Advanced Practice Roles in Nursing
The steady demand for healthcare services in the United States necessitates the increased delivery of efficient nursing services. Advanced Practice Nurses (APNs) have played a significant role in not only delivering comprehensive nursing services but also helping to address the shortage of physicians. APNs have various functions that include diagnosing and treating illnesses. However, certain regulations to guide these services have been developed.
Family Nurse Practitioners also belong to APNs, and they contribute immensely to addressing the increased demands for healthcare services. Thus, the regulations should favor their practice to help them meet the healthcare needs of people. APNs have various roles, and Family Nurse Practitioners are some of the key players among them, which necessitates the need for democratic leadership among them and favorable health policies in Florida to enhance their practice.
Definition and Differences Between ANP and APN
Advanced Nursing Practice (ANP) has various specialties that help nurses to provide preventative care to the public. ANPs also provide therapeutic services, and their scope of practice is broad since they possess more knowledge regarding nursing care and healthcare in general (Zug et al., 2016). Additionally, these nurses can work independently by prescribing medications and offering directions for compliance. Therefore, they can collaborate efficiently and utilize an evidence-based practice approach competently to address the needs of healthcare consumers. Advanced Practice Nurse (APN) is a general term for all nurses that have advanced degrees, and it involves clinical nurse specialists and nurse practitioners (NPs) among others (Zug et al., 2016). Therefore, ANP is a part of APN. Some of the evident roles of APRNs include clinical practice, primary care, education, administration, and health information.
- Clinical practice.
Clinical practice roles for APNs involve the assessment, diagnosis, and treatment of illnesses as well as further evaluation of the progress of patient recovery. According to Zug et al. (2016), APNs should collect patient data to identify the contributing factors to their illnesses. The objective data, collected by these professionals in the clinical environment, provide information from the perspective of the patient. This information is useful for APNs as it enables them to relate the behaviors of patients or their backgrounds to illness. This data is also helpful as it aids in identifying the real problems that the patient experiences. With this information, APNs can arrive at an appropriate diagnosis. Consequently, they often use an evidence-based approach to prescribing appropriate medications that can assist in the management of patient diseases (Zug et al., 2016). Therefore, APNs must be competent in using the current technology in diagnosing illnesses appropriately to identify the most appropriate medications.
- Primary care.
Primary healthcare involves the first contact that nurses make with patients in healthcare facilities. Thus, Contandriopoulos et al. (2016) stress that health promotion is an important function of APRNs in primary care. Their role involves the prevention and treatment of diseases as well as community development. Specifically, primary care providers have similarities to clinical practice nurses regarding the diagnosis and treatment of various illnesses. However, they focus on health promotion more than clinical nurse specialists do. Regarding the prevention of diseases, APNs can screen patients and recommend lifestyle behavior that can help patients stay free from illnesses. When it comes to community development, APNs can understand all determinants of health in any given community and implement appropriate ones to help people cope with or recover from illnesses. At the same time, Contandriopoulos et al. (2016) argue that nurses in primary care must ensure that the interventions they recommend are socially appropriate, accessible to patients, and based on sound scientific evidence. Therefore, APNs that work as primary care providers must prioritize any inequalities that patients experience and encourage patient participation in improving healthcare.
Nurse educators have clinical expertise, which indicates that they understand the roles of clinical practice nurses and primary care providers. However, Maxwell, Black, and Baillie (2014) think that the role of these specialists lies in mentoring other nurses to advance their practice. Therefore, nurse educators must design, implement, and evaluate academic programs to ensure that clinical nurse specialists and primary care providers among other nurses acquire the relevant information and skills to practice competently. Although these professionals are involved in teaching more than practice, they acquire their expertise and experience through engagement in clinical practice, which makes them competent in mentoring other nurses. Thus, nurse educators must have excellent communication skills, and clinical background, and commit themselves to lifelong learning so that they could impart skills to other nurses properly.
