This paper will focus on the role of the advanced practice registered nurse (APRN), specifically highlighting the family practitioner and the integral role played with the underserved. The focus will be on a San Diego nurse’s journey to become an APRN and her work in giving back to underserved communities throughout the county. Mary Baker, MSN, RN, CNS, FNP-BC, APHN-BC continues to contribute to nursing as part of her dedication to serving the underserved.
Historical Perspective
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).
One such family pracitioner began her journey nearly a decade ago. Following a career in information technology, Mary Baker completed her nursing degree at California State University San Marcos in 2009 and continued to pursue her advanced practice nursing degree as a family nurse practitioner. In 2014, she obtained her national certification as a family nurse practitioner as well as
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.
For this assignment, I had the opportunity to interview Samantha Hage De Reyes, family nurse practitioner, currently working at the University of California, Riverside (UCR) Health Center in Riverside, CA. Family nurse practitioners are described as health professionals with analytic skills for evaluating and providing evidence-based, patient-centered care across settings, and advanced knowledge of the health care delivery system (Hamric, Hanson, Tracy & O’Grady, 2014). My objective was to ask a series of questions pertaining to the role of a family nurse practitioner, challenges concerning this nursing role, opinions regarding the future of family nurse practitioners, and more. This interview was conducted over the phone, and it was a valuable opportunity to learn more about what it means to be a family nurse practitioner and to start thinking about what I want to achieve in my own
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.
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 role of the nurse practitioner began in the 1960’s, with the development of an advanced nursing role in pediatrics in Colorado, to meet the need of treating children of low-income families. Since the inception of the advanced nursing role, there has been controversy in educational standards, educational requirements, knowledge base needed, and state imposed restrictions on practice. It is through the rapid development of ARNP programs and inconsistencies in educational standards that have created obstacles in the advancement of these roles, licensure differences, and restrictions that have minimized the role of the ARNP (Stanley, 2011).
Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.
Advanced practice nurse practitioners (APRNs) have been attempting for many years to eliminate barriers that prevent full practice authority nationwide. Each state has its own licensure and regulates APRN practice roles. APRNs benefit health care by addressing two pertinent needs: the lack of available physicians; and, the increase in patient comorbidities (Gray, 2016). Florida is about to experience a shortage of medical practitioners. According to the Physician Workforce Annual Report of 2014, statistics state 13.4% of medical providers are expected to retire within the following five years after 2014 due to an increase
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.
Throughout the development of theory in the discipline of nursing there are concepts of knowledge that are fundamental. Four of these patterns of knowing were first explored by Carper (1978) which included: empirical knowing, ethical knowing, personal knowing, and aesthetic knowing. Later, an additional facet was added by Chinn and Kramer (2008) which introduced emancipitory knowing. While all of these forms of knowledge are critical for holistic nursing care, this paper will place an emphasis on personal knowledge and how it contributes to the development of knowledge within nursing and the roles of advanced care practitioners.
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
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).
Integration of Advance Practice Nurses has been an ongoing process for the last four decades (Wilson, 2016; DiCenso & Bryant-Lukosius, 2010). There are several types of APNs including Primary Health NPs, Pediatric NPs and Adult NPs (Wilson, 2016; DiCenso & Bryant-Lukosius, 2010). The following assignment intends to explore a particular advance practice nurse (ANP) role in the current Canadian health care system. Melissa Harriott, BScN, RN, MN, NP has been interviewed to describe her advance practice role, philosophy of health, core competencies, and the nature of her practice as an ANP at the University of Alberta Hospital.
The role of Advanced Practice Nursing (APN) has changed dramatically in recent years. Currently, the Unite States (U.S.) health care is focusing on delivering a cost -effective health care to all patients. In the last decades, there were many efforts to control health care over spending in the U.S. One of such efforts is to focus on applying proven principles of evidence-based practice and cost-effectiveness to find the least expensive way to produce a specific clinical service of acceptable quality (Bauer, 2010). The vast changes in health care system, such as cost, need for high productivity, limitation on reimbursement, and the inadequacy on access have made APNs to think in a way where they most fit to provide independent care for
Since the start of my nursing career, I made the decision early on to get a few years of Registered Nurse (RN) experience and then continue on the further my education to become a Family Nurse Practitioner. My first job after graduating with my Bachelors of Science in Nursing (BSN), I worked in Pennsylvania as an oncology and hospice RN in a small rural hospital. After gaining one years’ experience, I decided to further my career by starting a career as a travel RN and simultaneously I enrolled at Chamberlain College of Nursing in the FNP program. After graduation, I plan on settling down in Washington and start my career as an FNP. Throughout this paper, I will effectively explore the scope of practice for APNs in Washington, complete a personal assessment that reflects my strengths and weaknesses, explore local and professional organizations that can be accessed to gain information on employment opportunities, determine