Advance Practice Roles in Nursing
Escalating demand for healthcare services with a shortage of physicians is placing a burden on the healthcare system. Advanced practice nurses are among the providers expected to deliver more of the nation’s healthcare to bridge this gap. They have met the requirements of clinical practice and advanced education. The demand for advanced practice nurses is growing as healthcare organizations focus more on unstable and vulnerable patients. Continued development of advanced practice nursing is of critical importance for the nursing profession due to the changes in the healthcare environment. Advanced practice nurses are highly competent to handle complex health issues and improve the healthcare system.
They are essential in bridging the gap between demand and supply for medical services. Moreover, these medical attendants have the skills, knowledge, and abilities needed to provide high-quality and safe primary care. Although advanced practice nurses adopt different roles of either direct or indirect care, their duties overlap. They focus on the quality and safety of healthcare services to improve the outcomes. Additionally, they are engaged in nursing research and education to achieve clinical benefits. They also assume leadership in healthcare to advocate for a change in the health policy and enhance the quality of care through teamwork. Advanced practice nurses have the potential to meet the demand for medical services and increase the quality of care because they have advanced education, are highly competent to deliver primary care, and are well positioned to introduce reforms to the health policy.
Nurse administrators are the registered nurses, who play a crucial role in satisfying the increasing healthcare needs. They work at all levels to influence the quality of care by controlling the organization to create an environment for the optimal provision of healthcare. The primary responsibility of nurse administrators is the management of the delivery of medical services. They assume leadership in healthcare facilities to improve health outcomes and ensure patient safety. The scope of practice of nurse administrators includes management of the clinical practice, nursing professional development, education, and research. They apply management skills to enhance the collaborative relationship among healthcare providers, handle resources and resolve conflicts in the clinical settings. Nurse administrators hold the accountability to transform organizational values to make institutional performance effective and efficient. Being in charge of resources, they allocate the latter wisely to facilitate safe and patient-centered care. Therefore, nurse administrators play an indirect role in improving the quality of patient care.
The field of informatics has the potential of enhancing the quality of healthcare by helping nurses to integrate management, clinical practice, and knowledge with technological tools. According to Darvish et al. (2014), nurse informatics has extensive clinical practice along with considerable experience in technology work. They assume leadership in incorporating information and communication technologies in clinical practices. In nursing information systems, medical attendants can contribute to patients’ documentation, treatment plan, and access to the available research findings. Nurse informatics guide other healthcare professionals in analyzing patient data using information systems to gain insight into the management of care. Furthermore, nurse informatics conduct nursing research to identify the new technological tools that can be implemented in the clinical practice to improve patients’ experience.
Nurse practitioners (NPs) are well prepared and have enough experience to practice independently. They provide primary health care in a variety of settings such as hospitals, nursing homes, nurse-managed clinics, schools, and health maintenance organizations to individuals, families, and communities. The primary role of NPs is to prevent and manage diseases while meeting personal needs. Nurse practitioners have advanced education, and are entitled to examine patients, and diagnose and treat illnesses. They are in charge of direct care in the primary care settings, and they are on the frontline of patient care. Another accountability of NPs is to educate patients to promote health and prevent ailments. They teach and counsel individuals, families, and communities on how to manage their physical and mental conditions to improve health outcomes. Furthermore, NPs serve as healthcare researchers and patient advocates by informing the public about the health policy. NPs facilitate clinical research by working with consented patients. They conduct various studies to expand clinical knowledge and incorporate relevant findings into clinical practice to get greater clinical benefits. They also work with the interprofessional team to develop and integrate new technologies into treatment practice to increase healthcare quality.
Nurse educators counsel and prepare both the current and potential nursing workforce. They work in either clinical settings or classrooms to strengthen the nursing staff by assuming leadership in the adoption of evidence-based practices. They combine the passion for teaching and clinical expertise to improve the quality of healthcare indirectly by equipping medical attendants with adequate skills and knowledge. Nurse educators design, evaluate, revise and implement nursing education programs that award a certificate or a degree. By working with nursing students, nurse educators help them to identify their learning needs and weaknesses. Therefore, nurse educators are critical in improving the quality of nursing education to ensure that the nursing workforce is adequately prepared to practice in a diverse and unpredictable healthcare environment. They guide nursing students through the learning process and document the educational program results.
The roles of NPs, nurse educators, nurse administrators, and nurse informatics overlap in that they share some responsibilities. As the healthcare conditions change, NPs, nurse educators, nurse administrators, and nurse informatics will keep working collaboratively to advance health. All of them participate in nursing research to identify evidence-based practices and enhance patient outcomes. NPs combine the functions of healthcare provider, educator, administrator, and researcher. Both NPs and nurse educators are actively involved in nursing education to improve clinical practice. At the same time, nurse practitioners and nurse administrators cooperate to increase the quality of care through collaboration and maximum utilization of the available resources. Nurse practitioners and nurse informatics work together to offer better treatment. Nurse informatics helps nurse practitioners to integrate technology into their practice. Despite having different roles and positions in a healthcare organization, advanced practice nurses join their effort and share some duties.
