Similarities And Differences In Early Childhood Education

Knowing the similarities and differences among the four advanced level nursing fields helps to better understand the practicing capacity within each field. In the ARNP scope, there are many specialties and subspecialties, this section will focus on Family Nurse Practitioner (FNP). The FNP is an ARNP who assesses patients across the life span in a primary care setting. The FNP diagnose and treat patients, teach health promotion and focus on disease prevention (Dritt, 2016). To become an FNP there are certification requirements which must be obtained, legal guidelines to follow and optional organizational memberships.
Certifications
In the state of Florida, experienced bachelor-prepared registered nurses must pass the FNP master’s prepared

program courses. Throughout all FNP courses, the seven core competencies are applied into the curriculum. Once FNP courses are completed, the RN can register to take the national certification exam. For FNP practice, there are two options to become certified which are taking the exam offered by the American Academy of Nurse Practitioners or with the American Nurse Credentialing Center (“ Family Nurse Practitioner, Certification,” 2016).
Legal Aspect
After the certification exam, FNP follows the specific scope of practice and state regulations of the practicing state. In the state of Florida, FNP practice under a restricted structure. Florida state has laws restricting the ability of nurse practitioners to engage fully in practice (State Practice Environment, 2016). For example, nurse practitioners in Florida need to practice under a physician’s supervision to provide patient care unlike other full practicing states such as Nevada (“State Practice Environment,” 2016) which all FNP can assess and treat patients independently. The regulatory body who determines the regulations and legal aspect is the Florida Board of Nursing. Through the Florida Board of Nursing, FNPs are able to know what the scope of practice is and what are the limitations to practice. FNPs can keep updated on practice regulations through Florida Board of Nursing as well as with joining professional organizations.
Aside from state regulatory control, another legal aspect which affects FNP practice is insurance reimbursement. For example, since the state of Florida is a restricted practice state, this means insurances are strict on reimbursement because the FNP do not practice independently. According to Hain and Fleck, there are health insurance companies who do not acknowledge nurse practitioners (NP) as providers forcing NPs to be employed by the physician’s practice so that the billing can be recognized and the reimbursement rate can be 100% versus less if NP were to bill on their own. “State legislative reforms continue to focus on NPs issues such as state scope-of-practice and payer polices”(Hain & Fleck, 2012). Currently many local and national organizations such as the American Nurses Association and the American Association of Nurse Practitioners are advocating to allow NPs to be able to practice to the full extent and resolve insurance reimbursement restrictions (Hain & Fleck, 2012).
Organizations
In order to improve FNP practice, nurse practitioners join professional organizations which can serve as a larger advocate group for change to improve practice. Other benefits of joining professional organizations are to define the basis of performance which can reflect the accountabilities, obligations, and rights of the members (Hamric et al., 2014, p. 340). Family nurse practitioners can join multiple professional state organizations and national organizations such as American Association of Nurse Practitioners (AANP). Professional organizations offer continuing education courses and serve as a tool to help nurse practitioners become more knowledgeable. Among the various organizations available, the most beneficial organization for FNP in the state of Florida, in my opinion, are AANP and Florida Association of Nurse Practitioners (FLANP). The FNPs who join AANP and FLANP focus on the policy changes across the life span (“Florida Association of Nurse Practitioners,”2016). I predict to join an organization that can be applied within a clinic that focuses on health promotion, prevention and education such as the AANP and FLANP. Being a part of professional organizations gives professional support to be able to suggest change within the workplace. Along with being a part of an organization another important aspect of creating change is the leadership style.
Leadership Attributes
The leadership style I possess is called democratic leadership. This type of leadership works with team members by encouraging open communication, staff participation and providing constructive staff feedback (Frandsen, 2014) This leader uses the above attributes to improve the work environment and create positive change. Among the mentioned attributes, as a leader I possess constructive feedback and open communication. To be a stronger leader I need to build more on open communication and staff participation. In order to build on those two characteristics, according to Frandsen, vision and attitude need to be attained. Vision involves having the team work towards a meaningful goal and attitude includes staff being involved in the change to see the overall positive outcome within the work environment (Frandsen, 2014, p.5). In order to attain open communication, I would establish monthly goals for the staff to work towards and weekly meetings to address how the goals are being met and gain feedback from staff. The attitude I would portray would be positivity in all staff participation events so that the staff would have a better communication. Once open communication and staff participation are practiced more, I will evaluate the staff response through annual surveys to determine if I have been successful in applying the lacking attributes into practice. Leadership qualities are important to implement change for example in health policy changes.
Health Policy and the Advance Practice Role
In the United States, there are many health policy issues which need to be addressed.

