Advanced Practice Nurse Practitioners - Assignment Example

Advanced Practice Nurse Practitioners al Affiliations Advanced Practice Nurse Practitioners Conflict Resolution among APNs APNs are trained to be leaders in the entire nursing fraternity and link up with fellow leaders in the clinical settings to ensure proper channels of conflict resolution (Naylor & Kurtzman, 2010). All organizations have the potential to engage in conflicts, but how these conflicts are handled makes the difference between successful and unsuccessful service providers. Conflict resolution is a function expected to be performed by professionals, and it is a duty that normal nurses will rarely be able to accomplish (Gilmartin & Nokes, 2015). Since APNs have the experience of normal nurses, having worked in their position at some point, they can understand conflicts that occur amongst the nurses (Naylor & Kurtzman, 2010). Moreover, they are in the best position to apply justice in solving such conflicts from priory obtained nursing experience (Gilmartin & Nokes, 2015). Complementary Therapies and the APN Role in Guiding Their Inclusion in Treatment Plans Complementary therapies refer to all the hospital practices aimed at improving the quality of care to the patients and eventually reducing the total time spent in the hospital. Apparently, this would cut on the cost of medical care by reducing burdens directed to patients that spent months to years under hospitalization (Harvey, Buckley & Novicevic, 2006). Applying complementary therapies allows the treatment of patients on an outpatient basis, and some of the therapies in this category include psychological treatment options, various forms of chemotherapeutic procedures, diet and nutrition, and kinesiology among others. The importance of this approach is that it enables patients to understand that there are other options for solving their medical conditions other than forever staying in their hospital beds. The long term result is an empowerment to the patients who get to understand the best ways of out-competing their challenges (Clark et al. 2013). The role of the APNs will be to come up with suggestions of alternative therapies that can be applied during the process and also aid in the supervision of the patient. In the entire process, the APNs will be engaged in the provision of education services to the patients and their caretakers on the advantages of new approaches to medication that can reduce the level of pain and suffering (Clark et al. 2013). The APNs will at the same time also provide tools to the patients that will significantly apply ultimate control during their treatment. They will also engage the patients in effect management of events and conditions that befall the patients during their treatment period. By so doing, the hospital management will be in a position to achieve their goals as provided for in the plan of treatment (Harvey, Buckley & Novicevic, 2006). The APNs play a central role in this particular process since they target the patients with the aim of enlightening them on various procedures that would benefit them in their entire lives. Eventually, these procedures will serve to reduce the length of stay in the hospital, cutting on the medication costs of the patients as well as empowering the patients (Gilmartin & Nokes, 2015). It I the role of APNs to make patients and their family members understand the most effective techniques amongst combined therapies that will be in a position to boost their options of treatment. To be able to deliver effectively in their role as educators to patients and their families, APNs will be under obligation to come up with a realist educational plan. The health professionals have been well prepared for this role through experience as normal nurses, through skills acquired in their practice, leadership and also insights from other senior colleagues in the field. Developing a teaching plan will, therefore, be an easy task for them which would guide inclusion of complementary therapies into treatment plans. Such a teaching plan will be tailored to serve effectively the targeted group that may sometimes lack knowledge of medical terms and procedures; hence a mechanism that would comfortably meet their needs would be workable for this matter. Various steps that APNs will consider in coming up with a suitable teaching plan include first keeping in mind the limitations and disabilities associated with the target group. By so doing, the APN will be able to understand the challenges that will probably make them not help the patients and their families through their role as educators. Next, the APNs will produce the plan that reaches out to the target group at individual basis with the capacity to make the individuals understand the key concepts (Naylor & Kurtzman, 2010). This will be achieved through making the ideas as simple as possible and having both short and long term goals of the teaching plan together with positive reinforcement to encourage the patients and families to internalize the concepts (Frakes & Evans, 2006). Applying this kind of approach will be essential since it will enable the APN to limit challenges and final assess and evaluate the outcomes of the teaching plan to find out whether the plan bore any fruits. The final step in developing the teaching plan will entail organizing for follow-up programs to ensure that the patients or families are responding positively to the concepts introduced to them (Gilmartin & Nokes, 2015). Transcultural concepts and evidence-based practice Research in the recent past has established cultural competence as one of the most important concerns in the delivery of healthcare accompanied by legal and also ethical implications. The American Nurses Association and the American Medical Association have published lots of works directed towards the orientation of clinicians and medical practitioners and the development of standards aimed at the promotion of cultural competence amongst the healthcare providers. There are already existing regulations and standards that have been previously developed by other healthcare agencies, but applying them to the clinical set up has been faced with a lot of drawbacks (Naylor & Kurtzman, 2010). Some of the drawbacks are associated with the abstract nature of cultural competence and its constant comparison with race and