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Aim Examine metrics and policies regarding nurse workforce across four countries. Background International comparisons inform health policy makers. Methods Data from the OECD were used to compare expenditure, workforce and health in: Australia, Portugal, the United Kingdom ( UK) and the United States ( US). Workforce policy context was explored. Results Public spending varied from less than 50% of gross domestic product in the US to over 80% in the UK. Australia had the highest life expectancy. Portugal has fewer nurses and more physicians. The Australian national health workforce planning agency has increased the scope for co-ordinated policy intervention. Portugal risks losing nurses through migration. In the UK, the economic crisis resulted in frozen pay, reduced employment, and reduced student nurses. In the US, there has been limited scope to develop a significant national nursing workforce policy approach, with a continuation of State based regulation adding to the complexity of the policy landscape. The US is the most developed in the use of nurses in advanced practice roles. Ageing of the workforce is likely to drive projected shortages in all countries. Limitations There are differences as well as variation in the overall impact of the global financial crisis in these countries. Conclusion Future supply of nurses in all four countries is vulnerable. Implications for nursing and health policy Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries. [ABSTRACT FROM AUTHOR]

The nursing profession has experienced significant change over the last 100 years. Consequently, the work-force of the 21st century is a diverse entity that is edging toward the specialization of nurses in a specific clinical setting. In such an environment, a common knowledge base is demanded of nurses - a factor that has affected the development of second level, or enrolled nurses (ENs). The forces at play raise questions about nursing roles and scopes of practice. The establishment of education pathways that promote career development has been the stimulus for conversations about the effectiveness of the transition of EN to registered nurse (RN). This paper presents a review of the literature that identifies and explores common emerging themes (making the move from EN; adapting to Bachelor of Nursing; transitioning to RN) associated with this transition through the process of undertaking baccalaureate studies in nursing. [ABSTRACT FROM AUTHOR]