Advanced Nurse Practitioner Research Paper

Nurse practitioners are advanced practice registered nurses who have received special courses and training. They usually work closely with doctors and can perform many high-level primary care tasks. They often specialize in specific types of practice such as pediatrics, psychiatry, or obstetrics. Some establish private practices; however, most work in doctors' offices, hospitals, or neighborhood health centers. Their duties often include taking detailed medical histories and performing complete physical exams, providing diagnoses and recommending treatment plans, treating common medical conditions, illnesses, and injuries, prescribing limited medications, and counseling patients and families. They also care

There are four types of Advanced Practice Nurse roles, the nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, and certified nurse-midwife. The Family Nurse Practitioner is the advanced practice role that will be discussed. According to Hamric, Hanson, Tracy, and O 'Grady (2014) the primary care NP provides care for patients in diverse settings, including community-based settings such as private and public practices, acute, and long-term care settings across the life span (pg. 396). Family Nurse Practitioners have faced many challenges in the medical profession to be recognized as health care providers. Most of these challenges where from fellow nurses. According to Hamric, Hanson, Tracy, and O’Grady (2014) conflict and discord about the Nurse Practitioner role continued to characterize relationships between NPs and other nurses (pg. 18). Despite the resistance to NPs in nursing, physicians increasingly accepted NPs in individual health care practices (Hamric, Hanson, Tracy, and O’Grady, 2014, pg. 18). Physicians readily accepted the role of the Nurse Practitioner, working together to improve patient outcomes and safety.

Credentialing from advanced practice registered nurses (APRNs) perspective is defined as “furnishing the documentation necessary to be authorized by a regulatory body or institution to engage in certain activities and use a certain title” (Hanson, 2014). Credentialing is also define from a local institutional process that consider specific documentations for APRN before they assume the practice role as APRN within their facility. In health care system, credentialing ensures individuals meet required standards of practice and is prepared to perform those duties implied by the credentials. National certification and education are considered as part of credentialing for APRN to acquire basic level of competence to practice. (Hanson, 2014)

The APRN Consensus Model was released in July of 2008 to define advanced practice registered nurse, identify the titles to be used by APRNs, and define specialty area of practice. The Consensus Model also describes population foci, suggests a process for recognition of new APRN roles, and recommends requirements for implementation (American Nurses Association [ANA], 2010). The APRN regulatory model helps uniform scope of practice of APRN across the United States, which benefit individual APRN, enhance patient outcomes, and improve the quality of care. Consensus Model consists of Licensure, Accreditation, Certification, and Education. The Education criteria in LACE Consensus Model relate to all APRN programs regardless of master’s or doctoral

The health care industry is experiencing a surge in the number of baby-boomers needing health care and increased demands on the physicians providing the care. This trend has made the role of Advanced practice providers more important (cite). It is imperative to understand the differences and similarities in the advanced practice provider roles as it pertains to healthcare. This paper will identify specialty nursing roles including advanced practice registered nurses (APRN). It will further compare and contrast the advanced practice nurse (APN) and physician assistant (PA) roles in practice.

In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.

These organizations developed the Consensus Model document in 2008 to unify practice, identify APRN clinical roles, identify the acceptable titles to for NPs, and define the requirements for general practice and licensure. Note to mention that laws and regulations statute on the APN scope of practice may vary by states, whereas some adhere to full scope of practice, other to reduced practice, or restricted practice. For instance, the state of Florida defines advanced registered nurse practitioner as a licensed person with ability to practice professional nursing and certified to in advanced or specialized nursing practice (Buppert, 2011). The four advanced clinical specialized roles include certified registered nurse anesthetists, certified nurse midwives, clinical nurse specialist, and nurse practitioners (Buppert, 2011). In terms of licensure, 46 states out of 50 require nurse practitioners to pass a certification exam. The Florida Board of Nursing requires certification by an appropriate specialty board and graduation from a program leading to a master’s degree (Buppert,

2. Can an APRN be licensed solely within a specialty such as an ER nurse practitioner?

The Texas Nurses Association (TNA) District one meeting for the El Paso area, took place on September 20, 2016 at 1845. The President of District one, Paula Meagher was unable to attend the meeting as she was ill. She did however provide us with a list of the current Advanced Practice Registered Nurse (APRN) issues that TNA is engaged in. The issue that really caught my attention was Texas Occupations Code, section 157.011 (b-1) which deals with APRN restrictions on writing prescriptions for Schedule two controlled substances. The TNA website states:

The role of the advanced practice nurse has evolved immensely over the years, so why not take a stand and continue your education to become one of the four advanced practice nurses? Transitioning to an advanced practice nurse role requires a master’s degree and some experience as a registered nurse in order to have the background to propel forward in this career. Advanced practice nurses are comprised of nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives who are often primary care providers and provide comprehensive care to patients. Out of the four advanced practice nurse roles, nurse practitioners and clinical nurse specialists have both been providing care to patients since the 1960s. They both have many similarities and differences, and strengths and limitations of practicing in these specialized roles.

The Full Practice Authority for APRNs (HB 1415/ SB 681) deals with the legislation which will permit Nurse Practitioners (NPs) to practice to the complete magnitude of their education and training. It will also eliminate expensive and difficult regulatory requirements like having contracted delegation arrangements with physicians, and will place NPs under the select supervisory authority of the Texas Board of Nursing (BON). Bill HB 1415 was filed on 02/01/2017 and was “Left pending in committee” as of 04/25/2017. Bill HB 681 was filed on 01/31/2017 and was “Referred to Health and Human Services” as of

There have been concerns regarding the identification and credentialing of advanced practiced registered nurses (APRNs). A APRN is a registered nurse who has successfully completed an accredited graduate-level education program, in which the individual is well prepared and successfully passed the nationwide certification examination (APRN Consensus Model, 2008). However, there are still debating issues of who would fall under the APRN category. The National Council of State Boards of Nursing (NCSBN) has identified four APRNs who are deem fit to be called ARPNs; however, only two will be named. They would be certified registered nurse anesthetists (CRNAs) and certified nurse practitioners (CNPs). Whereas, the nurse informatics and the nurse administrations are not considered to be APRNs; although, they are still license registered nurses but they do not provide direct patient care and are not required to take the national certification examination (ARPN Consensus Model, 2008).

The American Association of Nurse Practitioners (AANP) is the largest national professional membership organization for nurse practitioners of all specialties (AANP, 2012).

Many Americans use Advance Practice Nurse Practitioners (APRN) for a number of their health care needs. For more than fifty years, APRN’s have provided a great amount of services in primary care and acute settings, making their presence in the health care system important. Likewise, expectations are that APRN’s will become even more crucial to the delivery of healthcare as more Americans gain access to providers through the new tax reform. With this being said, it is imperative that the APRN be able to practice to his or her full practice authority. “Full practice authority is comprised of state practice and licensure laws that allow advanced practice registered nurses to practice fully in the four domains of practice, under the exclusive licensure

Currently, in the state of Texas APRN, such as nurse practitioners must legally document as APRN. Texas BON states, “At a minimum, an individual must legally represent themselves, including in a legal signature, as an APRN and by the role. He/she may indicate the population as well. No one, except those who are licensed to practice as an APRN, may use the APRN title or any of the APRN role titles. An individual also may add the specialty title in which they are professionally recognized in addition to the legal title of APRN and role” (APRN Joint Dialogue Group Report, 2008). Example: After successfully completing Loyola University’s post BSN-DNP program, and obtaining a passing score on the certification exam, I will be entitled to documents