NP Professional Competency Framework
Since she took office ten years ago, the Nurse Practitioner has convincingly proven her added value in healthcare in the Netherlands – and thus her right to exist. This is evident from several evaluation reports. At the beginning of 2019, more than 3,600 Nurse Practitioners were active; not only in specialist medical care, but also in primary care, integrated primary/secondary health care and care for the elderly, mental health care, care for the intellectually disabled, and work-related care.
The Nurse Practitioner is a connecting professional with generalist and specialist skills or competences who takes on challenges in care as a collaboration partner with the care recipient, the care team, and with others within and outside the care organization. She is aware of transitions in care, for example of the shift from specialist medical care to primary care or of the progressively stronger link between mental and somatic health care, which makes coordination between practitioners increasingly necessary. She is a T-shaped professional who acts as an independent practitioner in the role of coordinating practitioner or co-care provider.
The Professional Competency Framework describes the expertise of the Nurse Practitioner somatic health care (NP) and that of the NP mental health care. A number of competences are shared between the two NP types. In addition, each NP practices one of the two specialties and disposes of the corresponding specialist competences.
In an ageing society like the Dutch one, which is struggling with shortages of qualified personnel, the available expertise should be used as efficiently as possible. This can be done, for example, by task substitution. In addition, the location of care provision is shifting from institutions to the care recipient’s own living environment; a paradigm shift from illness to functioning is taking place; and also views on health are changing. Under these circumstances, the NP, who combines nursing and medical expertise and treatments, can make an important contribution. After all, NPs, as bridge-builders between nursing and medicine, naturally think outside the boundaries of traditional care domains.
This Professional Competency Framework builds on the previously conceptualized Professional Competency Framework. There are three reasons for the revision. First, the Council for Nurse Practitioners (CSV) has decided to reduce the previously distinguished five nursing specialties to two: somatic health care and mental health care.
Secondly, on 1 September 2018 the statutory independent practice authority of the NP became definitive; a milestone for the professional group. By acquiring this definitive independent authority, the NP can continue to fulfil her role as an independent practitioner in all care sectors.
Thirdly, certain social developments influence the demand for and supply of care, such as the increase in the number of care recipients (with multimorbidity), (chronically) ill people’s continued participation in society, increasing deinstitutionalization and the growth of cross-sectoral care, as well as the role of technology in maintaining care recipients’ autonomy, control and independent functioning. These developments demand new and different competences from the NP.
The NP has definitively ‘arrived’ in the Dutch healthcare sector. Nevertheless, there is still a lot of work to be done. She is not yet the obvious partner in the organization of healthcare in all organizations. V&VN Verpleegkundig Specialisten (V&VN VS) does everything in its power to change this. This requires the commitment of the NP at all levels: from the clinic to politics. It also calls for the professional group to be connected, both in the institutions and in networks, and nationally in a powerful professional association.