Nurse Practitioners: The International Scene

When I first became a nurse practitioner, I had the urge to travel abroad for a year or two.  Young, single, and having promised myself I would never actually live in Tennessee long-term (10 years and counting...I think it's safe to say the promise has been broken) I was ready for an adventure.  I contacted a healthcare recruiter in New Zealand, filled out stacks of paperwork and was beginning my housing search.  My beeline for the boarder came to an abrupt halt however, when I discovered the nurse practitioner role is much different in New Zealand.

A healthcare recruiter explained to me that New Zealand required nurse practitioners to have several years of nursing experience before advancing their profession, which I did not have.  I would be required to work as a floor nurse if I chose to relocate.  Also, the salary for both nurses and NPs was much lower in New Zealand than in the U.S. so an ocean view high rise in Auckland wouldn't be in the budget.  

Ultimately, I decided that having just graduated from my nurse practitioner program I wanted to take my newfound knowledge straight to practice.  I was worried that if I moved abroad and worked as a nurse, I would have trouble finding a job as an NP when I arrived back to the states.  But, my misadventure opened my eyes to the nurse practitioner role around the world.  What is life like for NPs practicing in other countries?

The nurse practitioner profession is much younger in other countries than in the United States.  Many countries are just beginning to use NPs are are working towards finding a way for them to fit into their current healthcare systems.  Here's how a few countries around the world are using nurse practitioners and looking to make them an integral part of patient care. 


The nurse practitioner education in Australia is much different than in the United Sates.  In Australia, NPs must work their way up over many years from nurse to clinical nurse, then to clinical nurse specialist and finally clinical nurse consultant.  Once a nurse has progressed through these steps, he or she may become a nurse practitioner.  This process takes years and the rate of progression is subject to job availability in each step preventing some nurses from moving up efficiently.  Aspiring NPs are only admitted to nurse practitioner university courses once they have achieved a certain level in their nursing career.  

Based on the method by which nurse practitioners are trained in Australia, they have limited utility in the healthcare system.  Many nursing groups are fighting for reform trying to make the path to becoming an NP more accessible. 


The nurse practitioner profession is on the rise in Canada thanks to efforts from nursing organizations.  Nursing organizations have successfully advertised a catchy slogan "It's about time" to generate public interest in developing the nurse practitioner role.  The number of nurse practitioners practicing in Canada has nearly tripled in the past six years with over 3,400 NP now certified in the country.  

Canada faces similar scope of practice issues to the United States.  Some provinces in Canada don't allow nurse practitioners to prescribe medication, order certain medical tests or discharge patients from the hospital.  Nursing groups are fighting to improve utility of NPs in the name of providing improved access to primary care for Canadians. 

United Kingdom

In the United Kingdom, the role of the nurse practitioner is not as developed as in the United States.  While all NPs in the UK have the ability to prescribe medications, the NP education and certification lack standardization across the country.  As a result of this lack in standardization, many physicians are hesitant to work with nurse practitioners uncertain of their qualifications.  Some companies may also refuse orders for imaging studies and procedures written by nurse practitioners.  

There are no specific educational requirements for NPs practicing in the United Kingdom.  Educational programs vary significantly contributing to further confusion over the NP role. Nurse practitioners practicing in the UK do not need to be licensed or have their own national registration.  The NP role in the United Kingdom is expanding but lack of standardization inhibits professional growth and public confidence in the nurse practitioner role. 


The concept of nurse practitioners is very new to Taiwan.  Due to language differences, the term "nurse practitioner" isn't used in the country.  The Taiwanese version of the NP translates to something more along the lines of "clinical nurse specialist".  The first advanced practice nurses in Taiwan emerged in 1994 when nurses became responsible for caring directly for patients after surgery in one private medical center.  Since then, the role has slowly begun to develop.  Taiwan's government officially recognized the profession in 2000 making it legal for nurses to work in direct patient care.  Since then, the number of advanced practice nurses has grown rapidly.  Most advanced practice nurses in Taiwan practice in the hospital setting alongside physicians. 


Unlike most other countries exploring the implementation of nurse practitioners into the healthcare system, Singapore has been organized in its efforts.  Singapore created legal guidelines surrounding the nurse practitioner title making the NP role rigorously defined.  Recognizing it was losing nurses to other countries, Singapore began educating and hiring NPs as a way to advance the profession keeping nurses in the country.  The first nurse practitioner education program in Singapore began in 2003 and consists of 24 months of coursework.  Most nurse practitioners in Singapore work in the hospital or mental health setting.

Nurse practitioners are cropping up around the globe as countries are recognizing the need for affordable care for a larger number of individuals.  By training nurses to take on advanced roles, countries can improve their overall healthcare services and quality of life.  

Are you interested in learning about the NP role in a specific country?  Comment below for more information. 


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I am a neonatal nurse practitioner and am interested in job opportunities outside of the United States. Thank you

Kim Mitchell

Hi, I am interested in any nurse practitioner any place in Europe. I would appreciate any help. thank you

amanda s

I am interested in Ireland and wondering what the FNP scope is there?


I am interested in relocating to the Bahamas, Carribean or some more specific locations even would be Dominican Republic, St. Croix or Mexico. How are NPs utilized in these countries?


I am an adult nurse practitioner with 6 years experience. I will be moving to Taiwan at the end of the year and hoping to work. Any advice or info you might share re: immigration to Taiwan and working as an NP?


Interested in knowing more about NP jobs and how to get it to work abroad. ThAnk you!


I am a mental health nurse practitioner in the US, many years of independent practice. Can someone tell me which countries , as of this time 11/17 , have independent practice roles for NP's and which ones may be getting independent practice for NP's soon?


I am an acute care nurse practitioner, trained in the US but with Irish citizenship. What are the opportunities if any for me to work in Spain?, since work visa would not be an issue for me....


We don't need to go to Doctor school to do doctor stuff....we are capable of providing the same quality care.... Jealous little anonymous person.....


I am a nurse with 25 years of experience and I am currently finishing my Family Nurse Practitioner . I would love to work in Greece. I have traveled there several times and I am in the process of learning the language. Is it possible to work as a nurse practitioner ( or a nurse n any capacity) in Greece as an American?
Thank you!!