Nurse administrators manage other nurses, which indicates that they have an understanding of the clinical practice and the needs of healthcare consumers. They also manage staff and financial resources in various healthcare facilities (Saarnio, Suhonen, & Isola, 2016). Additionally, nurse administrators supervise and coordinate the delivery of nursing services in the healthcare environment (Saarnio et al., 2016). Some of their more defined roles include delegating responsibilities to the staff, assessing their training, and observing budgetary compliance (Saarnio et al., 2016). Finally, nurse administrators must recommend policies and monitor their compliance. Consequently, they must have experience with nursing practice and understand healthcare consumer needs.
- Health information.
The similarity among nurse informaticists, nurse educators, and nurse administrators is that they do not work directly to manage patient illnesses in healthcare settings like the clinical nurse specialists and primary care nurses do. However, they contribute immensely to the outcome of patients. For instance, Darvish, Bahramnezhad, Keyhanian, and Navidhamidi (2014) explain that nurse informaticists manage communications crossing with other specialties of nursing practice and healthcare in general. Additionally, they use communication technologies to improve the health of individuals, families, and communities. For instance, Darvish et al. (2014) claim that nurse informaticists help in defining healthcare policies and recommending appropriate ones for nursing practice. This role is comparable to that of nurse administrators. Further, these professionals interpret research methodologies and disseminate new knowledge as a way of promoting evidence-based practice. Thus, this function helps them assist clinical nurse specialists and primary healthcare providers in enhancing their practice. Moreover, it can help nurse educators teach relevant information to other nurses that advance their education. Consequently, nurse informaticists are useful not only in improving the professional life of nurses but also in enhancing the health outcomes of patients.
Family Nurse Practitioner
Becoming a family practice nurse has always been my preference since this specialty can give me a chance to provide proper healthcare to many patients. FNPs can manage various illnesses ranging from pediatrics to geriatrics (Fenstermacher & Hudson, 2015). Their functions include assessing patients by using subjective and objective data, diagnosing diseases appropriately, planning relevant interventions, and implementing them (Fenstermacher, & Hudson, 2015). Then, FNPs can evaluate patients to examine whether they progress well towards recovery. Considerably, family nurse practitioners can perform duties similar to those of physicians, except for surgery. Therefore, this specialty will give me a chance to care for many people holistically and enhance my satisfaction as a healthcare provider.
Four qualities in my philosophy of nursing have influenced my decision to choose this role. Firstly, for me, human life is sacred, and I believe that people deserve proper healthcare regardless of their background. Therefore, I have such a quality as compassion, which has enabled me to be empathetic to the suffering of my patients. I believe that this attribute will allow me to not only improve patient experiences in my practice area but also create a positive impact on the nursing profession as a whole.
Secondly, I recognize that some patients do not receive proper healthcare services due to their ignorance about effective health interventions. Therefore, I have always developed communication skills that have enabled me to advocate for the needs of my patients in the areas I have worked. I believe this quality will be useful in my role since it will assist me in assessing patient needs through proper communication and help them through effective collaboration with my fellow healthcare providers. This approach will enable me to involve other health care providers in improving nursing care delivery.
Thirdly, I believe that respecting the needs of patients, both in the clinical setting and the community, is crucial. Thus, I have often respected the sociocultural aspects of my patients during nursing care. The reverence I have for my patients has helped me offer appropriate health interventions that do not violate their beliefs. I believe that this trait will help me provide holistic and culturally competent care to my patients.
Finally, I am confident with the nursing services that I deliver since they follow the current evidence-based approaches to managing illnesses. Therefore, confidence has helped me work with minimum supervision, and it has increased the faith that my fellow healthcare providers have in me. For this reason, I believe that I can handle critical situations competently to improve the health outcomes of my patients.
Regulatory and Legal Requirements in Florida
The legislature has enacted various laws to regulate the practice of family nurse practitioners in Florida. Every nurse practitioner must be licensed after undertaking these or national examinations such as NCLEX (Lockwood, 2017). Nurses take the exams as Registered Nurses (RNs). Therefore, every nurse practitioner must be a Ran and further possess a master’s degree to qualify for licensure.
