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Roles in Advanced Practice Nursing

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Roles in Advanced Practice Nursing

Introduction

Advanced Practice Nurses sit higher on the organizational structure of healthcare settings compared to registered nurses. That is, where registered nurses often act in a support role to other health care personnel, advanced practice nurses have a position of authority and autonomy. By undertaking a master’s degree or doctorate, a registered nurse attains the option of transitioning to an advanced practice nurse where they will choose a specialty and take up more leadership roles in healthcare. This paper will discuss why advanced practice nurses are considered vital to the healthcare system and what it takes to transition into the role successfully.

The Four APN Roles

While pursuing the education required to become an advanced practice nurse, one has to choose an area of specialty which will influence the type of health care setting they work in and their demographics of their patients. According to the National Council of State Boards of Nursing (2020), the four APN roles include; Certified nurse-midwife whose demographics are mostly women and children. Therefore, they provide gynecological, prenatal, and postpartum care, and they administer childbirth. A certified registered nurse anesthetist is mainly found in surgical settings providing anesthesia care to patients undergoing surgery.

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Similarly, a certified nurse specialty focuses on the nurse, the patient, and the nursing practice meaning that not only are they responsible for providing direct care to patients, but also, they cater to educating other nurses and revolutionizing how the nursing practice is conducted. Equally, the certified nurse practitioner focuses wholly on patient care where they can provide comprehensive medical care to both acute and regular patients as well as engaging in activities that educate communities on health promotion. Therefore, as advanced practice nurses are expected to choose a specialty, they are encouraged to pick something that aligns with their knowledge, skills, and abilities. Most importantly, they should consider their preferences in the working environment.

The rationale for Choosing CNP Role

The role of a certified nurse practitioner has some notable advantages over the other three roles. For example, the roles of nurse-midwife and nurse anesthetists are highly specialized in that for the rest of their careers; these nurses will be dealing with women’s health and anesthesia care, respectively. Therefore, it is a bit restrictive for a nurse who may want to look at medicine holistically and practice in different areas depending on changing interests and preferences. Correspondingly, while the roles of a nurse specialist and nurse practitioner appear to be similar, there are significant differences when it comes to autonomy and authority. For example, where the nurse practitioner can diagnose, assess, order lab tests, and prescribe medication, nurse specialists have no such power; hence, they have to collaborate with other nurses and physicians during patient care (Nurse Practitioner Schools, 2020). Therefore, the nurse practitioner role can allow the nurse to practice without supervision. As a result, nurse practitioners have the option of opening their private practice and becoming their bosses. Similarly, a nurse practitioner is committed wholly to patient care, whereas the nurse specialist spreads out their focus on education and public health promotion, among others. For this reason, most nurse specialists are directed towards research instead of direct patient care.

Plans for Clinical Practice

Once I become a nurse practitioner, I intend to join a state of the art hospital in a big city where I will get the opportunity of experiencing various specialties ranging from general medicine to cardiovascular and neurology. Also, in a big hospital, I will be exposed to trauma, internal medicine, and surgery. This exposure will allow me to decide whether I want to specialize further or remain in holistic patient care. With this decision, I will be able to pick a fitting doctorate. I will ensure that I am initiative enough to place myself in the line of hands-on experience in some of the most compelling cases so, I will seek out collaborative partnerships where we will work on innovative solutions for patient care.

How my understanding of NP practice has changed after researching the four ANP roles

Before my research, I knew that when a registered nurse transitions into a nurse practitioner, they take up more leadership roles. For me, this meant becoming the leader of registered nurses whereby the duties would remain the same, but at this point, they would be on a supervisory level. However, my research revealed that while a supervisory role may be one of the duties of a nurse practitioner, the transition reduces the registered nurse duties and fosters on some of a physician’s tasks such as diagnosis and prescribing medication. Correspondingly, while I was not sure about what specialty the nurse practitioner takes up, I assumed there would be a restricting specialty such as that of the nurse-midwife and nurse anesthetist. In contrast, I realized that while a nurse practitioner is labeled as a specialty, it is quite general where patient care is concerned as demographics or the healthcare setting does not restrict one.

Role Transition from the RN role to the NP role

The transition from a registered nurse to a nurse practitioner is considered stressful and sometimes unsuccessful, despite the importance the government puts on increasing nurse practitioners in the country. Research shows that the nurse practitioners turnover rates are double those of the physicians, and the attributable factors include experience and orientations. For instance, it is challenging to shift from an experienced registered nurse to a rookie nurse practitioner. Such a shift has been observed to cause low job satisfaction among other detriments. Comparatively, where registered nurses usually receive a formal orientation when they join a healthcare setting, nurse practitioners do not receive the same courtesy, which can lead to low confidence and a feeling of hostility (Barnes, 2015). In this case, when these two go hand in hand, they can dictate how successful or unsuccessful the transition will be for new nurse practitioners.

Studies show that a successful transition can be guided by three strategies inclusive of mentorship, professional relationships, and establishing the identity of a nurse practitioner (Twine, 2017). For example, I will need to ensure there is a clear line of communication between me and the management where my roles as a nurse practitioner are discussed, and I have an understanding of where I fit in that health care setting. Subsequently, I will ensure that I forge functional professional relationships with my colleagues so that we can be at ease with working together, and they can feel free to correct me or give me credit for the work I have done. Most importantly, I will seek out a mentorship with an experienced nurse practitioner who understands what I am going through and can provide advice on what path I need to take to succeed in the role.

Conclusion

In summary, to be able to transition from a registered nurse to an advanced practice nurse, one needs to study a master’s or doctorate in nursing. Subsequently, as there are four roles under the advanced practice nurse role, a choice will need to be made. From research, a certified nurse practitioner is best for someone who wants to focus on patients’ care while not limiting themselves to specific departments. Also, among the four, the nurse practitioner attains the most autonomy and authority. Consequently, transitions from a registered nurse to a nurse practitioner are considered challenging mostly due to the lack of experience and a formal orientation. However, some strategies can ensure success, and they include establishing an identity as a nurse practitioner, forging professional relationships, and finding a mentor.

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