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When I first became a nurse practitioner, I had the urge to travel abroad for a year or two.  Young, single, and having promised myself I would never actually live in Tennessee long-term (10 years and counting…I think it’s safe to say the promise has been broken) I was ready for an adventure.  I contacted a healthcare recruiter in New Zealand, filled out stacks of paperwork and was beginning my housing search.  My beeline for the boarder came to an abrupt halt however, when I discovered the nurse practitioner role is much different in New Zealand.

A healthcare recruiter explained to me that New Zealand required nurse practitioners to have several years of nursing experience before advancing their profession, which I did not have.  I would be required to work as a floor nurse if I chose to relocate.  Also, the salary for both nurses and NPs was much lower in New Zealand than in the U.S. so an ocean view high rise in Auckland wouldn’t be in the budget.

Ultimately, I decided that having just graduated from my nurse practitioner program I wanted to take my newfound knowledge straight to practice.  I was worried that if I moved abroad and worked as a nurse, I would have trouble finding a job as an NP when I arrived back to the states.  But, my misadventure opened my eyes to the nurse practitioner role around the world.  What is life like for NPs practicing in other countries?

The nurse practitioner profession is much younger in other countries than in the United States.  Many countries are just beginning to use NPs are are working towards finding a way for them to fit into their current healthcare systems.  Here’s how a few countries around the world are using nurse practitioners and looking to make them an integral part of patient care.

Australia

The nurse practitioner education in Australia is much different than in the United Sates.  In Australia, NPs must work their way up over many years from nurse to clinical nurse, then to clinical nurse specialist and finally clinical nurse consultant.  Once a nurse has progressed through these steps, he or she may become a nurse practitioner.  This process takes years and the rate of progression is subject to job availability in each step preventing some nurses from moving up efficiently.  Aspiring NPs are only admitted to nurse practitioner university courses once they have achieved a certain level in their nursing career.

Based on the method by which nurse practitioners are trained in Australia, they have limited utility in the healthcare system.  Many nursing groups are fighting for reform trying to make the path to becoming an NP more accessible.

Canada

The nurse practitioner profession is on the rise in Canada thanks to efforts from nursing organizations.  Nursing organizations have successfully advertised a catchy slogan “It’s about time” to generate public interest in developing the nurse practitioner role.  The number of nurse practitioners practicing in Canada has nearly tripled in the past six years with over 3,400 NP now certified in the country.

Canada faces similar scope of practice issues to the United States.  Some provinces in Canada don’t allow nurse practitioners to prescribe medication, order certain medical tests or discharge patients from the hospital.  Nursing groups are fighting to improve utility of NPs in the name of providing improved access to primary care for Canadians.

United Kingdom

In the United Kingdom, the role of the nurse practitioner is not as developed as in the United States.  While all NPs in the UK have the ability to prescribe medications, the NP education and certification lack standardization across the country.  As a result of this lack in standardization, many physicians are hesitant to work with nurse practitioners uncertain of their qualifications.  Some companies may also refuse orders for imaging studies and procedures written by nurse practitioners.

There are no specific educational requirements for NPs practicing in the United Kingdom.  Educational programs vary significantly contributing to further confusion over the NP role. Nurse practitioners practicing in the UK do not need to be licensed or have their own national registration.  The NP role in the United Kingdom is expanding but lack of standardization inhibits professional growth and public confidence in the nurse practitioner role.

Taiwan

The concept of nurse practitioners is very new to Taiwan.  Due to language differences, the term “nurse practitioner” isn’t used in the country.  The Taiwanese version of the NP translates to something more along the lines of “clinical nurse specialist”.  The first advanced practice nurses in Taiwan emerged in 1994 when nurses became responsible for caring directly for patients after surgery in one private medical center.  Since then, the role has slowly begun to develop.  Taiwan’s government officially recognized the profession in 2000 making it legal for nurses to work in direct patient care.  Since then, the number of advanced practice nurses has grown rapidly.  Most advanced practice nurses in Taiwan practice in the hospital setting alongside physicians.

Singapore

Unlike most other countries exploring the implementation of nurse practitioners into the healthcare system, Singapore has been organized in its efforts.  Singapore created legal guidelines surrounding the nurse practitioner title making the NP role rigorously defined.  Recognizing it was losing nurses to other countries, Singapore began educating and hiring NPs as a way to advance the profession keeping nurses in the country.  The first nurse practitioner education program in Singapore began in 2003 and consists of 24 months of coursework.  Most nurse practitioners in Singapore work in the hospital or mental health setting.

Nurse practitioners are cropping up around the globe as countries are recognizing the need for affordable care for a larger number of individuals.  By training nurses to take on advanced roles, countries can improve their overall healthcare services and quality of life.

Are you interested in learning about the NP role in a specific country?  Comment below for more information.

 

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42 thoughts on “Nurse Practitioners: The International Scene”

  • Thanks for this article! I am aspiring NP. Having lived abroad for several years – and missing it – I was hoping for more international opportunities. What about working with international organizations? I have seen the State department advertising for NPs, but I have not investigated other organizations.

  • Hi Anne,

    Working with a U.S. based organization is a great way to work abroad while maintaining the role and standards of being a certified nurse practitioner in the U.S.  The State Department is the largest organization that employs NPs abroad.  You can also try working with organizations like Doctors without Borders. 

  • Thank you for the information. I have worked as a RN for four years and I am graduating with my family nurse practitioner degree in Feb. I really want to move somewhere and make a difference. I am not too concerned with the salary, but I knew the role of a nurse practitioner is different is every country. Have you found anywhere that will hire new nurse practitioner graduates if they have RN experience? Thank you so much.

