RCN defines enhanced, advanced and consultant nursing
New definitions of enhanced, advanced and consultant nurses have been issued by the Royal College of Nursing (RCN).
The college said it hoped the definitions would “bring clarity and consistency” to the different levels of nursing practice beyond registration.
“There are many experienced nurses who are currently just not seen but essential for safety and high-quality services”
Alison Leary
The RCN noted how enhanced nursing was a “relatively new” concept that had emerged in 2019 from modelling by nursing workforce academic Professor Alison Leary.
Now seeking to define this group, the college said enhanced nurses were those with additional post-registration education and learning in a relevant subject to their role.
The proportion of nurses working at an enhanced level is “considerably larger than for those at advanced or consultant level”, added the college.
Meanwhile, there has been a spotlight on advanced nursing recently as the Nursing and Midwifery Council (NMC) is looking at introducing specific regulation for this group.
The RCN said that, while advanced level nursing was widely recognised, it had “lacked a consistent definition, remains unregulated and covers a wide range of roles and titles”.
In its new definition, the RCN described advanced nursing as that delivered by registered nurses with “with substantial experience and expertise”.
The college has also produced its first-ever definition of consultant level nursing practice.
It said consultant nurses were those who had “progressed from an advanced level within their field to reach a significantly higher level”.
The definitions have been published as part of a wider piece of work being undertaken by the RCN to develop a new professional framework for the entire nursing workforce.
The work has already seen the RCN release an updated definition and principles of ‘nursing’ as a whole, to underpin the framework.
Next, the RCN will work on definitions for nursing support worker and nursing associate levels of practice.
Rachel Hollis, chair of the RCN Professional Nursing Committee that is overseeing the development of the professional framework, said: “Beyond the point of registration, the work of the registered nurse increases in its complexity.
“This is inconsistently and poorly recognised by employers, policy makers and the public.
“We set out to change this, and a working group, made up of expert members and staff from the RCN nursing department, have come together to clarify and bring consistency to the levels of nursing practice.”
Professor Leary has been advising RCN in its work on the definitions.
She told Nursing Times: “It will be really helpful to have these clear definitions of different levels of practice; in particular, enhanced/proficient practice being valued in its own right.
“There are many experienced nurses who are currently just not seen but essential for safety and high-quality services.”
Enhanced
Enhanced level nursing describes a level that can only be delivered by registered nurses who have gained additional post-registration education and experiential learning in a relevant subject area.
This level is differentiated from other levels by a registered nurse’s expertise in applying specific knowledge and skills to a designated area, such as a client group, skill set or in an organisational context.
Nurses working at the enhanced level should know how to manage discrete activities in complex, challenging and changing situations, seeking further guidance when needed.
Advanced
Advanced level nursing is a level delivered by registered nurses with substantial experience and expertise.
The advanced level is differentiated from other levels by a registered nurse’s expertise in applying highly developed theoretical and practical knowledge to complex, unpredictable, and sometimes unfamiliar situations. This involves use of critical thinking, high-level decision making and exercising professional judgement.
Consultant
Consultant level nursing describes a level of nursing delivered by registered nurses who have progressed from an advanced level within their field or specialty.
It is differentiated from other levels by a registered nurse’s expertise and credibility; strategic and enabling leadership; learning, developing, and improving across the system; research and innovation as an embedded researcher; and underpinning consultancy as the foundations of putting expertise in place to sustain quality.
