Role of the Advanced Practice Nurse
Nursing roles develop globally, with various advanced practice roles found in the nursing curriculum. Delivering modern health services has become a complex activity, increasingly relying on inter-professional collaboration. This paper aims at synthesizing different advanced practice roles as well as the scope of practice, all of which is the master of the nursing curriculum. This research begins with an introduction to general nursing functions and the distinction between APN and ANP as well as my philosophy on the advanced nursing role I aspire. Then, this work discusses the legal aspects of practice for an NP and goes further to analyze and recommend transformational leadership and its importance in nursing. The paper also addresses the nursing practice authority among states and examines value-based care and its impact on the decisions of nurse executives. Aside from discussing a current policy in nursing, the paper also presents the Board of Nursing and how it regulates nursing education.
Describing the Role
Nurses constitute the largest group of American healthcare providers at the initial point of contact with the patient in several settings. The number of registered nurses has grown to 2.9 million in the United States alone over the past few years (Senter & Hatfield, 2016). The growth in the workforce of Registered Nurses has led to an increase in the capacity as well as some vastly educated advanced-practice registered nurses (APRNs). Thus, they are highly trained registered nurses who have a master’s degree in nursing at their lowest level of training. They are also certified by the specialty or professional nursing organizations and they have the license to deliver care according to their areas of expertise. Nurse practitioners (NPs) are the leading group of nurses that provide primary care in the USA. The diverse functions of the members of nursing teams may depend on the division of labor and on traditional job demarcations to maximize efficiency and improve outcomes. Healthcare managers, as well as policymakers, continually work together in search of opportunities to advance healthcare delivery by making nursing roles more modernized (Austin, 2016). The growing healthcare demands, driven especially by the increasing frequency of chronic diseases, limited physician access, and tight budget constraints, foster the implementation of innovations in the healthcare industry. Furthermore, in countries where nursing supply is an issue, developing more advanced practice roles can increase retention and recruitment rates by enhancing the prospects of a nursing career. Thus, advanced practice nurses bring very promising innovations by intervening with patients in the need of coordinated actions of specialized professionals. They have significantly enhanced patient access to care and lowered patient wait times. Hence, despite the challenges faced by nursing departments, the future of the advanced nursing practice looks promising with the development and integration of the advanced nurse practice roles that are crucial to realizing nursing sustainability, accessibility, and quality of healthcare.
Advanced Practice Nursing and Roles
The growing number of Registered Nurses has led to changes in the quality of these professionals, which presupposed the emergence of highly educated advanced-practice registered nurses (APRNs). These healthcare providers with master’s degrees in nursing have significantly improved the access of patients to medical care and contributed to better wait times for them. Graduate education is essential in developing skilled professionals who contribute to the health and educational structure of the USA. Additionally, their roles are important in the administration since they can range from those of the Chief Nursing Officers to nursing supervisors who are always ready to provide the best possible care to patients and even handle issues when they arise. They also play a role when it comes to health-related information since they review it and ensure that it is evidence-based.
However, there is a noticeable difference between the ANP and the APN. Thus, the latter has the highest and best possible training of all registered nurses, with a doctorate or a master’s degree in nursing. Their functions include those previously meant for doctors such as prescribing medications, requesting and interpreting lab tests, giving anesthesia, and diagnosing conditions (Gardenier, 2015). At the same time, the nurse practitioner (ANP) is a type of APN; however, one should remember that Advanced Practice Nurse is a generalized term for all nurses who have attained an advanced degree in a nursing field. Nurse practitioners (NPs) are the leading group of nurses that provide primary care in the USA, and they have the license for the provision of care within their expert levels. They distribute primary care in all settings. They also function in collaborative and independent practice arrangements while also taking the roles of clinical, accountability, and management professionals to provide innovative care.
