Comparision of the Competencies for Advanced Practice Nurses

Our healthcare system is ever evolving, remarkably changing the sphere of nursing practice. The roles of Advanced Nurse Practice practitioners are expanding, taking up a multitude of roles across a diversified healthcare specialties. Advance Nurse Practice practitioner stands as leader in this comprehensive profession bridging the gap in management and clinical aspect of care (McDermott & Morant, 2010), reflecting the complexity of culture, organization and practice setting (Hyrkas & Dende,2008) to improve the quality of patient care. This paper is about the interview with a Certified Nurse Practitioner. The Certified Nurse Practitioner interviewed is from the Hematology/Oncology Department in one of the university affiliated hospitals in Chicago. The purpose of the interview is to learn about the competencies needed to successfully perform the various roles of a Certified Nurse Practitioner in this complex health system. The rationale of the interview process is to give an opportunity as a graduate student to “assimilate primary care competencies into specialty nurse practitioner practice that exemplify professional value, scholarship, service, and culturally global awareness” (Chamberlain College of Nursing, 2014) that can be advantageous for my professional development. The interview showed the importance of knowledge of competencies appropriately applied in practice essential in the functions and roles of a Certified Nurse Practitioner within the scope of practice for

Nurse Educators are indirect care advanced practice nurses while Nurse Practitioners are primarily direct care practitioners. With direct care the practitioner uses their clinical expertise to assess, diagnose, treat and educate the client. Nurse educators are in key positions to promote leadership. Nurse educators serve as leaders to their colleagues. They develop relationships with new nurses and groom the nurse to their fullest potential to promote their professional development and facilitate their personal leadership abilities.

Credentialing from advanced practice registered nurses (APRNs) perspective is defined as “furnishing the documentation necessary to be authorized by a regulatory body or institution to engage in certain activities and use a certain title” (Hanson, 2014). Credentialing is also define from a local institutional process that consider specific documentations for APRN before they assume the practice role as APRN within their facility. In health care system, credentialing ensures individuals meet required standards of practice and is prepared to perform those duties implied by the credentials. National certification and education are considered as part of credentialing for APRN to acquire basic level of competence to practice. (Hanson, 2014)

With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.

In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.

The Advanced Practice Nursing profession retraces a particular evolutionary pathway over the years to become what it is known today. The movement started in the late 1950’s and the early 1960’s, whereas there was a shortage of primary care physicians because of the rapid expansion of specialization in medicine. Thus, the demand for health care grew to the point that the recruitment of registered nurses to collaborate with physicians was the option. At this point of time, nurses’ collaboration was significant in terms of treatment, disease prevention and health promotion. Since then, the idea of a need for advanced nurse practice takes place in the underserved population areas to increase access to health

Three issues or trends I see that are important with regard to credentialing are reimbursement, malpractice and education. Within each issue are opportunities for the advance practice nurse (APN) to grow in knowledge and participate in change. It is important to understand why each one effects credentialing for the APN.

The knowledge of and experience of and Advanced Practice Registered Nurse (APRN) can be of value when examining core competencies. This paper will discuss the nine core competencies stated by The National Organization of Nurse Practitioner Faculties (NONPF). To gain a more complete understanding of how the core competencies integrate into practice an interview of an APRN was conducted. Additionally, an analysis of selected NONPF core competencies will be discussed and how they apply to the roles of the APRN. The paper will end with a conclusion of key points and benefits from interviewing an APRN.

The report shows that the part of nursing must be expanded so that nurses are able to practice to the fullest degree of their education and training. Currently, advanced practice nurses (APRNs) work according to the scope of practice guidelines set forth by their individual state, meaning these highly educated nurses may not be working to the extent of their training but to the individual state laws. The report offers recommendations to streamline these idiosyncrasies and get rid of the red tape so that nurses can work in their appropriate manner and deliver safe quality care to some 32 million Americans who will before long gain access to health care services (American Association of Colleges of Nursing [AACN], 2012). The report correspondingly finds that nurses need to attain advanced levels of education and training through an enhanced education structure which encourages a cohesive academic progression as to safeguard the delivery of quality health care services. Patients are becoming progressively more complex and nurses need to attain the proper skills to care for these persons. Nursing education must embrace the continuous move towards a streamline approach to higher degree programs (Institute of Medicine [IOM], 2010, p. 2). Nurse residency programs

The historic article by Safriet (1992) fully lists and analyzes the major challenges facing the advanced practice nurse (APN). At the time the article was written compared to now, a few aspects are changing. In areas where change has occurred, it has been an exceedingly slow process. Change for APNs is often dependent on legislation and regulatory authorities which receives half-hearted support, at best, from the medical establishment (Safriet, 1992). Since the first day nurses were given any authority to practice outside of regular practice, physicians only objected when it began to encroach upon their perceived hierarchal status or potential for compensation (Hamric, Hanson, Tracy, & O’Grady, 2014). The concern that this

For current and future needs we need to enable all healthcare professionals especially nurses to practice to the full level of their education and training. Advanced practice nurses can fulfill the primary care needs. This will free up physicians to address more complex cases which needs their expertise. Current practice focus on specialty and acute care only and a shift in practice to deliver more primary care and community care services is essential to improve the quality of nursing care and address the growing need of care in these areas.

The educational requirement for advanced nursing practice is a master’s level education in a program or track leading to APN licensure, including graduate degree-granting and post-graduate certificate programs with established educational standards and attainment of the APN core, role core and population core competencies (National Council of State Boards, 2012). APN’s acquire increased knowledge in the sciences of anatomy, physiology, microbiology, chemistry, pathophysiology, and pharmacology. The core curriculum for the advanced practice role includes priorities in

The role of the Advanced Practice Nurse (APN) is expanding internationally throughout the healthcare system. Since the initiation of the Patient Protection and Affordable Care Act in 2010, there has been an increased need for APNs due to the growing demand for primary care services and increased population that have gained healthcare coverage (Lanthrop & Hodnicki, 2014). The purpose of this paper is to explore the role of APN and develop a professional development plan for my future career.

“Advanced nursing practice is the deliberative diagnosis and treatment of a full range of human responses to actual or potential health problems.” (Calkin, 1984). Advanced nurse practitioners attempt to maximize the use of knowledge and skills and improve the delivery of nursing and health care services. The field of advanced nursing practice differs from basic practice as the former requires clinical specialization at the master’s level. At this level, nurses become expert practitioners whose work includes direct and indirect patient care. Direct patient care involves caring for patients and their families; this is the focus of my section on nurse clinicians. Indirect patient care includes work as an educator, researcher, and a

Nursing is a profession that is always changing to benefit the patient and the community. In the complexity of nursing, and to give uniformity an APRN (Advanced Practice Registered Nurse) Consensus Model was established. The Consensus Model promotes uniformity to the four roles of APRN’s which are as follows: Clinical Nurse Specialist (CNS), Certified Nurse Practitioner (CNP), Certified Registered Nurse Anesthetist (CRNA), and a Certified Nurse Midwives (CNM). A “CNS is n APRN with a focus on macrosystems with three spheres of influence: patient, nursing, and healthcare system. The CNS follows Core Competencies as outlined by the National Association of Clinical Nurse Specialist.” (Stuesse, 2014)