Letourneau Dominique
Abstract
For 15 years the France is engaged in an in-depth study on the evolution of its health system. The issue of collaboration between doctors and nurses is redesigned on the mode of practice advanced care. The ageing of the population, medical demography and technological development accelerate this change. Once the principles laid down, the actors struggle to agree to their implementation as professional hierarchies are debates. Advanced practices are finally recognized, but are based on two relatively different conceptions of nurse practitioners or clinical nurses. The choice to put under medical supervision confirms a position of medical assistant. But paradoxically this is the unavoidable way, in the French system and culture, to move towards greater autonomy for nurses. With the issue of advanced care practices, it is the entire process of the transfer of nursing education to the University which is at stake with the prospect of clinical masters and then PhD in care, as exists in many countries. The development of clinical training at the University will feed nursing research and contribute to the knowledge on the evolution of the practices of care for the benefit of users