The Advanced Practice Nurse
Introduction (Definitions and Scope)
Every licensed profession has an own scope of practice for the nurses, which is legally defined according to the board of nursing in every state in the United States. The scope refers to the processes, actions, and procedures entitled to a health practitioner to keep with the terms of the professional license. In any field of practice, Advanced Practice Registered Nurses (APRNs) play vital roles in the current and future state of healthcare. There are more than 267,000 APRNs in the US, which translates into a powerful and dynamic force of the US healthcare system. A nurse with postgraduate nursing education (masters or post-masters certificate) is the one referred to as APRN. A master’s degree prepares graduates for an array of roles and areas of practice. Some graduates may undertake direct practice roles of healthcare, for example, clinical nurse leader or educator. Others may choose indirect areas and roles of health care or the areas that have an organization focus, for example, health coordinator, public health, informatics, nursing or management of health programs (American Association of College of Teaching, n.d.) The curriculum for the master’s education includes three components. The first one is the Graduate Nursing Core, which is the basic content of the curriculum considered vital for any student pursuing master’s degree in nursing no matter the functional focus. The second component is the Direct Care Core, which provides direct services for patients at a higher level. The last one is the Functional Area Content. It includes the experiences, which are instructional and clinical. Their identification and definition are done by the certified bodies and professional nursing organizations for the explicit functions and s of nursing. This paper is a compilation of the various aspects of this course. One of the aspects to be covered will be looking at the similarities and differences of advanced practice roles related to education, administration, clinical practice and primary care. The second component will be the legal and regulatory requirements for the states of California. The paper will also cover the competencies, qualities of a nurse educator, the leadership qualities that I possess at the moment and the ones I may develop. Additionally, it will give an account of the organization and the context and the population that I am planning to work with. Lastly, it will cover literature describing the current policy and what ought to be changed.
Comparison and Contrast of Advanced Practice Roles
Different advanced practice roles-nurse administrator, nurse informaticist, nurse educator and NP shows a great deal of similarities and differences in the research, administration, education, primary care, and clinical practice. These four The Joint Dialog Group addresses the four specialties as being constituents of the APN since the four must have a regulatory recognition and they offer immediate concerns for the patients (American Association of College of Teaching, n.d.). All the APRNs, regardless of the role, should have investigation as an element of the basic skills as provided in the report by the Institute of Medicine’s (IOM) Future of Nursing. According to the report, both the traditional and evidence-based research is pivotal, and it has grown to be a factor crucial in the practitioner’s direct health operations (Fitzgerald, Kantrowitz-Gordon, Katz, & Hirsch, 2012).
The roles of NP and nurse educator are direct while those of the nurse administrator and informaticist are indirect. The NPs offer comprehensive roles in a variety of areas such as prescribing medication for patients, ordering and interpreting diagnostic tests, assessing patients through the physical examination (Gardenier, Todd & Davis, 2016). They may specialize in a certain age group or a certain medicine area. They are board certified in a discrete specialty. On the other hand, the nurse educators are experts in education, having development and leadership skills to train nurses. The courses of nursing programs are a faculty with graduate level academic development and professionals who are advanced in the field of training (American Association of Colleges of Nursing, n.d.). Master’s programs are developed to fulfill the growing need for educators who can fill the education roles in the health care delivery system.
Even though the nurse administrators have a different setting with the nurse educators, both can act as mentors for other people. The educators offer nurses the required skills for the advancement of studies and the development of skills, while the administrators provide guidance and advice to the employees and colleagues. On the contrary, a nurse informaticists role is indirect. Nurse informatics is practice and science, which combines nursing, its information, and skills that enhance the health of communities, families, and individuals. According to the American Association of Colleges of Nursing, n.d.), a nurse informatic’s entry level is a master’s degree. Nurse administrators as well have indirect roles of ensuring everything is in order in the health institution. They are policy makers. They also make important decisions in the organization, representing employees and ensuring the welfare of patients. According to Nayak (2015), they are the heads of nursing agency.
Regulatory and Legal Requirements for Health Educator
My role after graduating from South University is the role of a nurse educator. The various aspects that are regulated are standards of practice, requirements for educational programs, the basis for license suspension, the requirement for collaboration, the scope of practice, as well as the requirement for licensure (American Nurses Association, 2010). The California Board of Registered Nursing provides legal the requirements that a nurse educator must meet. In the state of California, the first legal requirement is RN license. This is a requirement for all the registered nurses in all the states. They are as well supposed to complete a study program, which conforms to the standards provided by the board. The third regulation/legal requirement is the certification by the state or national government. The course content taken must be relevant to the technical practices or the knowledge required and directly or indirectly relate to the client care. They should relate to the practice’s specialty area (California Board of Registered Nursing, n.d.). The accepted courses are home study courses, Continuing Medical Education, college courses related to the area of specialty, and courses approved by other entities (California Board of Registered Nursing, n.d.). There are various unacceptable courses like the ones intended for personal gains. In California has only one organization for the nurse educators; that is, California School Nurses Organization.
