NR 500 Week 2 Roles in Advanced Practice Nursing

Sample Answer

The Roles and Competencies of the Advanced Practice Nurse (APN)

Modern medicines have advanced considerably, improving the quality of care patients receive. Most nations, such as the United States, have extended the nurses’ roles to increase specialties and improve care. Advanced practice nurses attain a special certification and licensure, enabling them to practice autonomously with more prepotency in their work. The advanced roles include clinical nurse specialist (CNS), certified nursing practice (CNP), certified registered nurse anesthetist (CRNA), and certified midwife (CNM). Every role holds a different scope and standards of practice but with unique contributions to the medical care sector. The US has developed an education system that allows nurses to specialize, attain accreditation, and improve healthcare.

Advanced Practices Role in Nursing

APRNs are prepared to handle complexities at the front and beyond. They play a pivotal role in enhancing the quality of care, and most governments have focused on increasing their number globally. According to Mayo et al. (2017), they provide opportunities for individuals who interact with the medical care system and receive exceptional care. They include CNS, CNP, CRNA, and CNM. These roles vary considerably regarding clinical care, primary care, research, administration, and education requirements.

Clinical Nurse Specialist (CNS)

CNSs were the first designated category of advanced practice nurses in the US. In 1956, Hildegard Paplau was one of the founders of the roles through a master’s program that focused on clinical practice. According to Mayo et al. (2017), CNS education and competencies developed on the education level attained by registered nurses (RNs). CNSs are licensed RNs who further their education to include graduate-level preparation for a master’s or PhD. Level. The education system is designed to equip them with skills and competencies to handle complex and specialty patients’ populace.

Mayo et al. (2017) assert that the core of the CNS curriculum covers advanced physiology, pharmacology, and physical assessment. Besides, the curriculum covers additional coursework that equips them with unique and advanced competencies to offer expert specialist care, such as advanced diagnosis, expertise in supporting care, and leadership, to ensure that the best and evidence-based practices are adopted to attain exceptional standards of care.

CNS uniquely incorporated care across three continuums. Patients, nurses, and the medical care system are the three domains where influence is propagated. According to Mayo et al. (2017), all three spheres possess an idiosyncratic of CNSs who pursue the core goal of providing primary care while simultaneously boosting the outcomes and nursing care. Furthermore, the education system utilizes the three-sphere and design curriculum, either as a specific course or integrated through various courses.

Mayo et al. (2017) argue that preparation in advanced specialties, such as mental health, diabetes, oncology, and gerontology, ensures that CNSs are well equipped to resolve critical care outcomes, including avoiding complications and lowering hospital readmissions. Additionally, CNSs utilize their system theory knowledge to understand accreditation, regulation, licensing, and identify practice gaps and adopt evidence-based care. Therefore, CNSs are equipped with advanced skills and competencies that improve the quality of care in the health care system.

Certified Nursing Practitioner (CNP)

The first CNP began in 1956 in Colorado to address the challenges facing primary care. During the same year, the US expanded Medicare and Medicaid that increased the number of Americans who qualified for the coverage. Over the years, the number has risen considerably as the nation seeks to strengthen its health care system. According to Matulis and Lloyd (2018), Medicare and Medicaid cover more than 32 million Americans, and the adoption of the Affordable Care Act (ACA) has increased the number significantly.

The number of CNPs has grown over the years as the nation has responded to the lack of primary care physicians. Nursing practitioners are distinct from other healthcare providers as they monitor patients’ health and health being holistic. Glarcher and Lex (2020) indicate that CNPs are trained to diagnose and treat patients independently. CNPs have advocated for policy changes to enhance healthcare access, specifically for children, low-income persons, and marginalized communities throughout the profession’s history.

CNPs perform diverse roles and have several specialties. In most healthcare facilities, CNPs manage care for complex and vulnerable populations, educate and support inter-professional staff, and facilitate a safety culture. The education program equips them with the relevant skills and competencies required in healthcare. CNPs must obtain graduate education at the master or doctorate level and acquire the national board certification. The education program follows established educational standards that ensure the attainment of core competencies.

Nurses can choose different fields of specialties, such as women’s health that focuses on training students to provide preventive care to women, family health that focuses on providing primary care to people across their life span, and pediatric health, focusing on child health from birth to the age of twenty-one years. In this regard, Brown et al. (2019) claim that specialization in oncology has increased over the years to address the cancer cases that have risen considerably. CNPs perform various roles, and several specialties exist to allow the US government to improve care.

Certified Registered Nurse Anesthetist (CRNA)

CRNA is one of the specialties of advanced nursing practice. According to Glarcher and Lex (2020), a CRNA is qualified to offer the full spectrum of individual anesthesia care and anesthesia-related care in different settings. CRNAs are found in a range of practice settings, including dental offices, hospitals, pain management centers, public health facilities, and outpatient surgery centers. Additionally, they provide emergency and pain management services, whereby they discuss medication with patients to ensure their safety and appropriateness.

According to McMullan et al. (2017), CRNAs provide more than forty million anesthetics annually in the United States. For one to acquire the required skills and competencies, they must obtain a bachelor’s or a master’s degree in nursing and become an RN. They are also required to undertake a CRNA program and pass the examinations to be licensed. The length of the program is different from one institution to another. Markedly, at the master’s level, nurses specialize in anesthesia, preparing them with specific competencies required in doctoral programs.

Certified Midwife (CNM)

In the US, midwifery practice continues to be driven by consumer interest, health care economics, and political policies at the state level. According to Marzalik et al. (2018), CNM is an advanced practice RN who undertakes comprehensive training by providing care to pregnant women from labor to postpartum care. Furthermore, their role includes more generalized health services, such as assessing and managing contraception and birth control methods and providing gynecological care and preventive care.

