Role of Advance Practice Nurse - Research Paper Example

Role of Advanced Practice Nursing Part I: Advanced Practice Roles in Nursing Roles of an Advanced Nurse Practitioner (ANP) An Advanced Nurse Practitioner (ANP) holds a masters degree and is a registered nurse working in a certain nursing specialty according to Hamric, Spross and Hanson (2000). Clinical practice refers to the basic medical responsibilities of a medical practitioner (Watson, 2006). The roles of an ANP in clinical practice include prescription and management of medications, assessment, evaluation and treatment of chronic and acute diseases, evaluation and assessment of medical histories of patient and effective treatment of chronic and acute illnesses (Hamric, Spross & Hanson, 2000). Primary care or primary nursing refers to the complete care that is given to patients according to Watson (2006). Advanced Nurse Practitioners are advantaged in this field because they are able to offer complete care to a wide range of patients suffering from a wide variety of illnesses. Their primary care roles include offering counseling to patients to promote healthy lifestyles, ascertaining and recommending specialized health care for extreme illness cases, performing physical examination of patients and provision of health screening services (Hamric, Spross & Hanson, 2000). The ANP should use his advanced level of education to advice and counsel the public on healthy living habits. Hamric, Spross and Hanson (2000) suggest that he or she should also assist middle level nurses in solving serious medical anomalies. ANPs are allowed to use their advanced medical knowledge for medical diagnosis and prescription. The administrative roles of ANPs include monitoring and mentoring junior medical staff and managing specialty medical sections according to Hamric, Spross and Hanson (2000). ANPs should engage in research in their various specialty areas to realise and improve treatment methods and medical practices. Roles of an Advanced Nurse Educator (ANE) An Advanced Nurse Educator (ANE) is a nursing instructor that is responsible for educating nursing students and they are mainly based in universities, colleges and medical research facilities (Furlong & Smith, 2005). Furlong and Smith (2005) assert that the main role of ANEs in clinical practice is to implement the most effective medical research and care standards into the nursing profession. The role of ANES in primary care is to impart high standard skills and knowledge to nursing students to ensure they practice primary care effectively. In education ANEs have several roles including teaching nursing students and assessing their educational performance, developing and implementing nursing curriculum, monitoring educational progress and evaluating the outcome of the various learning programs (Furlong & Smith, 2005). ANEs are tasked with tailoring the nursing curriculum to achieve favorable outcomes on the nursing students. ANEs should also engage in medical research which can involve participating in nursing discussions and forums. Furlong and Smith (2005) add that they have an important administrative role to monitor and coordinate nursing students during their course. They must maintain a favorable learning environment using appropriate rules and regulations. Roles of an Advanced Nurse Informaticist (ANI) An Advance Nursing Informaticist (ANI) is an extensively skilled nurse who oversees and implements the integration of nursing with computer technology boosting communication and enhancing information and knowledge flow thereby promoting health according to American Nurses Association [ANA] (2001). The roles of ANIs in clinical practice include improved service delivery in a medical facility through fast patient data retrieval, efficient diagnosis because of data integration, professional development of staff, promotes integrity and enhances consultation (ANA, 2001). The role of ANIs in primary care include improved coordination of patient care, application care support for patients and automated primary care delivery using technology. The education role of ANIs is to promote educational development of staff in terms of technology to enhance their proficiency. According to ANA (2001) ANIs have a administrative roles that include coordinating policy development in medical facility, advocating and promoting information and data security and development of a workflow design and process. ANIs play a major role in researching and evaluating the most effective nursing information system to improve information flow in a medical facility (ANA, 2001). Roles of an Advanced Nurse Administrator (ANA) An Advanced Nurse Administrator (ANA) is a senior nurse whose main responsibility is managing the nursing personnel in a medical facility. Watson (2006) affirms that the role of an ANA in clinical practice is to ensure that the nursing staff performs all their duties and tasks efficiently through effective management. They ensure that the nursing staff adopts the most cost effective, fast and safest ways when executing their duties. ANAs also play a major role in primary care by ensuring that the nursing staff offers high standard primary care to o patients according to Watson (2006). The role of ANAs in education is to ensure that all nursing staff is educationally competent and qualified. The main task of ANAs is administration where they play the role of managing staff and resources strategically to ensure efficiency in a medical facility. ANAs also play a role to ensure that the medical facility upholds and supports required legal guidelines and regulation policies. They play a research role through consultation with administrative experts to ensure an ethical working culture in a medical facility (Watson, 2006). Conclusion The roles of a Nurse Practitioner, Nurse Educator, Nurse Informaticist and Nurse Administrator in advanced practice nursing differ when their professional tasks are considered. However, Watson (2006) these occupations play the same social role in a medical organization. They are the senior nursing staff and they play a mentorship role to their juniors in their respective specialties. They also have an ethical role in their respective medical facilities which dictates they act as role models to the junior staff (Watson, 2006). Part II: Selected Advanced Practice Role Regulatory and legal requirements for advanced nursing practice in Virginia (West Virginia Legislature, 2014) An Advanced Practice Nurse (APN) or nurse specialist must be registered and must have completed a graduate nursing course in an accredited institution approved by the West Virginia Board of Examiners for Registered Professional Nurses (Board). An APN must meet all requirements as demanded by the Board including a valid license indicating he can practice as a certified nurse midwife, a certified nurse practitioner, a certified nurse anesthetist or a clinical nurse specialist. An APN must prove to the Board that he or she has advanced clinical skills and knowledge to offer direct and indirect medical care to patients according to West Virginia Legislature (2014). An APN who was previously registered as an advanced practice nurse having fulfilled the above requirements is eligible to reapply for licensure following the passing off the new nursing laws on December 31, 2012. Any APN wishing to practice or practicing as an advance registered nurse for compensation must prove his or her qualification in order to be licensed as provided by the Board. All practicing APNs must be duly registered with the Board and must bear an authentic license with an exemption of travelling professional nurses accompanying their patients across state lines. The following requirements must be submitted to the Board by any APN wishing to be registered as a professional advanced nurse; a written declaration supported by oath that the APN has completed the required graduate program from an institution approved by the Board and that he or she has good morals. The Board also requires that the APN pass a written examination which may be supplemented by an oral examination in subjects of its discretion (West Virginia Legislature, 2014). The Board may issue practice licenses, temporary permits or waiver licenses to APNs from a different state or country provided they fulfill the required provisions. Application fee for a practicing license shall be communicated by the Board upon application of a license according to West Virginia Legislature (2014). An APN who wishes to offer voluntary medical practices will not receive compensation for his or her services but they must be duly licensed and registered. Licenses of all registered practicing APNs must be renewed annually except in cases when the Board demands otherwise. A penalty fee will be charged for late renewal of a license by the Board (West Virginia Legislature, 2014). A license will bear the applicant’s full name, serial number, date of issuance, a seal of the licensing Board, date of expiry and signature of the Board’s executive secretary (West Virginia Legislature, 2014). Revocation, denial or suspension of practicing license will occur if the Board ascertains that the applicant or holder is incompetent or unfit to practice because of negligence or poor habits, addiction, guilty of deceit or fraud in acquiring the license, a convicted felon, mentally unsound or incompetent, violates the above provisions repeatedly, practicing without a valid license or is found guilty of immoral conduct in his practice. Voluntary rehabilitation is encouraged by the Board and participating practitioners will not be denied a license provided the APN adheres to the program fully. No APN should practice using a fraudulently acquired license, academic material for applying for a license because such cases will be considered misdemeanors. Also practicing without a valid license and violating any of the above provisions. Professional organizations for membership National Association of Social Workers (NASW) is the largest organization for professional social workers in terms of membership according to NASW (2014). NASW promotes professional development, enhances quality social practices and advocate for ethical and informed career practices in terms of skills, research and techniques. NASW has an open Credentialing Center for all qualified candidates and promotes Advanced Practice Specialty Credentials. The organization has a 24 hour online education resource offering accredited courses at discounted prices (NASW, 2014). National Council of Hospice and Palliative Professionals (NCHPP) is a branch of the National Hospice and Palliative Care Organization (NHPCO) according to NCHPP (2014). The organization’s main objective is to employ interdisciplinary strategies to enhance and improve end of life care. The organization supports its members by providing resources to improve their social careers. Networking opportunities and education are also provided resulting in career development for palliative or hospice care professionals and also volunteers (NCHPP, 2014). Competencies of a Hospice Nurse Practitioner The role of a Hospice Nurse Practitioner is to maintain the quality of life and comfort at the end of life for patients suffering from terminal diseases. The competencies for a Hospice Nurse Practitioner are mainly social and emotional skills. They must be compassionate and empathetic especially when communicating with patients and also with the patient’s families. They must maintain high ethical standards, must be keen observers and be knowledgeable to identify changes in patient’s medical conditions. Hospice nurse practitioners should be physically and emotionally stable to handle stressful and sad episodes such as death of patients and also severe pain. Resilience, understanding and sympathy is also necessary when dealing with severely ill patients. Certification for Hospice Nurse Practitioner requires post-master’s certificate in palliative care programs (NCHPP, 2014). Nursing practitioners must have valid licenses to practice in addition to a master’s degree that is nursing. They should also complete several courses including advanced health assessment, pharmacology, pathophysiology and primary care. Finally, the National board for Certification of Hospice and Palliative Nurses offers a rigorous exam to award the candidate an Advanced Certified hospice and palliative nurse certificate (NASW, 2014). A hospice facility like the Hospice of Virginia requires the services of a Hospice nurse Practitioner to care for the terminally ill. The environment for hospice practitioners is mainly in the private wards of the patients. The colleagues in this line of work include hospice physicians and palliative social workers. The work may involve supervision of licensed (practical) nurses or vocational nurses and nursing aides. The setting of this job is mainly in hospitals, private homes, nursing centers and residential care facilities. Conclusion The role of a Hospice Nurse Practitioner is very important in bridging the gap between the physician and the palliative social workers. Although not as skilled as a physician the Hospice Nurse Practitioner can manage many important tasks to maintain the comfort of a terminally ill patient. The hospice industry is very important because it provides a favorable nursing environment for the terminally ill and