The Role Of a Nurse Practitioner In Acute Care
Seynor Massalee Kennedy
South University
The Role Of a Nurse Practitioner In Acute Care
There are several recognized advanced practice nursing roles in many countries with requirements of a graduate education with a specified focus. These roles includes: Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Nurse-Midwife (Cnm), Certified Registered Nurse Anesthetists (CRNA). A NP main focus is direct patient care which comprises of delivering to patients and their families medical and nursing care. However, the introduction of a NP to health care team and resulted into both negative and positive responds (Kilpatrick, Lavoie-Tremblay, Lamothe, Ritchie,
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& Doran , 2013). The purpose of this paper is to write an empirically based literature review on research and expert opinion on the role of an acute care nurse practitioner and the implementation of this role in unfamiliar primary health and acute care setting. NP in this document refers to an Acute Care Nurse Practitioner (ACNP). Safety of patients is essential in all aspect of direct and indirect clinical practice including the ability to offer support for new nurses. The main capability of the ACNP practice is direct clinical practice and it is the purpose that expends most of ACNP practice time. Previous strong clinical nursing foundation is important for the role of an ACNP due to the ACNP responsibility to care for acutely and critically ill patients. ACNP specialty practice which relates to diagnosing, managing disease and promotion and protection of patient’s health is the main capabilities as it relates to ACNP. However, the ACNP has to be acquainted with the National patient safety goals as a resource to keep informed of patient safety concerns. Therefore, evaluating protocols and the use of the National patient safety goals (NPSG) to prevent errors is the function of the ACNP in the function as a direct patient care (Hamric, Hanson, Tracy, & O’Grady, 2014). Review of the Literature In a study by Kilpatrick, Lavoie-Tremblay, Lamothe, Ritchie, & Doran (2013), the purpose was the comprehension of health care team productivity following an ACNP’s role, the components of the role and the role enactment of the ACNP. The study was designed as a descriptive multiple-case study and the method used was a multiple-case study design. Similarities in the cases selected were affiliation with university, implementation time, clinical specialty, and amount of professional roles in the team while differences included location of region geographically and surgical activity. The case participants were selected by purposeful sampling and maximum variation with collection of data from March –May 2009. Time and motion study measuring the activities of ACNP, interviews with individuals, groups and observations of communication behaviors, documents, and field notes of structured non-participant were included in the data sources. Impressions and theoretical ideas were recorded by field notes throughout the study. In the study by Sangster-Gormley, Martin-Misener, & Burge (2013), the purpose was to discuss the implication of implementing the role of a NP in primary health care (PHC) and elements that could strengthen the process during implementation.
The study was designed as an integrative review of an informative, single case study with embedded unit of data analysis and a method of important documentations and semi-structured examination with participants (n=16) from three primary health care units in British Columbia was incorporated into the data source. Inclusion criteria included PHC units where the NP had worked for at least six months, English speaking participants that worked directly or indirectly with the NP and have worked on the unit for at least six months before the NP role …show more content…
implementation. During the case study, the NP, administrative manager, physician, staff nurse or medical assistant working with the NP was interviewed.
Additionally, documents were reviewed to corroborate data from the interviews. All interviews occurred as a private, face-to-face encounter in a location that had been mutually agreed upon except one which was conducted as a telephone interview. The research questions that were asked focused on how identifying the intentions of the NP’s role and involvement and acceptance of team members (Physicians, managers, other staff and the NP) influence the role implementation process. In Addition, what was the change in PHC setting after the NP enacting the role domains of clinical practice, collaboration, research, leadership, and change agent (Sangster-Gormley et al., 2013)?
