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The APN Professional Development Plan
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An issue that seems to have always been of concern, yet never fully settled for APNs is that of full practice authority. Full practice authority has been an issue for a long time. APNs have been restricted and held back by legislation for too long. In restricted states APNs are under supervision by both the Board of Nursing and Board of Medical Examiners for their corresponding state (Myers, 2013). This causes friction between the two factions for the reason that there is still a great deal of physicians out there that do not truly understand the role of an APN. Due to their inadequate knowledge on the matter of APNs and their role in practice, APNs’ role are being discounted to the general public by having to be under the Board of Medical Examiners supervision and not practice to their autonomous full extent. APNs are subject to minimum of a Masters degree, with option of Doctoral and PhD. With extensive academic education and closely regulated minimum clinical and didactic training hours, APNs are more than qualified to retain full practice authority. Any rule, regulation, or legislature preventing full practice authority is outdated and the author responsible is …show more content…
Frankly, many people do not understand nor truly know what it is that APNs are capable of and their training. With a current push by AANP and other organizations promoting full practice authority but also the role of an APN, the public view of APNs is starting to change positively. We are starting to see an increase in legislator and states as a whole adopting full practice authority. In order to have the backing of the general public it is imperative to educate the public on the role and training of APNs, ironically, who would be better than that of APNs as patient education and community involvement are just two of the many skills in which APNs have extensive training and
Even so, physicians and nurses debated the best way and extent to which the NP role should be integrated into care, as well as how far NPs could extend their scope of practice. The National Joint Practice Commission (NJPC), funded by the Kellogg foundation in 1972 was one attempt to bring nurses, physicians, and broader professional organizations together to model the collaborative behavior that made nurse-physician teams so effective at the practice level. The NJPC funded nurse Virginia Hall to investigate legal issues related to expanding nursing roles related to nurse practitioner practice. In 1974, she published Statutory Regulation of the Scope of Nursing Practice – A Critical Survey. Hall’s work was one of few nationally unifying positions to guide physicians, nurse practitioners, and state boards (Hall, 1975). The Commission also published Together, as series of exemplars that highlighted effective NP-physician collaborations (Hidgen, Offan, & Starr, 1977). Still, the American Medical Association and other physician organizations could not accept the broader scope of practice recommended by the NJPC, and it folded in 1981 after only 9 years of existence. (Fairman, 2008,
The model discusses the impact of new regulations on education for APRN, Licensure Accreditation, Certification & Education Document, certification and practice. The model is implemented to grasp the general understanding and definition of advance practice registered nurse APRN role, inconsistencies with state by state recognition of APRN roles, and determining eligibility for APRN licensure (Consensus Model for APRN Regulation, 2015). The consensus model definition of APRN is a nurse who is educationally rounded to assume the responsibility of assessing, diagnosis, treating, teaching health promotion and disease maintenance, acquired advanced clinical knowledge and skills to provide direct patient care, has passed a national certification examination, and licensed to practice in one of the four roles (Consensus Model for APRN Regulation, 2015).
In fact, there have been numerous studies supporting the clinical performance and outcomes of NPs. A systematic review covering the literature from 1990-2008 found that patient outcomes of care provided by APRNs in collaboration with physicians were similar to and in some manners, exceeded those of physicians alone (Newhouse et al., 2011) Newhouse, et al’s review added to the available evidence that APRNs provide safe, effective, quality care to specific populations (2011). In their review, they did not separate outcomes of NPs with full practice authority from those with reduced or restricted practice. Due to the patchwork of state regulation and restrictions on NP practice, it may be challenging to compare the outcomes of NPs with full independent practice from those with reduced or restricted practice. Furthermore, the AANP states “there are numerous studies that demonstrate nurse practitioners consistently provided high-quality and safe care” (n.d.). They go on to state “in the more than 100 studies on care provided by both nurse practitioners and physicians, not a single study has found that nurse practitioners provide inferior services” (AANP, n.d.). The Federal Trade Commission (FTC) has also reviewed the literature and determined there is not a significant difference in the outcome of NPs and physicians that would necessitate the anti-competitive nature of scope-of-practice regulations and restrictions on advanced practice nursing (Federal Trade Commission [FTC],
This discussion board is about the nurse’s scope of practice. The purpose of this posting is to discuss the definition and standards of the nurse’s scope of practice as defined by the American Nurses Association (ANA) and by the Ohio Board of Nursing with an example of how to use the standards of practice. Per the ANA, when determining the nurse’s scope of practice there is no one specific explanation that can be provided due to the fact that registered nurses can have a general practice or a practice that is very specialized. The limits that are placed on a RN’s scope of practice will depend on a registered nurse’s education, type of nursing, years as a nurse, and the patients receiving care. At the basic level, every nurse’s practice
...rained for specialty practices. Two-thirds of today’s PAs work in specialty care. This, therefore, leaves NPs to work in general practice (p. 828). Woolsey and Cutter (n.d) seem to have a different opinion by stating “PAs are generalists while NPs can be either [specialist or generalist] depending on the area of medicine they practice” (para. 5). They go on to explain that PAs are trained to generalize, so that they can hop from one area to another (Woolsey & Cutter, n.d., para.5). PAs have the ability to specialize if they complete a residency program, but one important thing to note is that a PA is still documented as a generalist whether or not they have specialized (Woolsey & Cutter, n.d., para.5). Woolsey and Cutter (n.d.) then note that NPs often have to have a national certification in a nursing specialty before they can practice within a specialty (para.5).