Family Nurse Practitioners
Regulatory and Legal Requirements
Unfavorable laws concerning family nurse practitioners (FNP) prevent them from practicing to their full potential. The laws regulating NPs in Florida are among the strictest in the US. FNPs in Florida face resistance in their efforts to expand their scope of practice. FNPs must hold a state license to practice in Florida. Moreover, FNPs are not allowed to work independently, and they are denied prescriptive authority. Physicians supervise them, and they may not prescribe controlled substances even under the control of the physician. Florida’s legislators have also implemented laws that prevent FNPs from using prescription forms that are signed by doctors. Furthermore, FNPs must have a certification from an appropriate board to practice in Florida and engage in continued education for the license to be renewed (Florida Nurse Practitioner Network, n.d.). Although FNPs in Florida are as competent and skilled as medical attendants in other states the rules and regulations in Florida for FNPs limit the scope of their practice.
Professional organizations play a vital role in career development and continued learning for FNPs. They serve as a framework for professional networking, relationships, and association of members sharing the same interests. Additionally, such establishments bring NPs together and help them to stay actively involved in clinical practice. The organizations shape the quality of healthcare and advocate for their members. Moreover, they encourage leadership and advance professional growth while placing individuals in a position to influence health policy decisions through advocacy, research, and education, which in turn improve healthcare quality. NPs who seek membership in professional organizations are better prepared than those who are not members of any establishment.
Thus, there are several professional organizations, and many of them are based in certain regions. They ensure that NPs who work in the same clinical settings undergo training together and attend professional events for career growth. One of the professional organizations is the American Association of Nurse Practitioners (AAPN), which provides its members with information resources and services. It offers NPs many resources such as legislation practice, which can help them to facilitate their development. AAPN is an important professional organization for NPs seeking to access vital resources to advance their career.
The second organization is the National Organization of Nurse Practitioner Faculties (NONPF), which focuses on the quality of NP education. NONPF emphasizes that the education of NPs must be relevant and innovative due to the crucial role these professionals play in healthcare. The organizations provide education support to NPs through evaluation methods and the establishment of competencies to enhance their training. Furthermore, NONPF analyzes, reviews, and influences health policy decisions that affect NP practice and education. Hence, NONPF is an important professional organization in improving the quality of NPs education.
Nurse Practitioners Associates for Continuing Education (NPACE) considerably contribute to the education of NPs. It is tailored for NPs to ensure that they are highly competent in changing the healthcare environment by providing evidence-based education. The organization searches for relevant information and secures that NP's education is guided by current findings. They also explore professional issues by forming discussion groups. NPACE equips NPs with the skills and knowledge needed to offer medical services that are consistent with the newest studies.
NPs can also seek membership at the international level, as they extend their practices to different parts of the world. Professional organizations in the international arena enable them to deliver high-quality care globally. The establishments give NPs easy access to resources about health policy and education. Professional organizations that focus on the international scope create a global network of NPs to allow them to share ideas and supply others with useful information to influence health policy. Therefore, NPs have a chance to associate with each other across borders.
Competencies and Certificate Requirements
NPs should demonstrate several competencies upon graduation to deliver healthcare services that address the complex challenges of the ever-changing healthcare environment. Thus, NPs professionals are to exhibit the competencies needed to practice independently. Independent practice competencies enable NPs to be accountable for their actions while treating patients. They integrate nurse research findings into the clinical practice to improve the quality of care. Moreover, they should display analytical skills for the provision of patient-centered care. NPs have the competencies, knowledge, and abilities to integrate technology into their clinical practice and engage in the inquiry to refine the delivery of healthcare, as well as policy and patient outcomes. They must also show effective communication skills, leadership, and the ability to address complex health issues. Furthermore, NPs are guided by ethical principles in making clinical decisions to ensure that they adopt ethically sound solutions. NPs are highly qualified nursing professionals who possess the competencies needed to enhance the quality of care.
Professional certifications are required credentials for FNPs in all states. Certification demonstrates clinical training and advanced education as well as allows FNPs to provide quality care. To obtain certification, they must receive high-level training and become registered nurses. After FNPs complete their degree program, they must register for an examination for the certification, which is awarded by the American Nurses Credentialing Center (ANCC). In some states, certification is not mandatory but certain employers require FNPs to be certified. The latter must engage in continuing education for the certification to be renewed every five years. FNPs must take an examination to be certified and receive continuing education for license renewal.
