Integration of advanced geriatric nurses: A mixed methods study of role and scope of practice

Abstract

This study focuses on the introduction of a nurse practitioner role, called advanced geriatric nurse (AGN) into the Norwegian healthcare system. The overall aim was to investigate the role of AGNs, what AGNs and their collaborators see as an appropriate scope of practice for these nurses and to what extent AGNs are being integrated into the Norwegian healthcare system. The 21 AGNs that were interviewed explained that they had developed a complex and extensive role. They had also developed a new ‘gaze’ based on a combination of their new knowledge and skills with their experience and interests. This new gaze provided them with the ability to see a wider range of medical, social and environmental problems in the older adults’ situation. The study also included a survey focusing on the integration of AGNs and their scope of practice among 23 AGNs and 195 of their colleagues. The survey showed that most of the respondents perceived the activities related to coordination, teaching/supervision and research and development work as appropriate for AGNs. Respondents also thought the same for half of the direct care activities, and for the one third of the indirect care activities. The survey also showed that the majority of the AGNs experienced that they were using their knowledge and skills to their full potential when providing direct care, but only a minority experienced doing so when providing indirect care, teaching/supervision and coordination. Around one-fourth of the colleagues stated that the AGNs’ scope of practice was completely clear and that they collaborated with the AGNs several times a week. Overall, the results indicate that the AGNs are not completely integrated into their workplaces. This study provides evidence that AGNs have a multifaceted role and a broad scope of practice, both of which are desired by AGNs, their colleagues and their leaders. The study also revealed a need for greater focus on the integration of AGNs into the Norwegian healthcare system.