Describe how the role of advanced registered nurse transformed over time NUR 513

Re: Topic 1 DQ 1
In the past, the APRN was only considered to NPs, CNMs, CRNAs and CNS who can provide clinical care in the acute setting all of which require master’s degree and licensing beyond the RN license except the CNS.For instance, in the past, a nurse with a baccalaureate degree must have wide extensive clinical

Describe how the role of advanced registered nurse transformed over time NUR 513

experience before they can even be considered to advance their education and must be at the doctoral level to be included in the academia as a faculty.With the global reform in health care where population health is the focus, demands for quality of care in the acute and long-term care settings have been at the forefront.More skillful graduate nurses are required to fill the shortage; more NPs are needed due to shortage of primary care providers.The implementation of these reforms has been entrusted to the care of the nurses and the push for nurses to achieve their highest level of education and training has opened various pathways to meet these projected goals.

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Therefore, AACN expanded the definition of APRN which allows nurses with baccalaureate degree to advance their studies towards mastery of a specific role whether they provide direct or indirect patient care just as long as it can effect healthcare outcomes. Their set curriculum encompasses the AACN Essentials designed to deliver all the core competencies expected of an APRN. Now we see more nurses going for their master’s degree such as but not limited to education to shape competent future nurses; more nurse practitioners who will serve as a primary care provider consistently providing high quality of care; more nurse leaders whose vast knowledge and understanding of health care policies bring us to the forefront; more nurses who are leaders in research and develop efficient model of care based on evidence data and APRNs who are experts in data mining and informatics. Nursing has certainly evolved to a more autonomous role in the healthcare industry in the 21^st century (Denisco & Barker, 2016).

References

DeNisco, S. M., & Barker, A. M. (2016). Introduction to the role of advanced practice nursing. In Advanced practice nursing: essential knowledge for the profession (3rd ed., pp. 5-16). Retrieved fromhttps://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php

Re: Topic 1 DQ 1 Describe how the role of advanced registered nurse transformed over time NUR 513

Over the years, the role of the nurse has expanded in response to advances in scientific knowledge and changes in health care needs. Integrate nursing science with knowledge from the organizational, biophysical, psychological and analytical science, as well as ethics, as the basics for the highest level of nursing practice. Nowadays as a consequence of the expansion of the role of the nurse within health care, the need for formal education and training become more common. The development of advanced practice nurses become very popular in the nursing profession and the majority of nurses coming from different backgrounds are particularly eager to expand their clinical practice responsibilities. As today nursing continues to be one of the tops trusted professions in the United States( Gallup 2012) and Nurse Practitioners have extremely high patient satisfaction score (Weiland 2008)

As the health care system has expanded over the 40 years, the education and roles of APRNs, in particular, have evolved in such a way that nurses now enter the workplace qualified to provide more services than had been the case previously. Yet while APRNs are educated and trained to do more, some physicians challenge expanding scopes of practice for nurses. The committee stresses that physicians are highly trained and skill providers and that some services clearly should be provided by physicians who have received more extensive and specialized education and training than APRNs. However, given the great need for more affordable health care, nurses should be playing a larger role in the health care system, both in delivering care and in decision making about care.

Today Nurse Practitioners have proven their effectiveness in delivering high quality, lower-cost health care services. Healthcare consumers, recognizing the value of a good service flock to NPS for numerous health care needs. While it remains unclear at this time how health care reform effort will change health care delivery, it is abundantly clear that nurse practitioners will be a vital component of future American health care services. Describe how the role of advanced registered nurse transformed over time NUR 513

References

American Association of colleagues of Nursing (AACN) 2004 AACN position statement on the Doctorate in nursing http://www.aacn.nche.edu/DNP/DNPPositionStatement.htm

APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Advisory Committee (May 2008). Consensus Model for APRN Regulation.

American Association of Nurse Practitioners(AACN) 2014 Nurse practitioners fact sheet. http://www.aanp.org/all-about-nps/np-fact-sheet

Re: Topic 1 DQ 1

The advanced practice registered nurse (APRN) has seemed to evolve based on shortages and demands of the population within our healthcare system. Deficits have expanded many nursing roles, leading to the need to define the nursing scope of practice and educational requirements. The traditional four roles of APRN, nurse practitioner (NP), certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS); have all grown exponentially since the 20th century (DeNisco & Baker, 2016). These four roles all seemed to have stemmed from disparities in our healthcare system, whether it be a shortage of physicians, under-severed rural areas, vulnerable populations, or times of war. A great example of this is the advancements within the CRNA field. CRNAs were initially brought about during World War I due to a physician shortage during wartimes (DeNisco & Baker, 2016). The continuation of wars through United States history gave the CRNA field a strong foothold as a chief provider of anesthetics to the frontline. This expansion of the nursing scope of practice in anesthetics eventually led to credentialing and the American Association of Nurse Anesthetists (AANA) to monitor and regulate this growing field (DeNisco & Baker, 2016). Similarly, the growth and expansion of the other original APRN roles through the end of the 20th and 21st century required the nursing field to define graduate-level educational requirements and each specialty’s nursing role. The transformation of traditional APRN roles has now begun to open doorways for other nontraditional advanced practice nursing areas like public health nursing, clinical nurse leaders, nurse administrators, nursing research, and nurse educators.

DeNisco and Baker do a great job of laying out the ongoing evolution and need of the APRN role in the American healthcare system and the need for more advanced practice educators to sustain the APRN field’s continuous growth (2016). With a growing and aging population and a continuing shortage of physicians, the APRN roles offer a cost-effective solution that can also improve patient satisfaction (DeNisco & Baker, 2016). I will say that this week’s reading has made the decision to continue my education in nursing even more appealing and necessary.