The results indicated that there are barriers to overcome when unfamiliar roles are introduced to a unit. In order to overcome these barriers, members of the team should be informed of the need and the role of the nurse practitioner during the hiring process. Involvement of the community health care providers in the implementation of the new role of a nurse practitioner can developed acceptance with gaining knowledge of the new role (Sangster-Gormley et al.,
2013). Sangster-Gormley, Martin-Misener, & Burge (2013), concluded that the implementation process can be successful and the nurse practitioner is able to perform as expected if all three of these concepts: the interconnectedness of the concepts of intention, involvement and acceptance are incorporated. Gosby (2014) discussed the role of a NP as collaboration between patients, their family members and their community. The Australian research on the role of an NP emphasizes the significance of the relationship between the patients and the NP. Therefore, with the use of authentic and collaborative approach, NP’s are able to plan a course of action based on the patient’s needs and available resources. Furthermore, mentoring and professional support of new NPs, clinical leaders can use collaboration to ensure safe and effective care. Moreover, the process of treatment can be achieved without neglect to the care factor with the individualizing patients’ care that is provided by the NP. Summary In summary, the literature reviewed enforces how identifying the intention for the role of the NP and the involvement of other care members can determine role acceptance and the implementation process thereby enabling the NP to work effective as an advance (Sangster-Gormley et al., 2013). Nursing Implications The nursing implications related to the implementation of the role of NP in a health setting that is unacquainted with the role of NP calls for understanding of the implementation process by stakeholders and policy makers. The determination as to how and where to implement the roles of NPs, as PHC has moved from disease-centered to a patient-centered approach, however, it is important to have consumers engaged in legitimate partnerships with health authorities and policy makes (Sangster-Gormley et al., 2013). When introducing ACNP in unfamiliar settings, managers and team members can use the new conceptual framework to identify structures or process of focus and provide safe and effective patient care. However, collection of data in one clinical specialty and jurisdiction can be seen as a limitation of the study (Kilpatrick et al., 2013). Conclusion In conclusion, identifying the intention for the role of the NP and the involvement of other care members can determine role acceptance and the implementation process thereby enabling the NP to fully enact the competencies of the advanced nursing practice (Sangster-Gormley et al., 2013). Structural and process dimensions that inhibit ACNP role enactment in teams and the processes that inhibits the outcome of team effectiveness is identified in the conceptual framework. The ability of the ACNP to perform the entire scope of practice is accomplished if attention is placed on these dimensions. The addition of an ACNP to a health care team can improve the team process by providing timely patient care, comprehensive patient discharges, and mentoring of new team members (Kilpatrick et al., 2013). . References Gosby, H. (2014). Collaboration for process and care. Journal For Nurse Practitioners, 10(8), 620. doi:10.1016/j.nurpra.2014.07.029 Hamric, A. B., Hanson, C. M., Tracy, M., & O'Grady, E. T. (2014). Advanced practice nursing: An integrative approach (5th ed.). St. Louis, MO: Saunders/Elsevier Kilpatrick, K., Lavoie-Tremblay, M., Lamothe, L., Ritchie, J. A., & Doran, D. (2013). Conceptual framework of acute care nurse practitioner role enactment, boundary work, and perceptions of team effectiveness. Journal Of Advanced Nursing, 69(1), 205-217. doi:10.1111/j.1365-2648.2012.06046.x Sangster-Gormley, E., Martin-Misener, R., & Burge, F. (2013). A case study of nurse practitioner role implementation in primary care: what happens when new roles are introduced? BMC Nursing, 12(1), 1-12. doi:10.1186/1472-6955-12-1 Sangster-Gormley, E., Martin-Misener, R., & Burge, F. (2013). A case study of nurse practitioner role implementation in primary care: what happens when new roles are introduced? BMC Nursing, 12(1), 1-12. doi:10.1186/1472-6955-12-1
The role of nurse practitioner in the Canadian healthcare system is relatively new compared to the traditional roles of doctors and registered nurses, and as with any new role, there are people who oppose the changes and others who appreciate them. Some members of the public and the healthcare system believe that the addition of the nurse practitioner (NP) role is an unnecessary change and liability to the system because it blurs the line between a doctor and a nurse; this is because nurse practitioners are registered nurses with additional training (usually a masters degree) that allows them to expand their scope of practice into some areas which can be treated by doctors. Other people feel that nurse practitioners can help provide additional primary care services, while bridging communication between nurses and doctors. There are always legitimate challenges to be overcome when changing a system as complicated as healthcare,
The Ottawa Model of Research Use (OMRU) offers a “comprehensive, interdisciplinary framework of elements that affect the process of health-care knowledge transfer, and is derived from theories of change, from the literature, and from a process of reflection” (Graham & Logan, 2004, p. 93). It promotes research use, and could be used by policymakers and researchers (Logan & Graham, 1998). The OMRU is an example of a planned change theory, which helps “administrators control factors that will influence the likelihood of changes occurring at the organizational level and how these changes occur” (Graham & Logan, 2004, p. 2).
Every little kid has high exceptions for what they want to be when they grow up. Some dream of becoming president of the United States of America, or becoming an Astronaut, a lot of little kid’s say that they want to be a Doctor. What kids do not understand is that there are many types of doctors, like an orthopedic surgeon, they work with feet, or an oral surgeon, who work with the mouth. Another similarity to a doctor is a nurse practitioner. They do many of the same tasks, like performing minor surges, fixing broken bones, or simply giving a routine check up. Becoming a nurse practitioner takes many years of schooling, good grades, a lot of time and dedication, and money.
