Advanced Nursing

8/12/2019 Advanced Nursing

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Running head: ADVANCED PRACTISE NURSING 1

Advanced practice nursing

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ADVANCED PRACTICE NURSING 2

Advanced practice nursing

An advanced practice nurse is a nurse prepared with advanced knowledge in the nursing

education and diagnosis and evaluation of required care. At this level, the nurses hold a

postgraduate degree in nursing and can act as a specialist or a general practitioner. The nurse is at

almost same level as the doctor only that their field of concentration is on the well-being of the

patients. In the last two decades, there has been an increase in the number of APNs as the local

and global number of nurses continue to dwindle (Hamric, 2014, p.14). The expanding

populations of elderly persons and those with chronic diseases, an increasing volume of

information and regulation, new technologies, and other innovations have increased the

complexity of care delivery and clinical decision-making. Some of these trends have created

favorable conditions for APNs. According to the American Nurses Association, contemporary

nursing practice has six essential features namely inclusion of the full range of human

experiences and a practice based on the integration of objective and subjective experience. On

top of that, they should have the ability to apply scientific knowledge, and the provision of a

caring relationship that facilitates health and healing (Hamric, 2014, p.25).

One of the licensing and credentials difficulties facing APNs is the variance in board

regulation from state to state. In some states, only the board of nursing governs advanced

practice nursing; in others, the boards of nursing and medicine; and in still others jointly

administer it, the boards of nursing and pharmacy govern it. There is also the multiplicity of role

for APNs, which is confusing to policy makers and regulators. For instance, at CMS where major

designations for Medicare and Medicaid reimbursement, set the standard for all reimbursement

of APNs across the country. In addition, discrepancies in advanced practice nursing definition


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and licensing criteria among states make mobility difficult for APNs in terms of prescriptive

authority and reimbursement. APNs are primarily answerable to individual state boards of

nursing. Credentialing of APNs ensures that they meet competency and safety standards that will

protect the public (Hamric, 2014, p.234). For there to be uniformity in the credentialing of APNs,

regulations should entail all stakeholders to avoid the problem of second licensure. The notion of

second licensure is unwelcome among the health professions but given the various routes of

entry into the nursing profession, it seems as the only way to ensure a minimum set of

competencies or requirements.

Credentialing refers to the refers to the regulatory mechanisms applied to individuals,

programs or organizations for the purpose of meeting standards, protecting the public and

improving quality. Elements for accreditation in the APN field include a masters, or doctoral in

a nursing related course. An accreditation of APN programs, national certification and in some

states recertification and finally licensure. These conditions make one a fully accredited

advanced practice nurse (Hamric, 2014, p.345). Credentialing involves the furnishing of

documentation necessary for authorization by a regulatory body or institution to engage in a

certain activities and use a certain title. It seeks to assure the public that the individuals meet

proposed standards and are ready to perform duties implied by the credential. State regulations

affect APNs in the sense that at times they have to get a second licensure from the state. National

certification is only one part of credentialing and many states use it as one vehicle to ensure a

basic level of competency to practice. Nonetheless, certification alone is insufficient to provide a

credential to perform as APN. Regulatory groups commonly request evidence of the primary

criteria of graduate education, national certification, and patient focused practice. Oversight of

specialty education for APNs will help deal with the specific of approval of specialty advanced


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practice nursing content. The clearest oversight models are those administered by the ACNM and

the AANA, which oversee and review CNM and CRNA educational programs and their review,

is separate from the overall graduate nursing accreditation processes from other bodies (Hamric,

2014, p.398).

Certain regulatory barriers exist for APNs and this limit the number of people who are

interested in joining the field. The rigorous process of acquiring accreditation is not for the faint

hearted. Furthermore, the mandatory practice requirements that are the number of adequate

clinical practice hours between the year of recertification to ensure that APNs are remaining

clinically current and competent through regular practice (Hamric, 2014, p.616). Each

certification process clearly spells out the clinical hour practice requirement for specialty. On top

of that, there is collaborative practice arrangement where there is a collegial agreement between

the APN and physician that defines parameters of practice for the APN. The specificity of the

collaborative practice depends on the trust and respect between the collaborating APN and

physician colleague. Other barriers and problems include the mandatory requirement of national

provider identifier number, which identifies health care providers.

Profession is the daily occupation that a person engages themselves in. for instance APN

is a profession that involves the taking care of patients and administering the right medication to

them. Professionalism on the hand, involves performing of duties with a lot of care and a lot of

knowledge. It also entails handling matters wisely and taking time to listen to what the other

party in the conversation wants. Professionalism in the APN field may involve the listening of

patients needs and maintaining patient confidentiality in their private matters. It involves the

handling of all patients in an equal manner without favor and giving them the right diagnosis and


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treatment. APN has evolved over time to become a pillar in the medical care world. In the 19th

century, the field of nursing involved the nurse taking care of patients and ensuring they took

medicine on time. The first half of the 20 thcentury not only witnessed growth but also the

classification of nursing into different subdivisions such as midwives and aesthetes. From 1960,

there was expansion of nursing with many schools constructed at this time. There was emergence

of clinical, pediatric nurses. There was allocation of more duties to the nurse that is from a mere

helper to an assistant of the physician. In the 80s, the practice stood on its own literally that is

there were separate classes and completely new concepts. Societal forces including wars, the

economic climate, and health care policy have influenced APN history. Providing care to people

in underserved areas by default fell under nursing throughout the twentieth and early twenty-first

centuries. Moreover, history is clear that the concept of expanding the scope of practice for

nurses was in relation to that assignment.


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References

Hamric, A. B., In Hanson, C. M., In Tracy, M. F., & In O'Grady, E. T. (2014).Advanced

practice nursing: An integrative approach.

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Advanced Nursing