The pronunciation of Nursing (HuLi) and Physics (WuLi) in Chinese are similar. Therefore, sometimes people would misunderstand my major as Physics rather than Nursing expecting me to have a more “professional’ major, because Nursing is not a profession in many Chinese’s eyes. When I studied in the US, people would mishear the word of Nursing as “Nothing”. They were very surprised why I went to their country for “Nothing”. Another misunderstanding many people would make is that they think a nurse would become a physician after he/she pursues a higher degree in nursing, such as a Master degree or a Doctorate degree. Both the Chinese and Americans have the same thought. Therefore, there is a need to clarify the practice of nursing. Based on the scope of practice, there are three types of nursing practices which are Registered Nurse (RN), Nurse Practitioner (NP), and Clinical Nurse Specialist (CNS) .
One of the types of nursing practice is the Registered Nurse (RN) who is a health care professional responsible for implementing the practice of nursing through the use of nursing process. RNs use the nursing process to assess, plan, implement, and evaluate nursing care of the sick and injured. RNs can be employed not only in a hospital setting but also in non-hospital environments, such as a physician’s clinic and insurance companies. Research RNs conduct or assist in conduct of research in many areas such as biology, psychology, or pharmacy. The scope of practice is monitored by a set of laws. Different countries have different laws. In the USA, the set of the laws is called “The Nurse Practice Act”, and in Taiwan, it is called the Bylaws of Nursing Practice. There are three routes to initial licensure as a registered nurse, namely a two-year Associate of Science in Nursing, a three-year Diploma program in Nursing, and a four-year Bachelor of Science in Nursing. Completion of any one of these three routes allows graduate nurses to take the National Nurse Examination held twice per year in Taiwan and also allows them to be admitted to the advanced education in Nursing program. Currently, there are more than 40 Master-prepared Nursing programs and 10 Doctorate-prepared Nursing Programs in Taiwan.
Another type of nursing practice is the Nurse Practitioner. In the USA, a Nurse Practitioner is a registered nurse who has completed specific advanced nursing education (generally a master’s degree) and has trained in the diagnosis and management of common medical conditions. Nurse practitioners provide a broader range of health care services than those of RNs. Nurse practitioners provide care in family practice offices, urgent care centers, and rural health clinics, and maintain collaborative working relationships with physicians. Nurse practitioners treat both acute and chronic conditions through prescribing medications, physical therapy, ordering tests and therapies for patients. In the US, NPs are licensed by the state in which they practice, and have a board certification in their area of practice. In Taiwan, four hundred registered nurses were trained and certified as Nurses Practitioners two years ago. Those nurses were not master-prepared and received only one to two years of training. There was a debate concerning the safety of patient care, but a compromise was made due to shortage of resident doctors in regional hospitals. Unlike their counterpart in the US, NPs in Taiwan cannot practice independently. They have to be supervised by a physician.
The last type of nursing practice is the Clinical Nurse Specialist. A clinical nurse specialist (CNS) is an advanced practice nurse with graduate preparation (earned master's or doctorate) from a program that prepares CNSs. CNSs are clinical experts in the diagnosis and treatment of illnesses, and the delivery of evidence-based nursing interventions. CNSs work with other nurses to advance their nursing practices, improve outcomes and provide clinical expertise to effect system-wide changes to improve programs of care. In the U.S., there is a nationally recognized CNS certification sponsored by the American Nurses Credentialing Center (ANCC)that can be taken once the master's degree is completed. In Taiwan, the CNS has not developed yet. Most of the CNSs earned their doctorate degree from a university located in the US and became an instructor in a university in Taiwan, and they have never practiced as a CNS.
In conclusion, none of the three types of nursing practice can function as a physician. The scope of NP’s practice has little differences with that of physicians, but the NPs are not physicians. There are graduate programs provided for the RNs and the CNSs. The scope of their practice is focused on nursing services.
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