Nursing is a knowledge-based profession within the health care sector that focuses on the overall care of individuals. According to The American College of Nurse Practitioners (ACNP), “defines nurse practitioners as registered nursed who have received graduate-leveling nursing education and clinical training, which enables them to provide a wide range of preventative and acute health care services to individuals of all ages. They deliver high-quality, cost effective care, often performing physical examinations, ordering tests, making diagnoses, and prescribing and managing medication and therapies”. Nurse Practitioners are able to specialize in a particular area, such as family and adult practice, pediatrics, and women’s health; and refer patients to other specialist when necessary. Some Nurse practitioners work under the supervision of a physician; while others run their own practices.
I have had the privilege to work with an incredible nurse leader over the past two years. This particular nurse leader shares my passion for population health and case management for the support of patients in their homes and keeping patients safe and healthy. The purpose of this interview was to obtain further knowledge about the role desired by the interviewer. By attaining information from a practicing Master’s prepared nurse, the interviewer will develop a deeper understanding of the career advancement and potential opportunities that are available in the local community.
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).
It is no secret that the current healthcare reformation is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify a way to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal…” (Bailey, Jones & Way, 2006, p. 381). The key to a successful healthcare reformation is interdisciplinary collaboration between Family Nurse Practitioners (FNPs) and physicians. The purpose of this paper is to review the established role of the FNP, appreciate the anticipated paradigm shift in healthcare between FNPs and primary care physicians, and recognize the potential associated benefits and complications that may ensue.
Healthcare is a continuous emerging industry across the world. With our ever changing life styles and the increased levels of pollution across the world more and more people are suffering from various health issues. Nursing is an extremely diverse profession and among the highest educated with several levels ranging from a licensed practical nurse (LPN) to a registered nurse (RN) on up to a Doctorate in Nursing. Diane Viens (2003) states that ‘The NP is a critical member of the workforce to assume the leadership roles within practice, education, research, health systems, and health policy’.
I want to be a nurse, specifically a nurse practitioner. I have always been fascinated with the medical field and see a bright future in it for me. I have the opportunity of meeting new people every day with a variety of personalities. There is always something new to discover in this field. A nurse practitioner's job is to be able to diagnose and treat illnesses. They also prescribe medicine and run physical exams. I am highly interested in pursuing the career of a nurse practitioner because the healthcare field is always in need for medical professionals, it pays well, and I am helping people at the same time.
Defining the role of an advanced nurse practitioner (ANP) is complex and commonly open to interpretation. Internationally there are many variances in what the role of the advanced practitioner entails, and the characteristics of individual roles are often shaped by the country and particular speciality in which they are practising (Mantzoukas & Watkinson 2006), (Sheer & Wong 2008), (Stasa et al 2014), (ICN 2008), (Dalton 2013), (NHS Wales 2010), (Haidar 2014), (Lowe et al 2011), (Pearson 2011).
The PES-NWI survey is used as a measurement tool to look at the quality of a nursing practice environment. Dr. Lake added five subscales to be included in the PES-NWI survey. “The five subscales are Nurse Participation in Hospital Affairs; Nursing Foundations for Quality of Care; Nurse Manager Ability, Leadership, and Support of Nurses; Staffing, and Resource Adequacy; and Collegial Nurse-Physician Relations” (Lake, 2007, p.109S). Dr. Lake felt it was necessary to include these five subscales in the survey to incorporate leadership and administrative qualities along with the other characteristics.
Masters, K.(Ed.). (2005). Role Development in Professional Nursing Practice (p. 186). Sudbury, MA: Jones & Bartlett Learning.
With my academic, professional and volunteer experience, I have reached a point in my career where I am fully equipped to enter the advanced curriculum of the Doctor of Nursing practice, Family Nurse Practitioner program. Working in the nursing profession for the past three years has shown me that there is an increasing need for research to improve health care delivery and access to vulnerable populations. It is rewarding to be a nurse; however there are limitations in my current scope of practice that prevents me to go beyond my job requirements. Through advanced education, my aim is to provide quality patient-family
The first key message that is discussed is that nurses should practice to the fullest extent of their education and training. Most of the nurses that are in practice are registered nurses. Advanced nurse practitioners are nurses that hold a master’s or doctoral degree and include nurse midwifes, clinical nurse specialists, nurse practitioners, and nurse anesthetists and consist of about two hundred and fifty thousand of the nurses currently working today. Advanced practice nurses are limited to what
The nursing profession has changed drastically over time. The roles and responsibilities that nurses take on have increased and become far more complicated. Nurses are managers, leaders, supervisors and have become experts in many areas of care. Every day nurses are faced with the task of improving and strengthening professional leadership within their work environment. Managing good quality and eliminating risk is the major challenge in health care. All members of the team must work together to accomplish outstanding patient care. Budget cuts and nursing shortage in all areas of health care leads to less licensed staff, where use of unlicensed personnel have been used widely, where delegation is not an option, but a necessity. Nurses must be aware of delegation guidelines, what tasks to delegate,when to delegate for the safety of patients, liability of nurses and the facility.