Definition and Scope of Practice of a Nurse Practitioner
Introduction
An advanced practice nurse is a registered nurse who has developed and accomplished extensive practical experience and theoretical knowledge in critical decision making, and practice in their different areas of practice (Joel, 2013). Advanced practice nursing is a level of practice for such nurses who have acquired a certain level of educational and practical knowledge. The APNs play a major role in the healthcare industry, providing services such as patient assessment, patient history taking, physical and clinical examinations, ordering lab tests for patients, referring patients for specialized care if need be, performing diagnosis, and prescribing medications (Zaccagnini & White, 2013). They work at the primary care level, where they act as the first line of respondents for the patients.
The APNs can specialize in either of the four general areas; Nurse Anesthetists, Nurse Midwives, Clinical Nurse Specialists, and Nurse Practitioners. Each specialization requires it’s defined theoretical and practical or class hours, different from the other specializations. A nurse can further take a
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A nurse practitioner can work in any setting, including, but not limited to, primary care, pediatrics, cardiology, geriatrics, and obstetrics or women’s health. In Florida, becoming an APN doesn’t require one to have a license as an RN and as an APN, since APN is an upgrade of the RN, which results to one certification (Hamric, Hanson, Tracy & O 'Grady, 2013). Also, all specialties under the APN are required to bear a national certification in order for them to practice in Florida, and are required to renew their licenses accordingly and as stipulated by the Florida
One similarity between NPs, other APNs and PAs is that, they all play a very important role in health care and patient centered approach of care is their objective. Also, their practice is based upon their education, training and certification in collaboration and under supervision of physicians. Another similarity is that, their scope of practice face limitations and restrictions in practicing be it state base or nationally. State laws and regulations act as barriers towards the broadening of PAs professional competencies same as NPs face licensure and practice laws that prevent full extent of their education practice. NP practice requires supervision, delegation, or team-management by an outside health discipline in order to provide
Advanced practice nurses (APN) have a vital role in the future of health care, especially since the enactment of the Affordable Health Care Act. With more citizens having health insurance coverage they will be seeking health care providers, and there are not enough physicians to care for them all. According to Letiziam (2014), advance practice nurses are licensed autonomous health care providers that have been trained to evaluate, diagnose, and treat patients and their conditions. Advanced practice nursing is an umbrella that covers four separate roles of nurses, this includes: the certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), certified nurse practitioner (CNP), and certified nurse specialist (CNS).
FMLA and ACA in regards to APRN or NPs Introduction The Affordable Care Act created new health care delivery and payment models that emphasize teamwork, care coordination, value, and prevention: models in which nurses can contribute a great deal of knowledge and skill. Indeed, the nursing profession is making a wide-reaching impact by providing quality, patient-centered, accessible, and affordable care. - Institute of Medicine
These studies illustrates that NPs can play a key role in providing services to health care market. NPs provide a full range of high quality care to patients of all ages. These services include primary care, acute care, special health care services such as oncology, gerontology health, or women’s health to name a few (American Association of Nurse Practitioners (AANP), 2015). NPs practice in many health settings, including private physician office, hospital, urgent care site, emergency room, community health center, school, and others. Family Nurse Practitioners (FNPs) are NPs are primary care providers who focus on
National certification in the general practice specialty is required prior to becoming eligible for APRN authority and the District of Columbia Board of Nursing accepts certification for APRN’s offered from several national bodies including the ANCC (American Nurses Credentialing Center) and AANP (American Academy of Nurse Practitioners). There is also a required preceptorship that is at least one year long along with coursework covering adult care, primary health care, pharmacology, physical assessment, diagnosis, family care, gerontological care, pediatric care, neonatal care, school nurse care, and psychiatric
The Indiana State Board of Nursing (2011) defines advanced practice nursing as a registered nurse who has attained advanced knowledge and skills through an organized program of study. The three categories of study include nurse practitioner, certified nurse mid-wife, or clinical nurse specialist. National certification is not required for nurse practitioners completing an accredited graduate program. However, if the continuing education is part of a certificate program then a national certification is required. Although certification is not required in Indiana, Riley Hospital for Children nurse practitioners are required to certify within one year of employment.
An advanced practice registered nurse, in the state of Missouri is a nurse that has education beyond a basic nursing education. They are nationally certified as a nurse practitioner, nurse midwife, certified registered nurse anesthetist, or clinical nurse specialist. APRNs must hold a current RN license, and have completed the required amount of clinical hours and post graduate education, master’s degree or
Despite accepting advanced roles and responsibilities APRNs have often encountered various barriers in the delivery of effective health care based on the variability in the legislative requirements endorsed by various states. To overcome these barriers and improve the delivery of healthcare the Consensus Model for APRNs has been endorsed by 41 various nursing organizations focusing on defining the roles, population foci and implementation strategies across the nation (American Nurses Association [ANA], 2017). Creating a standard expectation regarding the practice of APRNs will help to foster more consistent, quality education APRN programs nationwide (Rounds, Zych, & Mallary,
Retrieved from: https://www.aanp.org/legislation-regulation/state-legislation/state-practice-environment. Villegas, W.J. & Allen, P.E. (2012). Barriers to advanced practice registered nurse scope of practice: Issue analysis. The Journal of Continuing Education in Nursing, 43(9), 403-9. DOI:
While the main focus of APNs is clinical practice and direct patient care,
Differences between Nurse Practitioner and Physician Assistant in USA Nurse Practitioners and Physician Assistants are two such professionals in the field of medicine who are important for the medical field equally. Their functions are also quite similar with very minor differences between the two. Due to such similarities it becomes difficult for the general population to differentiate between these two professionals. The nurse practitioners undergo their training through nursing schools, whereas the physician assistants study in medical schools (Nurse Practitioner Schools, 2015).
It states that the scope of an advanced practice nurses will differ between nurses. The advanced practice nurse has the responsibility of practicing within their individual and professional scope of practice. When adding new procedures to their scope of practice there are considerations they should take. Firstly, they must identify why the new practice is needed and how it will benefit the patient. Furthermore, they must be knowledgeable of any regulations preventing the practice of being put into play.
Licensed Practical Nurses take vital signs, give out medication and measure/monitor frequency and amounts, provide personal hygiene assistance to patients, supervise nursing assistants and aides, set up, clean up, and use catheters, oxygen supplies, and other equipment, and provide care and feeding to infants. They are required to know how to do these things and be certified in doing them. A Licensed Practical Nurse is required to have a diploma or certificate in practical nursing. All Licensed Practical Nurses are to take and pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN). This occupation can require a two year
Public Health In community health setting, Advanced Practice Nurses serve as clinicians, nurse educators or administrators. They provide services in schools, day care centers, community health clinics, group homes as well as in skilled nursing facilities. They are involved in the health of new mothers and babies through pre-and post-natal care, preventing domestic violence and child abuse through education and awareness
In the U.S. (and increasingly the United Kingdom), advanced practice nurses, such as clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe