The roles of advanced practice nurses have been an ongoing debate in many states. In a globalized world, advance nurse leaders are regarded as forefront leaders that provide first-rate healthcare to the public. However, the role of new advanced practice nurses is known to be complex. Advance practice nurses use countless different strategies and nursing theories to improve the wellbeing of their patient. To improve the well being of all patients, there is a growing demand for advance practice nurses worldwide. The advanced practice roles of CNM, CNP, CNS, and CRNA require a toolbox of skills, understanding, and integrative abilities that synthesize advanced practice nursing knowledge" (Buppert, 2011). With the rapid development of the advance practice nurse leader, the national organization of Nurse Practitioners are eager to help ensure the competencies of the diverse roles of APN.
Palumbo, Marth, and Rambur (2011) stipulate that over the years, advanced practice nurses have continued to avail care that is of top quality. Subsequently, they have been able to create a recognized place within the healthcare system. By 2012, it was reported that there was an approximate number of 240, 000 advanced practice nurses (Newhouse et al., 2012). The report also added to the assertion by Palumbo, Marth, and Rambur (2011) through the indication that advanced practice nurses offer their services in settings that need a heightened range of professional independence while providing healthcare. What concerns their function, LaBrocca and Angosta (2016) indicate that as a health expert, an advanced practice nurse foresees issues in healthcare
According to the American Academy of Nurse Practitioners (N.D.), the progression of the advanced practice nurse (APN) began nearly 50 years ago. From the advent of the first APN program to the over 350 accredited programs and over 222,000 certified nurse practitioners in the United States, the role of the APN has significantly increased and expanded a profession to better improve healthcare for Americans (American Association of Nurse Practitioners, N.D., American Academy of Nurse Practitioners, 2016). Of these, more than half are in the field of family practitioners (American Academy of Nurse Practitioners, 2016).
The history of nurse anesthesia cannot be accurately studied without a thorough analysis of the pioneer and transformational leader, Alice Magaw. Charles Mayo called her the Mother of Anesthesia for many good reasons (CRNA Profiles, n.d.). It is worthy of the student anesthetist’s time to study the life, education, employment, leadership, publications, and legacy of Alice Magaw.
The history of the Nurse Anesthetist dates back prior to the Civil War and were considered by many as the pioneers of the practice of anesthesia. As the complexity of administering anesthesia increased, physicians deemed the practice of anesthesia to be equivalent to the practice of medicine. As time progressed, some physicians attempted to have the practice of anesthesia banned from the nursing scope of practice. It was not until a case was brought in front of the California Supreme Court where they ultimately established the legal precedent granting nurse anesthesia its legality. Specifying that nurses can administer anesthesia and that they would be operating under their scope of practice as long as it was done under the guidance of a supervising physician (Hamric, Tracy, & O 'Grady, 2014). That law was federally mandated until 2001, when the Centers for Medicare and Medicaid changed the federal supervision rule of Anesthesiologist and Nurse Anesthetists in order for facility to receive reimbursement of care ("Certified Registered Nurse Anesthetists Fact Sheet", 2016). This offered states an “opt-out” rule allowing the unsupervised practice of nurse anesthetists. This change led to conflict in the anesthesia community between physicians and Certified Registered Nurse Anesthetists (CRNA) as the debate of a CRNA’s ability to practice autonomously was now the center of attention. With the costs of healthcare rising and the
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
The purpose of this paper is to describe the role of health care reform with regards to the evolution and development of advanced practice nursing (APN) in the United States. Foundational aspects prominent in the development of defined APN roles include the health needs in society, support for innovation in health care, governmental health policy and regulation, health workforce supply and demand, and the development of advanced education, among other factors (Ketefian et al., 2001). APNs are comprised of nurse anesthetists, nurse midwives,
The afore= mentioned issues being addressed through legal channels by the AANP are barriers to effective and efficient practice, the type of barriers that were to be eliminated by the expansion of the Affordable Care Act (ACA) (Dunphy, Winland-Brown, Porter, & Thomas, 2015). Only twenty-two states have allowed full practice authority, which is less than half of the nation. It is imperative that every advance practice nurse has a voice that is heard in their state and the nation, this is the message of the AANP (Hain & Fleck,
There was conflict with RN’s over roles that had historically been their responsibility and that they felt were inappropriate the AP. Such as catheterisation; IV cannulation; wound care and handover at shift changes. In Spilsbury et al. (2010) findings, this led to some RN’s to voice concerns that the situation was taking a step backwards to the old two tier level of nursing with State Enrolled Nurses. They were also fearful that AP’s would be replace some RN’s, which in turn would put more pressure on the remaining RN’s by having to cover extra duties that the AP could not perform e.g. Drug rounds. The opinion of many RN’s was that the AP’s were a form of cheap labour and a way of reducing staffing costs.
With all of the different specialties in healthcare, some get overlooked or may be under the radar. An uncommon and often disregarded career choice in healthcare is that of a Certified Registered Nurse Anesthetist or a Doctorate of Nurse Anesthesia Practice. Although not many people know about these healthcare careers, they play a vital role within the healthcare team. This field is growing rapidly and the likelihood of coming into contact with a nurse anesthetist during a hospital stay is on the rise. Knowing the history, education, responsibilities, and career outlook for a Certified Registered Nurse Anesthetist or a Doctorate of Nurse Anesthesia Practice can aide in understanding their very specific role in the care of patients.
Three issues or trends I see that are important with regard to credentialing are reimbursement, malpractice and education. Within each issue are opportunities for the advance practice nurse (APN) to grow in knowledge and participate in change. It is important to understand why each one effects credentialing for the APN.
This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component
There have been many influential publications, agencies, and people in the field of nursing research. Write 1–3 sentences in each cell of the table below to describe the importance, goal, or influence of each item.
As the healthcare system in America is overhauled, advanced practice nurses are going to increasingly assume the role of primary care providers. Many states have kept up with the evolving expansion of
Visiting home health nurses are a well-known profession and becoming more popular as time grows. The service of public health nursing was carried out on the frontier by nurses under the name of “Visiting nurse services” which were part of the late 19th century health reform out of ‘The Henry Street House’ in 1893, as discussed in the film “Nursing in America – A History of Social Reform”. They held many roles outside of nursing, those roles and missions and struggles will be discussed.