NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

Jessica’s colleague is not correct. No matter if your state allows for full practice, reduced practice, or restricted practice, NPs just as RNs are accountable for providing care according to their scope of practice. Mennella and Heering (2017) state “accountability is the primary outcome of all levels of professional nurse autonomy” (p. 1). According to Park, Athey, Pericak, Pulcini, and Greene (2018), 21 states and the District of Columbia allow NPs to practice independently and have full practice authority. In NJ NPs have reduced practice authority and must have physician’s sign off on certain care decisions. I worked in LTC in NJ, we had an NP that came in weekly and did wound rounds. She was able to make care recommendations, but we had to call the primary physician to write the order for the needed treatment.

CNP (Certified Nurse Practitioner)

• Provide primary health care services to pediatrics, families, and geriatrics. These NPs can diagnose and treat illness and injuries. They can prescribe medications and diagnostic tests. Depending on the state that the NP is employed they may have to work with a physician on certain aspects of patient care. (www.nursejournal.org)

CRNA (Certified Registered Nurse Anesthetist)

• Administer anesthesia care to patients. These duties include administering anesthesia during medical and dental procedures, follow-up care, pain management and inserting PICC lines. This is a highly skilled position and requires licensing from the American Association of Nurse Anesthetists. (www.anaa.com)

CNS (Clinical Nurse Specialist)

• Work in many areas of health care including acute care, home health, and community health settings. There knowledge and skills are used to apply theory and research to practice improving patient outcomes. In my hospital the CNS works with stroke and palliative care patients. They manage care of these patients and have the ability to prescribe care based on organizational protocols. (www.graduatenursingedu.org)

CNM (Certified Nurse Midwife)

• These NPs specialize in women’s reproductive health and childbirth. They provide preventative and health maintenance, family planning, and all aspects of childbirth. They provide holistic care to the women in their care. This NP position can be stressful, emotional, and include long hours. (www.registerednursing.org).

APN Role     Median Salary
CNP                 $98,000 
CRNA             $154,000 
CNS                 $80,000 
CNM                $91,000

A nurse pracitioner master’s degree program may not be practical for Jessica to complete if she is only given 2 years to complete the degree. Also, if she accepts the administrative position she may find it difficult to complete the intensive practicum required by most programs. However, if she chooses to enroll in a program, she would probably be most suited for a clinical nurse specialist program. In this position she can still have direct patient interaction and can make a positive impact on patient care and outcomes.

Thanks for reading,

Resources:

Certified registered nurse anesthetist fact sheet. (2017, October 10). Retrieved from https://www.aana.com/patients/certified-registered-nurse-anesthetists-fact-sheet.

Certified nurse midwife. (2017). Retrieved from https://www.registerednursing.org/nurse-midwife/.

Clinical nurse specialist (CNS). (2018). Retrieved from https://www.graduatenursingedu.org/clinical-nurse-specialist/.

How to become a CNP certified nurse practitioner. (2017). Retrieved from https://nursejournal.org/nurse-practitioner/how-to-become-a-certified-nurse-practitioner/.

Mennella, H. & Heering, H. (2017). Professional autonomy and advanced nursing practice. Cinahl Information Systems.

Nurse practitioner career guide. (2018). Retrieved from https://nurse.org/resources/nurse-practitioner/. Park, J., Athey, G., Pericak, A., Pulcini, J., & Greene, J. (2018). To what extent are state scope of practice laws related to nurse practitioners’ day-to-day practice autonomy. Medical Care Research and Review, 75(1), 66-87.

I enjoyed reading your post. I also learned a great deal about the various advanced nursing degrees during the past week. I as well did not know much about the CNS role.  Clinical nurse specialists (CNS) tend to be one of the more misunderstood APRN roles. Their responsibilities may also include diagnosis and treatment, health promotion, disease management, prevention, and risk reduction. Clinical nurse specialists are registered nurses with a graduate degree in nursing at the Master’s or Doctorate level and must complete formal education in Pharmacology, Physiology, and Physical Assessment.  Very similar to our chosen FNP track. However, CNS scope of practice varies state by state but CNS’s are licensed in 28 present states. The FNP role is licensed to practice in all 50 states and has as of 2017, 22 states and Washington D.C. have granted NPs full practice authority. This is a major difference in acceptability nationwide.  I am confident that we will receive the appropriate knowledge as a foundation prior to our clinical’s to meet the needs of the AACN and board of nursing for licensure. I feel like these are safe guards that are in place to protect ourselves and the public to produce solid pracitioner’s.

Reference:

American Association of Colleges of Nursing (AACN). (2014). AACN position statement on the practice docture in nursing. Retrieved from http://www.aacn.nche.edu/DNP/pdf/DNP.pdf (Links to an external site.)Links to an external site.