There are various core competencies for a nurse educator. One of the competencies is possession of a sound understanding of the modern principles, standards, theories and models of education that underlay the curricula design and the worth of adult education. Secondly, the nurse educator should be competent in the curriculum development and implementation. Here, the educator should exhibit and demonstrate ability and skills to manage, monitor, implement and design the curriculum based on the best evidence, principles and contemporary education models. The third domain is the nursing practice where the educator is required to maintain the current skills and knowledge in the practice and theory, based on the best evidence available. Fourthly, the nurse educator should be competent of design and evidence. The educator should be able to develop the ability to conduct research and the critical inquiry to spot and solve problems associated with the education and practice. Fifth, they should be competent in demonstrating the effective communication skills, which ensure collaborative work. Sixth, they should develop competence in professionalism including the professional, ethical and legal values. Seventh, they should have competence in evaluation and monitoring. Lastly, they should be able to demonstrate leadership and system management skills develop and maintain the necessary nursing programs and shape the future of the institutions for education.
Organization and Setting, Population, and Colleagues
I plan to work at one of the community colleges in California. A nurse educator typically works in an academic setting where the duties include keeping up with the contemporary nursing skills and information, handling administrative work, attending meetings of the faculty, grading papers, mentoring students, giving lectures, and preparing for classes. With the teaching skills that I have, I am fit for being in class more than in an office. The population will be students and other nurse educators in the community school. I find it rewarding interacting with students, and I take pride in the role that I play in educating nurses to care for the patients.
There are four domains in which the leaders in the nurse education should practice leadership. The domains are health policy, system level, the nursing profession and clinical practice. It is the scope of these domains that the nurse educator should draw various qualities of a successful leadership and the leadership style. First, the nurse educators require excellent and efficient communication skills. Good communication skills mean that the educator can articulate well in writing and speech to drive every point home in a way that the intended individuals can well understand it. Again, the leader should learn to listen well, hear, internalize and understand other people’s point of view. This way, the leader can remain connected to others, and it will ensure a successful and a conducive environment in the institution. Additionally, a good leader should be committed and visionary in every operation that they undertake. Regardless of whether the operation being undertaken is personal or professional, the leader should aim at the well-being of the organization or the institution, as well as achieve the personal goals that they have set to accomplish. They should engage in personal reflection to ensure that there changes occurring in the scope and practices of nurse education for the goodness of the field of nursing at the whole and benefiting both the institution the leader is working with, as well as oneself. Good leaders are autonomous, setting their style and getting involved. They know what to prioritize depending on the urgency of the activity, as well as the requirements of the institution. They set limits, have a sense of humor. Besides, good leaders are also risk takers by being willing to get involved at any level, and they demonstrate assertiveness and self-confidence.
They are also creative. Creativity is the mother of innovation. With innovations undergoing in the institution, the leader can achieve both personal and professional visions and goals. Again, creativity makes an institution unique, which offers a competitive advantage over the others. Doing things in a different way is crucial in ensuring that the organization maintains a good position in the serving its clients. Good leaders show flexibility in that they can do the good timing for any planned activity and in case there emerges a problem that requires immediate attendance, then the leader can solve it without it costing the institution a lot of money, time or any other resources. They avoid procrastination which brings failure. Good leaders respect cultural diversity, and they are willing to work with people from different cultural backgrounds. What should matter is the person’s intellectual capability. Again, successful leaders are those that are willing to share their power for the betterment of person and the institution. Good leaders mentor are willing to mentor and empower others. The people requiring empowerment most are the students. They should constantly be motivated to ensure that they work to their optimum level (Frandsen, 2014). Lastly, successful leaders are those who are ready to build a team with the alliances. No one is perfect, and for the sake of the well-being of the field of nursing, the leader should build strong teams with similar interests.
I use democratic leadership style. To identify this style, I took “What’s Your Leadership Style?” test (Cherry, 2016) to discover my strengths and weaknesses. Democratic leaders encourage participation of other participants in the process of decision making and also retain the decisions made by the team members on a certain aspect. Other team members feel motivated by this kind of leadership. The staffs are given accountability according to the performance. As a result, the democratic leaders are more focused on the instead of looking for the problems with the individual staff member. This builds a strong relationship between the members of the team and the leader.