Organization, Setting, Population, and Colleagues
I am planning to work in one of the community health centers in my state, which are located in low-income areas, to increase access to primary medical care provided professionally and compassionately. Community healthcare facilities offer services that satisfy the needs of the patient population. Besides, such healthcare settings are crucial in the delivery of primary care for the low-income individuals, who constitute the underserved and the most vulnerable population and their role is expected to advance, as the demand for healthcare rises due to insurance expansion under the Affordable Care Act (ACA). Primary care is a vital strategy for maintaining population health because it prevents the progression of diseases and reduces the cost of medical aid (Shin et al., 2013). Medical institutions offer a broad range of primary healthcare services including behavioral care and support such services as exercise programs, health education, case management, and nutritional assistance. Therefore, community health centers allow NPs to work with the most vulnerable classes in society and satisfy the growing demand for care.
My colleagues will be other healthcare providers, namely physicians and general practitioners. We will work collaboratively to ensure that complex healthcare needs are met. To fulfill individual unique requirements, we must know the peculiarities of patients and their response to the proposed treatment. A better understanding of the population who is served by the community health center will help emphasize patient-centeredness in our practice. Using close cooperation with my workmates, I will realize my full potential.
Leadership styles are a combination of relationship behaviors and tasks used by the leader to influence his/her followers to achieve the desired results. My leadership style is democratic leadership, which is very effective in a healthcare environment due to its dynamic nature. I view myself as a coworker and demonstrate important attributes such as teamwork and communication. Rather than focusing on employees’ mistakes, I concentrate on upgrading the quality of care and building harmonious working relationships. I allow others to contribute to decision-making; hence, the skills and abilities of all medical workers induce the improvement of healthcare quality. Involving team members in the decision-making process increases their motivation and job satisfaction because they feel like part of the organization. Another advantage of engaging other caregivers in decision-making is that all areas of expertise are represented in overcoming complex obstacles. Through effective communication and shared decision-making, I have learned to avoid conflicts by ensuring that the ideas of each employee are valued and respected. Another attribute of a democratic leader is good judgment skills, which help in handling difficult problems. The qualities of a democratic leader are desirable in addressing the issues in modern organizations.
In nursing, the democratic leadership style is effective, as all team members feel valued and thus motivated. Democratic leadership is the most successful style in a rapidly changing environment. In such healthcare conditions, efficient changes are necessary to meet the increasingly complex and changing needs of the diverse patient population. Democratic leadership provides me with great flexibility to adapt my practices to improve health outcomes. Hence, the democratic leadership style is beneficial in a healthcare setting because it allows collaborative work and shared decision-making, which in turn enhance employees’ motivation and satisfaction with their job.
One of the attributes I have to develop is time management skills. Democratic leaders are slow in decision-making because all team members must be involved. Decision-making through a democratic process is time-consuming since it requires an extended period to reach a consensus. Leaders who apply a democratic leadership style need some time to introduce change and thus solve health issues. I will acquire this quality by making the medical staff understand the importance of producing a healthcare solution and implementing it as soon as possible to improve the quality of medical services and protect patient safety. I will also ensure that discussion during the decision-making process is not lengthy and convince other caregivers to be driven by passion while delivering high-quality services whenever they have to make certain that commitment is reached in a timely way. I will not involve the team members in urgent decisions to develop time management skills. Democratic leaders need the latter to secure that critical issues are addressed in time.
Health Policy and the Advanced Practice Role
The Robert Wood Johnson Foundation (RWJF) Center is the largest research organization in the US that helps in building a culture of health by influencing policy development. It offers health policymakers innovative solutions and recommendations to guarantee the adoption of health policies that tackle health problems. According to RWJF (2016), one of the current health policies is price transparency. The cost of healthcare in the US is inappropriately high making it difficult for the healthcare delivery system to function efficiently. Consequently, there is a need for policymakers to formulate policies that may curb the healthcare price. The estimates of the Robert Wood Johnson Foundation (2016) revealed that healthcare spending is expected to total around 20% of the gross domestic product in the next four years. Healthcare consumers lack access to the data regarding the prices of medical services; thus, they make decisions that are not informed. Greater price transparency is aim to lower the cost of healthcare and ensure that patients take more responsibility for their choices. The policy in price transparency focuses on supplying patients with information about the out-of-pocket cost before they receive assistance. Health care consumers lack access to pricing data which may lead to adverse results.