eliminates the pain from their families. A Hospice Nursing Practitioner can be very useful in this field due tie the advanced skills and knowledge that are essential in the hospice practice. Part IV: Health Policy and the Advanced Practice Role Literature review The current health policy that is the Affordable Care Act (ACA) promotes health care for all and advocates that the race and ethnicity of patients should be tracked according to Robert Wood Johnson Foundation [RWJF] (2014). This is aimed at alleviating health disparities in the country. There are many factors that cause health disparities in the society including social factors such as ethnicity, race, income levels, marital status, sexual orientation and education level according to Williams and Jackson (2005). Other factors include genetics and biology such as gender, geographical location or physical environment, built environment and infrastructure such as buildings and transportation systems and finally health services such as insurance status and quality health care access. Williams and Jackson (2005) suggest that most of these factors are solved by implementing favorable health practices but social factors pose a barrier to uniform health care. Health disparities are evident between different races and ethnic groups (RWJF, 2014). The health policy should be tailored to reduce health disparities especially among minority races and ethnic groups. The main illnesses that reflect disparities include cancer, HIV/AIDS, heart diseases, diabetes and infant mortality (due to poor immunization practices) according to Williams and Jackson (2005). The government should liaise with medical practitioners to ensure that collection of patient data is consistent and objective. Tracking of patient race and ethnicity should be made mandatory and the government should use this data to distribute health resources uniformly across the country. The process that should be used to overcome health disparities that result from race and ethnicity requires the participation of all stakeholders that is; the government, medical practitioners, the affected communities and all other related institutions. The first step is to create awareness regarding the issue of health disparities to all. Eliminating health disparities should be the responsibility of all institutions, organizations and sectors in the society. This will ensure that the seriousness of this calamity is felt and understood by all. The next step involves the government and related stakeholders and it involves addressing all inequalities in the society including economic, social and environmental inequalities. This step ensures that all communities and organizations promote equality and uniformity enhancing equal health care. The third step involves promoting universal access to quality and affordable health care. This is essential in eliminating health disparities and persuading deployment of quality health care to all regardless of economic status (Williams & Jackson, 2005). The fourth step involves the affected communities and they must play a primary role to eliminate inequality in health care (Williams & Jackson, 2005). The affected minority groups should demand quality and affordable health care from the government persuading it to implement favorable health policies. The fifth step involves the use of research and data to ascertain causes and discover solutions for health disparities. Finally, the health policy should dictate that all health services to be linguistically and culturally accessible to reduce and eventually eliminate health disparities (Williams & Jackson, 2005). The first strategy that can be used to influence change in health policy is through campaigns. Campaigns can be conducted using the available communication media such as television, online campaigns and bill boards. These campaigns are bound to inform or create awareness of the prevailing health disparities and they can include live interviews with affected minority groups. The government will be persuaded to act regarding this issue which will result in a change in health policy. The other strategy is to consult with anti drug agencies to combat tobacco advertisements in minority communities. Tobacco advertisements are high in minority communities especially in African American communities than in White neighborhoods (RWJF, 2014). This will result in reduced influence on harmful health habits in minority areas. Another strategy is to start charitable foundations that will assist by financing quality health care among minority communities. The charities will be advertised targeting advantaged Americans to secure funding which can be used to build medical facilities among these communities. Conclusion Reduction and eventual elimination of health disparities will improve the quality of health care greatly (RWJF, 2014). Implementing universal quality and affordable health care program will ensure that all communities live healthily translating into longer life spans. Uniform health care will ensure that all communities are not exposed to health threats. Minority groups are highly affected heavily by disease outbreaks but with proper immunizations and early treatments the effects will be reduced. A society that has uniform health care will be healthy and more productive improving the overall livelihoods in the world. References American Nurses Association. (2001). Scope and standards of nursing informatics practice. Amer Nurses Assn. Furlong, E., & Smith, R. (2005). Advanced nursing practice: policy, education and role development. Journal of clinical nursing, 14(9), 1059- Hamric, A. B., Spross, J. A., & Hanson, C. M. (2000). Advanced nursing practice: An integrative approach. WB Saunders Co.1066. National Association of Social Workers. (2014). Practice & Professional Development. Retrieved from http://www.naswdc.org/pdev/Default.asp National Hospice and Palliative Care Organization (2014). National Council of Hospice and Palliative Professionals. Retrieved from http://www.nhpco.org/membership/national-council-hospice-and-palliative-professionals Robert Wood Johnson Foundation. (2014). Disparities. Health Policy. Retrieved from http://www.rwjf.org/en/topics/rwjf-topic-areas/health-policy/disparities.html Watson, J. (2006). Caring theory as an ethical guide to administrative and clinical practices. Nursing Administration Quarterly, 30(1), 48-55. West Virginia Legislature. (2014). Chapter 30. Professions and Occupations. West Virginia Code. Retrieved from http://www.legis.state.wv.us/wvcode/code.cfm?chap=30&art=7 Williams, D. R., & Jackson, P. B. (2005). Social sources of racial disparities in health. Health Affairs, 24(2), 325-334. Read More