Additionally, NPs are usually responsible as well as accountable for health education, health promotion, counseling, diagnosis and management of some chronic and acute diseases, and disease prevention (Senter & Hatfield, 2016). Furthermore, it is their duty to provide primary, constant, and wide-ranging care to patients in internal medicine, women’s health, geriatrics, family practice, and pediatrics. At the same time, they perform almost all services, which are usually rendered by physicians, except for surgeries, including such services as performing prenatal and adult care check-ups, managing minor trauma, splinting and suturing as well as medication prescription (Senter& Hatfield, 2016). The NP is usually prepared to work in the primary care or acute care setting, all of which have different certifications and separate national competencies. Moreover, with the growing medical complexities and the decreasing availability of primary care physicians, many patients nowadays turn to family nurse practitioners when they require some help with their primary care needs (Senter & Hatfield, 2016). Aside from helping patients manage chronic and acute illnesses, NPs also perform diagnostic procedures and tests as well as diagnose and treat patients.
Personal Philosophy
A nurse administrator manages nursing teams to ensure they function optimally and properly. These specialists are fully trained to implement appropriate administrative processes as well as practice general nursing procedures. Further, nurse administrators adopt the leadership position in the healthcare setting where they interact with internal managers, but they do not have a direct interaction with patients to obtain the executive, managerial position. Hence, the nurse administrator is responsible for ensuring the best nursing patient care, establishing nursing staff procedures, promoting nursing development through relevant procedures and training, maintaining standard practice and guidelines, supervising nursing staff, analyzing treatment decisions, and offering employee counseling. Above all, the nurse administrator actively participates in updating procedures and policies and addresses problems with legal and ethical issues in their healthcare facility whenever they arise.
I aspire to become a nurse administrator because I believe I am a realist who recognizes my talents and those of others. I am also good at time management and I can quickly master my schedule and empower others to be organized. Additionally, I have the knowledge of business principles, which enables me to operate a facility and develop a sustainable budget for it as well as its people. My life is full of experiences where I have helped and cared for others. Since my childhood, I have always had the desire to care for others, which has led to my decision to become a nurse and later, a nurse manager.
Regulatory and Legal Requirements for a Nurse Administrator in Florida
In Florida, much of the law is regulated, with some being statutory. Thus, Florida state law requires a nurse manager/administrator to have a professional licensure with malpractice insurance. Additionally, the state requires at least a certification by a recognized specialty board, the completion of the post-basic educational program, or a graduation from a master’s degree program. At the same time, every applicant for licensure should have completed examinations developed by the National Association Board of Examiners of Nursing Administrators as well as taken an examination that covers the Florida state laws and regulations that govern the practice of nursing administration. Most importantly, if one desires to be a nurse administrator in Florida, they must hold a valid active nursing administration license and they must have practiced nursing administration for two years within five years preceding the endorsement of their application.
Furthermore, firstly, based on the roles of a nurse administrator, the professional organizations for membership include the Health Care Administrators Association which represents associated professionals such as administrators, medical management, and healthcare consultants. This not-for-profit organization was founded in California to act as an advisor for administrators and service providers. Secondly, the American Association of Healthcare Administrative Management is another nursing administration membership organization that serves nursing administrators by providing them with education and information while also advocating their rights (“Health administration,” n.d.). Thirdly, the American College of Health Care Administrators recognizes and supports healthcare leaders with benefits such as advanced education and leadership development. Lastly, the Association for Healthcare Administrative Professionals is a membership organization that supports its members and provides them with education opportunities.
Required Competencies for a Nurse Administrator
Aside from having attained the required qualifications, the competencies of a nurse administrator include scientific foundation competencies to ensure that these professionals have a wide-ranging background in medical sciences, leadership skills that focus on their professional accountability, quality care techniques, technology literacy skills, health delivery competencies, and ethics competencies. Additionally, they have to complete courses on clinical and didactic to gain the clinical competence and specialized knowledge necessary to practice in varied healthcare settings (Murphy, 2015). Furthermore, when it comes to selecting the organization, setting, population, and colleagues I intend to work with, being a certified nurse administrator, I will choose those that deal more with children since I love children and would love to see them grow up healthy and strong. I plan to work in a primary care setting, especially a pediatric facility, working together with the pediatric care staff to care for sick children. In general, I intend to be a nurse administrator managing the nursing activities in a pediatric facility and ensuring children get the best care possible to create a healthy future for them.
