This document will evaluate the local, national and international factors that have influenced the development of advanced nursing practice. Discussion will include the political, economic, social, and technological influences that have contributed to the transformation from the traditional nursing role to the many exciting advanced-level career opportunities available in nursing today. We will discuss the dynamics that have shaped my current advanced nursing role and finally some reflections on the future of advanced nursing practice. Defining the role of a nurse practitioner (ANP) is complex and commonly open to interpretation. Internationally there is much variation in what the role of the advanced practitioner entails, and the characteristics of individual roles are often shaped by the country and the particular specialty in which they practice (Mantzoukas & Watkinson 2006), (Sheer & Wong 2008), ( Stasa et al 2014), (ICN 2008), (Dalton 2013), (NHS Wales 2010), (Haidar 2014), (Lowe et al 2011), (Pearson 2011). Historically the first ANP roles and educational programs were introduced in the United States in the 1960s to fill a gap due to the shortage of medical personnel, but also to address the problem of health inequalities in ethnic minorities, which highlighted at an early stage that nurses were a valuable resource in addressing particular health problems (Mantzoukas & Watkinson 2006 ), (Sheer & Wong 2008). ANP roles are well accepted as an effective approach to managing patient care, however the introduction of these roles has increased dramatically often leading to confusion over their scope of practice and a clear definition of the role (Pearson and Peels 2002 ), (Daly & Carnwell 2003 ), (Castledine 2003), (Gardner at al 2007), (Pere...... middle of paper ......sa, H. Cashin, A. Buckley, T. Donoghue, J. (2014) Advancing the conceptual confusion. Nurse Education Today 34 (2014) 356–36151. . 4/1/2014]53.WHO (2005). Preparing health workers for the 21st century. The challenge of chronic conditions, World Health Organization, Cluster on non-communicable diseases and mental health .who.int/chp/knowledge/publications/workforce_report.pdf?ua=1 [Access 1/4/2014]