2018 Volume 10 Issue 1 Pages 90-106
The development of advanced practice nursing roles internationally holds promise for improving patient care, the health of the local community, and the health of a society. Advanced practice roles have developed for a variety of reasons, although reasons may differ somewhat among countries. One compelling reason for the proliferation of advanced practice roles from the nursing profession’s standpoint is that higher levels of education and expertise permit a more comprehensive evaluation of, and attention to, a person’s needs. However, a worry about advanced practice roles is that other professions may want to control the APNs practice and direct it to other purposes than nursing goals. This has become a concern in the U.S. that must be guarded against. The situation in the U.S. provides a warning for advance nursing practice in other countries, including Japan. Advanced practice nursing is a nursing role and should not be subverted for other objectives or for the objectives of other professions. Because the nursing profession exists to provide a ‘good’ or service to society all nursing actions have ethical aspects. Accepting the ethical nature of everyday nursing practice is critical to the development of ethical expertise and thus for meeting nursing goals. We can be criticized when we get diverted from our goals whatever the reason. Advanced practice nurses with their higher levels of expertise and education are ideally positioned for leadership. A critical component of advanced practice nursing education, formal and ongoing, is the development of ethical expertise. Ethical expertise, in turn enables leadership of others, nurses as well as colleagues and allied professionals. In this talk I discuss the inseparable nature of nursing and ethics, proposing that advanced practice nurses are in the ideal leadership position to develop ethical environments of care. The skills and capacities needed to develop confidence in ethical decision-making are suggested, as are strategies for continuing to develop advanced practice nursing ethics expertise. Advanced practice leadership is proposed as a way to support and advance ethical practice settings.
