APN Role Exists in Country Today:
Nurse (with advanced degree)
Public Health Nurse (with advanced degree)
Recognize Foreign Licensure:
There are two chief roles identified for Advanced practice Nurses in Finland, namely that of the Advanced Nurse and Public Health Nurse, both of which are prepared with graduated level schooling (Delamaire & Lafortune, 2010). There is additionally a nurse midwife role available in Finland, but is understood as a registered nurse specialization rather than that of an advanced practice role (Robinson & Griffiths, 2007). This will be described further under the specializations category below. The roles for APNs in Finland can be delineated as follows (Delamaire & Lafortune, 2010):
- Public Health Nurse
- Advanced assessment, consultation, diagnosis, ordering and interpretation of diagnostic tests, management of various chronic diseases (follow-up, monitoring, and education), and referral to specialists
- Advanced Nurse
- Advanced assessment, consultation, diagnosis, ordering and interpretation of tests, and management of various chronic illnesses (follow-up, monitoring and education for non-acute cases)
- Triage for prioritization of patients
The first Advanced Practice Nurses in finland graduated in 2006 (Fagerström & Glasberg, 2011). While this role has recently been added to healthcare in Finland, the role primarily expands the autonomy and scope of practice of current nursing in the country. According to Fagerström and Glasberg (2011), the role of APNs primarily was observed as beneficial in the care of acute and chronic health conditions. Acutely, nurses and doctors in Finland have a longstanding cooperative relationship allowing nurses to participate in various roles (Delamaire & Lafortune, 2010). These may appear as nurses providing greater triage or reception of patients, or even working along side a doctor as a dual discipline team. Additionally, APNs in Finland also play an influential role in providing care to more rural areas underserved by physicians while also providing care at a lower cost than care provided by physicians (Delamaire & Lafortune, 2010). Often in these situations, nurses will provide the general examination of patients and have further electronic consultation with doctors for providing complicated care, often providing 70% of patient care (Delamaire & Lafortune, 2010).
Meanwhile, Delamaire and Lafortune (2010), reported that Finland was of the top nations with the highest number of nurses per 1000 people in the country at 15.5; thus indicating a surplus of nurses. Meanwhile, they indicated that Finland held a mildly below average ratio of doctors per capita (2.7 to 1000 people; European average was 2.8) (Delamaire & Lafortune, 2010). As a result, Finland presents itself as good place to further develop the Advanced Practice Nursing role, with a higher ratio of nurses and a lower number of doctors per capita, similar to that of the United States and United Kingdom (Delamaire & Lafortune, 2010).
Proposal to expand the role of APN practice in Finland to include limited prescriptive authority to those working in public health centers is currently underway (HAI Europe, 2012; Tynkkynen, n.d.).
Education and Certification
Education for Advanced Practice Nurses in Finland produced it’s first graduates in 2006 (DeGeest et al., 2008; Fagerström & Glasberg, 2011). Education for the registered nurse usually requires 3.5 years, and 4 years for the public health nurse (Robinson & Griffiths, 2007). The advanced degrees are available afterward to those who desire further advancement in scope of practice at the graduate level (Delamaire & Lafortune, 2010). While registration and certification is available for nursing in Finland, it is not currently provided for APNs (Robinson & Griffiths, 2007). Registration for healthcare individuals within Finland is maintained by the National Authority for Medico-Legal Affairs (Terveydenhuollon Oikeusturvakeskus).
At this time, APNs have been working in various roles including rural healthcare, general practice, and acute care (Delamaire & Lafortune, 2010). However, registered nurses in Finland have the choice of specializing in various categories nearing graduation of nursing school in acute care, geriatric care, mental health, multi-cultural, pediatrics, palliative care and youth and adolescent care (Robinson & Griffiths, 2007). Additionally, an individual can choose to be a nurse midwife with an additional year of schooling (Robinson & Griffiths, 2007).
De Geest, S., Moons, P., Callens, B., Gut., C., Lindpainter, L., & Sprig, R. (2008). Introducting advanced practice nurses/nurse practitioners in health care systems: A framework for reflection and analysis. Swiss Med Weekly, 138(43-44),621-628.
Delamaire, M. & Lafortune, G. (2010). Nurses in advanced roles: A description and evaluation of experiences in 12 developed countries. OECD Health Working Papers, 54, OECD Publishing.http://dx.doi.org/10.1787/5kmbrcfms5g7-en
Fagerström, L. & Glasberg, A.L. (2011). The first evaluation of the advanced practice nurse role in Finland – The perspective of nurse leaders. Journal of Nursing Management, 19, 925-932. doi:10.1111/j.1365-2834.2011.01280.x
HAI Europe (2012). The next chapter in promotion of healthcare professionals: Nurse prescribers [fact sheet]. Retrieved from: http://haieurope.org/wp-content/uploads/2012/02/27-July-2011-HAI-Europe-Nurse-Prescribers-Factsheet.pdf
Robinson, S. & Griffiths, P. (2007). Nursing education and regulation: International profiles and perspectives [online publication]. Retrieved from: http://eprints.soton.ac.uk/348772/1/NurseEduProfiles.pdf
Tynkkynen, L.K. (n.d.). Limited right for nurses to prescribe medication. Health Policy Monitor. Retrieved from: http://www.hpm.org/en/Surveys/THL_-_Finland/15/Limited_right_for_nurses_to_prescribe_medication.html