The Role Of A Nurse Practitioner?

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

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

Loretta Ford, is commonly known as the pioneer of the nurse practitioner role. The NP role was shaped by Ford, in collaboration with pediatrician Henry K. Silver in 1965, in response to the need for providers for well-child care, in community based settings (Zaccagnini & Waud White, 2017). Though many texts, Zaccagnini included, cite a physician shortage as the impetus for the creation of the role, Ford herself disputes the emphasis on this shortage, as one of several “myths” many of which continue to influence the NP movement (Towers, 2011). This creates a view of NPs as “physician extenders” or substitutes for physicians, and diminishes the role of the NP (Sullivan-Marx et al., 2007). The creation of the NP was in conjunction with nursing leadership, who were focused on creating graduate nurses for clinical specialization (Towers, 2011). The lack of providers simply created an opportunistic environment for nurses to reclaim the role that public health nurses had historically held, focusing on wellness, health promotion and disease prevention (Zaccagnini & Waud White, 2017). The first NPs were certified in the area of pediatrics, but soon began to develop focus on other populations, such as whole families, gerontology, women’s health, or psychiatry.

The American Association of Nurse Practitioners (AANP) is the largest national professional membership organization for nurse practitioners of all specialties (AANP, 2012).

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

The role of the nurse practitioner includes assessment and management of clients using nursing skills and includes performing roles such as ordering diagnostic tests, direct referralsof patients to other health care providers and providing medications. NPs first originated in the united states to try and help improve primary healthcare in underserviced communities across the country. Today NPs exist worldwide in primary and acute healthcare settings in both rural and urban locations.

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 American Association of Nurse Practitioners (AANP) is a national professional organization for Nurse Practitioners. The AANP is an organization that promotes education, advocacy for federal legislation related to Nurse Practitioners, networking, community involvement,

While uncertainty about the role of an Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) persists, what research has found about the role is that AG-ACNP’s provide advanced nursing care to those who are acutely, critically or chronically ill in both traditional and nontraditional healthcare settings (Kleinpell et al., 2012). Standard of scope differs between all types of scopes and nurse practitioners alike. The scope of practice (SOP) for an Acute Care Nurse Practitioner (ACNP) is not based on practice setting, but rather what type of care the patient will need, for example, someone who needs ventilator management in either the home or hospital environment (Kleinpell et al., 2012).

With change comes evolution. Most professions, specifically nurse anesthetist, as we know them today did not begin in the state they are in today. They grew through trial and error. Before revealing the history of this profession and most important, its leading pioneer, one must be familiar with the role of a nurse anesthetist. Nurse anesthetists, often confused with anesthesiologists, are nurses with baccalaureate degrees in nursing and master degrees in anesthesia who are responsible for administering anesthetics to patients preoperational. Contrary, anesthesiologists are physicians whose education requires a baccalaureate degree as well as medical schooling with special education in anesthesia. However, the anesthesia part of the education is very similar for both providers (KANA. 2011).

In order to practice as a Nurse Practitioner (NP) in Indiana you must hold a state registered nursing license complete a master 's program with certain course requirements. According to NursingLicensure.com (n.d.) there are two educational options leading to Advanced Practice Nurse (APN) recognition in Indiana: obtain a master 's degree or higher in nursing, or obtain a bachelor 's degree in nursing plus national certification. There is not a specific application to become a NP unless you are also pursuing prescriptive authority. Most laws in Indiana focus on regulating practice of nurse practitioners center around prescribing.

The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van

There have been concerns regarding the identification and credentialing of advanced practiced registered nurses (APRNs). A APRN is a registered nurse who has successfully completed an accredited graduate-level education program, in which the individual is well prepared and successfully passed the nationwide certification examination (APRN Consensus Model, 2008). However, there are still debating issues of who would fall under the APRN category. The National Council of State Boards of Nursing (NCSBN) has identified four APRNs who are deem fit to be called ARPNs; however, only two will be named. They would be certified registered nurse anesthetists (CRNAs) and certified nurse practitioners (CNPs). Whereas, the nurse informatics and the nurse administrations are not considered to be APRNs; although, they are still license registered nurses but they do not provide direct patient care and are not required to take the national certification examination (ARPN Consensus Model, 2008).

There are four types of Advanced Practice Nurse roles, the nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, and certified nurse-midwife. The Family Nurse Practitioner is the advanced practice role that will be discussed. According to Hamric, Hanson, Tracy, and O 'Grady (2014) the primary care NP provides care for patients in diverse settings, including community-based settings such as private and public practices, acute, and long-term care settings across the life span (pg. 396). Family Nurse Practitioners have faced many challenges in the medical profession to be recognized as health care providers. Most of these challenges where from fellow nurses. According to Hamric, Hanson, Tracy, and O’Grady (2014) conflict and discord about the Nurse Practitioner role continued to characterize relationships between NPs and other nurses (pg. 18). Despite the resistance to NPs in nursing, physicians increasingly accepted NPs in individual health care practices (Hamric, Hanson, Tracy, and O’Grady, 2014, pg. 18). Physicians readily accepted the role of the Nurse Practitioner, working together to improve patient outcomes and safety.

Advanced Practice Registered Nurses are registered nurses who have completed masters or post-masters degrees. The National Council of State Boards of Nursing recognizes four APN specialties