Advanced Practice Competencies: Nurse Practitioner

A family nurse practitioner (FNP) is a member of the health care team who provides quality and cost-effective care to patients across the lifespan, from newborn to old age. They provide care in various healthcare settings such as outpatient clinics, hospitals, community health centers and public health departments. They focus on disease prevention, health and wellness promotion. The FNP empowers patients through patient education and partnerships in clinical treatment decisions (Hamric, 2014; “Nurse Practitioner,” 2014). How does one become an effective Family Nurse Practitioner?

These studies illustrates that NPs can play a key role in providing services to health care market. NPs provide a full range of high quality care to patients of all ages. These services include primary care, acute care, special health care services such as oncology, gerontology health, or women’s health to name a few (American Association of Nurse Practitioners (AANP), 2015). NPs practice in many health settings, including private physician office, hospital, urgent care site, emergency room, community health center, school, and others. Family Nurse Practitioners (FNPs) are NPs are primary care providers who focus on

Objective One During my clinical day three, I demonstrated entry-level competence in professional nursing practice in caring for patients with multiple and/or complex unmet human needs. I addressed safety needs, safety in medication administration, effective communication, and surveillance for my patients. First, I addressed safety needs my ensuring the appropriate safety measures were implemented for the patients. Some of the safety measures included, wearing non-skid socks, wearing a yellow armband which indicated fall risk, keeping the bed in lowest position, two side rails up, bed locked, and the call light within reach.

The role of Nurse Practitioner came into inception in the mid 60s. This was in response to a shortage of physicians across the nation. With the demand for primary care services for all ages, one option to close the demand gap and increase the number of providers is the option for states to revisit the laws governing how Nurse Practitioners practice and provide care to patients in different settings like hospitals, outpatient clinics and others. Whether they work autonomously or under a physicians' supervision, their scope of practice involves but is not limited to assessment and planning with a goal to provide the the best care for optimal patient health and outcomes.

The role of the Advanced Practice Registered Nurse (APRN) is multifaceted. According to the Consensus Model for APRN Regulation (CMAR), the APRN is a registered nurse (RN) who has a finished an accredited graduate-level program to become a particular APRN. The APRN expands one’s expertise beyond the practice of an RN to provide more autonomous and comprehensive care (APRN Consensus Work Group & National Council of State Boards of Nursing [NCSBN] APRN Advisory Committee, 2008). Upon reviewing the American Nurses Association’s Standards of Care and Professional Performance, the CMAR, and the local state’s Nurse Practice Act, the APRN may gain insight into one’s scope of practice. However, there are strengths and weaknesses associated with these APRN standards and scope of practice statements that the APRN must consider.

This nurse’s plan as a registered nursing and student is to become an Advanced Registered Nurse Practitioner (ARNP) with a specialty certification in Family Nurse Practitioner (FNP). The geographical area in the state of California is in a community with patients having health disparities and it is an underserved population. Healthy people 2020 identified patients with healthy disparities as lesbian, gay, bisexual, or transgender, personnel living in nursing homes with disabilities, individuals living in rural areas, and women households with children (Centers for Disease and Control, 2015). The writer’s role as a FNP working in these underserved population will include doing assessments, diagnosis and treatments of common conditions, as well as preventative care services such as ordering laboratory work, medical tests, and prescriptions (American Association of Colleges of Nursing, 2015; National Organization of Nurse Practitioner Faculties, n.d).

It is important to understand the profession of the Advanced Practice Nurse. To understand the profession, a plan of action must be in place. First one must understand the scope and practice that the state requires. This has to be researched and understood what is expected of the practitioner. Once the practitioner knows what is expected, it is time to reflect on strengths, weakness, goals and objectives.

The administrator's job is to make sure everything is on top of its game and the Director of Nursing is doing his/her job. The Director of Nursing’s job is to make sure The LPN (License Practical Nurse)

“The NP is an APRN who provides health care to a group of patients, usually in an outpatient, ambulatory care, or community-based setting (Potter, Perry, Hall & Stockert, 2013, p. 8).

The controversy over the roles of physicians and nurse practitioners in primary care in the United States has been heatedly discussed over the past years. Although many may not even know the difference between the two, the issue is very important to those with the careers. A nurse practitioner is an alternative career for professionals who want to work in advanced healthcare but do not wish to make the commitment necessary to become a physician ("Nurse Practitioner vs Physician Assistant."). Physicians and nurse practitioners are different in their education and approach to care. Physicians study medicine and disease, while nurse practitioners study how to care for the sick.

The guidelines set by the NP’s Core competencies involves educational programs for nurse practitioner and are referred to as essentials behaviors for all NPs (The National Organization of Nurse Practitioner, ([NONPF],2017). As a future NP, this course has echoed the importance to critically examine information given by finding evidence to support and manage care for the individual or the population, which I will apply to my practice. This, in turn, will offer better treatment plan and optimize better patient outcome. Using the differential diagnosis to pinpoint the best possible diagnosis for individuals has helped me to use critical thinking about my patient and to find the appropriate plan of care.

First, it is important to define what it means to be an “Advanced Practice Nurse” in the state of Indiana before we can look at the stipulations set. It is defined as a registered nurse who is currently holding: knowledge acquired from a formal, and organized institution of learning, and additionally, clinical experience, or a stated board approved equivalent.

350). Due to the increase in accountability of FNPs to provide safe, quality, and cost-effective health care, it is imperative that the nurse is fully prepared for practice as a nurse practitioner (NP). The outcome of the NP’s role transition can be inhibited or promoted by different transition conditions, such as the environment, availability of resources, support, and nursing experience. All of which fall into the lines of Meleis’s types of transition, making the process complex and multidimensional (Meleis, et al., 2000, p. 18). The role of nurse practitioners has extended in practice to provide comprehensive care.

State and local legislatures also worked to get NP's more prescriptive privileges. (Marchione et al., 1980) Although many advances had been made within the role of the NP, there was still some confusion regarding their educational requirements as well as scope of practice. Then, more recently in 2008, The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education, further defined the role of the advanced practice registered nurse and its' educational requirements. The model defined the educational requirements as "formal education with a graduate degree or postgraduate certificate awarded by an academic institution and accredited by a nursing or nurse-related accrediting organization."

Importance of nurses A nurse is a health care professional who is engaged in the practice of nursing. Nurses are men and women who are responsible (along with other health care professionals) for the treatment, safety and recovery of acutely or chronically ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings. Nurses may also be involved in medical and nursing research and perform a wide range of non-clinical functions necessary to the delivery of health care. Nurses develop a plan of care, sometimes working collaboratively with physicians, therapists, the patient, the patient 's family and other team members.