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Defining The Roles of Advanced Practice Nursing
Defining The Roles of Advanced Practice Nursing
GuestAuthorHelenV.CalalangJavier,MSN,RNC,IBCLC
Areyoulookingforautonomyinyournursingpractice?Areyougettingboredofyour
routineactivitiesasastaffnurse?Areyoustressedoutorburntout?Areyouundecided
onhowtoexpandyourvision/responsibilitiesasanursingprofessional?Well,letssee
whereyoufitin!
TheAdvancedPracticeNursing(APN)isthewaytogo.Therearesomanynew
optionsandeducationalpathwaysthatwillsuityourneeds.Ifyoudonothaveyour
bachelorsdegreeinnursing,therearesomanywaysnowtoaccomplishthisandthere
aremanyschoolsandcollegesthatwillprovideyouwiththepreparationyouneedto
succeed.Whetheryouareconsideringtakingcoursesatthebiguniversitiesorcollegesor
simplyconsideringlongdistantlearning,theimportantthingisthatyoumakethe
decisionandcommitmenttoupgradeyourself.
Manyschoolsofferthecombinedbachelors/mastersdegreetrackormasters/doctorate
degreetrack.Exploreyourhospitaloryourfacilityforschoolprogramlistings.Most
hospitalsorhealthcarefacilitiespartnerwithcollegesanduniversitiestobringthe
programwithinyourreach.Allyouhavetodoistomakethatdecisiontogoforit.After
allitisyouwhowillbenefitfromitandhopefullyfindmorevaluetowhatyoudoevery
day.Hereisalistingofthemostpopularadvancedpracticenursingroles.Theseareallat
themastersdegreelevel.Thescopeofpracticeisdependentoneachstate,soinaddition
totheresourcesprovidedhereitbehoovesyoutolookfurtherintowhatisavailablein
yourstate.Oftentimes,theseprogramsmaynotbelistedandtouncoverthemmeansthat
youwillhavetogodiggingfortheinformation.
Nursepractitioners(NP)
Nursepractitionersareadvancedpracticenurseswhocanfunctionindependentlyoras
partofahealthcaresystemthatcanmanagemostdiseaseprocessesbutarenotlimitedto
diagnosisandprescriptiveprivilege.Theirpracticemainlyfocusesonhealthassessment,
maintenance,andpreventionofdisease,counselingandpatienteducation.So,completion
ofthisprogrammeansthatyoucanworkindependentlyorcollaborativelyinadoctors
officeoranyhealthcarefacilityinthecommunity.
Clinicalnursespecialists(CNS)
Clinicalnursespecialistsareadvancedpracticenurseswhoareexpertsinthecareof
specificpatientpopulations.Therolefocusesonclinicalpractice,teaching,research,
consulting,leadership,andmanagement.Thescopeofpracticemaycovernursingstaff
managementaswellaspatientcaremanagement.Therefore,asanexpert,youcan
functionasanursemanager,clinicalnursespecialistinyourspecialtysuchastakingcare
ofdiabeticpatients,cancerpatients,careofspecialpopulationwithanomaliesoreven
patientswithHIVorAIDS.
Nursemidwivesandnurseanesthetists
Nursemidwivesandnurseanesthetistsaretwooftheoldestadvancedpracticenursing
rolesthatfunctionwithinaspecializedpatientcareservice.Ifyouareinterestedinthe
managementofwomeninchildbearingyearsandnotlimitedtochildbirthpreparation,
processandmanagement,thenthenursemidwiferyprogrammaybeofinteresttoyou.If
youareacriticalcarenurseandareinterestedingivinganesthesia,sedation,careof
patientduringpre/post/perianesthesia,painmanagement,andworkcollaborativelywith
theanesthesiologist,thengoforthenurseanesthetistprogram.