According to the Robert Wood Johnson Foundation (RWJF), there are five current health policies that need to be addressed. This area of the paper will focus on one of the five health policies called “Can Early Childhood Interventions Improve Health and Well-Being?”. This policy focuses on improving the U.S. educational and social experiences during early childhood because studies show that children with early education have healthier outcomes. According to RWJF, “investing in improving children’s development at the beginning of life is a crucial component of any effective strategy for realizing the health potential of all Americans” ( Braveman, Egerter, Arena, & Aslam, 2014). This issue is further supported by research conducted by Landry; Swank; Smith; Assel and Gunnewig (2006), which indicates early literacy beginning at age 3 allows children to better develop cognitive and social skills for a more positive future such as more adolescents wanting to complete college prepared professional careers. In order for the U.S. to improve the overall health of children, changes need to be implemented such as more emphasis on early childhood programs (Landry et al., 2006). The benefits of early childhood programs are they serve as a foundation for children to learn social skills, develop cognitive readiness, have counseling support and other community resources which may not be easily available to children not involved in early childhood programs (Hillemeier, Morgan, Farkas & Maczuga, 2013). In order to have early childhood programs, financial assistance needs to be

acknowledged.
The process of making a change in this health policy involves key players such as the lobbyist group, the legislative party and those who studied the health policy issue. The lobbyist “are experts in navigating the complex legislative process” (Maryland&Gonzalez,2012) The lobbyist personnel will bring forth the issue to the legislator for review. It is the lobbyist and the health policy founder who strive for change in front of the legislator. The policy is reviewed by the legislative committee. The committee evaluates the risks and benefits of implementing change if the benefits are proven to make a difference policy changes may occur (Maryland & Gonzalez,2012). Aside from the legislative party approving the change to a policy, experts in health practice can serve as advocated for change such as FNPs.
Family Nurse Practitioners are expert clinicians who can make a difference by applying the clinical practice experiences to prove that change is needed. The clinical experiences serve as a tool when evaluating policy implementation or changes to a policy (Maryland & Gonzalez,2012). FNPs are leaders who advocate for change to make the healthcare environment better for the community. “Nurses should not underestimate their ability to influence access to appropriate, efficient, and effective quality care”(Maryland & Gonzalez, 2012). FNPs as well as experienced nurses are powerful voices in the policy-making or changing process and nurses need to continue to advocate for the community (Maryland & Gonzalez,2012).
As an experienced nurse, I can influence change by conducting research to prove that this health policy needs to be addressed. I would gather data from those in freshmen college semester who attended preschool education and those who did not attend preschool. Two main focus areas I would inquire about would be if they think preschool helped them succeed and for those who did not have early childhood education, ask if they had any positive educational or social influences early in life that lead to the determination of aspiring of professional degrees. Research findings would indicate if early childhood does, in fact, prove a positive outcome in overall health and well-being of individuals. Aside from conducting research, I would also incorporate clinical experiences with the young population ages 25 years of age and younger who have had health conditions such as depression and suicide ideation due to social isolation. Based on the clinical experience many of the young patients with suicide ideation and/or depression is related to poor childhood upbringing and poor social support. I would use clinical experience and supporting research to influence policy change.
If experienced nurses and FNPs were to get together to implement change in policy, this would lead the U.S. to have a better rating on literacy outcomes. According to RWJF, U.S. is ranked twenty fifth out of twenty-nine developed countries in investing in early childhood education (“Can Early Childhood Interventions Improve Health and Well-Being”,2016). Multiple research studies indicate that early schooling is the basis for social and cognitive influences which can make a difference in the overall lifestyle of an individual. When a child in particular from age 3 and up are provided with strong foundational schooling it leads to a strong cognitive, social and emotional development ”( Braveman, Egerter, Arena, & Aslam, 2014). Improving early childhood education such as with preschool and kindergarten obligations will lead to better health and well-being of individuals as evidence in the RWJF research analysis and other research mentioned earlier. U.S. would have less health crisis among the young population which could potentially lead to a better adulthood. This could be evidenced by a decrease in the amount of psychological and physiological irregularities currently faced in health care today .
If this policy change was to occur, the government would need to fund more early childhood educational programs throughout the U.S. Although this policy involves financial support, the benefits of having healthier children can lead to healthier adults. Overall this could potentially decrease governmental spending in health care for health issues among the young adult population.
Conclusion
In conclusion, advanced practice nursing has similarities in basic advance education and core competencies. However, it is the different routes and various attributes which define each role independently. All roles focus on a team approach through the core competency of collaboration which allows for other healthcare providers to imply thoughts to better serve the community. As mentioned, each advanced nursing practice role has their own licensure and authority privileges which may or may not impede the advance practice nurse to treat patients entirely. Nurse practitioners in the state of Florida need to advocate for change to be able to practice to the full extent and prove to the insurance companies that NPs are knowledgeable providers like physicians. All advance practice nurses are leaders and experts who need to. advocate for change. Although the main focus of this paper was the ARNP who practices as an FNP, all advance practice nurses can join professional organizations, have their own legal aspects to overcome and also can influence policy changes.