Naturally, as noticed while I was analyzing these leadership styles, I have most of the qualities of leadership discussed above. I have good communication skills with the ability to work with others, listen to them and talk to them. However, I need to develop eye contact while speaking to the client and other practitioners to ensure effectiveness in the passage of information. Similarly, I am a visionary leader who looks at the big picture, plan well both the short term and long term goals. I ensure that I never give up on my personal goals, as well as the institution’s to ensure successful accomplishment and go even beyond expectations. Am also autonomous, able to work with teams and make others feel like part of the organization. However, I have a weakness of the rude people taking advantage of my kindness. However, I need to develop the sense of humor. I like being on time and I respects cultural diversity.
Literature-Describe the Current Policy and What Needs To Change
I identified an issue in the policy after visiting the Robert Wood Johnson Foundation. The Department of Agriculture (USDA) and Health and Human Services (HHS) secretaries do not accept all the reports given to them by the Dietary Guidelines Advisory Committee’s (DGAC) (Goldman, 2015). The DGAC is responsible for analyzing the latest nutrition science (Health Affairs – Robert Wood Johnson Foundation, 2015; Goldman, 2015). USDA and HHS are responsible for publishing the American dietary guideline at least once in every five years. Some changes are required in the policy which can be solved mostly by educating people on the loopholes in the health programs. First, simplification of the process and the subcommittees is necessary. Additionally, lobbying and bureaucracy should as well be checked. Robert Wood Johnson Foundation (2015) tells about the lobbying of billions if not trillions of dollars by cooperates and smaller nonprofit interests. This results in a failure of numerous health programs in America such as the war on cancer (Campbell & Campbell, 2006). Torrers, Geuvara-Cruz, Velazquez-Villegas and Tovar (2015) assert that proper dietary plays a vital role in the prevention of conditions like arteriosclerosis. But, the Health Affairs – Robert Wood Johnson Foundation (2015) recognizes the role of the school in enhancing better health practices such as early childhood programs, implementation of updated nutrition standards and physical activity. My effort to drive the change in the policy is writing to the political leaders, especially the president and the top leaders in the health programs, talk with them about the major concerns in the health sector and draw them possible ways of improving its well-being. It is obvious that the American health sector is not in the best state that it should be in. This is what I could discuss with them and suggest a way of blocking the loopholes, once and for all.
In conclusion, the USA requires several changes in the policy and practice not only in the nurse education but also in the whole nursing and health sector. The changes can be introduced and implemented by the practitioners in their respective areas of practice. As a nurse educator, I possess various attributes that a medical practitioner and educator should have such as effective communication, team working skills, visionary, commitment among others. These attributes are connected to my democratic leadership style. Together, the attributes and the leadership style are crucial in meeting the competency requirements for a medical practitioner. The Advanced Practice Nurse has a wide scope, and I choose to be an educator because I have a passion of training others to take care of the patients.
American Nurses Association. (2010). Nursing: Scopes and Standards of Practice. Silver Springs, MD: Nursebooks.org.
California Board of Registered Nursing. (n.d.). Continuing Education for License Renewal. Retrieved from http://www.rn.ca.gov/licensees/ce-renewal.shtml#apcerts.
Campbell, T., & Campbell, T. (2006). The China Study. Dallas. TX: barbella Books, Inc.
Cherry, K. (2016). “What’s your leadership style?” Retrieved from https://www.verywell.com/whats-your-leadership-style-3866929.
Fitzgerald, C., Kantrowitz-Gordon, I., Katz, J., & Hirsch, A. (2011). Advanced practice nursing education: challenges and strategies. Nursing research and practice, 2012.
Frandsen, B. (2014). Nursing leadership management & leadership styles. Retrieved from https://www.aanac.org/docs/white-papers/2013-nursing-leadership—management-leadership-styles.pdf?Sfvrsn=4
Goldman, T. (2015). Dietary guidelines for Americans. Retrieved from http://www.rwjf.org/en/library/research/2015/12/dietary-guidelines-for-americans.html.
Nayak, P. (2015). Strengthening research in clinical nursing practice: Role of the nurse administrator. Nursing Journal of India, 106(2), 55-57.
Torrers, N., Guevara-Cruz, M., Velazquez-Villegas, L., & Tovar, A. (2015). Nutrition and Atherosclerosis. Archives of Medical Research, 46, 408-426. http://dx.doi.org/http://dx.doi.org/10.1016/j.arcmed.2015.05.010
WHO (n.d.) Nurse educator competencies. Retrieved from http://www.who.int/hrh/nursing_midwifery/nurse_educator050416.pdf?Ua=1.