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The Future of Nursing
Cathleen Atkins
Grand Canyon University
September 16th, 2012
The Future 2 The future of healthcare is dependent upon the role nurses play in the care of the patient. A committee was formed between the Robert Wood Johnson Foundation and the Institute of Medicine to address the needs of reformation of nursing. The purpose of the study was multifold. The study looked at ways to reform our healthcare system to meet the challenges of safe, quality patient care while maintaining affordability and accessibility with the help of a transformed nursing profession. The transformation of the nursing profession focuses on three main areas. The areas include education, nurse practice setting, and the nurses’ role
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Nurses with their BSN The Future 3 degree is usually favored over the ADN degree nurse to be hired in an acute setting. Although there is a shortage of nursing faculty the ADN degree student has a variety of options open to them to obtain their BSN degree. Many colleges and universities offer an online program to achieve higher education.
The nurse practice setting is an ever evolving entity. Legislation is underway to shift healthcare toward prevention and wellness, primary care and transitional care settings. The shift will deviate from the areas of acute and specialty care. Advanced Registered Nurse Practitioners play an important role in the primary care setting. Most ARNP’s are limited in their scope of practice by the state in which they live, although they received the education to provide advanced care. Sometimes the ARNP’s extensive and specialized training cannot be put to use because of policy regulations or barriers. Some barriers have resulted because of a limited work force while other barriers are due to a flawed healthcare system. An Advanced Registered Nurse Practitioner’s education has taught them how to work with different entities to successfully take care of a chronically ill patient. ARNPs’ can work with a team of physical therapists, nutritionists or social workers to help manage the overall health of the patient. If the patient’s condition is more complex than what the ARNP can take care of then the
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.
This paper will discuss various aspect of the future of health care focusing on the future of how nursing will play an ever-important role in the reformation of health care. Presentation regarding, the Robert Wood Johnson Foundation Initiative on the future of nursing, at the Institute of Medicine report entitled, “Future of Nursing: Leading Change, Advancing Health,” will help set the stage for this paper. Discussion will be had regarding the relationship of the Institute of Medicine to that of the nursing profession and the foreseeable changes to practice based on the Institute of Medicines recommendations. Further discussion will be had no the
While uncertainty about the role of an Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) persists, what research has found about the role is that AG-ACNP’s provide advanced nursing care to those who are acutely, critically or chronically ill in both traditional and nontraditional healthcare settings (Kleinpell et al., 2012). Standard of scope differs between all types of scopes and nurse practitioners alike. The scope of practice (SOP) for an Acute Care Nurse Practitioner (ACNP) is not based on practice setting, but rather what type of care the patient will need, for example, someone who needs ventilator management in either the home or hospital environment (Kleinpell et al., 2012).
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.
The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing
Conversely, the main difference between an ADN and a BSN degree is the emphasis on leadership and management, wellness, and community nursing. Equally important, as noted by Ellis (2006), “BSN prepared nurses possess greater knowledge of health promotion, disease prevention, and risk reduction as well as illness and disease management
The success of NPs depends on practicing evidence-based care with competency in assessment, diagnosing, managing patients, and maintaining a caring practice. The nursing component of the NP role continues to be challenged from within nursing, as well as by large national physician organizations. NPs are extensions of nursing practice who are guided by nursing theory. The transformation from nurse to the advanced practice role of NP involves development of advanced knowledge and skills for listening, knowing, being with patients, connecting patients to their communities, promoting health,
The report shows that the part of nursing must be expanded so that nurses are able to practice to the fullest degree of their education and training. Currently, advanced practice nurses (APRNs) work according to the scope of practice guidelines set forth by their individual state, meaning these highly educated nurses may not be working to the extent of their training but to the individual state laws. The report offers recommendations to streamline these idiosyncrasies and get rid of the red tape so that nurses can work in their appropriate manner and deliver safe quality care to some 32 million Americans who will before long gain access to health care services (American Association of Colleges of Nursing [AACN], 2012). The report correspondingly finds that nurses need to attain advanced levels of education and training through an enhanced education structure which encourages a cohesive academic progression as to safeguard the delivery of quality health care services. Patients are becoming progressively more complex and nurses need to attain the proper skills to care for these persons. Nursing education must embrace the continuous move towards a streamline approach to higher degree programs (Institute of Medicine [IOM], 2010, p. 2). Nurse residency programs
The historic article by Safriet (1992) fully lists and analyzes the major challenges facing the advanced practice nurse (APN). At the time the article was written compared to now, a few aspects are changing. In areas where change has occurred, it has been an exceedingly slow process. Change for APNs is often dependent on legislation and regulatory authorities which receives half-hearted support, at best, from the medical establishment (Safriet, 1992). Since the first day nurses were given any authority to practice outside of regular practice, physicians only objected when it began to encroach upon their perceived hierarchal status or potential for compensation (Hamric, Hanson, Tracy, & O’Grady, 2014). The concern that this
As the young and rapidly-aging population continues to increase, the demands of primary, acute and chronic disease management will also increase. As a result, more health care professionals who provide primary care will be needed to meet these demands. Thus, the emergence of Advanced Practice Registered Nurse (APRN) evolve. APRN is a nurse who has completed a graduate degree and has acquired advanced knowledge and skills. APRNs are grounded with theory, concepts and principles that enable them to assess, diagnose, treat and manage their patients. APRNs can work in conjunction with other health care professionals or independently. APRNs improve access to health care by providing care in the rural and underserved areas. APRNs also reduce the cost to health care (Joel, 2013).
The Affordable Care Act of 2010 (ACA) will have a great effect on nursing. According to this article nursing will have to change it role in the ACA and the three main categories that need to be changed and redeveloped is transforming practice, education and leadership.
Advanced practice nursing is an evolving field that is integral to the healthcare delivery system. The role of a nurse practitioner is to provide patient and family-centered care by practicing health promotion, disease prevention, and health education. With a shortage of primary care physicians nationally in the United States, there is a high demand for certified nurse practitioners to help meet the needs of patients across all age populations. According to the Consensus model, Advanced Practice Registered Nurses (APRNs) “are prepared educationally to begin practicing with responsibility and accountability to diagnose, treat and manage health problems including pharmacological or diagnostic interventions” (Stewart & Denisco, 2015). With a
For current and future needs we need to enable all healthcare professionals especially nurses to practice to the full level of their education and training. Advanced practice nurses can fulfill the primary care needs. This will free up physicians to address more complex cases which needs their expertise. Current practice focus on specialty and acute care only and a shift in practice to deliver more primary care and community care services is essential to improve the quality of nursing care and address the growing need of care in these areas.
The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and