Marzalik et al. (2018) postulate that a CNM attends to 8.3% of 3.9 million births registered in the United States. The US Midwifery Education, Regulation, and Association (US MERA) was formed to develop education standards to align with the global ones. The organization has developed several policies and laws to strengthen the midwifery programs.

CNMs undergo education programs that equip them with advanced skills and competencies. Marzalik et al. (2018) indicate that more than forty education programs exist in the US to prepare individuals to become CNMs. The Accreditation Commission certifies the Midwifery Education (ACME) education programs, recognized by the US Department of Education (Yang et al., 2016). The forty educational programs require a baccalaureate degree or higher for one to be considered for admission and conferred a graduate degree or post-graduate certificate upon successful completion of their course.

Moreover, Marzalik et al. (2018) assert that students must be registered nurses before joining the antepartum care, advanced primary care, and postpartum care for newborn care. They also complete clinical rotations in a professional setting of more than 500 hours. The work settings for this role differ from one medical care facility to the other, but those that focus on midwifery duties tend to have better job environments.

The Rationale for Choosing a CNP Role

A CNP is one of the most preferred advanced roles due to various factors. Selway (2018) indicates that CNPs account for the most prominent advanced practice nurses at the forefront of healthcare. One of the primary advantages of CNP compared to the CNM is that in twenty-three states, the former may practice independently without being supervised by a doctor. This practice allows them to establish their medical facilities to create revenues and leave a mark in the health care industry.

They can also provide care to the general populace since they have the knowledge and clinical expertise to diagnose, treat, educate, and prescribe medication, enabling them to work in different clinical settings. Additionally, a CNP’s salary is very competitive due to the increased demand for the role. Finally, the CNP program takes 24 to 36 months, including 500 hours of clinical practice. A CNP provides the highest flexibility and numerous job opportunities.

Plans for the Clinical Practice

My future focus will be CNP, as it presents numerous opportunities in the medical field. Precisely, I will focus on oncology, which entails caring for cancer patients. The number of cancer cases has increased in the last two decades, but the government has adopted several policies that focus on its prevention and early detection. The American Cancer Society published a summary of early detection guidelines, data, trends, and screening rates (Smith et al., 2019).

The nation has focused on breast, cervical, colorectal, lungs, endometrial, and prostate cancer. Smith et al. (2019) assert that breast cancer is the most common and the second leading cause of death in the United States. In 2019, the ACS projected that there would be 268600 cases of invasive breast cancer diagnosed in US women and 41760 deaths (Siegel et al., 2019). Therefore, focusing on oncology will allow me to be a part of the initiative adopted by the government to lower cancer cases and promote life quality.

Markedly, the NP has changed due to consumer health, economic challenges, and government policies. For instance, the role of CNP has increased after the adoption of ACA that led to a rise in the number of Americans who could access healthcare. Technological advancement has introduced innovations that have revolutionized medical care by improving early detection and providing high-quality medication and care. For instance, three-dimensional organoid technology has emerged and gained popularity among health researchers (Xu et al., 2018).

The innovation represents a promising, near-physiological model for human cancers adopted in oncology investigation. Additionally, deep learning algorithm, a sub-branch of artificial intelligence, has improved diseases’ detection and data collection, allowing medical practitioners to make well-informed decisions (Bi et al., 20119). Lastly, the education system has witnessed a change that seeks to improve the skills and competencies of RNs. The NP has undeniably changed due to several US policies, the education system, and economic variations.

Role Transition

The transition process is pivotal in nursing practice, and it entails a significant change from an RN to a nurse practitioner. Ares (2018) asserts that the process entails developing or moving from one state to another. The time span begins with the initial anticipation of the change and concludes when the new roles stabilize. Several factors influence the transition, including confidence, where nurses with elevated confidence levels quickly adapt to the changeover compared to those with inadequate certitude levels. The other one is communication skills that allow a nurse to articulate their role and adjust to the new duty accordingly. The two skills can be acquired through education or occur naturally within an individual.

Markedly, the nursing role requires confidence and effective communication skills to move from an RN to a nurse practitioner. Barnes (2015) argues that a poor transition leads to high turnover rates but lowers the effectiveness of nurses. Accordingly, a poor transition and an individual’s traits affect the process and determine a nurse’s effectiveness in practice. Several strategies can be adopted to alleviate stressful transitions while enhancing the effectiveness of nurses. The first one is guiding them to choose the roles that fit their interests. Several studies assert that selecting the right role promotes work engagement and motivates employees to grow in their careers (O’Keefe et al., 2017).

In this case, the education stakeholders can design a system that allows nurses to make the right choices. The other strategy is developing goals and objectives either daily, weekly, or monthly. The act may include goals of improving time management, self-care, critical thinking, problem-solving, and self-advocacy skills. The approach equips nurses with the required expertise to transition from one role to the other. Undeniably, the two strategies eliminate the stress developed by tarnation and allow nurses to adapt to their new roles and positions quickly.

Conclusion

The role of advanced nursing practice has changed over the years to align with society’s needs and changes. CNS, CNP, CRNA, and CNM are the four advanced roles that improve primary health care. The education system has developed guidelines and programs that allow nurses to advance in their selected roles. CNPs account for the most significant number of nurses and focus on different roles, including knowledge and clinical expertise to diagnose, treat, educate, and prescribe medication and enable them to practice autonomously.

However, the transition process from an RN to a nurse practitioner is challenging and requires a nurse to choose the right role and develop objectives to transition without stress. The advanced nursing role has increased, thereby improving care and promising to address the challenges that have plagued nations for decades.

References

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