(67) No Advanced Practice Without Quality Basic Practice: The Voice of a Nurse Who Rejoined the Frontline During the COVID-19 Pandemic

Prof. Claudia LAI^1,2,3,4
1The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, ²The Hong Kong Baptist University, Hong Kong SAR, ³Kaohsiung Medical University, Kaohsiung City, Taipei, ⁴Yangzhou University, Yangzhou, China

Purpose
I rejoined the workforce when the COVID-19 pandemic called for more manpower. The experience exposed me to the daily life of older persons seeking specialist consultations in out-patient departments (SOPD) in a local district hospital. This purpose of this paper is to share the author’s contention that good basic nursing care should form the foundation of advanced practice, an insight developed through her lived experience.

Method
This narrative is an account of her observations of older people’s journeys through the SOPD as patients during the pandemic. Using real-life examples, different scenarios of how older patients navigate through the specialist clinics will be described to convey the importance of basic care in an era when specialization is hailed.

Findings
The author’s observations over a period of several months provided opportunities for deep reflections on the work that nurses do in an out-patient setting. The insights she developed helped her to arrive at the conclusion that while emphasizing the development of advanced practice as a means to promote patient care, good basic care must be present. Quality management of older patients with special needs does not always call for the expertise of an advanced practice nurse (APN). 

Discussion
The literature informs us that it may be challenging to standardize the scope of practice of registered nurses and APNs, but their levels of competencies differ. The International Council of Nurses states that APNs plan, coordinate, implement, and evaluate actions to enhance healthcare services at an advanced level. It also states that all APNs are practitioners of nursing, who provide safe and competent patient care. While pursuing advanced nursing practices, the profession must never lose sight of the fact that quality basic care needs to be at the foundation of advanced practice in order to truly benefit patient care.

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