Advanced Practice Nurses (APNs) are key to improving access to timely care at the local level and to ensuring quality, innovation, and developments in healthcare in Europe and worldwide. As we begin the process of implementing APNs in the Estonian healthcare system, it is necessary to understand what roles are attributed to APNs within the nursing profession in order to distinguish them from the roles of other healthcare professionals in the country. Therefore, qualitative longitudinal research was conducted to describe and understand how APN students identify their higher-level roles in their specialities and positions. 183 narrative essays written by the APN students in the second semester of their master’s studies in Health Sciences at Tallinn Health Care College were analysed using inductive content analysis. Eight roles of APNs were revealed as observed by the students themselves: the continuously evolving direct care provider, the experience counsellor, the improving practitioner, the team player, the fighter and the advocate, the developer and the promoter, the leader, and the advancer on the move. From this we can conclude that APN students are already experienced and focused on clinical practice and evidence-based activities as a Clinical Nurse Specialist (CNS) while they have acquired and apply all the other core competencies of an Advanced Practise Nurse. The period of the COVID-19 pandemic and developing advanced practice has significantly increased the APN students’ ability to work in and lead teams, and their courage to protect the rights of patients and nurses.
Bryant-Lukosius, D. and DiCenso, A. 2004. A framework for the introduction and evaluation of advanced practice nursing roles. J. Adv. Nurs., 48(5), 530–540.
https://doi.org/10.1111/j.1365-2648.2004.03235.x
Bryant-Lukosius, D., Valatis, R., Martin-Misener, R., Donald, F., Morán Peňa, L. and Brousseau, L. 2017. Advanced practice nursing: a strategy for achieving universal health coverage and universal access to health. Rev. Lat. Am. Enfermagem, 25, e2826.
https://doi.org/10.1590/1518-8345.1677.2826
Dowling, M., Beauchesne, M., Farrelly, F. and Murphy, K. 2013. Advanced practice nursing: a concept analysis. Int. J. Nurs. Pract., 19(2), 131–140.
https://doi.org/10.1111/ijn.12050
EKKA. 2021. Report on the re-assessment of the study programme group of health care: master’s programme of Health Sciences, Tallinn Health Care College.
https://haka.ee/wp-content/uploads/4_Tallinn-HCC_-Health-Sciences_Report_final_25.05.21.pdf (accessed 2023-02-27).
Estonian Nurses Union, Estonian Midwives Union, Estonian Nurse Directors Association. 2020. Eesti õenduse ja ämmaemanduse arengustrateegia 2021–2030: ühised sammud terviseni (Estonian nursing and midwifery development strategy 2021–2030: common steps to health) (in Estonian).
https://www.estnda.ee/pildid/dokumendid/Avaleht/Eesti_oenduse_ammaemanduse_arengustrateegia_2021_2030.pdf (accessed 2023-02-27).
Heale, R. and Buckley, C. R. 2015. An international perspective of advanced practice nursing regulation. Int. Nurs. Rev., 62(3), 421–429.
https://doi.org/10.1111/inr.12193
International Council of Nurses. ICN annual report 2021: Advocating for protection, value and investment in nursing.
https://issuu.com/icn9/docs/gp_liens_icn_ra_2021_anglais_v10 (accessed 2023-02-27).
Liivet G. 2020. Eriõe mõiste ja baaspädevused (Definition and basic competences of an Advanced Practice Nurse). Eesti Õde, 3/4, 1–35 (in Estonian).
Ministry of Social Affairs, Republic of Estonia. 2022. Minister Peterson ja Eesti Õdede Liit: õdede õiguste ja vastutuse piirid vajavad täpsustamist (Minister Peterson and the Estonian Nurses Union: the boundaries of nurses’ rights and responsibilities need clarification) (in Estonian).
https://www.sm.ee/uudised/minister-peterson-ja-eesti-odede-liit-odede-oiguste-ja-vastutuse-piirid-vajavad (accessed 2023-02-27).
Moon, J. 2001. Reflection in higher education learning (PDP working paper 4).
http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.503.5288 (accessed 2023-02-27).
Schober, M., Lehwaldt, D., Rogers, M., Steinke, M., Turale, S., Pulcini, J., Roussel, J. and Stewart, D. 2020. Guidelines on advanced practice nursing. International Council of Nurses.
https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf (accessed 2023-02-27).
Tracy, M. F. and O’Grady, E. T. 2017. Hamric and Hanson’s Advanced Practice Nursing: An Integrative Approach. 6th ed. Elseiver Inc., St. Louis.
Unsworth, J., Greene, K., Ali, P., Lillebø, G. and Mazilu, D. C. 2022. Advanced practice nurse roles in Europe: implementation challenges, progress and lessons learnt. Int. Nurs. Rev., 1–10.
https://doi.org/10.1111/inr.12800
