessity to create a
Advanced practice nurses are born in               culturally competent nurse practitioner
Thailand                                           curriculum in order to provide the people of
Prathana Langkarpint Payap, University             Puerto Rico with health services at lower cost
Thailand                                           and to promote and maintain health.

The APN concept was adopted by the Nursing         The initial challenge was to gain support from
Council of Thailand in 1998 and in 2003, the       the people and the medical and nursing
first group of 49 APNs were certified in           professions. Language barriers, limited
Thailand.                                          accessibility to a Nurse Practitioner
                                                   Programme and no legal recognition of the
In order to avoid the title confusion and          nurse practitioner role were other obstacles.
hierarchical fragmentation, only one title was     Strategies to meet the challenges were:
used: advanced practice nurse. However,            assisting and providing continuing education
graduates were certified in five branches:         to health professionals, networking through
medical and surgical, paediatrics, maternal        attending international meetings to promote
and child, community, and psychiatric and          the programme, and conducting research.
mental health nursing. It is hoped that APNs       There are more challenges to be met.
will be valuable health care providers to meet
the goal of the National Health Care Reform        Although there is much to learn from the
and the 9th National Health Development            experiences of other countries about
Plan.                                              developing the nurse practitioner role, each
                                                   culture is unique and the most efficient and
                                                   effective strategies to overcome the
News From Malaysia the Clinical Nurse              challenges must be determined.
Specialist Programme
Aini Ahmad, University of Malaya, Malaysia         The ultimate goal and main reason for
                                                   meeting the challenges will always be to
Raising the educational level of nursing in        provide culturally competent care that is
Malaysia has been a long and difficult task. It    accessible and acceptable in order to improve
took from 1981 to September 1993 to                the health and wellness of the people living in
convince university officials that a degree        Puerto Rico.
programme in nursing should be started.
University Malaya, being the oldest and            This is just the beginning. The best is still to
premier university in Malaysia, has taken the      come and we will be prepared.
initiative to start a three-year nursing degree
programme with the emphasis towards                6. Featured Member Activities
preparing nurse leaders in management and          Promoting Primary Health Care Nursing in
education. Most of the graduates are now part      Central America, by Aruna Thampy
of the workforce of Malaysian healthcare
services: as ward manager / matron/ nursing        Central American countries, including
officer for those who specialised in nursing       Nicaragua, Guatemala, Honduras and El
management, and as nurse educator in public        Salvador, continue the familiar struggle of
or private nursing colleges for those who          populations in poverty, and with inadequate
opted for teaching.                                access to basic health care especially in rural
                                                   areas. Given this situation, nurses in both
In 1999, the programme identified the              Canada and Central America have come
discipline of clinical specialty with the aim of   together to teach community workers within
preparing the nurse leaders in the clinical



                                                                                                      3
the national policy framework to work towards      grants, education and clinical practice issues.
achieving health for all.                          This summer, we moved into our new office in
                                                   Bethesda, Maryland, a suburb of Washington
Given the geographic and economic                  DC. This move will facilitate interactions with
challenges, appropriate distributive learning      other advanced practice nursing associations,
technology is both a viable and practical          members of the congress of the United States
method to reach large numbers of potential         of America, and other health care
students in the communities. Nursing faculty       organisations.
from the Centre for Nursing Studies, St.
John’s, Newfoundland/Labrador, together with       We have a website www.ncgnp.org and we
nursing faculty from the four Central American     welcome all advanced practice nurses
countries, will work together over the next five   interested in Gerontological nursing to log on.
years to develop and implement primary             It is also possible to become a member “on
health care distributive learning to a number of   line” and we welcome you to do that.
students in all four countries. Currently,
Nicaragua has already commenced the ten-           The highlight of the year is in September
month programme, and Guatemala is                  when we have our annual conference and
engaged in a prior learning assessment to          business meeting. We provide over 30
evaluate learning needs of rural health            continuing education units in Gerontological
workers in the north of the country and plan to    advanced practice nursing, which many
use similar technologies by the end of 2004.       nurses need to maintain state licence and
Feasibility studies are being conducted in         national certification. We invite all advanced
Honduras and El Salvador.                          practice nurses to submit papers and research
                                                   for these conferences.
This project also engages in national policy
dialogue on the role of the primary health care    NCGNP values the important input from our
within national health systems. There are          colleagues around the world. No one has all
broad-based, multi stakeholder discussions on      the answers when it comes to caring for the
the role of nursing in the health reforms within   elderly. By sharing ideas, experiences and
each country.                                      research we strive to improve care for the
                                                   elderly. That is the essence of NCGNP.
Primary health care delivery to outlying and
rural areas of developing countries, taught by
nurses, using appropriate distributive learning    8. Meeting News
technologies, is a practical model for other
countries. We look forward to sharing our          We hope to see you at the 23rd Quadrennial
experiences in this project, including our         Congress in Taipei, Taiwan, May 21-27, 2005.
challenges and successes.                          It is a much anticipated event, showcasing
                                                   nursing innovation, new nursing roles and
                                                   cutting edge research. Early registration
7. Featured Organisation                           deadline is February 1, 2005. Additional
THE NATIONAL CONFERENCE OF                         information is available at
GERONTOLOGICAL NURSE PRACTITIONERS                 http://www.icn.ch/congress2005.htm.

M.J. Henderson, President, NCGNP                   Looking ahead
                                                   Plan on joining the network at the ICN
The National Conference of Gerontological          INP/APNN Conference in 2006 to be hosted
Nurse Practitioners (NCGNP) was established        by DENOSA in the Republic of South Africa.
in 1981 by a group of Gerontological Nurse         Information will be posted at http://www.icn-
Practitioners (GNPs) in the northwestern           apnetwork.org.
region of the United States of America. They
originally met to discuss common interests         Communication News
and issues affecting Gerontological Nurse          We are interested in learning about the
Practitioners (GNPs) and to become more            advanced practice movement in your country.
educated about new nursing science as it           Please send information about your progress
related to Gerontological advanced practice        to sheer@udel.edu.
nursing.

Since 1981, NCGNP has grown into a full
service advanced practice nursing association
with a current membership of 1100 NPs. We
now welcome all advanced practice nurses
who are working with elderly people to
become members of NCGNP. We have a six-
member elected Board of Directors and an
appointed Executive Director. We have
several committees working on research



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