Advanced Nursing

With the using of more move on ways to deliver consumer centered quality wellness cargon services the traditional professional roles of retain and doctor be being transformed. The shift from provider driven to consumer driven wellness vexation system anticipated a change in traditional ethical, cultural, and morphological doctrine of professions in the system.As such, there is distinct shift in presidential term and culture of nurse profession, which includes the way nurses argon educated, development of new breast feeding competencies, Code of Ethics, and a Code of Conduct, influences of human in force(p)s movement, opportunity policy, and legislation.There eat been kind of a number of speculations and criticism behind the establishment of advance(a) nurse act but generally a lot of potential and promises have been seen from this profession. Proof of this is that States such as Kansas have since revised their laws concerning the practice since 1999, and has generated confirmative responses thus far ( treat habituate Act changes to be introduced in 1999, 1999).Similar cases in which there was an increase in the number of advanced nursing Practiti onenessrs has withal been note in States interchange equal Connecticut, where a community of APNs started their confess discussion group until they found that their population has increase since they were established in the late 1990s (Capobianco, 1999).Definition of go nurse charge in advance(p) nursing practice at its simplest, is the attainment of further bringing up, caring skills and field of practice of registered nurses. Those who are under(a)going advanced nursing practice posses a masters or stock-still a doctorate degree in nursing, and in doing so whitethorn entitle themselves to additional certification examinations.The practicians of Advanced Nursing Practice are called Advanced Practice comforts or APNs may likewise take the depute of Certified Nurse Midwife (CNM), Nurse Prac titioner (NP), Clinical Nurse Specialist (CNS) or Certified Registered Nurse Anesthetist (CRNA) whenever required. They may too administer primary wellness care, perform mental health services, examine and prescribe medicine, do some scientific research and finally they flowerpot also teach in medical and nursing schools.As with other professions, examinations are conducted to earn and maintain licenses which some professionals claim as almost like trying to acquire a medical practice license (Advanced Practice Nursing, 2006).Another definition of advanced nursing practice comes from Jeffrey Bauer, one of the authors of Telemedicine and the Reinvention of Healthcare The Seventh Revolution in Medicine. He defines advanced practice nursing as not just the attainment of higher education and training of a nurse but also the pursuit of worth through the six foundations of professional autonomy.Bauer also noted that APNs can write out their own clinical practice and that they are p robably the solution for the rudes ever present shortage of health care practitioners (Sharp, 2000).Brown (2003) in the position statement defines advanced practice nursing as an umbrella term appropriate for a licensed registered nurse prepared at the graduate degree level with specialized knowledge and skills that are utilize within a broad range of patient populations in a variety of practice settings.The competencies of specialists include the ability to assess, conceptualize, diagnose, and analyze complex problems cerebrate to health. Credentials for a specialist require latest licensure as a registered nurse, at least a masters degree in nursing, current study certification in the advanced practice area, and approval by the tabular array of nursing, (Brown, 2003, p. 391).As such, even though there is a variety of definitions that are apply by scholars to define advanced nursing practice, there are tercet crucial features that distinguish advanced practice nursing from a incessant registered nurse graduate level advanced education, strong relevant and particular(prenominal) theoretical base, professional application of theoretical knowledge in a day to day practice.Definition and Roles of a Nurse PractitionerA nurse practitioner (NP) is an advanced practicing nurse, whose practice is focused on services that meet the general require of community, individuals, families and groups. NP is one of the four types of dances practicing nurses, the other three certified nurse midwife, certified registered nurse anesthetist, and clinical nurse specialist normally shorten on a specific area of health, such as cancer care, gerontology, mental or national health (Hickey, 2000).High level of collect for nurse practitioners that is caused by economic efficiency of these specialists as compared with doctors is a figure of the roles and focus of services provided by NP.When it comes to speaking about the scope of roles attributed to a nurse practitioner, they are broad. Earlier definitions address health promotion and ailment prevention as well as involve diagnosis and vigilance of common illnesses alongside with stable chronic diseases.Nurse practitioners roles also include ordering, conducting, and interpreting laboratory tests alongside with prescriptions, treatments, and therapies. The general roles must hence be matched with the specific theoretical background of a nurse practitioner and the field of practice (Raingruber, 2003).As such, the focus of the nursing practitioners roles is on chronic health care treatment, performance of parental, child care, well-woman and adult care check ups, and, finally, health promotion and teaching alongside with disease prevention.Primary attention is given belatedly to patient nurse practitioner relationships and the scope of NP roles in a given situation. Firstly, scholars emphasize advocacy relationships amidst the two, as there is a conflict between NPs freedom to practice and patie nts rights and interests in health care settings.Ellen W. Bernal (2002) emphasizes the importance of