Advanced Practice Nursing Essay

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American Healthcare System: Implications for Advanced Practice Nursing



Advanced Practice Registered Nurses (APRNs) is the group of health care professionals on whom stakeholders and lawmakers depend to deliver most of America's health care. APRNs refer to registered nurses who've attained advanced clinical and educational practice requirements. They include clinical nurse specialists, nurse anesthetists, certified nurse-midwives and nurse practitioners. Experts project that the demand for APRNs is bound to increase as hospitals pay more attention to the most unstable and sickest patients and move most of health services to homes, nurse-managed clinics, birthing centers, schools, community health centers, and other centers and venues (American Nurses Association, 2011). This stand on health policy as nurses view it, calls for action for APRNs to equip themselves with the knowledge of how current health policy works and how various initiatives will affect the policies. The knowledge will be instrumental in helping them have a positive impact on their patients and the community (Goudreau & Smolenski, 2013).



Role of APRNs



APRNs are practitioners that have completed formal graduate education and have earned a minimum of master's degree in nursing and eventually progressing to earn a Doctor of Nursing Practice degree in any one of the main APRN roles (American Nurses Association, 2011):



Nurse Practitioner (NP)



NPs give primary and specialized care to individuals, groups, families, and communities in several settings. They work in nursing homes, nurse-managed clinics, workplaces, schools, hospitals as well as private practices that they may run independently. Most of them specialize in a given area -- for instance -- family, pediatric, gerontological or adult care along with other areas like mental/psychiatric health and women's health (American Nurses Association, 2011).



Certified Nurse-Midwife (CNM)



CNMs are popularly known to help mothers deliver babies in birthing centers, homes, and hospitals. They also have other roles like managing women's health over their lifespan, giving primary care, performing gynecological checkups, giving advice on family planning, providing women with neonatal care and also catering to certain reproductive health concerns of the male partners of their female patients (American Nurses Association, 2011).

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Clinical Nurse Specialist (CNS)



Nearly 70% of CNSs apply their skills in inpatient hospitals settings. Other CNSs work in clinics, their own practices, nursing homes and community-based centers. Besides providing psychotherapy and direct primary care, CNSs offer mentorship to other nurses, serve as case managers, help in the development of quality control standards and methods and also serve as educators, administrators, researchers and consultants (American Nurses Association, 2011).



Certified Registered Nurse Anesthetist (CRNA)



CRNAs usually work side by side with anesthesiologists or independently to administer anesthesia or provide care during therapeutic, surgical, obstetrical and diagnostic procedures. They also help in managing chronic pain and providing emergency care (American Nurses Association, 2011).



Barriers



One of the ways NPs are regulated at the state level is state licensure and it hinders the ability of NPs to practice fully and apply all their training and education. While the main goal of licensure is to define practice authority, states still have different practice and licensure laws for NPs (Hain & Fleck, 2014). Full practice authority refers to the collection of licensure laws and state practices that permit NPs to evaluate patients, diagnose, order and also interpret diagnostic tests, initiate, manage and make prescriptions for treatments as licensed exclusively by the state board of nursing (AANP, 2014).



As several nursing schools make transitions to the Doctorate of Nursing Practice (DNP), the advanced practitioner faculty who do not have doctorates may be rendered underqualified. APRN graduate numbers peaked in 1998 before beginning a decline which was influenced by several factors and barriers nurses face when seeking graduate education. It is very difficult to be admitted to an APRN educational program. About 17% of the programs have high selection criteria and there are limited, insufficient openings available for those who are qualified and willing applicants (Fitzgerald, Gordon, Katz, & Hrisch,….....

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References


AANP. (2014). Issues at-a-glance: Full practice authority. Retrieved from AANP: www.aanp.org/images/documents/policy-toolbox/fullpracticeauthority.pdf

American Nurses Association. (2011). Advanced Practice Nursing: A New Age in Healthcare. American Nurses Association.

Fitzgerald, C., Gordon, I., Katz, J., & Hrisch, A. (2012). Advanced Practice Nursing Education: Challenges and Strategies. Nursing Research and Practice.

Goudreau, K., & Smolenski, M. (2013). Health Policy and Advanced Practice Nursing. Springer Publishing Company.
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