NURS 6003 Week 10 Discussion Examining Nursing Specialties1
My first step when choosing a nursing specialty within the program was to know what I absolutely did not want to do within this profession. I Immediately knew that I was not interested in psychiatric nursing, pediatrics or maternity. Nursing education is a specialty that I am very interested in, but not at this time. I would love to be an adjunct faculty at a college or university once I have been a nurse for 15 years or greater. Having been a nurse for only 7 years, I believe that gaining more experience in the field will help me to become an even better instructor. Moreover, I realized that I was no longer interested in working in a hospital setting so the acute care nurse practitioner program also did not seem like a good fit for me. I chose the adult gerontology primary care nurse practitioner (AG PCNP) program because I wanted to work with the older population and build long-term relationships with my patients. I also like the fact that this specialty’s scope of practice is based on patient needs rather than the setting itself (Adult-Gerontology NP Competencies Work Group, 2016).
Professional organizations seek to advance the profession and interests of its members. However, the cost of membership can be a deterrent for many nurses especially if a nurse wants to become a member of multiple organizations. Since membership to these organizations comes at a cost, it would behoove the nurse to take time choosing an organization to join. Choosing the right organization includes ensuring that membership in a particular organization is in line with personal and professional goals (Echevarria, 2018). As a future AG PCNP, I am interested in becoming a member of the American Association of Nurse Practitioners (AANP). I believe that no matter the specialty, it is extremely important to build a solid foundation as I advance in the nursing profession in a new role. This organization provides flexibility with membership, offering six options for membership based on where you are in your career. For example, there is a student NP membership with an annual fee of $55. This membership is made specifically for the student nurse practitioner who does not have experience in the role. It provides opportunities for networking and free continuing education courses to facilitate career growth (American Association of Nurse Practitioners, n.d.). In order to apply for membership, simply click the link that says “Join AANP” and the user will be redirected to another page for which they will be given prompts to join. Licensing information is required and the annual fee is due at the time of registration (American Association of Nurse Practitioners, n.d.).
References
Adult-Gerontology NP Competencies Work Group. (2016). Adult-gerontology acute care and primary care NP competencies. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/NP_Adult_Geri_competencies_4.pdf
American Association of Nurse Practitioners. N.d. Membership. Retrieved November 1, 2021 from https://www.aanp.org/membership
Echevarria, I. M. (2018). Make connections by joining a professional nursing organization. Nursing, 48(12), 35–38.
Thank you for providing details on your professional nursing journey. I sympathize with your struggles on deciding where you feel you are a best fit after achieving your graduate nursing degree. We are similar in our choices, I also did not see myself working in psychiatric or maternal-fetal medicine. I have been working in acute care and recently made the switch from the FNP program to the Adult-Gerontology Acute Care Nurse Practitioner program.
Adult-Gerontology Primary Care nurse practitioners (AGPCNP) are responsible for developing relationships with their patients that will assist them in preventing acute exacerbations of chronic diseases and the development of new illnesses.
According to the American Association of Nurse Practitioners (2020):
Many AGPCNPs work in long-term care settings, hospital-based clinics and private practices, which may require them to obtain medical histories, perform physical examinations, order screening tests, interpret diagnostic tests and administer age-appropriate pharmacological and nonpharmacological therapies. AGPCNPs may also manage transitions between care settings, provide patient and caregiver education and evaluate caregiver competence (para. 2).
You described that you want to develop strong patient-caregiver relationships, so I feel that you are making the right choice. These patients will be part of your long-term clientele, so when you are making decisions based on their health status, you will be well aware of not only their health history, but of social, environmental, and financial factors that attribute to their health.
Since you expressed interest in primary care and nursing education, I feel that this puts you in an interesting position to become a nursing leader. Primary care will allow you to understand the influence of laws, public policy, and epidemiology on the health of your patients. It is important that you are aware of health policy because it will affect the care that your patients receive, as well as insurance premiums, medication affordability, and more. As a nurse educator, your job will be to teach the foundations of nursing to students who will develop their own self-concept as a nurse and hopefully seek out leadership roles. The profession needs nursing leaders to influence policymakers to create laws that improve healthcare working conditions and protect staff and patient safety. The AGPCNP competencies include a section on policy. These competencies explain that professional nurses should advocate for healthcare laws that dismantle barriers to care, understand the policymaking process and the factors that influence laws, and evaluate the effects that health policies have not just on a single area, but across the globe. Ultimately, the nurse practitioner should promote improved delivery of services to the patient to improve safety and health outcomes (Adult-Gerontology NP Competencies Work Group, 2016). I hope you give this some thought as nursing education really needs to include policy development! We need nurses invested in leadership and transformation of the field.
Great post!
If you asked me 13 years ago where I saw myself in nursing, I would have told you the only place for me was as a trauma nurse. In no fantasy did I ever imagine that I would want to have any involvement in psych of any kind. As I have grown in nursing, parenthood, and friendship, I have discovered that psych nursing is where I want to be, but not in the way that I understood the profession to exist all those years ago. I am highly motivated to be a PMHNP to help people with addiction recovery or with reproductive health needs. Hopefully, as I learn more in my courses and clinicals, I will identify which population will be a better fit for me professionally. In the past, I considered FNP but my heart was not in it. I have had personal experiences with both of the psychiatric populations that brought me to this path, and I feel like working in either will feel like less of a job and more of a mission.
Research shows that nurses who participate in professional organizations demonstrate increased advocacy and work toward advancing the nursing profession (Cherry et al., 2019). The American Psychiatric Nurses Association is a professional organization that I joined when I started this program to connect with other nurses and APRNs who practice in the field of psychiatric nursing. Full-time nursing students can obtain membership at a discounted and affordable rate of $25 per year (American Psychiatric Nurses Association, n.d.). The website states that membership provides not only opportunities for social networking, but also classes for continuing education credits, and access to peer-reviewed research databases. Another professional organization that is affiliated with my specialty is the International Society of Psychiatric-Mental Health Nurses. This organization has four divisions and one that is of special interest to me is the International Society of Psychiatric Consultation-Liaison Nurses because if I decide to work in reproductive health, it will be as a secondary service to the patients who are undergoing medical evaluation and treatment. The membership for this organization runs on a fiscal year calendar and is also discounted for students in advanced practice psychiatric-mental health nursing programs however may not vote or hold office (International Society of Psychiatric-Mental Health Nurses, n.d.). I found this resource while working on this discussion post and have since joined as a member to help me in my educational journey.
References
American Psychiatric Nurses Association. APNA. (2021, October 22). American Psychiatric Nurses Association. https://www.apna.org/.
Cherry, B., Caramanica, L., Everett, L. Q. , Fennimore, L. & Scott, E. (2019). Leveraging the Power of Board Leadership in Professional Nursing Organizations. JONA: The Journal of Nursing Administration, 49 (11), 517-519. doi: 10.1097/NNA.0000000000000805.
International Society of Psychiatric-Mental Health Nurses. (n.d.). Membership. https://www.ispn-psych.org/assets/docs/ispn-divs-councils03.pdf.
When I first entered the nursing profession, my goal was to become a pediatric acute care nurse, transfer to the pediatric intensive care unit, then eventually specialize as a pediatric endocrinology nurse practitioner. Nursing is a great career field because it makes you flexible and adaptable. After I had a clinical rotation of pediatrics, I realized that acute care pediatrics was not my passion and that I was more suited for adult-gerontology acute care nursing. After 2 years of progressive care nursing, I transferred to an intensive care unit where I found my passion for critical care.
Critical Care
Ever since I started working in a critical care setting, I have gained a deeper understanding of anatomy and physiology, pharmacology, and interpretation of labs. More importantly, I have improved my assessment skills, implemented new interventions, and collaborated with the multidisciplinary team to achieve patient goals. I care for multiple different types of patients in my line of work, and this connects to the nurse practitioner competencies set by the National Organization of Nurse Practitioner Faculties. For example, their competencies are separated based on different aspects of healthcare, such as leadership, technical skills, research, cultural sensitivity, and ethics (National Organization of Nurse Practitioner Faculties, 2017). While caring for my patients, evidence-based research methods set the standard for my drug administration, assessment tactics, and communication. I use ethics to approach patient care in a non-biased manner and apply cultural sensitivity for a thorough psychosocial assessment. This is useful when holding critical conversations with the families of very ill patients. To prepare for my time as an independent nurse practitioner, I try to gather as much information about the patient so I know how to develop my own plan of treatment. What does the patient understand about their situation? Do they have the financial resources to obtain medications or other treatment measures? What is their family dynamic like, and what goals does the patient wish to achieve during their care? These are just some examples of the assessment pieces I have learned throughout my time in the intensive care unit.
My Concentration
I had many difficulties in deciding my area of concentration for my master’s degree. Initially, I chose the Family Nurse Practitioner (FNP) program because I wanted to treat patients in outpatient endocrinology. As a former pediatric diabetes patient, I worked with multiple nurse practitioners in an this setting to manage my disease through education, diabetes technology, and frequent labs and visits. I wanted to enter this role myself so I could help educate other patients, especially new pediatric patients and their families, because I understand the mental, physical, financial, and psychosocial difficulties that are associated with diabetes. However, my nursing journey led me in a different direction to critical care, a field that I also thoroughly enjoy because of its challenge. Critical care nursing has increased my knowledge of nursing and medicine to where I am comfortable in emergent situations, and it is a rewarding feeling to see interventions change the trajectory of a patient’s life. Ultimately, I decided that the Adult Gerontology Acute Care Nurse Practitioner (AGACNP) program was more conducive to my learning and success as a future healthcare leader. My entire nursing career has been spent in adult acute critical care, and I have grown to love the challenge of treating critically ill patients, medication titration and vent management, and multidisciplinary collaboration. Acute care will allow me to work in roles such as a critical care nurse practitioner or a hospitalist. I would collaborate with physicians to perfrom interventions such as central line placement, arterial line placement, continuous renal replacement therapy, and more. Initially, I was hesitant to stay with acute care because of my passion for diabetes management. I have found that some nurse practitioners that I work with are specialized and work in an acute and outpatient setting. This drove me to ultimately choose the acute care program because I could have a balance of acute and primary care practice and still eventually specialize in endocrinology if desired.
Professional Organization
The American Association of Critical Care Nurses (AACN) is a professional organization that is related to my chosen area of practice. The AACN is “…a nonprofit association, is more than the world’s largest specialty nursing organization – we are an exceptional community of acute and critical care nurses offering unwavering professional and personal support in pursuit of the best possible patient care” (American Association of Critical Care Nurses, n.d., para. 1). To join the AACN, prospective members can apply on their website and pay an annual membership fee. The AACN has discounted costs for nursing students who want to join their organization. The AACN also holds conferences, opportunities for continuing education credits, scholarships, and opportunities for volunteer work. There are many benefits to joining a professional organization. In acute care, my job will be affected by changes in health policy, new research, and health trends, such as disease outbreak. A professional organization will present relevant evidence-based research and help with my commitment to lifelong education. In addition, there are leadership opportunities present within these organizations. Eventually, I would like to seek leadership roles in health policy once I am experienced as a nurse practitioner. In a leadership role, I would have to be more cognizant of changes to health policy and programs, as well as collaborate with other nurses and members to influence policy and promote positive patient outcomes (Cherry et al., 2019).
I feel that I am well-suited for acute care practice. The knowledge that I will gain as a nurse practitioner will enable me to promote health behaviors in my patients, educate patients on diabetes management, and even advocate for changes in health policies, programs, and nursing staff ratios at the state or federal level.
References
American Association of Critical Care Nurses. (n.d.). About AACN. Retrieved November 3, 2021, from https://www.aacn.org/about-aacn
Cherry, B., Caramanica, L., Everett, L. Q., Fennimore, L., & Scott, E. (2019). Leveraging the power of board leadership in professional nursing organizations. JONA: The Journal of Nursing Administration, 49(11), 517–519. Retrieved November 3, 2021, from https://doi.org/10.1097/nna.0000000000000805 National Organization of Nurse Practitioner Faculties. (2017). Nurse Practitioner core competencies [PDF]. Retrieved November 1, 2021, from https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf
This is an outstanding work Clinton. You have provided a thoughtful and detailed discussion about how you arrived at working in a critical care setting. I agree with you that working in a critical care setting is exceptionally challenging (Khan et al., 2019). Working in a critical care needs physical and emotional strengths, and ability to balance various variables in relation to the condition of the seriously ill patients. Critical care nurses should be ready to face challenges such as long working hours, emotional burnout, stress, and work overload, which can lead to disparaging changes in the body (Bloomer, 2019). Importantly, critical care nurse should be ready for exposure to death. In critical care setting, death is stable reality. Working tirelessly for a long hours to keep a critically patient alive, only to see them die, can be stressful and overwhelming for nurses (Sole et al., 2020). This can be emotionally draining to some nurses. As such, critical care nurses should develop various self-care techniques that can be utilized to address loss in healthy ways.
References
Bloomer, M. (2019). Palliative care provision in acute and critical care settings: what are the challenges?. https://doi.org/10.1177/0269216319891789
Khan, N., Jackson, D., Stayt, L., & Walthall, H. (2019). Factors influencing nurses’ intentions to leave adult critical care settings. Nursing in critical care, 24(1), 24-32. https://doi.org/10.1111/nicc.12348
Sole, M. L., Klein, D. G., & Moseley, M. J. (2020). Introduction to Critical Care Nursing E-Book. Elsevier Health Sciences.
I agree with you that as one grows in the nursing field, they become self-aware and can select the nursing specialty that fits them best. Choosing the right nursing specialty can sometimes be challenging. Even though one may feel excited to be in the nursing profession, deciding the type of nurse is one common question aspiring nurses ask themselves. From the moment one expressed their interest in nursing, they have known they want to work in a particular nursing specialty. Also, others may feel that they have been called to do the general nursing concept. However, others change their specialty interest once they become more self-aware. Self-awareness is crucial when choosing a nursing specialty. For example, an introvert may choose a nursing specialty that deals with nursing informatics and nurse researcher. Nevertheless, if one enjoys a more predictable and routine work situation, one may consider being a school nurse. If an individual wants to enjoy more autonomy, they may choose to become a nurse practitioner. According to Burger (2020), as one becomes self-aware, one selects the nursing specialty that fits them best.
I agree with you that nurses should consider joining professional organizations. According to Cline et al. (2019), professional organizations are beneficial to nurses as they help them improve their professional network, clinical skills, and prospects in their careers. I am glad that you are already a member of the American Psychiatric Nurses Association, and I hope the organization will help you achieve your educational goals.
References
Burger, C. (2020, February 20). How to decide which nursing specialty is right for you. Trusted Health – For The Modern Nurse. https://www.trustedhealth.com/blog/decide-right-nursing-specialty-for-you
Cline, D., Curtin, K., & Johnston, P. (2019). Professional organization membership: The benefits of increasing nursing participation. Clinical Journal of Oncology Nursing, 23(5), 543-546. https://doi.org/10.1188/19.cjon.543-546
Thank you for providing your experiences in nursing that led you to your current career path. I commend you on your decision to choose mental health as your practice area. Mental health conditions are not always recognized as a legitimate illness by healthcare providers. We need more nurse leaders to advocate for people with mental illness to receive necessary treatment and improve the public perception of mental health. According to the National Institute of Mental Health (n.d.), “Nearly one in five U.S. adults live with a mental illness (51.5 million in 2019)” (para. 1). Traumatic events such as the COVID-19 pandemic have exacerbated mental illness and this has in turn elevated the need for mental health nurse practitioners. I found an article published in the Journal of American Psychiatric Nurses Association that describes the future workforce of mental health nurse practitioners. The article details the barriers to bringing more professional nurses into this field, such as unclear practice scopes, inadequate educational programs, a poor public perception of dealing with mental illness amongst healthcare professionals, and lack of effective clinical rotations to prepare students for mental health nursing. In addition, there will be an increased demand for psychiatric nurse practitioners since existing mental health professionals, such as licensed psychiatrists, are retiring. Overall, there are opportunities to introduce nursing students and retain existing nurses into mental health nurse practitioner programs. There is urgency for retiring practitioners to transition into educational role in these programs, so that the new generation of nurse practitioners are adequately prepared to deal with mental health crises. In addition, there is a call for more effective residencies to be established that encompass more mental health topics, such as substance abuse and pediatric mental health. If educational programs that truly reflect the mental health work environment are created, then more students who are truly passionate about mental health will be more likely stay within these programs, because they are truly reflect the real-life experience of psychiatric nursing(Delaney & Vanderhoef, 2019).
I appreciate that you want to become a PMHNP because of substance abuse and addiction medicine. I was researching other organizations that you could join in preparation for this role and I came across The National Association of Alcoholism and Drug Abuse Counselors (NAADAC). This organization is committed to providing support for multiple addiction professionals, educators, and healthcare professionals that work within the realm of substance abuse.
According to the National Association of Alcoholism and Drug Abuse Counselors (n.d.):
NAADAC promotes excellence in care by advocating for the highest quality and most up-to-date, science-based services for clients, families and communities. NAADAC does this by providing education, clinical training and certification. Among the organization’s national certification programs are the National Certified Addiction Counselor, Nicotine Dependence Specialist credential and the Masters Addiction Counselor designations (para. 5).
I think that by joining this professional organization, it would give you an opportunity to understand more about this area of medicine and ultimately lead you to gain a certification for addiction and substance abuse mental health services. I wish you well on your educational journey and applaud the work that you are doing!
