Advanced Practice Nursing in the Netherlands

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Nurse Practitioner

Nationally Certified:
Yes

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Yes

Prescribing Authority:
Yes? (conflicting information)

Practice Autonomously:
Yes

Contact:
Dutch Ministry of Health

Role

The role of Advanced Practice Nurses in the Netherlands is the Nurse Practitioner.  Introduction of this role started in 1997 (Storedur & Leonard, 2010).  The Nurse Practitioner role in the Netherlands has been focally evaluated as alternatives for general practice physicians based on a general practitioner shortage (Dierick-van Daele, 2010; Stordeur & Leonard, 2010; Zwijnenberg & Bours 2012).  According to Zwinjenberg & Bours (2012), on average Nurse Practitioners perform procedures on their patients 20% of the time.  As such, they have additionally been seen as a possible route of increasing cost-effectiveness of healthcare in the Netherlands (Dierick-van Daele, 2010; Zwijnenberg & Bours 2012).  The scope of practice for Dutch Nurse Practitioners primarily includes:

  • Advanced assessment (Dierick-van Daele, 2010)
  • Diagnosing and making decisions for further treatment (Dierick-van Daele, 2010)
  • Prescriptive Authority (Dierick-van Daele, 2010; Pulcini, Jelic, Gul, & Loke, 2009; Sheer & Wong, 2008)
  • Provision of procedures necessary for medication treatment (Zwinjenberg & Bours, 2012)
  • Referrals to primary or secondary services (Dierick-van Daele, 2010)

While several authors have stated that Nurse Practitioners have prescriptive authority in the Netherlands (see above, second bullet-point), Stodeur and Leonard (2010) state this is not the case and HAI Europe (2012) states that prescriptive authority is currently under legislation.

Since the introduction of the Nurse Practitioner role in the Netherlands, studies began showing that the role significantly addressed areas of patient care that were not previously adequately addressed by their physician staff (Stordeur & Leonard, 2010).  While the role is not intended to replace that of physicians, it has been greatly observed as a complimentary role and is pursuing more autonomous roles for Nurse Practitioners to perform patient care in patients homes and management of chronic illnesses (Storeur & Leonard, 2010).

Education and Certification

A four-year bachelor degree is necessary to work as a registered nurse in the Netherlands (Robinson & Griffiths, 2007).  The advancement of nursing practice to become a Nurse Practitioner requires an individual to receive a Master of Advanced Nursing Practice degree (Dierick-van Daele, 2010; Stordeur & Leonard, 2010).  The Dutch have been very proactive in developing a model to facilitate this role development, including having their APN students experience through immersion the Nurse Practitioner role outside their country (Ter Maten & Garcia-Maas, 2010).   Registration for Advanced Practice Nurses in the Netherlands requires individuals to register under a separate registry from that of registered nurses, maintained by a division of the Central Information Centre for Professional Practitioners, an branch under the Ministry of Health, Welfare, and Sport (Robinson & Griffiths, 2007).

Specialties

Currently, the role of Advanced Practice Nurses in the Netherlands greatly incorporates primary health care  based on the needs of the country (Dierick-van Daele, 2010).  Of note, the midwife role in the Netherlands is different than that of nurse midwives in much of the rest of the world, and is seen as its own independent profession.

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References:

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

Dierick-van Daele, A. (2010).  The Introduction of the Nurse Practitioner in General Practice [electronic publication].  Schering-Plough.  Retrieved from: http://arno.unimaas.nl/show.cgi?fid=20140

Pulcini, J., Jelic, M., Gul, R, Loke, A.Y. (2009).  An international survey on advanced practice nursing, education, practice, and regulation.  Journal of Nursing Scholarship, 42(1),31-39.  doi: 10.1111/j.1547-5069.2009.01322.x

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

Sheer, B. & Wong, F.K. (2008).  The development of advanced nursing practice globally.  Journal of Nursing Scholarship, 40(3),204-211.

Stordeur, S. & Leonard, C. (2010).  Challenges in physician supply planning: The case of Belgium.  Human Resources for Health, 8(28),1-11.  doi:10.1186/1478-4491-8-28

Ter Maten, A. & Garcia-Maas, L. (2010).  Dutch advanced nursing practice students: Role development through international short-term immersion.  Journal of Nursing Education, 48(4), 226-231.

Zwijnenberg, N.C. & Bours, G.J. (2012).  Nurse practitioners and physician assistants in Dutch hospitals: their role, extent of substitution and facilitators and barriers experienced in the reallocation of tasks.  Journal of  Advanced Nursing, 68(6),1235-1246.  doi: 10.1111/j.1365-2648.2011.05823.x

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