the job of "super" nurse was born

The event made little noise, but it is of importance. The decree instituting the creation of "advanced practice nurses" (IPA) was published Thursday, July 19 at Official Journal . Behind this term hides nothing less than the creation of a new profession: "super" nurses able to conduct consultations, practice examinations, renew prescriptions – all in semi-autonomy.

So a new level of care is emerging, halfway between nurses and doctors. The idea is not new: the law Health, promulgated in 2016 at the initiative of Marisol Touraine, provided for the creation of advanced practice. But the prerogatives and the level of autonomy of RPNs have been the subject of intense negotiations, between a nursing profession determined to badert its skills and liberal doctors not really enthusiastic.

Cancer, kidney failure, elderly … [19659004] The decree seems to draw a balance. The IPA will be in charge of monitoring patients with stabilized diseases, once a doctor has received a diagnosis and decided on a management. The scope includes oncology (where practice is common), chronic kidney disease (dialysis, renal transplantation), and "chronic stabilized conditions" in city care, the list will be specified. Mental health, initially envisaged, has not yet been adopted.

As part of a protocol signed by a physician, RPNs will be able to follow patients, perform clinical examinations and technical procedures, renew prescriptions and prescribe additional tests. "The nurses will refer their patients to the doctor when the limits of their field skills are reached," say the ministries of health and higher education, in a joint statement. The patient will of course have a say.

5000 advanced practice nurses by 2022

While regretting the limited level of autonomy confided to the IPA, Patrick Chamboredon, president of the National Order of Nurses, welcomed in a statement "a real step forward for the profession (…) but especially for the improvement of access to care". In view of the aging of the population and the declining medical demography, the IPA offers the hope of better care, especially in the areas under tension.

The diploma, master level, will be open to nurses justifying three years of experience. An experiment is already underway in Île-de-France and several universities (Paris, Toulouse, Caen, Rouen, Limoges-Bordeaux …) already offer a training offer, so that IPA should begin to become widespread in 2020. The government has committed to forming 5000 IPAs by the end of the five-year period.