Nursing

Advanced Practice Nurses

What is the scope of practice?

Advanced Practice Nurses (APNs) are registered nurses who possess advanced education preparation and fulfil specific clinical practice requirements. These are some of the following ways in which APN practice may differ from Registered Nurses (RNs):

  • Expected to lead clinical practice and standards
  • Receive rigorous training (masters prepared or higher) and take on clinical privileges as accorded by medical colleagues. For example:
    • Elicit health history from presenting health complaints
    • Conduct physical examinations
    • Interpret laboratory and diagnostic results
    • Develop clinical diagnosis and differential diagnoses
    • Provide treatment collaboratively with physicians and healthcare team
    • Furnish and manage medication

**Throughout the process of care, APNs apply critical analysis, problem solving and clinical decision making skills to achieve optimal health outcomes for the patients

How are the APNs prepared to take on this advanced nursing practice scope?

All APNs are Registered Nurses (RNs) under the Singapore Nursing Board (SNB) registry. After graduating with a Master degree in clinical nursing, the RNs are required to undergo a period of clinical internship as an APN-Intern under the mentorship of a Medical Consultant in the specific clinical specialty. The APN-Intern will be registered as APN under the SNB registry only after passing the exit interview organized by SNB.

More information can be obtained from http://www.snb.gov.sg

Which clinical specialties in TTSH have APNs?

At present, there are APNs or APN-Interns in the following clinical specialties:

  • Cardiology
  • Diabetes and Endocrinology
  • Gerontology
  • Neurology
  • Neurology Intensive Care Unit
  • Palliative Care

The future of APN in Singapore

Ministry of Health’s vision to develop 200 APNs by 2014 is both ambitious and exciting! Besides numbers, other avenues are also currently explored to increase the scope of APN practice.

One main area is prescription rights. Prescribing activities are traditionally medical domains. However, restricting prescriptive privileges defeats the primary intention of developing APNs for better access to healthcare services. Internationally, prescription rights ranges from limited formulary to full prescriptive authority that includes controlled substances. Locally, this is still work under construction.