Advancing Nursing Practice Amid Global Policy Changes

One of the most significant shifts in nursing has been the emergence and institutionalization of Advanced Practice Nursing (APN) roles, including nurse practitioners (NPs), clinical nurse specialists (CNSs), and nurse anesthetists. Delamaire and Lafortune (2020), in their review of 12 developed countries, found that advanced practice nurses have become essential to addressing physician shortages, improving access to primary care, and filling critical gaps in specialty care. The policy environment around advanced nursing practice varies widely across countries. While the U.S., Canada, and parts of Europe have made significant strides, many nurses globally still face legal and institutional barriers that prevent them from practicing to the full extent of their training and expertise (Fawaz, Hamdan-Mansour and Tassi, 2021). Challenges and Opportunities in Enabling Full Scope of Practice Despite global progress, nurses still encounter persistent challenges in practicing at an advanced level. Regulatory limitations, interprofessional resistance, lack of role clarity, and insufficient educational infrastructure continue to hinder progress. According to Jangland, Yngman Uhlin and Arakelian (2021), institutional support is critical for enabling advanced practice roles in hospitals. Their research highlighted the importance of clear role definitions, organizational readiness, and interdisciplinary collaboration in sustaining advanced nursing roles. Equally important is leadership development. Without strategic leadership at the administrative and policy levels, nursing contributions risk being underutilized or overlooked in systemic reforms.