Though we work across every setting, every specialism and in every nursing environment, there can sometimes be significant misunderstanding about the role and scope of advanced nurses.

As part of the ANP Forum in Focus Week, we’ve written this blog to challenge common myths, demystify the role, and clearly explain what ANP work is – and what it isn’t. We also hope it might inspire some of you to consider a move into advanced nursing practice in the future.

The ANP role

The Advanced Nurse Practitioner role is not new and was developed for a specific purpose: 

“In response to gaps in service delivery, national drivers and policy documents as part of workforce transformation to enable us to deliver high-quality care and reduce health inequalities.” – Jennifer, Director for Advanced Clinical Practice

ANPs play a vital role across health and care systems. We use our advanced training and master’s degree (or equivalent) knowledge to work in any setting where nursing care is delivered.

“Our training enables us to carry out detailed patient histories, assessments, examinations, diagnoses, and management of health conditions - including onward referral, requesting imaging and prescribing as indicated.” – Katie, Advanced Nurse Practitioner

Advanced practice involves complex clinical decision-making, a holistic approach to delivering care and working with a high level of autonomy across multi-disciplinary teams.

As Katie and Maria note they are often the only ANP working in their respective services, responsible for patient populations numbering in the hundreds of thousands.

ANP work is also firmly underpinned by all four of the pillars of nursing: clinical practice, leadership, education, and research.

“My role is 75% clinical. Some days will be focussed on training and research. I am able to adjust my days as patient need dictates.” – Maria, Advanced Nurse Practitioner (District Nursing)

Clinical Practice

ANP roles are hugely varied, and no two days or nights are the same. At the heart of advanced nursing practice is a holistic view of patient care. For Jennifer, the value of the ANP role is “not just in clinical expertise, but in continuity and connection. It is about seeing the whole picture; bringing people, processes, and patients together to create a pathway that works.”

There is also the higher degree of autonomous decision making involved in ANP work. As an ANP in District Nursing, Maria explains that she doesn’t “have the luxury of access to assistive technology such as radiology, blood gas machines, ECG monitoring and other clinical equipment for procedures” – meaning that she has to use her “learned skills and experience of clinical assessment to identify any acute exacerbations of disease or diagnose a new condition.” In practice this might mean taking a social or medical history, reviewing medications or carrying out a fully-body physical examination. The aim is to help people to live independently at home and avoid attending the emergency department for issues that could be prevented.

Prescribing medication is another key aspect to the ANP role. For Maria, being a non-medical prescriber (NMP) allows rapid access to medications for patients and can be completed “with the patient not needing to leave their own home, reducing carer burden and stress.”

For Mithun, who works across urgent and emergency care, it means “seeing patients with undifferentiated illness and injury, interpreting investigations, making diagnoses and getting people the right care as quickly as possible.” – Mithun, Lead Emergency Nurse Practitioner & Advanced Clinical Practitioner

Mithun writes that “ANPs are not just decision makers. We are constant emotional anchors - for patients, for families, and for the teams around us… The emotional labour embedded in even the most routine presentations is constant, cumulative, and almost entirely invisible in how we measure or value clinical work.” Being an emotional anchor is incredibly important in an emergency department where patients may be especially nervous, afraid or in shock.

Perhaps the greatest challenge we face is when a patient deteriorates, as Joanna explains:

“These are the moments that really test my advanced level skills. Being able to assess, intervene, and escalate appropriately is a responsibility I don’t take lightly, and it reinforces the importance of having a consistent, experienced presence within the team.” – Joanna, Lead Advanced Clinical Practitioner (Surgical)

These clinical roles have evolved over many years and are evidenced based practice. The positive outcomes for patients and the health and social care system demonstrate the added value that ANPs bring. Whilst some roles might be on multi-professional or senior decision maker rotas, we remain proud to be nurses.

Leadership

The ANP role also requires a higher level of leadership. This might be formally – as with Edith who leads a team of eight specialist nurses and one Health Care Assistant providing outpatient care, or through service design and development.

“I have taken a lead role in service redesign initiatives that aim to streamline pathways to ensure patients get the care they need. These efforts have been focused on reducing waiting times and facilitating better access to specialist nursing care. By identifying bottlenecks and proposing innovative solutions, I have worked to improve the efficiency and responsiveness of our services.” – Edith, Advanced Nurse Practitioner (Heart Failure)

Edith also notes that with services facing limited resource and fiscal constraints across the board, service transformation often cannot rely on “increased funding or staffing, but rather on doing things differently.” For her, ANP leadership is not a list of managerial tasks but about “leveraging our knowledge and expertise to improve care.”

Education

As ANPs, nursing education is not just a requirement but a passion. From undertaking advanced level clinical training to completing our master’s degrees[AJ4.1][WP4.2][AJ4.3][WP4.4], we agree that a professional curiosity and interest in development is essential for all ANPs.

ANPs deliver formal training and nursing education but being an ANP often also means being a role model and the person that everybody goes to. As Mithun explains “we are often seen by patients, by families, by junior colleagues, as the person who has the answers, who is in control, who knows what to do next.”

This added level of responsibility and expectation can take a toll, but it can also be one of the great privileges and pleasures of the job as Edith says:

“I have been fortunate to have had many opportunities for progression throughout my career, and some incredible mentors and role models who have taught me the value of paying it forward. Every day I try to emulate this, opening as many doors for others as I can as they move through their nursing journey, and celebrating success.” 

Adele describes something similar that she sees in her role as an academic, “I witness something that is rarely captured in competency frameworks: the emotional journey of becoming.” – Adele, Senior Lecturer and ANP

Research

For ANPs “research is not an optional extra; it is embedded in the very foundation of safe, effective, and evidence-based care…. A defining feature of advanced practice is the ability to translate evidence into action.” – Sharlene, Cardiovascular Advanced Clinical Practitioner and Advanced Nurse Practioner Forum Chair

In practice this means that we are often involved in critically appraising emerging evidence, engaging in multidisciplinary discussions, and supporting the development of updated care pathways.

Sharlene explains that “research is not always about large-scale studies or funding applications. It often begins with curiosity, reflection, and incremental improvement… The role of the ANP goes beyond applying guidance, it involves critically engaging with evidence, questioning practice and driving change where needed.”

Nursing research isn’t just limited to procedures and medicine either. Sharlene has contributed to work “exploring diversity and inclusion in cardiovascular research which highlighted the persistent underrepresentation of women in cardiovascular clinical trials.” Once more a person-centred holistic approach, and a focus on seeing the whole patient and not just their clinical presentation, gives us a unique vantage point from which to participate in research.

Inspired?

We hope that this blog has helped to showcase what advanced practice nursing looks and feels like.

If you’ve been inspired and if you’re considering a career in advanced practice, please do join our Advanced Nurse Practitioner Forum.

This blog was co-written by members of the RCN ANP Forum and Committee:

• Maria Betts - Advanced Nurse Practitioner (District Nursing)
• Katie Brown - Advanced Nurse Practitioner
• Joanna Das - Lead Advanced Clinical Practitioner (Surgical)
• Edith Donnelly - Advanced Nurse Practitioner (Heart Failure)
• Sharlene Hogan MSc RGN - Cardiovascular Advanced Clinical Practitioner and Chair of RCN ANP Forum
• Mithun Thampi - Lead Emergency Nurse Practitioner & Advanced Clinical Practitioner
• Jennifer Riley RN, MSc AP - Director for Advanced Clinical Practice
• Adele Parsons - Senior Lecturer and Advanced Nurse Practitioner