Advanced Practice Roles in Nursing
The starting point of all current-day nursing practices is a registered nurse. The current standards and policies with respect to education and legal regulations for attaining a basic first-level nursing standard weren't always fixed. For that matter, there weren't always professional nurses, either.
Specialist nurses can be considered as the primary product of nursing's professional evolution. The basis of the advanced nurses of today was established in the advent of specialist nurses in America. They were recognized in practice from the latter part of the 19th century; in the 1930s-1940s, the number of specialist nurses in USA grew. Clinical nurse specialists (CNSs) have become strongly recognized in the field of nursing since the 1960s. The Clinical activities of these nurse specialists were usually considered to be within conventional nursing practice domains, though their expertise was normally extended. Thus, CNSs were not considered to pose any particular threat to the conventional, broader healthcare system's arrangement. More recently, CNSs are intimately and commonly linked with advanced nursing concepts; this relates to the significant growth of advanced nursing (Development of Advanced Nursing Roles, 2012).
Contrary to the relatively extended evolution of specialist nurses, research scholars initiated the role and/or concept of nurse practitioner in pace with the initiation of a new pediatric primary healthcare role in 1965, in the United States (U.S.). The role was set up based upon specialist nurses' extensive functional capabilities; however, it also included conventional therapeutic diagnostic skills. It is stated by researchers that the necessity for this change arose from practical issues as well as social concerns of the present age, such as insufficiency of pediatricians. Initially, it is likely that there may have been some disquiet concerning the potential repercussions of transcending former professional limits on nursing practice's potential scope. This was predominantly significant in an era when more autonomy as well as distance from medical authority's long-established dominance was achieved by nurses (Development of Advanced Nursing Roles, 2012).
Many other important professional improvements in the 1990s and the early part of the previous decade led to future advanced nursing; this includes the institution of consultant nurses by the government (Development of Advanced Nursing Roles, 2012) as well as the introduction of legislation for non-medical prescriptions. Growth in the 1990's also contributed in different and significant ways to the development of advanced nursing (Development of Advanced Nursing Roles, 2012).
Role of Nursing Practitioners (NPs) in Advanced Nursing Practice
What is a Nurse Practitioner? One set of definitions describes the NP as a particular type of registered nurse who performs 'advanced practice'. Generally speaking, NPs are highly educated, with at least a bachelor's degree as well as their registered nurse license. Furthermore, the NP has clinical experience and additional education, depending upon the particular state where the NP chooses to practice. The functional role of the NP is fairly analogous to that of a physician, generally including the ability to prescribe pharmaceuticals and order laboratory tests as needed.
Studies indicate that NPs as well as other healthcare providers are trained for, and deliver, several primary care functions. Thus, they may be capable of facilitating increased accessibility to primary healthcare, especially in under-served localities. The term Advanced Practice Registered Nurse (APRN) is used to denote those nurses who, by way of graduate-level educational qualifications, have acquired advanced clinical skills and knowledge enabling provision of direct medical care to patients. Training is provided to APRNs through graduate and postgraduate courses in pharmacology, advanced health evaluation, physiology and other sub-disciplines of medicine.
NPs can be considered to be the largest cluster of APRNs. They practice in various areas of population focus, including family practice, women's health, geriatrics, and pediatrics. NPs constitute the most commonly-found non-physician suppliers of primary health care. They offer comprehensive services that include disease prevention, counseling, and health promotion. National licensing boards dictate the total range of services that can be performed by NPs, such as hospital admissions, prescribing of drugs, and diagnosis of patient ailments. Individual hospitals and Medicaid agencies can further enhance activities permitted for NPs. Half of the states in the U.S. allow NPs to carry out their practice independent of supervising physicians to a large extent. This includes diagnosis, treatment, referring patients (though not essentially prescribing except for medications); in some instances, significant limitations are imposed on the scope of the services that NP are allowed to provide. The laws for NP licensure, as well as regulations and certifications pertaining to the practicing limits of NPs differ widely by state; they are often not as broad or extensive as the APRN training (Schiff, 2010).
Role of Nurse Educators in Advanced Nursing Practice
Some features of efficient clinical training include particular...
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