Clinicalnurseleader(CNL)
Clinicalnurseleaderisarelativelynewtitlebuttherolehasbeenaroundfordecades.If
youareexploringtheworldofnursingleadershipandmanagementthismaybetheright
trackforyou.Today,thepreparationyouneedtobeinthispositionallowsyoutotransfer
yourbasicleadershipandmanagementskillstoallpatientcaresettings.Youcanfunction
asafirstlinemanager,supervisororadministratororasoneofthenursingexecutivesin
ahospital,managedcarefacility,homehealthagencies,orotherhealthcarefacilities
otherthanthehospital.
VisitorNote:PertheAACN,theCNLisNOTconsideredandadvancedpracticenursing
degree.Thetitleofadvancedpracticenurseisprotectedandonlythosewhoareclinical
nursesspecialists,certifiednursemidwives,nursepractitioners,andcertifiedregistered
nurseanesthetistsmayusethetitle.
Thefeelingofboredom,beingstressedout,andburnoutareindicatorsthatyouneed
changeinyourlifeorinyournursingpractice.Itistimetomoveon.OneofAmericas
mostbelovedmotivationalwriters,whorosefromabjectpovertyinthelate1800sto
becomeoneofthemostprolificandbelovedmotivationalauthors,NapoleonHill,
believedthatthepathtosuccessisnotlinedwiththeperfectmarriageofcoincidences
andluck,butrathercomesfromtherefusaltogiveuponesdream.Thissentimentis
summedupnicelyinoneofhisfamousquotesthat;Effortonlyfullyreleasesitsreward
afterapersonrefusestoquit.
Tolearnmoreaboutthedifferentcompetenciesandresponsibilitiesspecifictowhatyou
arelookingfor,visitthefollowingwebsiteorsimplyclickonthenursing
organization/associationonlinkonthiswebsite:
Administer Anesthesia
o An advanced practice nurse can administer anesthesia, as long as she has
received the proper training and certification. This role allows the nurse to perform an
assessment to determine if the anesthesia is necessary. If so, the APN will educate the
patient on the anesthesia process and administer the anesthesia herself. It is also the APN's
responsibility to oversee the patient's recovery from the anesthesia.
Midwife
o Some advanced practice nurses assume the role of a nurse midwife. This
role requires the APN to have training in obstetrics and to work under the supervision of
obstetrician. The APN will advise women on reproductive health issues. Conducting pelvic
and breast exams, as well as pap smears, are duties that come with this role. Some midwife
nurses provide neonatal care. They assist with labor and child birth.
Related Searches:
Nursing Care Management
RN Nursing Degrees
1. Advanced Practice Nursing
o Advanced practice nursing applies to several specialized fields of clinical
nursing, including clinical nurse specialists, certified nurse anesthetists, nurse practitioners
and nurse-midwives. These nursing professionals must complete master's or doctorate
degree programs and pass certifying exams required by their state nursing boards.
Nursing Administration and Education
o Another career development option for RNs is nursing administration and
education roles. Nursing university programs offer graduate degrees in health leadership,
nursing and health care administration, which combine coursework in advanced nursing and
business administration. Doctoral-level nursing programs offer research training for future
scholars and specialized curricula for RNs seeking to become nurse educators.
Nursing Informatics
o An increasingly more popular health care profession is nursing informatics. In
this role, RNs collaborate with technology staff to provide the best patient care, for example,
by providing training and support to nursing staff when new software or computer programs
are implemented. They may also create electronic databases for patient records and develop
telemedicine programs for patients living in remote areas.
Development & Evolution of the Role of Nurse Educator
The development and evolution of the role of nurse educator has changed significantly since
the first reported nursing research in 1906. As of 2010, nurse educators are responsible for
designing, implementing and reviewing nurse education programs in universities, teaching
Post-World War I
o In 1926, the Committee on Nursing Education was founded, which later
became the Committee on the Grading of Nursing schools. The committee was established
to make the necessary changes in nurse education to improve the care of terminally, acutely
and seriously ill patients. The key implications made by this committee were that only
individuals with a high degree of education (master's or Ph.D.) could educate new nurses.
