The role of the Nurse Practitioner was the last of the advanced practice nursing role to appear in

Patricia Benner, a well-known nursing theorist who published From Novice to Expert, theorizes how a nurse should progress through their career. Benner’s theory explains what stage of nursing one is in based on your education and the amount of time one has worked in a specific nursing field. She describes the five stages of the theory: novice, advanced beginner, competent, proficient, and expert. While this theory has its limitations, it is beneficial to the well-being of both the nurse and patient and that is proven by real world clinical practice.

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.

Nurse Practitioners (NPs) play a key role in long term health care by ensuring provision of holistic healthcare services particularly in remote areas and in those areas that have few physicians. Currently, there is a concern where there is a shortage of physicians in nursing homes and in other critical health care services questioning the care being provided (Colwill, Cultice, & Kruse, 2008). Due to population growth,

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,

With the passing of the Affordable Care Act in 2010 approximately 32 million more people will be insured throughout the United States. The need for healthcare workers and providers will be in drastic demand to provide care to these insured Americans. The 2010 IOM report details out how the advanced practice nurse can be a valuable asset in primary, chronic and transitional care and their skill set should be used to promote better healthcare across the nation (IOM, 2010). This impact of this report should help progress advanced practice nurse’s ability to practice without individual state regulation and be governed under one body to server in and outside of the hospital setting

Healthcare reform in the United States (U.S.), continues to be a hot topic in the news. Whether it discusses how the program will be financed, the need to redesign the organization, or how the process of delivering healthcare will be implemented; one thing that is a frontrunner, is the need for registered nurses (RNs) and advanced practice registered nurses (APRNs) to fill the increased demands on the primary care system (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 375). “Several programs and initiatives included in the health reform legislation involve interdisciplinary and cross-setting care coordination and care management services of RNs” (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 377).

NPs are not only moving into increased roles within the acute care hospital setting, but also into roles in the community as Primary Care Providers (PCPs). The anticipated shortage of physicians to handle an increased number of aging patients already affects my position as a staff nurse at a hospital. A career in nursing offers countless paths to further your education, whether it is to become a specialist in a field of practice, foray into research or to pursue a position as a nurse practitioner. I was interested to learn more information about how expanding the role of Advanced Care Nurse Practitioners (ACNP) may relieve shortages of physicians and lessen the burden on our current healthcare system. Increasing the roles of ACNP would only be feasible if patients are still receiving quality care while decreasing the cost of healthcare. As a nurse returning to school to further my education, I would like to know if pursuing a career as an ACNP would be a viable option for me to continue to interact with patients in an acute care setting in a more specialized role.

Throughout nursing, there are many theories that nurses may come across and use. Calista Roy’s and Betty Neuman are two theorists that use two different types of models to encompasses the health, person, and the environment. Callista Roy uses a theory that promotes adaptation to the stimuli a person may encounter. Betty Neuman uses a theory that promotes equilibrium in a time where a person will encounter stress. These theories allow the nurse to bring a knowledge to learn more about the person and the factors that influence their health. Although with any theory there are different approaches in how the nursing plan is done, but with the patient in mind, it makes the difference in care that is given and allows for better outcomes for the patient.

Advanced Beginner is the next stage in Patricia Benner’s model. Nurses considered to be in this stage have had enough real life experiences to note different aspects of a situation. They base their assessments of patients on previous experiences similar to the current patient they are providing care for (Benner, 1984). Nurses performing at this

When the Institute of Medicine (IOM) released its 2010 report, The Future of Nursing, Leading Change, and Advancing Health, many nurses felt affirmed by the spotlight this prestigious group placed on nursing. The reality is the newly designed healthcare requirements by President Obama will lead to millions of previously uninsured Americans needing care that nurses can provide. These growing demands lend themselves to different types of care providers under the nursing umbrella. There are: LPNs, nursing assistants, RNs with associate degrees, baccalaureate and master degrees, nurse practitioners,

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

Adaptation theory is one of the nursing theories that have had a significant impact in the general practice of nursing in the world. Nursing is one of the technical activities and undertakings that need immediate and tedious professionalism. In most cases, nurses are supposed to undergo equitable training and impartation programs that seek to add into their contemporary activities in the society. In order to be able to meet the daily challenges and difficulties posed by the profession, many nurses have engaged in education programs and training. Nursing requires nurse and all the participants to be at the forefront in the management of the available activities. For instance, nursing challenges are everywhere in the society. This means that in order to have a larger scale of performance and maintenance of the nursing standards in the nursing field, nurses, and many other participants should be introduced to the theory of Adaptation. According to Daniels (2010), adaptation involves educational measures that are directed at letting the client be conversant with the practical terms and conditions of the work they are to engage in the profession or the field. The Adaptation theory is used to solve many educational challenges being faced by nurses and other health specialists in the field (Daniels, 2010).

As the healthcare system in America is overhauled, advanced practice nurses are going to increasingly assume the role of primary care providers. Many states have kept up with the evolving expansion of

These impose severe constrictions on the ability of the nurse to move forward or advance into the areas of practice where traditional nursing practices were not allowed {Institute of Medicine, 2010}. However with the increase in the number of nurses graduating with advance degrees in nursing; the situation is changing. These well educated nurses are leading the charge to confront the complex issues that the rapidly changing health care situation presents. Regulatory barriers must be lifted so that nurses can practice within their scope in order to be reimbursed by private insurance for the services they provide. These changes can be done through the federal and state legislators as well as supervisory agencies and bodies such as congress and licensing regulatory boards. The IOM also recommends that nurses will expand their scope of practice and increase their responsibility through teaching and counseling of patients. {Institute of Medicine,2010}. The use of Advance Practice Registered Nurses and Physician Assistant in providing primary care services will decrease wait time and increase patient satisfaction. The high turnover of nurses transitioning from school to practice also affects the quality of care. These nurses do not have enough experience to make decisions in patient care.{Institute of Medicine,2010}.The IOM and JCAHO{2012} report supports the recommendations for the introduction of nursing residency

"Brenner (1984) described the 5 stages of development for the professional nurse. The stages are (1) Novice (2) Advance Beginner (3) Competent practitioner (4) Proficient practitioner (5) Expert Practitioner. The stages progress from a nursing student to the professional practitioner through growth and knowledge." (Lopez-Boyd, 1997, p. 41) Nursing is a profession. Look around you, you see competent, caring individuals