Regarding the scope of practice, nurses can assess patients by using subjective and objective data. Lockwood (2017) asserts that they can calculate drug dosages and assess any reactions that patients have towards any drugs under supervision. Further, nurses can inspect the administration of intravenous medications and assess all associated risk factors. Lockwood (2017) further informs that nurses cannot prescribe medications and alter drug orders. However, nurse practitioners can supervise other junior nurses such as RNs and Licensed Practice Nurses (LPNs).
APNs must comply with the nursing code of ethics. Lockwood (2017) notes that making unnecessary interventions to patients can make put advanced practice nurses at the risk of losing their licenses. Finally, advanced practice nurses can maintain patient records. The law requires nurses to ensure the confidentiality of patient information (Lockwood, 2017). Thus, they must inform the patients with published notifications if they wish to terminate their practice.
Available Professional Organizations
The Florida Association of Nurse Practitioners, the Florida Nurses Association, and the Florida Association of Nurse Executives are the most appropriate nursing organizations that relate to my role. Thus, the Florida Nursing Association (n.d.) represents nurses regardless of their specialty. Consequently, the members of this organization work together to protect their needs and further advocate the needs of their communities. Additionally, this organization promotes research in nursing practice, thus linking education with it. Therefore, membership in the Florida Nursing Association can improve my knowledge of healthcare, which will be instrumental in advancing my nursing practice.
The Florida Association of Nurse Practitioners is useful for my role as it has a membership of nurse practitioners that aim to impimprovingrsing care. Moreover, it provides access to various research studies to its members, which can enable them to improve their practice and knowledge (Florida Association of Nurse Practitioners, n.d). This professional organization also advocates the welfare of nurse practitioners, and it provides links for nurses to access various job opportunities. Therefore, this association can help me improve my professional skills and further guarantee my welfare as a nurse practitioner.
Finally, the Florida Association of Nurse Executives is relevant since it can help me develop my leadership skills to mentor other junior nurses. Further, the Florida Association of Nurse Executives (n.d.) promotes excellence in leadership to help nurses improve not only nursing care but also education and policy in the state. Thus, the advancement of research- and evidence-based practice are the core businesses of this professional organization. Consequently, integrating it with the services of the other two healthcare organizations can help me improve not only my practice skills but also enhance my leadership qualities.
Competencies and Certification
Family nurse practitioners have advanced knowledge more than RNs do. Thus, they must have basic training and a NanLEX or a Florida Board of Nursing certification (Lockwood, 2017). Then, their education must be furthered to a master’s degree level for them to qualify for practice. The first competency they should have is health promotion (Zug et al., 2016). Family nurse practitioners should assess the health status of patients, diagnose diseases, treat them, and recommend prevention methods. Secondly, family nurse practitioners should develop relations with patients (Brownie, Scott, & Rossiter, 2016). This competency can enable them to assist patients in making decisions about proper healthcare. The third skill involves teaching and coaching that nurses can use to assess the educational needs of patients and counsel them appropriately. Most importantly, the nurse practitioner must recommend self-care after evaluating the response of patients to their needs. The fourth competency involves maintaining professionalism during nursing care (Brownie et al., 2016). Nurse practitioners must be committed to preserving the values of their profession through the observance of ethics and they should use critical thinking in collaboration with other healthcare providers to deliver quality healthcare. Finally, family nurse practitioners must be culturally competent. Since nurses work with different patients from diverse backgrounds, they must understand the cultural and spiritual beliefs of their patients to deliver appropriate healthcare. Therefore, the observance of these competencies can improve the professional life of a family nurse practitioner, thus enhancing patient care.
Organization and Setting
I wish to practice in an outpatient setting in a hospital where I can diagnose minor illnesses and recommend health promotion activities. Practicing in such an area will allow me to assess a wide variety of illnesses in different patients, thus enhancing my experience and approach to managing different diseases. I will collaborate with physicians to interpret various diagnostic tests and involve my fellow nurses in giving the loading dosages of medications. This role will help me care for patients and involve them in the management of their diseases. Consequently, I can improve the health of the community as a whole.
