[American ambitions for the nursing profession].

There are more than four million nurses in the United States. In a context marked by the Obamacare vote and by an awareness of the underutilization of nursing potential, the Robert Wood Johnson Foundation, in association with the Institute of Medicine, published an inventory of the nursing situation in the United States in 2011, along with an action plan. In 2016 and 2021, the evaluation of the degree to which these objectives were achieved revealed numerous advances.

[The report's conclusions as seen by professional nursing organizations].

Nurses have largely contributed to the national effort to fight the Covid-19 crisis, but have also been strongly affected by its consequences. This observation, reinforced by the recent recommendations of the World Health Organization's report on the situation of nurses in the world, underlines the need to initiate changes in the nursing field in France without delay.

[Nurses' contribution to health systems, data for action].

The year 2020, originally dedicated to nurses by the World Health Organization (WHO), took an unexpected turn with the occurrence of the Covid-19 pandemic. However, the state of the art of nursing around the world was able to be published based on data collected in 2019. The findings of this report were used in the work of the 74th World Health Assembly in 2021 and led to the development of a new WHO global strategy to promote nursing in the health field.

A snapshot of clinical educational experiences for advanced practice nurses worldwide.

Using a convenience sampling, nurse educators representing 10 countries were surveyed to describe required clinical education for advanced practice beyond basic traditional nursing education. This article explores the many factors currently influencing the structure and diversity of these clinical experiences worldwide.

[Training and construction of leadership skills].

To fulfil the objectives set out for nursing teams, synergy needs to be created between managerial leadership and clinical leadership. The desire must be present, but specific skills also need to be developed both in nursing training and management training.

[Leadership and advanced practice nurses].

Clinical leadership is expected of advanced practice nurses with regard to their scope of competencies. The effective implementation of this competency within the teams requires management support. It is a first step towards the reinforcement of clinical leadership in France.

[Leadership and nursing specialities].

Specialist nurses who have acquired specific expertise are often expected to demonstrate clinical leadership within their teams. They must therefore be suitably prepared for this during their training.

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The largest health profession in terms of the number of employees, nurses are affected by the decisions taken with regard to their professional group but they also want to be involved in the decision-making processes relating to healthcare issues. In these negotiations, the task of professional nursing organisations is to demonstrate professional leadership.

[Clarification of the concept of nursing leadership and its different forms].

France needs to meet numerous public health challenges and maintain universal cover for its population. It is nevertheless surprising to observe that the development of nursing leadership, which is an effective strategy in numerous other countries, is not a priority in France. Faced with this observation, it is important to clarify this concept with the help of extensive foreign scientific literature in order to envisage how its practice can be boosted with the aim of obtaining similar benefits to those evaluated in other national contexts.

["It will be important to avoid a rift opening up between nurses and advanced practice nurses"].

After a long process of negotiation, laws passed in 2018 mean that advanced practice has finally become a reality for nurses in French legislation. Benefits are expected for patients, doctors, caregivers, management, organisations and for the health system. However, it will be necessary to take into account certain limits, and practices are expected to evolve.

[Assessing the contribution of the advanced practice nurse].

An assessment of the impact of advanced practice will be presented to the French parliament in 2021. Advanced practice nurses must make use of this opportunity. Indeed, this assessment is likely to come with major challenges in terms of the reorganisation of the healthcare provision following the implementation of this new function.

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The first advanced nursing practice training programmes became available in France in 2018. In this article, several students describe their experience of the course, their motivations and their expectations. Some have decided to undertake the training straight after their initial training, others already have a few years experience.

[The advanced nursing practice university course].

Following the publication of the regulatory framework by the relevant ministries, the summer of 2018 was very busy for the university teams intending to offer, from September, an advanced nursing practice course. The training programme selected mainly follows on from existing initial training programmes but there are also a number of aspects which are particularly innovative in the nursing pathway. Setting up this training requires a change in social representations, still a source of challenges.

[Producing, transferring and using scientific knowledge for the benefit of patients].

By combining clinical reasoning and evidence-based practice, nurses can create a virtuous circle which can in turn increase the probability of obtaining satisfactory clinical results for patients. Nursing research must thereby benefit practice by producing scientific knowledge which can be used in day-to-day care.

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Qualified nurses who go on to undertake further training often find the transition difficult. This phenomenon has been studied more specifically in the field of advanced practice nursing. As France prepares to train and deploy state registered advanced practice nurses, it is essential to incorporate the learnings arising from research, in order to facilitate their training programme and their integration into their first role.

[A senate report in favour of an emergency nursing speciality].

In July 2017, an information report written by three senators highlighted the difficulties encountered by emergency departments in France and attempted to pinpoint the causes. In addition, the recommendations of this report suggest reinforcing the nursing contribution within the multi-disciplinary emergency department team, by creating an emergency nurse speciality.

[The integration of advanced practice nurses in emergency departments].

The saturation of emergency departments due to inappropriate attendance by patients is becoming increasingly commonplace. It often leads to the discontent of users, due to long waiting times, and stretches the hospital staff physically, mentally and psychologically. Innovative organisation models have been developed abroad.

[Advanced practice nurse in France: first outline].

After several years of discussions and debate, regulations should soon be applied in France allowing for the deployment of advanced practice nurses as provided for by law no. 2016-41 of January 2016 relating to the modernisation of the French health system. The profile of this new category of nurse, whose scope of practice will be extended, will combine clinical practice carried out with patients with stabilised chronic diseases and activities aimed at promoting the continuing development of the nursing teams' skills and at supporting change processes.