ethnicity. Moreover, associating culture with disparities related to health issues is yet another challenge (Frakes & Evans, 2006). Some of the transcultural based concepts that are of utmost importance in providing quality healthcare and increasing rates of value acquisition in clinical practice are cultural blindness, cultural destructiveness, cultural proficiency, cultural incapacity and Cultural pre-competence. Considering a combination of all these concepts perfect links up with evidence-based practice in a clinical setting to improve the quality of care administered to patients (Harvey, Buckley & Novicevic, 2006). While trying to respond to some of the ideas related to health disparities, most of the organizations whether professional or educational in nature have resulted in making adoption of cultural competence a center of concern in their healthcare provision. As aforementioned, however, it is not very easy for organizations to adopt transcultural concepts for the benefit of the patients partly because of the confusion that exist between the concept, race, and ethnicity and also because of inability to differentiate between the organization and individual cultural competency (Harvey, Buckley & Novicevic, 2006). To develop transcultural competent care, the California Endowment decided to facilitate the development of principles and specific standards that would be used in assessment and planning for the education of healthcare providers. Moreover, some of the funds that had decided to offer for the purpose of improving cultural competence were also allocated for resources to be used in the healthcare organizations (Naylor & Kurtzman, 2010). In general, the approach to the education of healthcare professionals aimed at increasing cultural competence was targeted at increasing knowledge, skills and improving their attitudes towards the concept. Cultural sensitivity and awareness are the central agenda in the education offered to healthcare professionals as regards to cultural attitudes, and this is expected to act as the basis for cross-cultural care (Frakes & Evans, 2006). It appears quite difficult however to change the attitudes of pragmatically oriented medical practitioners. Nevertheless, to impart knowledge of the healthcare professionals only demands a categorical approach whereby application of norms that are clearly associated with a particular ethnic group is done (Naylor & Kurtzman, 2010). Evidence-Based Practice Evidence-based practice acts as a vehicle for unity amongst all medical practitioners and clinicians in the attempt to achieve cultural competency in clinical settings. EBP centers on three aspects that specify the best evidence-based research ever performed in a particular field linking it to the best medical practitioner and for the benefit of the values and circumstances of the patient. Combining these three essential aspects of EBP ensures an eventual achievement of a healthcare system that is patient-centered in terms of core values (Harvey, Buckley & Novicevic, 2006). It is impossible to separate patient circumstances such as the social, environmental and economic from cultural aspects hence the healthcare provider as per the EBP triad will be required to associate the symptoms, life concerns and situations of the patient to these circumstances. Such an approach will direct the healthcare services towards achieving the interest of the patient upon which the service providers are called to attend to. Culture is expected to shape the beliefs that are related to health, values and behaviors, hence healthcare providers to work towards achieving the values and preferences of the patients (Gilmartin & Nokes, 2015). Ethical Decision Making By APNs The field of Advanced Nurse Practitioners presents with a myriad of ethical issues on which the APN is required to make informed decisions. Most of the issues demanding critical decision-making ability are ethical dilemmas accompanied by legal consequences if mistakes occur. Moreover, if mistakes occur as a consequence of poor decision making by the ANP, they are fatal or equally harmful, emphasizing the importance of the decision-making the ability of ANPs (Frakes & Evans, 2006). These ethical situations that demand critical decisions are the blueprint of the difference between the role of the ANPs as just a technical expert and the role played as a humanistic and spiritual professional. Collaboration skills associated with APNs is one of the main reasons why APNs succeed as professional ethical decision makers (Harvey, Buckley & Novicevic, 2006). Exposure to such difficult situations makes the APNs keep away from power struggles but rather to engage in practices that not only improve their communication skills but also sharpen their ability to deliberate with more senior healthcare providers on matters patterning difficult decisions (Clark et al. 2013). Acquisition of decision-making ability by APNs is achieved through four stages, the first of which is acquiring knowledge, followed by applying the knowledge to decision making. The third phase is coming up with an ethical environment and finally ensuring that there is social justice while applying decision-making knowledge in the healthcare system (Clark et al. 2013). This process has been considered to be evolutionary because the present ability to solve a certain crisis through decision making is determined by the previous experience with a similar case to decide on. Competency of decision making amongst the APNs is based on the ability of the APN to maximize on the good outcomes while minimizing on the bad outcomes of a decision. Perfect decisions are made when the makers act out of good will and human mercy aimed at improving the quality of healthcare. Decisions that are made out of Evidence-Based Practice are also most of the times desirable since they have been proved elsewhere to have good outcomes. Ethical Issues Affecting APN Roles and Impact of Risk Management, Negligence, and Malpractices Ethical challenges have been always present and affect not only APNs but all nurses, with the difference being that APNs must play their role of research whereby most controversial issues are handled (Clark et al. 2013). As researchers, APNs engage in testing the usability of certain agents or the applicability of certain procedures on human subjects for the first time that may cause ethical