Modern Day
o In 2010, most universities in the U.S. now offer undergraduate and graduate
programs in nursing. The American Association for Critical Care nurses estimated that, in
2009, 55,000 individuals were not accepted into nursing programs because of the stringency
of nursing education standards.
Nurse Educators come in several varieties and can be found in multiple settings.
LVN/LPN Instructors. Experienced registered nurses with a Bachelor of Nursing (BSN)
degree or higher may instruct programs for licensed vocational or licensed practical nurses.
LVNs/LPNs graduate from one-year vocational programs and practice under the supervision
of an registered nurse. Their scope of practice is more limited than an RN and as a general
rule typically includes simple hands-on tasks that do not require evaluation or decision-
making.
RN Instructors. Registered Nurses holding a Master in Nursing (MSN) or higher degree may
instruct registered nursing students in an academic setting. This may be part of a two-year
certificate program or a four-year BSN. Both degrees lead to the same RN licensure,
although today the BSN is often preferred by medical facilities and may command a higher
wage. These instructors are found at community colleges and universities with nursing
programs.
Preceptors. Experienced RNs help induct and train new graduate nurses coming into
hospitals and other medical facilities. Preceptors are vital to assisting new RNs transition into
hands-on practice in a medical facility, and in their discipline or area of expertise, such as
medical, surgical, oncology or emergency medicine.
Graduate Instructors/Professors. RNs with Doctorate of Nursing Science (DNS) or Doctorate
of Nursing Practice (DNP) degrees instruct master's and doctorate-level programs. DNPs in
particular often instruct programs for nurse practitioners, certified registered nurse
anesthetists, certified nurse midwife and clinical nurse specialists.
Nurse Educators and Shortages
A lack of qualified nurse educators is contributing to a severe shortage of RNs.
A study by the American Association of Colleges of Nursing reports that in 2008, U.S. nursing
colleges turned away nearly 50,000 qualified applicants from bachelor's and graduate
nursing programs. Two of the leading reasons the study cited were insufficient number of
faculty and preceptors.
At the same time, an April 2006 study by the Health Resources and Services Administration
projects that by the year 2020, the U.S. will face a shortage of about 1 million nurses.
In March 2008, the Council on Physician and Nurse Supply based at the University of
Pennsylvania determined that 30,000 additional nurses should be graduated annually to
keep up with America's need for RNs.
Continuing Education
In addition to formal education to become a nurse--or earning a higher degree or
certification--practicing nurses must have continuing education in order to maintain their
licenses.
Therefore, nurse educators are needed to teach all manner of courses designed to keep
practicing nurses updated on the latest medical information, techniques, procedures and
even customer service trends.
Although some courses can now be taken on-line, most continuing education is done in
lectures, workshops or courses, which typically last from a few hours to a few days. The
more time spent in the course, the more "contact hours" are credited for the course.
Nurse educators cover a broad range from highly acute areas such as cardiac and
respiratory issues to development issues like autism and even to school nursing-related
issues like lice prevention.
Another role of a nurse educator can be patient education, be it directed at individuals or the
community at large.
Individual patient education includes important information about self-care upon discharge
from a medical facility. Such lessons may include post-surgical wound care, do's and don'ts
of wearing a cast, safety precautions after a procedure or teaching a diabetic patient how to
self-inject insulin.
Other patient education may include telephonic advising via help lines and medical
insurance company services. Patients call in to speak with an experienced RN about a
situation or condition before deciding whether or not to see a physician. Nurse educators in
this role advise patients on symptoms and behaviors to observe, simple remedies and when
to seek more urgent medical care.
Nurse educators are also involved in community education.
Health educators teach their communities about such topics as healthy lifestyles and
wellness. This involves informing individuals and communities on behaviors that promote
healthy living and disease prevention. For example, a nurse educator may hold a course on
self-examinations for breast cancer for women who are at higher risk, or lessons on fall
prevention for family and caregivers of the elderly.