The cost of healthcare varies depending on many factors including insurance type and services provided. Therefore, it is difficult for patients to determine the cost of given healthcare service. Price transparency is essential to ensure that consumers are aware of the price of healthcare to make informed decisions. Apart from serving as an educational tool, price transparency can lower the cost of healthcare. According to White et al. (2014), greater price transparency can help the US save approximately $100 billion in the next ten years. By providing patients with reference pricing, the latter can anticipate paying for some medical services, which reduce health care costs in the long run by helping them to make the right choices. Comparison of the costs of healthcare services can reduce spending in two ways. Firstly, patients may approach low-cost providers and avoid those who charge high prices. Secondly, medical professionals may cut prices when they realize that they may lose patients. Costly medical services do not equate with high-quality care; thus, there is a need for transparency (Robert Wood Johnson Foundation, 2016). Healthcare consumers must recognize that variation in healthcare prices is not necessarily a reflection of the quality of care.
Price opacity in healthcare can also be overcome by empowering insurers and caregivers to guide patients toward reliable price information and help them understand how the cost varies among the providers. The Robert Wood Johnson Foundation (2016) posits that the effect of greater transparency that can be amplified in healthcare spending makes patients more sensitive to price differences among alternative ways of treatment and providers by changing the benefit design. Replacing fee-for-service payment with other methods that place healthcare professionals at risk of spending more for a defined patient population can also increase the benefits of price transparency.
The process to Make the Change
A change is not always accepted and sometimes it receives strong resistance. I will partner with the key players and the party of interest to ensure greater price transparency in healthcare. The process to introduce the reforms will require a thorough understanding of the issue and the tools essential to secure that medical workers and insurance companies provide consumers with price data. I will play an advocacy role and seek support from healthcare policymakers as well as a government agency to influence the change. I will convince the authorities of the need to develop and implement legislation to guarantee that medical facilities and insurance organizations supply patients with pricing information before they receive care. The process will also involve setting up online databases with the key players where patients can access pricing information. Making a change requires a leader to understand the issues and assure team members of the necessity for adjustments.
Leading the Effort to Make or Influence the Change in Policy
Making a change in health policy is demanding, it requires perseverance and raises the problem with the current practices. As an NP, I should serve as a full partner in influencing the reforms in healthcare policy. I will follow four steps in leading the effort to foster health policy changes. Firstly, I will conduct comprehensive research to get a better understanding of the matter. I will search for different sources including government documents to investigate the link between healthcare costs and price transparency. By reviewing a wide variety of literature, I will obtain credible information that will help me to support my argument with evidence. I will prove that lack of price transparency increases healthcare spending and makes it difficult to establish an efficient healthcare delivery system and thus creating the need for a change. Secondly, I will form a powerful coalition by assembling a group of healthcare providers to maximize the likelihood of success. I will convince the group of the necessity to adopt reforms by ensuring that they are aware of the problems that arise when patients are not informed about the price of medical services. I will develop a vision for change and communicate it to the group to keep it alive.
Thirdly, I will devise a change plan that explains the issue, the grounds for a change, the proposed solution, and the resources required for the change to be implemented. The plan will be useful in identifying the processes that may hinder the change and the parties resisting the latter. With the support of the coalition, I will confront these obstacles by holding campaigns to affect the change by making all healthcare providers and insurance companies understand the demand for greater price transparency. We will make an effort to reach as many medical settings and insurers as possible to avoid resistance. Lastly, I will present the change plan to the health policymakers with the help of other medical professionals. By suggesting facts and credible data, I will influence the decision of health policymakers. I will answer any questions and address all the concerns to ensure that the latter is conscious of the need for a change.
Effect of the Change on Healthcare Quality
The implementation of the change will positively affect the quality of care. Providing pricing information for healthcare services can help consumers to choose professional caregivers at an affordable cost. Price transparency can upgrade the healthcare delivery system and ensure that services are of high quality. Educating patients about healthcare prices helps those with a low level of literacy to choose the best treatment option and explore the quality of care. Consumers who enquire about the cost of the medical services are likely to ask about their quality. Greater price transparency can also increase the quality of care by making the patients reach informed decisions and approaching the practitioners with the skills and abilities to enhance health outcomes. Hence, price transparency may improve the quality of care by encouraging patients to make wise choices.
Advanced practice nurses play an integral role in refining the healthcare system because they are well-prepared to deliver high-quality and safe primary care to bridge the gap between demand and supply as well as to influence health policies to address complex issues. Direct and indirect nurses share some roles. Both kinds of medical professionals are actively engaged in nursing education, research, and leadership to increase the quality of healthcare by identifying evidence-based clinical practices. NPs continue to play a crucial role in meeting the growing demand for medical assistance. Although the rules and regulations that guide practices of NPs vary in different states, constant education is an essential component to ensure that they are highly competent to tackle complicated health problems and offer patient-centered care. Moreover, nurses have to demonstrate strong leadership skills to influence the change in health policy as well as to reduce the cost of healthcare and improve the quality of care. Therefore, by identifying health policy issues and communicating them to policymakers, nurses can enhance the healthcare delivery system.