Leadership Attributes of the Advanced Practice Role
I believe I possess the necessary leadership attributes that would make me a transformational leader. Thus, not only does this transformational leadership style guide the group members, but it also allows them to attain their potential while participating in the group. Further, transformational leaders are usually emotionally intelligent, passionate, and energetic, and they contribute to helping their organizations accomplish their goals. According to Sherman (2012), leadership can be called a transformational one when a leader engages with their followers in a specific way to raise their performance and motivational level. This leadership style enables the members to find value and meaning in what they do and allows them to contribute significantly to the organization (Sherman, 2012). I believe that I am a competent and intelligent leader who can ensure that the team has enough competence to make wise decisions. I possess the attributes of serving as a role model, whereby I work with the team members together and inspire motivation in them by having a strong work vision. Hence, I have the intelligence attributes, which are expected from a transformational leader, as well as the quality of emotional intelligence that helps make sure that team members work together well.
At the same time, I am an honest leader who can present the situation as it is, without feeling the need to hide or alter any facts. I believe that honesty is important for a leader because it allows the subordinates to stay open as well and ensures a better working environment. I also have leadership traits such as fairness, whereby I take every opinion seriously without discrimination. Nevertheless, I feel that I might need to develop the original character, where I would have to challenge my followers to be creative and innovative since it is important for a transformational leader to exhibit plenty of artistic finesse to help the team nurture independent thinking. To develop creativity, I would need to stay competitive and develop my innovative capabilities. Moreover, I would choose the right environment, with enough stimuli to challenge my thinking, which will only help me improve my creativity levels. Hence, as a nurse administrator, I can practice transformational leadership, thus making my followers passionate, visionary, and committed. In other words, I can use my innovative ideas to transform healthcare delivery.
Health Policy and the Advanced Practice Role
For decades, many physician organizations have openly opposed nurse practitioners, acting as primary care providers, with the claims that educational gaps make them unqualified to care for their patients independently. Nevertheless, research has proven several times that they are necessary primary care providers with the ability to act just like physicians under various conditions. Consequently, FNPs gain independence and become autonomous with their capacity to provide medical care without the management of a doctor. Many states have full practice authority, a provision that allows nurse practitioners to assess, diagnose, prescribe medications, and interpret diagnostic tests independently. According to Gardenier, Thomas, and O’Rourke (2016), states like Alaska, Washington, Oregon, New Hampshire, Colorado, Nevada, Montana, and Idaho are just among the states that have full practice authority. Currently, 21 states have approved a full practice status for NPs. Furthermore, such states as Utah, Kansas, Louisiana, Alabama, Wisconsin, Illinois, Indiana, Pennsylvania, New York, Kentucky, and Ohio have a reduced practice for nurse practitioners, whereby the licensure law allows them to engage in only a few elements of the practice. At the same time, such states as California, Texas, Oklahoma, Missouri, Michigan, Florida, Georgia, Virginia, and Massachusetts have a restricted practice that allows the nurse practitioner to give patient care only in the presence of a physician (Gardenier et al., 2016). In my opinion, nurse practitioners should be authorized to provide primary care since they have the capability, ability, and knowledge to offer it properly and adequately.
Value-based care is the solution to address clinical inefficiency, the duplication of services, and the rising healthcare costs to allow people to receive the needed healthcare easily. Hospitals and doctors are paid for keeping people healthy in a cost-effective way. Thus, value-based care will impact the decisions made by the nurse executive negatively since it only focuses on patients. I find this regulation not satisfactory since all medical assistance teams are focused on the individual needs of the patient and not on advancing the ability of the team. Therefore, the nursing team is not motivated to provide the best care if the regulation ignores their needs and has only those of the patient as a priority.
