Differentiating Specialized and Advanced Nursing Roles: The Pathway to Role Optimization.

Aim: We aimed to differentiate the practice patterns of nurses in specialized and advanced roles in a cross-sectional study. Method: Canadian nurses completed a self-report questionnaire (June 2017-September 2017). Demographic data and time spent in five domains of advanced practice were compared across three nurse groups. Regression analysis examined factors associated with domain involvement. Results: Respondents (n = 1,107) represented all provinces/territories, including 396 specialized nurses (SNs), 211 clinical nurse specialists (CNSs) and 490 nurse practitioners (NPs). Nurses across all groups were the most involved in direct comprehensive care and the least involved in research. NPs were more involved in direct comprehensive care compared to CNSs (p < 0.001) and SNs (p < 0.001). CNSs were more involved than SNs and NPs in support of systems, education, research and professional leadership (p < 0.001). Role type, years as an advanced practice nurse and specialist certification were modest predictors of domain involvement. Conclusion: Distinguishing how specialized and advanced nursing roles contribute to healthcare can inform policies to support their optimal utilization in healthcare systems.

Reflect for success: use of mentor recommendations to help failing students.

Mentoring student nurses (STN) who fail to achieve can be distressing for all those involved in the process. A group of community nurse mentors (CNMs) and practice learning team teachers (PLTs) made recommendations to manage failing students. This paper reflects on the use of the recommendations in practice and discusses the impact on practice for the PLT and CNMs.

Reflect for success: recommendations for mentors managing failing students.

Failing a student nurse for not meeting clinical competency on a practice placement can be a distressing and traumatic event for both student and community nurse mentor. This paper describes how a reflective model can be used to support practitioners' to come to terms with the decision and action of failing a student and dealing with the aftermath of the final interview.