Advanced practice registered nurses play a significant part in extending access to health care by providing primary care and specialty care services to clients. Advanced practices registered are mentors, educators, researchers, and administrators. According to Health Resources and Services Administration, “Ninety-six percent of the NP workforce reported being in clinical practice, providing direct patient care” (Health Resources and Services Administration 2016). Furthermore, “Nearly three percentages were in faculty positions and approximately one percent was in administrative positions”(Health Resources and Services Administration 2016).
My plans after obtaining my advanced degree is to acquire licensure to practice as AGNP in the state of Texas. The Texas BON acknowledges that APN education, experiences, and competency levels vary, hence, holds individual APN accountable for knowing and practicing within their own scope of practice and competency always. The APN’s education is the grounds to their scope of practice: however, the APN can expand the scope of practice within the role and population-focus, as long as it remains within limits of the law. The Texas BON restricts the scope of practice for the APNs. The Nurse Practitioner Supervision Laws require¬¬¬¬¬ APN to work under physician supervision within seventy five mile perimeter. In addition, there is the Texas ' Nurse Practitioner Prescribing Laws which require APNs to prescribe medications under physician supervision and APNs are not allowed to prescribe schedule two drugs. All prescriptions written by the NPs must include the supervising physician 's name, address, Drug Enforcement Administration (DEA) number and phone number (Texas BON,
It is important to evaluate which learning style your patients prefer in order for them to best understand what needs to be done for the maximum appropriate outcome. Licensed practical nurses are advocates and that’s someone who supports and supplies information to their patients. Advocacy often involves standing up in support of a patient and their rights. This is especially true when patients are not able to protect their own rights. When filling the role of counselor, Licensed Practical Nurses can help patients and families explore ideas and feelings towards healthcare and illness (8 Roles of the LPN). Some patients have a difficult time accepting a disease or its treatment options. As a practical nurse you consult with RN supervisors regarding patient care and assessments. In some settings LPN 's communicate directly to physicians. Communicating information to the proper people assists in increasing the effectiveness of care plans (Role). As practical nurses we are only one part of a patient care team. Other important members include RN 's, CNA 's, physicians, physical/occupational/speech therapists, dietitians, volunteers, and more (8 Roles of the LPN). With such a large team, every member has their own scope of
The process of role development goes beyond networking and taking on a new role as an APN. According to Brykczynski’s study of clinical nurse specialists, role development involves a complete makeover of one’s professional identity and the ability to integrate the seven core advanced practice competencies.1 New graduate APNs go through phases during their transitioning period, from a registered nurse to an APN; these phases include orientation, frustration, implementation, integration, frozen, reorganization and complant.2
Over the past 5 decades, nurse practitioners have been utilized to deliver primary care, traditionally in underserved areas or to vulnerable populations. With the primary care physician workforce in decline it has been estimated, in 2020 we will see a shortage of nearly 45,000 primary care physicians. Currently, a nurse practitioners scope of practice varies widely state by state, many believe that drafting new laws to expand their scope of practice would help create a readily available supply of primary care providers to help combat the expected shortage.
...ers that can teach the nurses coping mechanisms. APNs also act as the advocate for both the patients and the nurses in health care settings.
Taking, analyzing, and interpreting patient health histories in order to provide correct diagnoses. Creating individualized treatment plans. Diagnosing and treating acute illness. Monitoring and managing chronic illnesses. Working with patients to create and maintain a healthy lifestyle. Can prescribe medications. Common practice settings: Private practice. Managed care facilities. Community clinics. College campuses. Research hospitals. University faculty. Licensing and certification: both the American nurses credentialing center (ANCC) and the American academy of nurse practitioners offer NP certification exams. Nurses must also register with the board of nursing in the state where they choose to work. Continue education requirement: certification with the AANP must be renewed every 5
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 APRN listens and engages with the patient as care and compassion take place. As the nurse discerns what the patient’s needs are and considers obstacles to achieving optimal care the application of theory is necessary as the process is not always quantifiable. The APRN who does not learn nursing theory may focus primarily on EBP and miss this engagement opportunity with the patient. One may prescribe medication; however, if the patient does not take the medication, then the nurse assumes the patient is noncompliant. The application of Watson’s themes where appropriate helps the APRN discern how to help the patient become compliant. It is necessary to care for the patient outside of the idea of only providing care to understand the obstacle in that patients circumstances and reach improved patient outcomes to any disease
To briefly summarize, the report identifies nurses as an important factor in enabling access to high quality, affordable health care. This was supported by the development of four fundamental recommendations. The first suggests that nurses be allowed to practice within the scope of their degree. This becomes evident in the differences in state laws that pertain to nurse’s who have acquired advanced degrees, such as the nurse practitioner.... ...