  • Hi Mallory,

    Unfortunately, most international NP opportunities require some experience. For example, the State Department requires 4 years. I would look at locum tenens companies or contact a recruiter with a larger medical staffing company as they would have the best connections for placing you without NP experience. 

  • I have over 25 years experience with an MSN and FNP and cannot find opportunities overseas. I am finding US degrees and credentials don’t translate to other countries. I would really like the opportunity to work in a different system so would prefer no to be with an American organization. Has anyone ever tried to get credentialed in the UK as an American?

  • A NP in the UK is one of the highest positions you can achieve as a nurse and you must pass boards and certs in order to prove you have the knowledge and skills in the field. I’m on the phone with a RN from the UK who has been a RN for over 50 years in the country.

  • Thank you for the article. I recently became a nurse practitioner and I too am young, single and adventurous. Past couple years I have been discovering Europe wondering if one day I can work as an NP there. So far I’ve traveled to Spain, Italy, and France.

  • Hello! Great article! I am currently in a nurse practitioner program. I am on an adult/gerontology track. I’m interested in working in Ireland or the UK after I graduate but I’m worried I need to be Family nurse practitioner certified. Do you have any information about what “kind” of nurse practitioner is required for these countries? I appreciate any help!

  • Hi Emmy, 

    As far as I’m aware, European healthcare systems accept nurse practitioners of all specialties. That being said, a Family Nurse Practitioner certification makes you more marketable as you are able to treat a wider patient population (ex. children and adults). 

  • Thanks for the sharing your experiences everyone. I am currently a Family Nurse Practitioner in the US looking to explore career options for NPs inSouth Of France at the border of France/Italy either in Italy or French side. I have experience both in Emergency Medicine, Hospitalist and Internal Medicine. Does anyone know if either country has practice allowances for Nurse Practitioners? Any information will be appreciated. Thanks.

  • In reference to the Dr statement, nurse practitioners like DOs are not here to replace MDs but to compliment one another’s care and bring a unique approach to holistic medicine. New research indicates quality outcomes are more likely to be met if a Np and MD are managing a case.

    • I find the the statement made by the Dr as uneducated and misinformed. It’s very disappointing to learn that some physicians are so ignorant. I think such MDs don’t deserve to practice medicine because it’s not safe for humanity. Many evidence-based studies have demonstrated that NPs have better outcomes than MDs in the primary care setting so why should some MDs brag about their credentials? They need to find a solution to their ignorance and leave NPs alone!

  • I am an adult certified nurse practitioner with 20 years of experience in the US. I’m considering moving my family abroad and I’m looking for the best places to work as a nurse practitioner. I am in adult certified nurse practitioner with 20 years of experience in the US. I’m considering moving my family abroad and I’m looking for the best places to work is a nurse practitioner. We’ve been considering Central America, new Zealand or Australia, and possibly some place in Europe maybe Ireland. What have you seen as the best practice opportunities for NP the broad?

  • My husband may be stationed in Nowra for three years to help train their helicopter pilots. I will be graduating with my doctorate in nursing next May (2017). Does anyone have an idea as to how I would be able to work in Australia as an NP? After completing 4 years of my doctorate I would like to work, but I’m not sure how they’re hiring process is for new NPs who are traveling abroad with the military. There are no US military bases in Australia.

  • Hi Ash, 

    I would contact the board of nursing in the state where you plan to live in Australia. They should be able to give you some insight into the NP role in Australia and what you will need to do as far as getting licensed abroad. 

  • Denise Janetos says:

    Hello, I have 20 years experience in the US mainly in urgent care. Do you know who I would contact in order to work in the UK and or Spain? Thank you.

  • Just a comment about the NP position in Canada. Not sure where the info came from but there are little to no restrictions on NP’s prescribing medications in Canada. They can do everything from antiretrovirals to narcotics so the scope of practice is immense. There aren’t any provinces that say NP’s can’t prescribe! Can order MRI’s work in critical care, without physician supervision, with neonates, ect.

  • My desire is to live in Spain. I am a pediatric nurse practitioner and I have a grand feeling that specialty is pretty nonexistent over there. Was wondering who can I contact to consider my options….an international travel agency???

  • I am a nurse with 25 years of experience and I am currently finishing my Family Nurse Practitioner . I would love to work in Greece. I have traveled there several times and I am in the process of learning the language. Is it possible to work as a nurse practitioner ( or a nurse n any capacity) in Greece as an American?
    Thank you!!

  • We don’t need to go to Doctor school to do doctor stuff….we are capable of providing the same quality care…. Jealous little anonymous person…..

    • NPs don’t provide the same quality of care as physicians; NPs provide better quality of care than physicians; studies have proven that, period!

  • I am an acute care nurse practitioner, trained in the US but with Irish citizenship. What are the opportunities if any for me to work in Spain?, since work visa would not be an issue for me….

  • I am a mental health nurse practitioner in the US, many years of independent practice. Can someone tell me which countries , as of this time 11/17 , have independent practice roles for NP’s and which ones may be getting independent practice for NP’s soon?

  • I am an adult nurse practitioner with 6 years experience. I will be moving to Taiwan at the end of the year and hoping to work. Any advice or info you might share re: immigration to Taiwan and working as an NP?

  • I am interested in relocating to the Bahamas, Carribean or some more specific locations even would be Dominican Republic, St. Croix or Mexico. How are NPs utilized in these countries?

  • Jeremy Ruiz says:

    I read your article entitled Nurse Practitioners: The International Scene. However, I noticed that it is a little over five years old. I was wondering if you have any updated information on the nurse practitioner scene in a few countries listed in this article, namely, New Zealand, Australia, and Singapore.

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