concerns and hinder the progress of the APNs in venturing into more beneficial programs. In as much as the APNs have gained more knowledge, and their role is diversified, they are still bound by the ethical requirements and standards of the nursing profession to uphold related duties, principles and virtues provided for by the nursing profession ethical standards. These nurses however come across various complicated moral choices on which they must make urgent and difficult decisions, putting them in a situation whereby some ethical rules may be broken to improve the quality of care from critical decisions (Frakes & Evans, 2006). Issues of moral rightness or wrongness of a decision made by APNs are greatest challenges in the nursing practice since this question may always come up irrespective of whether the APN decided to make the decision based on the good will of the patient or not (DOnise et al., 2013). The principle of beneficence requires that all acts should be done for the benefit of the patient and puts the APNs under such obligation. The patients are also ultimately granted the opportunity to enjoy the principle of autonomy, making their independent choices and demanding that the APNs must respect them. Such choices may, however, be a breach of the virtues and principles of the APN, hence making a decision to adhere to the rules guiding nursing profession or sticking to ethical rights of the patients may pose a great difficulty amongst the APNs (Naylor & Kurtzman, 2010). Ethical issues however in as much as they hinder the freedom of APNs in making decisions, they also have a positive impact on risk management, nurse negligence and malpractices (Frakes & Evans, 2006). Ethics makes the laws stringent enough to discourage any nurse or APN from neglecting their duties towards preserving the health of patients. Moreover, ethics offers provisions for strict punishments to nurses or APNs that engage in nursing malpractices, hence in overall, ethics will help in managing risks associated with irresponsible decisions made by APNs (Harvey, Buckley & Novicevic, 2006). Managing Cultural and Linguistic Challenges Nurses, and particularly APNs serving in the present day hospitals face the challenge of having to deal with a diverse population. Their target population that comes to them as patients expecting medical services have different cultural and linguistic origins with most of them presenting with health literacy barriers. Such health-related literacy barriers are associated with cultural origins of the patients together with language barriers that affect most of the patients presenting with this barrier (Clark et al. 2013). Unfortunately, very few nursing literature is available providing explanations on how nurses and APNs can be able to deal with such health literacy barriers whenever they present during provision health procedures. The APNs and some nurses, however, are highly skilled in terms of experience and training respectively to deal with such health literacy and linguistic barriers. In situations that bring up these challenges, the APNs are capable of creating a reliable inter-linkage between the health literacy barrier and culture or language of the patient for the common good of the patients with a myriad of positive changes (Frakes & Evans, 2006). Creating cultural diversity in hospitals and healthcare settings is one mechanism that has helped when it comes to dealing with cultural and linguistic challenges in healthcare provision. A healthcare center that has been able to cross the barriers of cultural discrimination and presents with a total representation of the available cultural units will rarely suffer the effects of cultural and linguistic barriers that hinder eventual best healthcare provision (Frakes & Evans, 2006). Reimbursement and Insurance Issues about the APNP Employee Contract Revenue streams are important in medical settings if APNP programs are intended to survive under the prevailing circumstances whereby most healthcare service providers are getting more and more finically oriented. It is very essential that all APNPs understand the issues that surround involving the third party in plans aimed at their reimbursement due to the increased billing opportunities in the provision of services by APNPs (Frakes & Evans, 2006). Reimbursement is quite complicated since it is not an individual decision-making process, it is a process that requires consultation between both the state and federal legal authorities. Likewise, insurance for the APNPs is subject to determination by these legal bodies that finally highlight the terms and regulations for their insurance purposes (Naylor & Kurtzman, 2010). APNPs will for instance only be allowed to bill the Medicare only under regulations of legal authorities and definition of APNP under the particular state as there are differences in the definition of the same in different states. The rules that guide reimbursement and insurance of APNPs are quite complicated and are determined via consultation between the federal and state law, differing from one subscriber to another (Clark et al. 2013). References Clark, Shannon,B.A., Phd., Parker, Rhian, Bsc, Msc,M.P.E.T., Phd., Prosser, Brenton, BA,Graddiped, Phd., & Davey, Rachel, Bsc,M.Medsci, Phd. (2013). Aged Care Nurse Practitioners In Australia: Evidence For The Development Of Their Role. Australian Health Review, 37(5), 594-601. DOnise, Katina, MBBS, MPH, Phd, Haren, Matthew T,Phd., N.H.M.R.C., Misan, Gary M H,B.Pharm, Phd., & Mcdermott, Robyn A, MBBS,M.P.H., Phd. (2013). Who Uses Complementary And Alternative Therapies In Regional South Australia? Evidence from the Whyalla Intergenerational Study of Health. Australian Health Review, 37(1), 1-11. Frakes, M. A., & Evans, T. (2006). An Overview of Medicare Reimbursement Regulations for Advanced Practice Nurses. Nursing Economics, 24(2), 59-65, 55. Gilmartin, M. J., & Nokes, K. (2015). A Self-Efficacy Scale for Clinical Nurse Leaders®: Results of a Pilot Study. Nursing Economics, 33(3), 133-143. Harvey, M., Buckley, M. R., & Novicevic, M. (2006). Addressing Ethical Issues Associated With The Inpatriation Of Nursing Professionals. Journal of Applied Management and Entrepreneurship, 11(4), 18-32. Naylor, M. D., & Kurtzman, E. T. (2010). The Role of Nurse Practitioners in Reinventing Primary Care. Health Affairs, 29(5), 893-9. Read More