Nurse Managed Health Clinics: A Case Study

“Nurses are more than caregivers in today’s healthcare settings. They are teachers, advocates and pioneers in improving healthcare. They are stepping out of the old model and taking ownership for changes in healthcare. Nurses are developing their own scientific research programs to improve patient care. They are playing a pivotal role in healthcare reform. Nurses are becoming leaders, not followers in healthcare reform.”

Nursing is defined as the promotion, protection and the prevention of illness and Injury, the treatment of a patient’s disease or diseases, the patient’s response to a disease, as well as one big thing that nurses are known for, and that is being a patient’s advocate nursing has been one of the fastest growing fields since the 1990’s (Mueller et al.,2012). Advocacy is defined as an action in which a person speaks out, argues a cause, supports and defends on the behalf of others. I believe that the role of being a patient advocate is one of the most important things a nurse can do because there are many patients that cannot speak on their behalf, I believe that it is up to the nurses to be those patients as well as all patient’s voices (Mueller et al., 2012).

In addition, a DNP degree will help me better serve my community by advocating for quality and safety healthcare system. Once attained, I would seek employment at either a school or university with the mission of educating nursing students to practice the highest quality of patient care. One of the major issues facing the nursing profession today is the lack of advance nursing practices. The medical field is in crisis. Doctors are stretched to the limits, and patients are demanding more advanced care. To alleviate some of the concerns facing medicine in the 21st century, advance nursing practices is a vital area in the contribution of understanding and working within the bounds of a team structure, and the promotion of communication between the interdisciplinary health team. The mission of the advance nursing practice is to help individual patients, and their families, determine and achieve optimum physical, mental and social potential, and to do so within the challenging context of the environment in which they live and work Nurses are among the largest professional care group within the healthcare service industry. We are responsible for providing quality care and assisting patients towards independent and healthy living. Considering the changing working environment, health care practitioners like nurses are

Samantha stated that initially many people asked her if she chose to be a family nurse practitioner to be a “mini physician” (S. Hage De Reyes, personal communication, June 22, 2016). In her perspective, it has been an issue to show others in health care professions that nurses just want to expand their knowledge. She “fights battles every day” for her patients because of the holes in our health care system (S. Hage De Reyes, personal communication, June 22, 2016). In her experience, she has seen many individuals without insurance. She has learned that being a family nurse practitioner is being an advocate for the patient and helping them get the resources that they need. Family nurse practitioners help provide care in a more affordable way. In Samantha’s opinion, family nurse practitioners are the answer to creating access to care for the large uninsured population and those that are newly insured under the Affordable Care Act, and I could not agree

In the article written by Ford, (2009), the doctorate of nursing practice (DNP) has an important role to play in the current health care system which is constantly changing. As healthcare around the world is transforming, the Institute of Medicine (IOM) 2011 report mentioned that in the United States, Advanced practice nurses play a vital role in the rapid complex changes based on the full extent of their education and training. This article describes some of the positive role of the advance practice Nurse as a facilitator in the regulatory and policy developments. The Advance practice nurse participates and provide cost-effective care models that will improve the access and quality of care of the population. Another positive area for the APN in this current healthcare system is health promotion, health maintenance, and prevention. In this evolving health care system, it gives the Advance practice nurse the opportunity to set up acute and primary care settings that will positively impact health care delivery as they meet the needs of an expanding, aging, and chronically ill population. All over the world, the NP’s role has developed and is beneficial to health care systems and health care consumers. As Advance practice nurses we must use this great opportunity to advance our role and work with others to improve and transform health care globally. DNP graduate 's role is include leadership, research, practice, education, and

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

Budzi, Lurie, Singh, and Hooker (2010) state, “Nurse Practitioners’ (NP) interpersonal skills in patient teaching, counseling, and patient centered care contribute to positive health outcomes and patient satisfaction.” According to their research they encourage healthcare systems in the U.S. to hire more NPs to allow for better access affordable, and quality care (Denisco & Barker, 2016). With the demand for primary care providers, The NP role aids in delivering a solution to some of the healthcare issues that exist today. Organizations like the Institute of Medicine (IOM) and Centers for Medicare and Medicaid (CMS) all agree to allow nurses to practice to their full abilities to make healthcare more accessible and affordable, especially for the aging baby boomers and less accessible rural neighborhoods, and densely populated urban areas. Research has proven that NPs that provide primary care have similar health outcomes to primary care physicians (DeNisco et. al., 2016). NPs particularly take pride in their holistic approach, forming therapeutic relationships between other providers of the healthcare team, patients, and their families, aiding the informed decision making process, use of the evidence based practice approach in health management (Brown, 2005). Some of the other actions or qualities that

Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different

Nurses’ involvement in policy debates brings our professional values to bear on the process. (Warner, 2003) The Master’s prepared nurse’s goal as an advocate should be to fight to enhance the client’s wellbeing in every possible way, at every available opportunity. This can be achieved by being part of organization that advocate for patients’ right as well as for better working condition for our colleagues. Also, nurses could choose to get involved in politics or lobby on behalf of other nurses.

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,

L.P., a currently practicing NP, was interviewed in an attempt to explore her thoughts on issue and possible solutions affecting NPs. L.P. started her education with a bachelor’s degree in education. She later returned to school to receive her registered nurse (RN) license and gained experience working in several hospital departments for over 20 years. During this time she worked on completing a master’s in healthcare administration and wellness promotion. She later returned to Drexel to complete her bachelor’s and master’s in nursing to work as a Family Practice NP. She has been practicing as an NP for five years, with her start in a physician practice and is currently working in the

Energized by the U.S. Supreme Court decision upholding most of the Affordable Care Act (ACA), the American Nurses Association (ANA) is continuing its wide ranging efforts to ensure that Registered Nurses (RNs) have an even greater role in providing high quality care as implementation of the landmark law progresses. As guiding principles, ANA contends that health care is a basic human right, and that all deserve access to essential health care services. As nurses witness every day, a lack of primary and preventive care can cause people's manageable chronic conditions to spiral, leading to poorer patient outcomes and increased overall health care costs. (Anonymous, 2012). According to Billings and Halstead (2012), nurses are poised to participate in transforming this nation's health care system. Participation requires nurses to possess political advocacy skills so that nursing voice is brought to the policy debates and policy development.

As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).

The American Nurses Association (ANA) is a full-service professional organization that symbolizes the interests of registered nurses through its constituent and state nurses associations. The ANA implements the nursing profession by raising high standards of nursing practice, honoring the rights of nurses in the work field, promoting a positive and realistic view of nursing, and by pushing the Congress and regulatory agencies on health care issues affecting nurses and the public. Their mission statement is, “Nurses advancing our profession to improve health for all.” Some of ANA’s main focuses are reformation of the health care system so that it delivers primary health care in the communities, growing roles for

Historically, nurses focused on the diagnosis and treatment of a disease, sickness or condition and emphasis on health promotion was nonexistent. However, today that has all changed. Nurses are now expected to expand their primary care services to include psychosocial nursing, advocacy, behavioral science, counseling and advocacy in addition to patient assessment, clinical diagnosis and patient-case management. In the article “Defining Nurse Practitioner Scope of Practice: Expanding Primary Care Services,” Sherwood, Brown, and Wardell (1997) state “the role of the nurse practitioner continues to evolve in response to changing societal and health care needs as consumers in all settings seek increasing services”. (Sherwood, Brown and Wardell, 1997).