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 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.
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.
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
Advanced practice nurses have core competencies that are similar or are specific to each specialization defined as an advanced practice. The profession of nursing presents favorable circumstances for nurses to specialize in roles with distinct responsibilities and opportunities to contribute to the function of a health care industry with growing demands and complexity. The profession of nursing continues to debate to whom the title advanced practice nurse applies to. Examination of the core concept frame works described by nurse leaders and professional organizations tend to either support or refute the argument related to the use of the term, advanced practice nurse for nursing administrators and educators. For the purpose of this paper the author will explore the core competency similarities and differences of a nurse practitioner and a nurse educator. Nurse educators and nurse practitioners are registered nurses that possess advanced education, skills, and experience. Each specialty nurse has defined scopes of practice with distinct sets of responsibilities, requirements, and skills. Each role represents distinct educational requirements and activities that contribute to the complex and diverse health care industry.
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,
Advanced Practice nursing (APN) is considered the usage of a broader scope of constructive, logical and research-based expertise related to the health and well-being of patients, within a varying disciplines (DeNisco & Barker, 2013). What is the future position of APNs in the progression of our healthcare system? What role will this writer assume, educator, practitioner, population health coach, or all three? The use of theory, primarily Sister Callista Roy’s Adaptation Model, and EBP give this writer a firm foundation to develop and modify her own practice framework.
The relationship of the advanced practice nurse and the patient, with the patient being a single individual or a family unit, is participative with the focus being on meaning as the nurse practitioner assists the patient to select one of the multitudinous possibilities in a given health situation. The nurse practitioner does not prescribe a patient to a set of interventions alone, but instead the FNP intervenes with active presence and listening to help the patient to identify their own desires for change. Instead of finding what is wrong with the patient, the nurse practitioner asks what the patient wishes to discuss during an encounter. Then, the FNP supports the patient and helps improve the patient’s quality of life through perspective, pattern recognition, and change if the patient desires. Together, the FNP and patient collaborate to achieve patient-chosen health goals.
As the health care system continues to change and the population of patient with chronic conditions transforms in the health care industry, the leaders of nursing much be able to adapt and change as well. Advance practice nurses are on the forefront and leaders of the patient health care. In addition to the challenges being faced with the current Affordable Health Care Act, the advance practice nurse must be willing to lead and take a stand for the betterment of the patient overall health and condition. As this writer reflects on the personal strengths, positivity, self-assurance, and relator are personality traits needed as an advance practice nurse. In the personal strength positivity, there is encouragement with individuals to believe within themselves and attempts to pull out their inner strength. This personal strength can be utilized with patients who are struggling to lose weight or being newly diagnosed with an illness, This writer can encourage the patient to believe within themselves and help create health care plans to assist the patient with changing their lifestyle.
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
Nurse Practitioner Core Competencies are a set of competencies that guides and regulates the scope of practice for Certified Nurse Practitioners (CNP). Patients and organizations benefit highly from nurses working at the top of the education in their profession. As a license Advance Professional, education will help innovate and govern our needs related to patient care, safety, evidence-base practice, and improvement of positive patient outcomes. Nurse Practitioner Core Competencies consist of Leadership, Quality, Practice Inquiry, Technology/Information Literacy, Policy, Health Delivery System, Ethics, and Independent Practice Competencies.
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).
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 of the Advanced Practice Nurse (APN) is expanding internationally throughout the healthcare system. Since the initiation of the Patient Protection and Affordable Care Act in 2010, there has been an increased need for APNs due to the growing demand for primary care services and increased population that have gained healthcare coverage (Lanthrop & Hodnicki, 2014). The purpose of this paper is to explore the role of APN and develop a professional development plan for my future career.
There should be a support system for new nurse practitioners that is established in graduate school and carried into the first two years of practice. Each graduate school of nursing should have a list of previous graduates who would like to share their experiences as nurse practitioners and help novice practitioners find their way through the transition. Conner (2014) concluded that a support system can be an effective coping mechanism for stress and anxiety. It provides an opportunity for the sharing of information, positive encouragement, and nurturing. Support systems can benefit new family nurse practitioners in their transition.