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Roles and responsibilities of nurse practitioners
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Nurse Practitioners as Primary Care Providers
Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the other hand, this has ignited the need for advanced practiced registered nurses to unveil the profession’s fullest potential. Nurse practitioners have been called to the public to meet the demand for safe and convenient healthcare. These academically and clinically well prepared nurse practitioners demonstrate their knowledge, skill and leadership in the communities (Hansen-Turton, Miller, Nash, Ryan, & Counts, n.d.). Due to the magnified concerns for additional access to healthcare, ANA has supported nurse practitioners’ ongoing work in retail-based health clinics to reflect a positive movement towards accurate, quality medical care for all citizens.
Since the year 2000, the nurse practitioners have been employed by convenience care clinics or retail clinics such as Minute Clinic and Take Care Health Systems. Either independently owned or as commercial chains, the retail clinics staff a family nurse practitioner or a physician’s assistant that offer the convenient location and evening hours...
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...istered nurse should have a clear understanding about the prevailing need for advanced practice nurses in our communities. Next, all nurses must realize the need to convene as one voice in order to participate in the transformation process that affects the nursing profession. In fact, the influential nursing voice representing the largest healthcare workforce can substantially impact the policies and reform that affect our communities. Equally important, nurses should prepare to improve clinical and communication skills in preparation to accept more responsibilities for promoting and managing today’s healthcare complexities. Nurse Practitioners in retail care clinics, demonstrating skill and artistry as primary care providers, symbolize the positive transformation the nursing profession is engaged with in fulfilling the urgent needs of the communities.
In 2011, Barbara Safriet published an article “Federal options for maximizing the value of Advanced Practice Nurses in providing quality, cost-effective health care” from a legal perspective. The article focused on the benefits of utilizing Advance Practice Nurses to the full extent of their abilities as well as the current barriers that APNs encounter in their practice. The aim of this paper is to discuss two regulatory provisions to full deployment of APNs in current health care system, as well as three principle causes of current barriers to removal of the restrictive provisions for the APN. Furthermore, I will discuss the critical knowledge presented in the article and how it relates the APN practice. This article was incorporated into a two-year initiative was launched Institute of Medicine (IOM) and by the Robert Wood Johnson Foundation (RWJF) in 2008 which addressed the urgency to assess and transform the nursing profession.
The Affordable Care Act (ACA) was passed in 2010 with the goal of expanding healthcare coverage to all Americans by reforming insurance policies and practices (Tillett, 2011). The ACA upsurges the demand for an increase in primary care providers in order to supply quality care to the much larger population that will have coverage and therefore acquiring healthcare. The Institute of Medicine (IOM) through its report The Future of Nursing: Leading Change, Advancing Health has generated a solution to the shortage of primary care providers by promoting a transformation of the nursing profession to fill the gap.
Access to quality healthcare is a growing concern in the United States especially in light of healthcare reform coverage expansions made possible by the Patient Protection and Affordable Care Act of 2010. It is estimated that 94% of all Americans will acquire healthcare coverage under the law, an increase of nearly 30 million people (King, 2011). This dramatic influx of patients into the healthcare system has projected to cause an immediate increase in added pressure on an already challenged healthcare workforce (King, 2011). Notably, at a time when healthcare demands are growing, graduate rates from medical schools remain unchanged while advanced practice registered nurse (APRN) graduate rates are rising (Cipher, Hooker, Guerra, 2006). The increased availability of APRNs, along with enhanced delivery of healthcare skills, gives the role a unique advantage in the current state of healthcare. These specialized advanced practice nurses provide services often at a patient’s first (and in some cases, primary) point of contact into the healthcare system (Brassard, 2013). Due to this, many states have started to take action to mitigate the increased healthcare system burden by enhancing the APRN’s scope of practice by broadening prescriptive authority. This has been shown to be one of the fundamental ethical avenues of increasing not only access to healthcare, but also efficiency and quality of care (Ross, 2012).
There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster health and prevent disease.
During this same time, Medicaid and Medicare programs were growing rapidly and increasing the number of individuals covered, such as to low income individuals, the disabled, and the elderly. The abrupt expansion of coverage caused the demand of primary care services to skyrocket. With physicians no longer able to meet the growing demand, nurses stepped to provide medical care, and soon believed that were qualified to broaden their role and scope of abilities. In 1965, a nurse and physician, Loretta Ford and Henry Silver, recognized the need for a training program, and developed the first curriculum for nurse practitioners. Since then, the role of nurse practitioner has rapidly increased in response to the expanding and growing need for accessible and affordable care and is currently ranked as one of the fastest growing professions in healthcare.
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
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’.
Nursing has always been a key career in the health care system. Although it is not often focused on media and stories surrounding health care, nursing is a career of great importance. If any patient was asked about their experience at a hospital or a care center, many would mention the capability and care that they received from the nurses. The health care system could not function efficiently, if at all, if nurses were not present to perform their part. Nurses are more than just physicians, support staff.
Being a nurse practitioner is a good career. A nurse practitioner is a registered nurse with an added education of two years, which gives them added advantage like those of a doctor. A nurse practitioner is different in his/her own way. He/she works along with other health professionals like doctors, pharmacists, and therapists. A nurse practitioner has mandates to treat the sick, prescribe drugs, and order for laboratory tests (Iglehart, 2013). The reason nurse practitioner is attractive is because I have always wanted to help people and the job is more challenging giving me the potential to grow. In this paper, I will discuss the duties of a nurse practitioner, the skills and education needed, pay range and the lifestyle.
There has been a drastic cut in both the Medicare and Medicaid reimbursement rates. According to Robert (2012), “cuts of more than $360 billion to Medicare and Medicaid will be made over the next 10 years. The focus of nursing needs to emphasize more on wellness care and prevention rather than acute care” (McNeal, G., 2012). Nursing practice will need to shift more towards community and population focused nursing. Baccalaureate prepared nurses are provided with a curriculum that includes both community health and leadership skills that are not included in the associate program. By encouraging associate’s degree nurses to obtain a bachelor’s degree in nursing, an increase in the awareness of the needs of the community and population may be seen. The IOM report has outlined the anticipated obstacles that healthcare will face if changes are not made. By allowing nurses to provide care within their full scope of practice, quality care may be provided at an affordable cost to the population. The use of advanced practice nurses in primary care may provide quality, access, and cost efficient healthcare to high-risk populations and possibly decrease hospital admission rates, thus lowering the overall cost of healthcare. If nurses partner with doctors and other healthcare providers, it may improve healthcare by providing seamless transitions (Institute of Medicine,
A myriad of challenges are faced in healthcare today. From over-crowding and long waiting lists to staff shortages which have knock on effects resulting in inadequate skills mix and unacceptable nurse-patient ratios. An aging population, high birth rates and an increase in chronic diseases also puts pressure on the healthcare system. The nursing role has had to evolve in response to changing societal needs and the challenges in the healthcare system today. (McCurry et al. 2009). This can bring additional challenges to nurses’ professional identity. ??
There are several nurses that have established themselves successfully in the work I am pursuing. The work mainly involves care management, client teaching and patient advocacy. Care management focuses on ensuring that the care that various health care providers offer is cohesive to meet the patients’ needs. Client teaching deals with enabling patient gain knowledge about the medications and health. Patient advocacy is involved with protecting and advancing patients’ rights.
Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings as well as the plans that put them at the forefront of the future.