Nurses And Advanced Practice Nurses

An ongoing debate for the requirements to become a Registered Nurse (RN) has been unsettled. Several different educational pathways lead to an RN licensure; however, the minimum educational requirements must be standardized at the baccalaureate level for several reasons. Spetz and Bates (2013) published that a growing number of hospitals prefer hiring nurses with a Bachelor Science in Nursing (BSN) as this increases the status of the nursing profession (p. 1). Associate Degree in Nursing (ADN), as well as a certificate on-the-job training Diploma are two other educational pathways to become an RN, which can be disadvantageous to the nursing profession in several ways (Tollick 2013; Spetz and Bates 2013). If entry-level nurses

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).

Nurses must achieve a higher level of education in order to meet the demands of evolving health care and the changing needs of patients (Rosseter, 2012). Nurses will need to be prepared for a broader scope of practice and to maintain quality within the health care setting. Associate degrees are still valuable tools when used as stepping stones to baccalaureate programs and performing the technical aspects of nursing. BSN-educated nurses are equipped with a more diverse skill set that assists them in leading and reacting appropriately in critical situations. In addition, they have the opportunity to pursue advanced practices. Baccalaureate programs can help develop a good or adequate associate degree nurse, into an outstanding nurse.

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).

Over the last six weeks we learnt a lot in this course. We learnt that advanced practice nursing has evolved over the years to become recognized today as an important and growing trend among healthcare systems worldwide. Different advanced practice registered nurse (APRN) roles were identified such as nurse practitioners, clinical nurse specialists, nurse anesthetists, or nurse midwives who all play a pivotal role based on different set of clinical skills and knowledge to impact in the future of health care. The educational qualifications of APRNs role must be at least up to the graduate level. Other RN specialty identified included; nurse educator, nurse informaticist, nurse administrator, nurse executive, nurse manager, and clinical nurse leader. Learning the evolution of APN helped me understand where the practice started and where it is heading.

If nursing had only one basic entry type into the profession, it would make the process much simpler for students, professors, and potential hiring entities. That said, however, the nurses who are already practicing proficiently at their current levels should be grandfathered into the change. A significant number of nurses, this author included, have worked for twenty-plus years in a variety of specialties and areas. Each one brings to the table unique experiences. Unfortunately, most hospitals that currently employ registered nurses are now requiring those nurses to get the BSN degree, despite many years of skilled and dedicated service.

Advance practice nurses have the ability to change the health care system as they play a critical role in improving health outcomes. In a clinical setting, implementing the recommended changes of monitoring, enhanced communication, greater collaboration and education of patients and more analysis of patients with a focus on their preferences and beliefs would create a more relaxed and trusting environment. This change would allow for better patient experience which would cause them to place greater reliance and confidence in the opinions and recommendations of providers and would more readily adhere to suggestions. A culture of medication adherence would be facilitated and would in turn build trust in the overall national healthcare system.

Advanced practice registered nurses (APRN) most importantly nurse practitioners play a vital role in fall prevention during hospitalization. APRN’s are healthcare providers who have enhanced knowledge in diagnosing, disease prevention, and health promotion. For example, APRN’s are highly educated and competent to assess, take a detailed history, perform comprehensive examinations, and identify patients who are at risk for falls and refer them to a pertinent specialist such as a physical or occupational therapist. Additionally, APRN’s possess great leadership skills, excellent communication skills and can collaborate with members of the interdisciplinary team to bring about change and promote patient safety.

Role development in advanced practice nursing is described as a process that evolves over time (Hamric, Hanson, Tracy, O’Grady, 2014, p. 86).The role of an advanced practice nurse can be very diverse. Specifically, the role of a nurse practitioner is not only diverse but is becoming one of the leading key players in the health care team whether it is in primary care or in specialized areas such as oncology. This paper will summarize two research articles and one expert opinion article about the role of nurse practitioners in general and as it pertains to cancer patients.

