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History of nursing
Historical development of nurse practitioners
History of nursing
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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. Description of the Topic Definition The American Nurses Association (2008) has defined the FNP, under the broader title of Advanced Practice Registered Nurse (APRN), as one “who is educationally prepared to assume responsibility and accountability for health promotion and/or maintenance as well as the assessment, diagnosis, and management of patient problems, which includes the use and prescription of pharmacologic and non-pharmacologic i... ... middle of paper ... ... Mundinger, M., (1994). Advanced-Practice nursing—good medicine for physicians? New England Journal of Medicine, 33(3), 211-214. Retrieved from http://www.nejm.org/doi/pdf/10.1056/NEJM199401203300314 National Council for the State Boards of Nursing, APRN background, (2012). Report of the nursing policy and legislative efforts. Retrieved from https://www.ncsbn.org/428.htm#Nurse_Practitioner_Certification O’Brian, J. M., (2003). How Nurse Practitioners obtained provider status: History of nurse practitioners. American Journal of Health-System Pharmacy, 60(22). Retrieved from http://www.medscape.com/viewarticle/464663_2 Rashid, C., (2010). Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature review. Journal of Advanced Nursing 66(8), 1658-1670. doi: 10.1111/j.1365-2648.2010.05327.x
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,
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.
National Council of State Boards of Nursing. (2014). Nurse licensure compact. Retrieved February 9, 2014, from National council of state boards of nursing: https://www.ncsbn.org/nlc.htm
Both Nurse Practitioners and Nurse Practitioner-students work closely with patients to monitor their health and provide care for acute and chronic illnesses. However, in the academic-clinical setting, the NP-student may only perform this function at the discretion of the supervising NP. Although work environments and responsibilities bestowed upon these distinctive nurses can be quite different, Nurse Practitioners, Registered Nurses and students is bound to the same laws and regulations governed by all states and territories that have enacted a nurse practice act (NPA). The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore each NPA establishes a state board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the governing practice law(s) more specific (NCSBN
“REGISTERED NURSES AND NURSE PRACTITIONERS.” Labor Market Information. 2002. Employment Development Department. 12 Feb 2008 http://www.calmis.cahwnet.gov./file/occguide/NURSEREG. HTM.
Routson, J (2010) Healthcare Reform and Nursing: How the New Legislation Affects the profession; HEALTHeCAREERS.com. Retrieved, September, 16, 2011 from: http://www.healthecareers.com/article/healthcare-reform-and-nursing-how-the-new-legislation-affects-the-profession/158418
The role of the primary nurse practitioner (NP) has emerged in the US in the late 1960s. The development of the primary NP role in the US is widely perceived as a response to increased medical specialization and the accessibility to medical care ensured by Medicare and Medicaid programs. The increase in physicians’ specialization shrank the number of primary care physicians mainly in the rural and medically underserved areas. Meanwhile, access to medical care by low-income people increased the demand for primary care services. To meet this demand, nurses stepped in to breach the gap (Pohl & Tsui-Sui, 2014).
Healthcare is viewed in an unrealistic way by most individuals. Many people view a physician as the only means to find a solution to their problem. Nurses are still seen by some as simply “the person who does what the doctor says.” This is frustrating in today’s time when nurses are required to spend years on their education to help care for their patients. In many situations nurses are the only advocate that some patients’ have.
The American Nurses Association (ANA) developed a foundation for which all nurses are expected to perform their basic duties in order to meet the needs of the society we serve. The ANA “has long been instrumental in the development of three foundational documents for professional nursing; its code of ethics, its scope and standards of practice, ands statement of social policy.” (ANA, 2010, p. 87) The ANA defined nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” and used to create the scope and standards of nursing practice. (ANA, 2010, p. 1) These “outline the steps that nurses must take to meet client healthcare needs.” () The nursing process, for example, is one of the things I use daily. Other examples include communicating and collaborating with my patient, their families, and my peers, and being a lifelong learner. I continually research new diagnoses, medications, and treatments for my patients. As a nurse of ...
In 1990 a group of educators, called the National Task Force for Family Nurse Practitioner Curriculum and Evaluation, created the initial curriculum guidelines for nurse practitioners (Graduate nurse practitioners education competencies, n.d.).Today, the NONPF represents most NP educational institutions worldwide and they continue to develop/improve the NP competencies and guidelines in order to prepare healthcare professionals across the world (Graduate nurse practitioners education competencies,
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
One of the biggest conflicts between Advanced Practice Nurses and physicians has been in the news as of late. The struggle to gain full autonomy over prescriptive rights and practice independently of physicians. Doctors and nurse practitioners with who they work face many different conflicts. Conflicts can develop within the individuals as they change their professional self-images. Each doctor-nurse team must develop new ways of working together and must do so against a background of longstanding professional territoriality. Similar struggles have been felt within schools and hospitals (BATES, 2014 Rev.)
Over the years nursing roles have expanded and has significantly overlapped with medicine. This has led to the rise of Advanced Practice Nursing (APN). An Advanced Practice Nurse (APN) is a registered nurse that has acquired enhanced knowledge and skills through the successful completion of an organized program of nursing education at a Master’s degree level, and has been certified by the Board of Nursing to engage in the practice of advanced practice nursing. The APN essentially has expanded upon their skill set and the ability to provide accurate assessments, diagnose patients and plan and implement care. Advanced practice nurses exercise a higher level of autonomy to include: decision making, managing individual and group care, collaborations with clients, manage physical and labor resources, act ethically within the boundaries of the law, and prescriptive and referral authority. They also have the authority to admit patients to health care
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.
Nurse practitioners (NP) are healthcare providers that are licensed and practice in an arrays of healthcare locales. According to the Association of Nurse Practitioners (2015), nurse practitioners can practice as autonomous practitioners in acute, ambulatory, and long-term facilities as either a primary providers or specialty providers. Each nurse practitioners’ state board of nursing plays a considerable role in their scope of practice with focal point on the community at large fortification and healthcare safety. Furthermore, the ability of the nurse practitioners to practice to fullest extent of their knowledge are structured, or governed and regulated by state law and the individual’s state Board of Nursing scope of practice (Xue, Ye,