Foreword

Nurses and specialist nurses are playing a growing role in the healthcare arena. Above the specialties already existing, such as nurse anaesthetist, operating room nurse, intensive care, mental health nurses, and paediatric nurses, new ones have emerged or are about to emerge, such as cancer nurses, endocrinology nurses, diabetes nurses, cardiology nurses etc.

 

Despite the fact that some formal training for some specialties has existed for years, practice, status, training duration and content may be drastically different from one country to another. Some other specialist roles have been established in Europe, with a professional transnational collaboration like diabetes, dialysis, urology and oncology.

 

Moreover, the development of higher medical technologies and more sophisticated treatments require specialist nurses but also advanced practice nursing roles at Masters, post-Masters and doctoral level in their professional field, in order to ensure safety and quality of care.

 

Nevertheless, their role is still not homogeneously defined across Europe; there is no mention of nurse specialists in the European Directive 55/2013/EU on the recognition of professional qualifications and there is no harmonisation in terms of education, practice and status.

 

We move more and more from a hospital care setting to a home, community and outpatient care setting with the development of ambulatory surgery, oral therapies etc. The hospital care setting is for the acute care and home and community care is for follow-up and long-term care.

 

That means we need to review our organisation where specialist nurses have a crucial role to play and where the fluidity of the patient pathway should be one of the priorities.

 

Indeed, a good coordination of the patient pathway with a holistic care approach involving all healthcare professionals inter alia reduces avoidable waiting time for appointments, enhances communication and collaboration between hospital and community/home, and enhances quality and safety of care. In the end, it is not only the patients who are satisfied and feel more confident, but also the healthcare professionals themselves.

 

Moreover, we will have to consider another care management, a tripartite model: physician, patient and other healthcare professionals like nurses/specialist nurses.

 

In fact, the patient is involved in decision-making regarding their own treatment, they learn to develop the skill for self-care, to be autonomous in taking treatment and spotting possible side effects of the treatment. And last but not least, they play a growing role in decision-making regarding healthcare policy. They are our partners.

 

So with regards to this context, we can see that specialist nurses are needed in hospital care settings as well as in home care settings and their skills are expected to evolve. But to ensure safety and quality of care, there is a crucial need to recognise specialist nurses at the EU level and to harmonise training, practice and status across Europe.

 

This is a great challenge for us, ESNO (European Specialist Nurses Organisations) as representatives of the specialist nurses in Europe, and there is a long way to go but let me say three typical sentences intrinsically linked to any conduct of project: “That is absolutely crazy”, “We will never succeed” and, at the end, “Why didn’t we think about that earlier?” We sustain the vision of specialist nurses being recognised at the EU level with a Masters, post-Masters, and PhD level qualification, and the future will assert this vision.