- Leadership Style
My leadership style is democratic. During self-assessment, I have noticed that I often involve other people in making decisions, but I provide the final solution. Additionally, I mentor them during any stressful situations to make relevant decisions. According to Suri (2016), this leadership style makes people engaged in the decision-making process. Additionally, creativity is a part of this leadership style (Suri, 2016). Thus, it can help me increase productivity in nursing care delivery, thus improving patient outcomes.
- Transformational Leadership
My democratic leadership style has qualities that ensure transformational leadership. For instance, despite involving my followers in making decisions, I often teach them the most appropriate ways of behaving in times of crisis. Such a leadership style is transformational (Suri, 2016). Therefore, being a transformational leader, I can improve my skills and those of my followers.
Transformational leadership will be useful in my practice since I seek to work with junior nurses in the outpatient settings to manage the care of patients. In the process, I will update them on the current best practices that are necessary to improve patient care. Additionally, I will monitor the interventions that they will perform and correct them where necessary. Although I need a democratic leadership style to engage them in making decisions, transformational leadership will help me engage them in identifying patient needs and planning better ways of addressing them.
Health Policy and Advanced Practice Role
The regulations for full practice differ by state. According to the American Association of Nurse Practitioners (n.d.), such states as Washington, Idaho, Oregon, and Montana advocate full practice. The licensure laws allow nurse practitioners that work in these states to assess patients, diagnose diseases, and prescribe appropriate medications with minimum supervision. At the same time, some states, such as Alabama, Mississippi, Louisiana, and Arkansas, have a reduced practice authority for nurse practitioners (American Association of Nurse Practitioners, n.d.). Nurse practitioners in these states must collaborate with an outside health discipline to perform at least one or more elements of nurse practitioners. Finally, Florida, Georgia, South Carolina, and North Carolina limit nurses from engaging in at least one element of nurse practitioners (American Association of Nurse Practitioners, n.d.). Therefore, nurses must undergo supervision and management by an outside health discipline. Thus, the laws of my state can be a barrier for me to experience the privilege of delivering compressive nursing services with minimum supervision.
- Policy for full practice.
Currently, Florida nurses do not have full prescriptive authority. According to Chesney (2015), full practice authority by nurse practitioners can increase access to quality and affordable healthcare. The services of nurse practitioners are less costly than that of physicians (Chesney, 2015). The Florida Association of Nurse Practitioners has contributed immensely to supporting the issue. For example, a small difference exists between nurse practitioners and physicians in caring for patients (Florida Association of Nurse Practitioners, 2017). For that reason, the organization has provided a bill that advocates a full practice authority to allow nurses to not only solve the problem of shortage in healthcare but also improve access to quality health services.
- The process required to make the change.
The current bill indicates that the organization has involved a legislator who delivered the bill to the clerk of the House. Its current state shows that the Senate has approved it. Thus, the Florida Association of Nurse Practitioners should let the bill undergo committee action, floor action for debate and voting, to the conference committee, to the President, and finally, it will ascend to become the law once the latter signs it. However, some legislatures and physicians outside the House may be opposed to the law. Thus, the legislature that provided the bill should explain relevant details that support it to enhance its acceptance.
- Individual efforts to change the policy.
Full practice authority relates to affordable and quality care. Thus, I could have supported the policy by first gathering necessary evidence on the impact of nurse practitioners on healthcare. For example, Chesney (2015) asserts that nurse practitioners can guarantee quality health services at affordable rates. Presenting such evidence to the legislature could have facilitated its acceptance and later be taken to the House for the process to become the law. Coherently providing sufficient evidence and stressing the importance of policy change could have enhanced the process of the bill’s transformation into law.
Advanced practice nurses can make a significant impact on the healthcare system. For instance, available evidence indicates that if nurse practitioners have full prescriptive authority, they can guarantee quick access to quality health services. My family nurse practitioner role can be useful in enhancing quality nursing care delivery through the assessment of patient needs, diagnosis, and appropriate planning and treatment. Although my state of Florida does not allow me to practice fully, I can join the Florida Association of Nurse Practitioners. Then, I can support its current bill that advocates for all nurse practitioners to practice to their full capacity and independently. Having done this, not only can I improve my professional life but also enhance access to quality health services for Florida residents.