References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 9781284072570

RESPOND TO GINA HERE

Hello Gina,

I agree with your statement that the advanced nurse practice numbers have soared high in the 21^st century compared by the 20^th century. The current Covid-19 pandemic has however, proved that health and wellness is a collective responsibility (Kovac, 2020). In this context both the patient and the nurse are at risk of contracting the disease regardless of age, gender or religious underpinnings hence adequate precautionary measures should be taken. The advanced nursing role has taken up active role in preventive measures of the disease by offering the routine guidelines of hygiene the emerging trends in the spread and severity of the disease. The concept of preventive care is one of the key pillars in the patient protection and well-being. The advanced nurse role requires the nurses to carry out educational programs, seminars and workshops that are meant to help the public on the need of maintaining our bodies for optimal health and reduced chances of hospitalization. The one situation where the advanced nurses’ practitioners have shown resilience is the tackling of the covid-19 pandemic. Countries that embraced strict, firm and taken early hard precautionary measures have known to be safer with very low reported cases in the country (Trnka et al., 2021)

References

Kovac, M. (2020). The Covid-19 pandemic: collective action and European public policy under stress. Central European Journal of Public Policy, 0(0). https://doi.org/10.2478/cejpp-2020-0005

Trnka, S., Long, N. J., Aikman, P. J., Appleton, N. S., Davies, S. G., Deckert, A., Fehoko, E., Holroyd, E., Jivraj, N., Laws, M., Martin-Anatias, N., Roguski, M., Simpson, N., Sterling, R., & Tunufa’i, L. (2021). Negotiating risks and responsibilities during lockdown: ethical reasoning and affective experience in Aotearoa New Zealand. Journal of the Royal Society of New Zealand, 1–20. https://doi.org/10.1080/03036758.2020.1865417

Topic 1 DQ 2

Access The Future of Nursing: Leading Change, Advancing Health. Identify the two recommendations for nursing education you believe will be most effective or radical in creating change within the industry. Provide rationale based on your experience in practice. Do you agree or disagree with how the Institute of Medicine (IOM) describes the advanced practice registered nurse role evolving? Why or why not?

Re: Topic 1 DQ 2

In the Institute of Medicine (IOM) report title “The Future of Nursing: Leading Change, Advancing Health” (2011), the IOM recommended changes to the nursing profession in order to improve patient outcomes. One of those recommendations is to “ensure that nurses can practice to the full extent of their education and training” (Institute of Medicine, 2011). These is probably the most important aspect of the IOM report because although we are facing a shortage of primary care providers in the country, many regulatory bodies still put boundaries in place for nurses trying live up to this recommendation. There are currently only 20 states in America that allow Nurse Practitioners to practice without a supervising physician (Full Beaker, Inc., 2021).

Another recommendation from the IOM report is that nurses should achieve higher levels of education (IOM, 2011). While I agree wholeheartedly with this recommendation on the surface, I believe that it may help and hurt the profession. Nurses should be expected to achieve higher levels of education and continue their education throughout their career because its just the right thing to do. Health care is changing constantly and nurses should keep up with those changes in order to keep patients safe. However, if the minimum educational level for entry into the nursing profession were to be changed to a baccalaureate degree it would prevent many people from entering the profession in the first place. The time and cost involved may be a deal breaker for many. In addition, with the nursing shortage getting worse every year we should not increase the time it takes nurses to obtain licensure. I know that for me, if I had to go straight through for a bachelor’s of science in nursing, rather than obtaining my associates degree, I would probably have chosen a different profession.

 

Full Beaker, Inc. (2021). Nurse.org Career Guide Series: Nurse Practitioner. Retrieved from https://nurse.org/resources/nurse-practitioner/#:~:text=Nurse%20practitioners%20have%20full%20practice,on%20certain%20patient%20care%20decisions.

Institute of Medicine (IOM) (2011). The Future of Nursing: Leading Change, Advancing Health. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK209881/

(RESPOND TO KELLY HERE)

Hello Kelly,

I do agree with you that one of the best recommendations by IOM about the role of the advanced registered nurse practice is to allow the nurses practice to the full extend according to their level of training and education. This has a direct impact on the effect of shortage of primary care providers in the sense that it will relieve the pressure on the already outstretched and overwhelmed primary healthcare providers. Additionally, the same concept was emphasized by the Center for Medicare and Medicaid Services (CMS) which broadened the concept of “medica staff” (Altman et al., 2016). This is meant to ensure that all healthcare facilities allow other healthcare practitioners like the APRNs to perform a number of roles that is within their area of training, practice and experience. Healthcare organizations that apply these recommendations are bound to be effective in terms of offering timely primary care for the patients and ease the pressure on the physicians. Additionally, this will encourage multidisciplinary health collaborations that are likely to result to high quality services and improved patient outcomes (Leach et al., 2017).

References

Altman, S. H., Adrienne Stith Butler, Shern, L., Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health, Institute of Medicine, & National Academies of Sciences, Engineering, and Medicine. (2016, February 22). Removing Barriers to Practice and Care. Nih.gov; National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK350160/

Leach, B., Morgan, P., Strand de Oliveira, J., Hull, S., Østbye, T., & Everett, C. (2017). Primary care multidisciplinary teams in practice: a qualitative study. BMC Family Practice, 18(1). https://doi.org/10.1186/s12875-017-0701-6