We discussed the competency of an APN in the process of ethical decision-making, and facilitating patient knowledge, patient decision-making and decreasing health disparity. J.M.C. stated ways of practicing ethical responsibilities were through the establishment of relationships with her patients, acknowledging their individual and collective strengths and assisting them in meeting their health care needs. She encourages many of her older adult patients to acknowledge the need to address advance directives and living wills, and engages in care-based ethics where she uses the relationships she develops with her patients to practice ethical behaviors. She adheres to the Health Insurance Portability and Accountability Act (HIPAA) rules and regulations by divulging patient information to those involved in the care of the patient or individuals the patient sign consent forms for that allows an exchange of information in the care provided. In regards to policy competencies, J.M.C. expressed the importance of the involvement of APNs in professional organizations to increase the power of the group and exponentially increase the influential power of advanced practice nursing and organizations in political changes. Her own experience as a member of the Kentucky Nurses Association showed the value of an APN’s dedication to high-quality nursing standards and improving methods of practice by professional nursing organizations leading to improved care and benefits for all involved
Ethical knowing or the moral direction of nursing is focused on the nurses’ responsibility of knowing what out to be done and what is good and right (Carper, 1978). Ethical knowing “guides and directs how nurses morally behave in their practices” (Chinn & Maeona, 2011, p. 7). This nurse practices ethics by being a patient advocate and preserving his client's right to choose or refuse care. This patient advocacy will continue as this nurse advances to the role of APN.
Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an
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
The American Association of Colleges for Nurses [AACN], (2006) in 'The Essentials of Doctoral Education for Advanced Nursing Practice ' Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking, affirms "advanced nursing practice (APN) includes an organizational and systems leadership component that emphasizes practice, ongoing improvement of health outcomes, and ensuring patient safety. APNs should be prepared with sophisticated expertise in assessing organizations, identifying systems’ issues, and facilitating organization-wide changes in practice delivery". (p.10) Hameric, Hanson, and Tracy ( 2014) indicates that APN must assess the clinical microsystems in which they perform nursing practices, have knowledge of the medical organizations that impact their specialties, assist with establishing patient centered care reforms to enhance quality of nursing care, improve patient safety, and provide nursing indicators that evaluates nursing performance. (p.266) APNs perform leadership capabilities in four chief areas including clinical practice settings, in the nursing career, within organizations, and in healthcare politics at regional and national levels. (Hameric et al, 2014, p. 266)
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.
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 association endeavors to enhance high standards of nursing practice by promoting safety and ethical decision making. The association represent nurses in lobbying regulatory agencies on issues related to policy and legal development. The association is involved in establishing the standards of nursing practice. It disseminates information to nurses though workshops, conferences and publications. The association publishes, American Nurse Today, The American Nurse, and The Online Journal of Issues in
Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s
As a practitioner or a population health coach, both APNs considered other nurses at any level, and physicians within the same discipline, as her peers. Over the course of their professional careers, increased confidence, trust, and knowledge were the commonalities with evolving roles. The confidence and trust originates with oneself, then, includes that of her co-workers and physicians, but mostly from her patients. Maturing from the novice RN to an expert APN, the confidence and knowledge base has developed, building an individual practice and supporting patients and communities towards optimal health. Each considered autonomy the greatest privilege guaranteed them as APN.
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,
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 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
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.
Nurse leaders are aware that today’s health care system has many issues complicating the goal of quality patient care and outcomes for all. Nurse leaders must stay informed and become involved as an advocate influencing changes in policy, laws, and/or regulations that govern the health care system they practice in. At times the advocacy requires a nurse leader to become more involved beyond their immediate level of practice and into the world of politics and policy.