Abstract

The responses from Europe, Asia, Australia, and America illustrate the diversity in the development of the nursing profession and in the possibilities of career advancement for nurses in different countries. Whereas advanced nursing practice is a natural component of the healthcare system in North America, and gradually becoming so in Australia and the United Kingdom, it is far from reality in many other countries. Although the presence or absence of such opportunities necessarily does not reflect the quality of nursing or skills of practicing nurses, their absence clearly prevents professional development, acceptance, and recognition for nurses as a group. In several countries, training programs and courses are available from individual hospitals and other sources. However, as long as such programs and, in particular, the qualifications they lead up to, are not recognized by health authorities at an official level, their contribution beyond that of improving personal knowledge of the trainee is very limited. Undertaking such training may be beneficial for nurses in their present positions but is of little use if they want to change to a new job. Unless the new employer chooses to acknowledge such qualifications, he does not have to. A nurse is a nurse, is a nurse. Needless to say, this also has important implications for nurses' salaries. This was illustrated in a recent survey that identified the average annual salary for nurses in the United States as $37,980 (U.S.). In comparison, official statistics from the Swedish Association of Health Professionals state that the average annual nurse salary in Sweden in 1999 approximated $25,146 (U.S.), with mean salaries ranging from $23,871 (U.S.) (hospital ward nurses) to $33,724 (U.S.) (nurse managers and executives). Although I have not been able to find old comparative data from other countries, informal sources have indicated that the pattern is similar. The need for increased and improved career opportunities for nurses is apparent. How these should be designed and the exact roles of different categories of nurses in various countries will have to be dictated by local needs and other circumstances. However, the scheduled inclusion of this topic at the forthcoming WFNN Congress in Sydney will provide an excellent opportunity for nurses from across the globe to discuss these issues and perhaps initiate work towards setting common international goals for neuroscience nurses. In parallel, it is of outstanding importance that contributions by advanced practice nurses are evaluated in a broad and scientifically sound manner in countries in which they are established and being introduced. Further comments on the topic are highly appreciated!

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