friendly relationships between patients and medical effect and the role of a nurse practitioner as a patients advocate. to a lower place this view, NPs are to identify unsafe and unethical practices and at the same cartridge clip maintain own autonomy in order to be able to openly stand up to moral and ethical dilemmas.At the same time, the regard to maintain treatment boundaries within the nurse client relationship is also one of the roles of nurse practitioners. As nurse find themselves working in different therapeutic settings working on his/her own or as a member of a team, the boundaries of client relationships are often a assailable to testing (Peternelj-Taylor, & Yonge, 2003).As such, one of the roles of NP is to adequately react to the testing within the boundaries of professional justice. Even though there is a large amount of literature addressing therapeutic trea tment boundaries for nurse practitioners, it is unsurmountable to address every situation and the issue still remains to be up to nurses consent, whereas the role of NP is to establish and maintain working boundaries in patient relationships.Professional Issues Surrounding Advanced Nursing PracticePerhaps, the hottest issue surrounding current ANP is the blurring line between being a doctor and ANP. To be more specific, ANPs feel as though their territory is slowly being intruded by APNs, which they believe is outrageously unfair for them who have the proper and real right to administer medical attention to patients.A drastically increasing number of ANPs in the United States, which doubled within the past 10 years and, under the most modest predictions, is likely to double within the next 4 years. The scope of the issue is broad, as in more then half(prenominal) of the states ANPs are allowed to practice without any(prenominal) distinct requirement for physician watch or collab oration (Mccabe & Burman, 2006).Going even further then this, as nurses have authority to prescribe some drugs and are eligible for Medicaid reimbursement in every state it is economically unreasonable for patients, whose focus shifted towards sustaining medicine and health care, to pay for considerably more expensive medical services provided by a physician. As such, there is a conflict between the roles of physicians and APNs, which leads to uncertainty and deprives medical students to pursue additional education.Thus, a way in which this case can be solved is by putting a leap on what an APN can and cannot do by setting-up a set of guidelines and regulations that volition sportyly state the roles of the physician and APN so that arguments like these would be avoided (Edmunds, 1999).It should be further pointed out, that the issue is very challenging, as there is a destiny to issue federal level guidelines and, perhaps, even regulates market economically in order to reso lve the current argument.Other professional issues surrounding Advanced Nursing Practice are related to patient-nursing roles, Ethical Code of Ethics and a Code of Conduct that define nursing behavior in a given situation. Being complicated and complex previously, they become a subject to even wider interpretation as a result of blurring difference between the roles of physician and APN, as they question the current hierarchy in health organizations and current reimbursement policy in health institutions.ConclusionNurses are the backbone of the intentness and thus it should be equated that a strong backbone is required for the integrity of the industry. Unfortunately, inability of government to establish in a timely musical mode guidelines for advanced nursing practice results in a conflict between the roles of a physician and a nurse practitioner, which leads to uncertainty and potential misconduct.And still, it is clear that the advantages and benefits of advanced nursing practi ces far outweigh its consequences. It should also be noted that there are boundaries and limits that are established between the two professions and that any argument regarding these should be settled in a much preferably mild-mannered and professional way. After all, professionalism is all about work and anything that is taken personally should be shrugged off.ReferencesAdvanced nursing practice update. (1999). Kansas State Nurses Association. Retrieved July 31, 2006 from http//www.findarticles.com/p/articles/mi_qa3940/is_199906/ai_n8877228/printAdvanced Practice Nursing. (15 July 2006). Retrieved July 31, 2006 from http//en.wikipedia.org/wiki/Advanced_Practice_NurseBernal, E. W. (2002). The Nurse as Patient Advocate. The Hastings Center Report, 22(4), 18.Brown, M.A., & Draye, M.A. (2003). Experiences of pioneer nurse practitioners in establishing advanced practice roles. Journal of Nursing Scholarship, 35(4), 391-397.Capobianco, M. (1999). Advanced practice nursing in the no rthwest Theres a lot possibility in our little corner of the state. Connecticut Nursing News. tribe/Nov. Retrieved July 31, 2006 from http//www.findarticles.com/p/articles/mi_qa3902/is_199909/ai_n8853925/printEdmunds, Marilyn W. (1999). Increasing professional tension limits NP opportunities. Springhouse Corporation. Retrieved July 31, 2006 from http//www.findarticles.com/p/articles/mi_qa3958/is_199905/ai_n8851221/printHickey, J. V. (2000). ANCC Responds. Perspectives in Psychiatric Care, 36(1), 33.Mccabe, S., & Burman, M. E. (2006). A Tale of Two APNs Addressing Blurred Practice Boundaries in APN Practice. Perspectives in Psychiatric Care, 42(1), 3.Nurse Practice Act changes to be introduced in 1999. Kansas Nurses. Jan. 1999.Peternelj-Taylor, C. A., & Yonge, O. (2003). Exploring Boundaries in the Nurse-Client Relationship Professional Roles and Responsibilities. Perspectives in Psychiatric Care, 39(2), 55.Raingruber, B. (2003). invoke The Fundamental Significance of Relati onship as a Paradigm for intellectual Health Nursing. Perspectives in Psychiatric Care, 39(3), 104.Sharp, Nancy. (2000). The 21st century belongs to nurse practitioners. Nurse Practitioner, April, 2000.