International Advanced Practice Nursing: The Role of the Nurse Practitioner in the Netherlands

The role of Advanced Practice Nurses in the Netherlands is the Nurse Practitioner or “Verpleegkundig Specialist”. Introduction of this role started in 1997 (Storedur & Leonard, 2010; Van den Brink et al., 2019). The Clinical Nurse Specialist role in the Netherlands had initially developed as an alternative health provider for general practice physicians based on a general practitioner shortage (Dierick-van Daele, 2010; Stordeur & Leonard, 2010; Zwijnenberg & Bours 2012). Progressively, the role expanded as the health system responded with generalized acceptance and improvement of cost efficiency and outcomes (Maier, 2019; Van den Brink, 2019; VSR, 2019).

Scope of Practice and Clinical Autonomy

While the role is not intended to replace that of physicians, it has been greatly observed as a complimentary role and is pursuing more autonomous roles for Nurse Practitioners to perform patient care in patients homes and management of chronic illnesses (Storeur & Leonard, 2010; Maier, 2019). Since the introduction of the Nurse Practitioner role in the Netherlands, studies began showing that the role significantly addressed areas of patient care that were not previously adequately addressed by their physician staff (Stordeur & Leonard, 2010).

The scope of practice for Dutch Nurse Practitioners primarily includes:

• Advanced assessment (Dierick-van Daele, 2010)
• Diagnosing and making decisions for further treatment (Dierick-van Daele, 2010)
• Full Prescriptive authority within specialization (Maier, 2019)
• Provision of procedures necessary for medication treatment (Zwinjenberg & Bours, 2012)
• Referrals to primary or secondary services (Dierick-van Daele, 2010)
• Autonomous practice without physician supervision (Van den Brink et al., 2019)

Education and Certification Requirements

A four-year bachelor degree is necessary to work as a registered nurse in the Netherlands (Robinson & Griffiths, 2007). The advancement of nursing practice to become a Certified Nurse Specialist requires an individual to receive a 2-year dual Master of Advanced Nursing Practice (MANP) degree (Dierick-van Daele, 2010; Stordeur & Leonard, 2010; VSR 2022). Registration for Advanced Practice Nurses in the Netherlands requires individuals to register under a separate registry (the Verpleegugkundig Specialist Register [VSR]) from that of registered nurses, maintained by a division of the Central Information Centre for Professional Practitioners (Robinson & Griffiths, 2007; VSR, 2017).

In the event an advanced practice nurse would like to practice in the Netherlands, there are several nations of the EU including Switzerland, Iceland, Norway, or Lichtensetin in which registration is transferrable (VSR, 2022). If an individual received their APN training outside of these nations, they will need to first complete the MANP degree, however individuals may qualify for a shortened trajectory based on their previous training (VSR, 2022).

Nursing Specializations in the Dutch Health System

Based on the needs of the Dutch health system, there two main specializations: general (or somatic) health and mental health (VSR, 2017). The curriculum for further specialization (i.e. cardiology, primary care) is then incorporated within the specific graduate coursework of one of the above specialties (VSR, 2017).

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Summary of Nursing Career Paths and Costs