Nurses are the first health care professionals that patients meet in a health care setting. The nurses have a major impact on the patients. A condition like Human Immunodeficiency Virus (HIV) infection and Acquired Immuno Deficiency Syndrome (AIDS) has a major stigma with it. In the past, the stigma of HIV/AIDS was higher among people due to the cultural, social, and religious reasons. The AIDS certified registered nurses and other nurses can help reduce the stigma towards the patients. Organizations like the Association of Nurses in AIDS Care (ANAC), promote the health and welfare of the people affected by this condition (Association of Nurses in AIDS care [ANAC], 2015). This global organization is, of nurses who are in the AIDS care and aim to study more about AIDS. They conduct community events such as promoting social awareness concerning issues related to HIV/AIDS. These nurses have the training to help the patients cope with and manage the different emotional and physical symptoms. They administer treatments to help the patient’s suffering through the different stages of this condition (Association of Nurses in AIDS care [ANAC], 2015). The Advanced Practice Registered Nurses (APRNs) play a critical role in maximizing the effectiveness of the care team. Their care outcomes in the patients with HIV/AIDS are comparable to the patients managed by the physicians (HIV Medicine Association [HIVMA], 2014).

As a future advanced practice registered nurse (APRNs) I have thus far acquired the advanced knowledge on theories and philosophies, reflective practice, ways of knowing and unknowing that will only prepare me in the future practice as I provide quality nursing care. The knowledge is critical in decision-making allowing me to collaborate effectively with a multidisciplinary team, patients, and their families to promote quality care and positive outcomes. As APRNs, in order to develop nursing theories the ability to use reflection and have an open mind to different concepts and possibilities in nursing care is crucial. It only takes a few minutes to apply Watson theory of caring to sit with a patient and hold their hand to influence the patient’s outcome and promote a healing environment. Newman’s model focuses on the individual and their interaction with the environment (Warelow, 2013).

There is an increasingly high demand for students going into nursing careers in our society, but there are also varying educational pathways for these students to get into these careers. Are the three educational pathways (Diploma, Associate Degree, and Baccalaureate Degree) preparing prospective nurses to be at the same competency level after schooling? Advancement in education has become an increasingly important topic amongst health care organizations. Educational preparation can indeed affect nursing care and the decision making of nurses. In this paper, an analysis of nursing history and the degree programs themselves will provide evidence of an increased level of patient care by BSN nurses vs. ADN nurses.

Of the analyzed schools, the University of Saint Joseph requires the lowest number of practicum hour requirements to fulfill the course objectives, that being 60 practicum hours. The MSN handbook describes the course as guided by an examination of each of the eight NLN core competencies. Within the 2016 MSN handbook, it is stated that the course provides students with “the opportunity to examine role and function of the advanced practice nurse in the educator role is examined through the “delivery of educational pedagogy in academic and health care settings.” The course is a blend of classroom and online classes, including the teaching practicum, which is graded as pass/fail. The blended classroom experience utilizes a face-to-face, “Go-to-meeting” format and self-paced online activities involving group activities using Blackboard; chats, blogs, emails, journaling, and web posting are also incorporated. Throughout the semester, weekly practicum experiences are recorded in a log which is reviewed at mid semester and at course completion. Each journal entry is expected to be a short summary of the week’s experience and include one-two references related to the educational concept of that particular week; the journal entries account for 35% of the class grade. In addition, when classes do not physically meet, online discussions of learning experiences, based on course objectives and evidencing literature reviews related to the learning experiences, are shared; this

Florence Nightingale says that, “For us who nurse, our nursing is a thing which, unless we are making progress every year, every month, every week, take my word for it, we are going back...” (Cook, 1914, p. 264). From the time Florence Nightingale practiced nursing, the discipline of nursing has evolved. Due to the lack of accessibility to health care and expanding health care needs, the scope of the nursing practice continues to broaden. Because of the rise of scientific knowledge related to illness and disease process, the advance practice nurse emerged. In 1965, the first nurse practitioner program was developed. Since that time the need for more formal education and training has become the norm (Fairman, n.d.). The remainder of this report will review the role of the advanced practice nurse and how this role delivers comprehensible care, followed by a brief personal philosophy.

Nursing achievements and requirements today vary within education. There are three entry levels in nursing, the Associate Nursing, (ADN), Bachelorette of Nursing, (BSN) and the Diploma in Nursing (DN). On the contrary, other professions have a greater amount of educational requirements such as law, engineering and medicine. When entering into specified careers, it is essential as well as required to further one’s knowledge base to a graduate level. However, in the nursing career there are no specific requirements which create a barrier for the profession by means of fewer achievements towards success in the nursing profession.