Introduction
Nurse practitioners (NPs) are recognised as advanced practice nurses internationally and nationally (Fry, 2011). Representing a relatively new and growing health professional workforce, NPs are highly skilled and educated nurses who provide timely, accessible and affordable health care for underserviced populations (Helms, Crookes & Bailey, 2015). Since the introduction of NPs into the Australian health care system 16 years ago, the role has demonstrated beneficial outcomes in the provision of safe and effective health care delivery, positively improving patient outcomes across all care settings (Centre for International Economics, 2013). NPs are a well-established nursing entity internationally, having been in existence in varying contexts, predominantly primary health care delivery, since the 1960s in the US and the 1980s in the UK (Diers, 2004). The majority of international NPs are employed within a primary health care (PHC) specialty practice area, with approximately 181 000 practising in this field in the US (Halcomb et al., 2016). Currently in Australia, there are 1400 endorsed NPs (Australian College of Nurse Practitioners, 2016) who practise collaboratively or independently across a variety of clinical specialty practice areas within hospital and community settings, including outreach services in rural and remote communities (Centre for International Economics, 2013).The emergency nurse practitioner (ENP) specialty is the fastest growing of the NP models, experiencing a 61 per cent increase in numbers during the period 2010–13 (Jennings et al., 2013). The Australian NP role has been recognised with a legislatively protected title only endorsed or authorised NPs can use (Nursing and Midwifery Board of Australia [NMBA], 2014).
Career progression to nurse practitioner
An NP is defined as an advanced practice nurse endorsed by the NMBA to practise within their scope under the legislatively protected title ‘nurse practitioner’ (NMBA, 2014, p. 5). The NP role has enabled experienced nurses to extend their scope of practice to include advanced client assessment, ordering and interpreting diagnostic investigations; referral and prescribing medications (Centre for International Economics, 2013). Effectively, NPs are able to provide care for their clients from presentation through to disposition depending on the context in which they practise, and as such have proven integral to the provision of highquality, safe, efficient and effective primary health care (Halcomb et al., 2016).