Academic Requirements
Nurse educators must have an extensive educational background. Nurse educators
often have a master's degree or a Ph.D., with a focus on a specific area of nursing or human
health. Nurse educators who have an expertise in a given area may often teach courses that
deal directly with that subject. Any certificates or degrees that do not directly apply to the
educator's main nursing degree, such as a certificate in child psychology, could also play a
role in the education program.
Nursing Areas
Since the nurse educators have some knowledge in several areas of nursing, they
can guide students who may not know all areas of nursing or human health. If the nurse
educator is specialized in one or two areas, it is possible that they do not know specific
techniques or details from other nursing areas. Nursing areas of study include psychology,
human anatomy, physiology, microbiology, chemistry, maternal and child nursing, research in
nursing practices, medical and surgical nursing, and general nursing practices in a clinic or
hospital.
Teaching Skills
Another qualification the nurse educator must have is the ability to create a teaching
schedule and curriculum. The nurse educator must recognize the most important aspects the
students need to know to work effectively in the nursing field and create a program that suits
the needs of the students. The educator must also teach the content in an effective manner,
provide frequent examinations, and evaluate the educational content and the teaching
process.
Clinical Nurse Specialists (CNS) are Advanced Practice nurses who hold a masters or doctoral
degree in a specialized area of nursing practice. Their area of clinical expertise may be in:
Nurse Practitioner
Nurse Practitioners (NPs) are Advanced Practice Nurses who provide care to patients
throughout the lifespan, from premature newborns to the elderly.
They perform comprehensive and focused physical examinations; diagnose and treat common
acute illnesses and injuries; provide immunizations; manage high blood pressure, diabetes,
depression and other chronic health problems; order and interpret diagnostic tests such as X-
Rays and EKGs, as well as laboratory tests; prescribe medications and therapies, perform
procedures, and educate and counsel patients and their families regarding healthy lifestyles
and health care options.
NPs can prescribe medications, including controlled substances, in all 50 states. In 25 states,
NPs have authority to practice independently.
Nurse Educator
Overview
Nurse educators are registered nurses with advanced education who are also teachers. Most
work as nurses for a period of time before dedicating their careers (part-time or full-time) to
educating future nurses.
Nurse educators serve as faculty members in nursing schools and teaching hospitals, sharing
their knowledge and skills to prepare the next generation of nurses for effective practice. They
develop lesson plans, teach courses, evaluate educational programs, oversee students clinical
practice and serve as role models for their students. They may teach general courses or
focus on areas of specialization, such as geriatric nursing, pediatric nursing or nursing
informatics.
Most nurse educators have extensive clinical experience, and many continue caring for
patients after becoming educators. Even if they no longer practice, nurse educators must stay
current with new nursing methods and technologies. This means nurse educators are always
on the leading edge of clinical practice.
With experience, nurse educators may advance to administrative roles, managing nurse
education programs, writing or reviewing textbooks, and developing continuing education
programs for working nurses.
History
Twenty years ago, the director of nursing (DON) was the most senior nurse in a
hospital, responsible solely for nursing care. As hospital leaders gained a better appreciation
of the role nurses play in patient outcomes, the DON took on a broader responsibility for all
aspects of patient care and assumed the title of nurse administrator.
Functions
A nurse administrator establishes effective patient care delivery systems, ensures
continuous quality improvement in patient care, and represents nursing as a member of the
senior leadership team when decisions are made.
Hierarchy
The nurse administrator directly supervises nurse managers or directors for
individual nursing units. She typically reports to the chief executive officer (CEO) of the
hospital.
Skills
A nurse administrator has a sound clinical knowledge base, solid fiscal management
skills, and the ability to establish and maintain effective interpersonal relationships across the
organization
Qualifications
A nurse administrator is a registered nurse (RN), and many hospitals require an
advanced degree in nursing (MSN) or business (MBA).
Read more: Nurse Administrator Description |
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