At the same time, one should not forget that technology has an integral role in modern health systems. Thus, nurse informaticists are more information technology developers, researchers, educators, chief nursing officers, policy developers, software engineers, and implementation consultants to advance healthcare (Lee, 2014). The informatics nurse (IN) is involved in clinical practice as well as the intersection of technology, which makes this discipline established rather well within nursing (Darvish, Bahramnezhad, Keyhanian, & Navidhamidi, 2014). The federal and state laws that protect health information are the Privacy Act of 1974, the HITECH Act, and the Alcohol and Drug Abuse Patient Confidentiality. These laws are designed to protect the personal health information of patients since the latter have a right to privacy as well as a right to the information shared among healthcare providers.
The nurse educator, on the other hand, combines the passion for teaching and clinical expertise to provide rich, rewarding careers. Thus, nurse educators are vital in reinforcing the nursing workforce by serving as role models and granting them the leadership, needed to employ evidence-based practice (Darvish et al., 2014). The agency that regulates nursing education is the Board of Nursing (BON) which protects the welfare and health of the public by ensuring that the nursing care provided is safe and competent. The agency fulfills this mission by making sure that qualified nurses have licenses and drafting the standards for proper and safe nursing care.
Current Policy
It is vital to understand the value of healthcare and its importance in developing the quality of care through health policies. One of the latest health policy issues identified by the Robert Wood Johnson Foundation is the one recognized in March 2016, prescribing that early childhood interventions can enhance health and well-being. This health policy aims at proving that positive educational experiences when a child is still young enough can positively affect their future health and well-being (Robert Wood Johnson Foundation, 2016). This policy looks into the varied ways schools and states as well as countries can invest in the interventions that can improve the life outcomes for children. According to the Robert Wood Johnson Foundation (2016), several bodies of evidence can create a relationship between early childhood experiences to children’s well-being throughout their lives. The general development of infants and toddlers is shaped more by the resources of the family and neighborhood as well as other economic and social factors, hence creating harsh conditions or a favorable foundation that would lead to a lifelong health.
This policy does not need to change because children are important aspects of any society; thus, it is vital to understand the importance of early childhood intervention to the health and well-being of children. I support this policy because it intends to use the whole-child approach that addresses children’s emotional, social, physical, and behavioral health, including their academic potential to enhance their overall health and well-being. At the same time, the policy requires early childhood programs, including training and support for parents as well as social-emotional learning programs to help children and teenagers to succeed (Robert Wood Johnson Foundation, 2016). I would lead the effort to keep the policy the same by ensuring that parents and guardians get the necessary education regarding the ways of helping their children grow socially and emotionally stable. Aside from providing educational programs for parents, I would also plan for social events, meant for children under the age of 18 and primarily intended for fun and socializing purposes to enhance their socio-emotional capabilities.
Conclusion
The concept of advanced nursing practice has changed over time and it will understandably continue to do so. This change is natural because it is dependent on the regular nursing practice scope at the registration point that has developed over time in response to the changing social and healthcare needs as well as the models of healthcare delivery. The standard scope of practice has led to the growing acknowledgment that nursing professionals can use the skills and competencies currently within their realm of practice and become essential elements of everyday nursing practice either in the community or a hospital setting. At the same time, the role of the advanced practice nurse has been actively used in several clinical settings in order to decrease the pressures of high patient acuity and clinical activity. APNs contribute to the development of nursing and extend the traditional scope of knowledge. Furthermore, the most natural role of the APN is to act as a change agent, which involves consultation and collaboration with other healthcare providers. Moreover, the corresponding regulations vary from state to state, and the transformational leadership style works best with the advanced nurse since it enables every individual to be creative.