Basically, nursing is the optimization, promotion and protection of the abilities and health, prevention of injury and illness, facilitation of healing, relief of suffering through the diagnosis and treatment of the human response, and advocacy in the care of people, groups, families, communities, and populations. What is an advanced practice nurse? An advanced practice nurse is a registered nurse with an expert knowledge base, clinical competencies for general practice, and complex decision-making skills of his or her specialty. Well, advanced practice nurses, whether nurse practitioners, nurse midwives, nurse anesthetists, or clinical nurse specialists, play an important role in the field of health care. Advanced practice registered nurses (ARPNs) are generally primary care providers always at the forefront of offering preventive care to the community.
- Responsibilities of an Advanced Practice Nurse
- Where Does an Advanced Practice Nurse Work?
- What is an Advanced Practice Registered Nurse (APRN)?
- Advanced Practice Psychiatric Nurses (APPNs)
- Advanced Nursing Practice Process
- Advanced Practice Nurse Jobs and Salaries
- Regulatory Mechanisms
- Advanced Practice Nurse Education and Licensure
- Healthy Advanced Practice Nursing
- Implications for Advanced Nursing Practice
Advanced practice nurses do these everyday functions:
- Perform comprehensive physical exams, including functional, psychosocial and developmental assessment, and obtain health histories.
- Provide patient or family counseling, education, and health promotion.
- Administer wound care, medications, and several other personalized interventions.
- Interpret patient data, maintain patient records and make important decisions about required activities.
- Coordinate care, develop differential diagnoses and arrange patient referrals or consultations with other healthcare professionals.
- Supervise and direct care offered by other healthcare providers, such as nurse aides and licensed practical nurses (LPNs).
- Conduct and take part in research studies in support of improved care, practice and patient outcome.
An advanced practice nurse works in various healthcare settings, including hospitals, medical offices, nursing homes, ambulatory care centers, schools, community health centers, and retail clinics. They can also give health care in very surprising locations such as homeless shelters, camps, prisons, tourism destinations and sporting events.
APRN is a general term given to a registered nurse with a Master’s education and clinical practice requirements surpassing the usual licensing required and nursing education of all registered nurses. A registered nurse should also offer a noticeable level of care to patients. The main types of APRNs include:
- Nurse Practitioner (NP) – works in clinics, hospitals, nursing homes, private offices, and provides a range of preventive and primary health care services, diagnoses and treats casual minor injuries and illnesses, and prescribes medication. Note that there are key differences between an advanced practice nurse and a nurse practitioner, including:
Education – NP needs a Masters of Science in Nursing while an advanced practice nurse must have a Master’s Degree in Nursing.
Typical duties – Nurse practitioner often acts as primary care medical providers, while an advanced practice nurse duties differ hugely depending on nurse’s specialization.
Prescribing medication – Nurse practitioner can prescribe medication while an advanced practice nurse has prescriptive authority depending on his own specialty.
Practice settings – NPs practice in private offices, ambulatory clinics, long-term care facilities, and community clinics while advanced practice nurse can practice in almost any health care setting.
Licensing and certification – NPs certification is available through the American Academy of Nurse Practitioners and American Nurses Credentialing Center (ANCC) while advanced practice nurse certification is available through the American Midwifery Certification Board (AMCB), and National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).
Other differences include specialization, successful personalities, common clinical collaborations and continuing educational requirements.
- Certified Nurse Midwife (CNM) – they offer low-risk obstetrical care and well-woman gynecological in hospitals, homes and birth centers.
- Clinical Nursing Specialist (CNS) – works in clinics, hospitals, private offices, community-based settings, nursing homes, and handles a variety of mental and physical health problems. Additionally, they work in research, consultation, education and administration.
- Certified Registered Nurse Anesthetists (CRNA) – this is the oldest advanced nursing specialty. CRNAs often administer more than 65% of anesthetics offered to patients each year.
The advanced practice psychiatric nurse assesses and diagnoses mental health issues, and offers treatment through psychotherapeutic and pharmacotherapeutic interventions. They work in clinical settings such as private psychiatric practices, psychiatric facilities, and community mental-health centers. Usually, they work with a lot of people, including:
- Children who are at risk for behavioral and emotional disorders.
- Adults dealing with emotional and stressful disorders, including people with chronic medical conditions, as well as older adults who are at risk for cognitive and emotional decline.
- Individuals with serious mental health problems or chronic mental illness that result in criminal behavior.
- People with substance abuse or substance-related problems.
- Homeless people, prisoners, and victims of abuse or violence.
Advanced practice nursing an integrative approach to the nursing practice which uses knowledge, experience and comprehensive skills in nursing care. Some of the levels constituting APN include direct & comprehensive care, support of systems, education, research, publication, and professional leadership. The advanced practice nursing process is the crucial core of practice for registered nurses to deliver holistic and patient-focused care.
An advanced practice nurse uses a dynamic, systematic way to collect and analyze information about a patient, which is the first step in providing nursing care. Assessment often includes physiological, psychological, spiritual, sociocultural, and economic data, as well as lifestyle factors.
The nursing diagnosis consists of the nurse’s clinical judgment about the patient’s response and potential health needs or conditions.
- Outcomes or Planning
Based on the diagnosis and assessment, the nurse plans, measurable and achievable short-term and long-term goals for the patient, including, maintaining adequate nutrition, resolving conflict via counseling, or managing pain by prescribing adequate medication. Documentation of assessment information, diagnosis, and outcomes/planning in the patient’s care plan is necessary for nurses and other health professionals providing care for the patient to use it.
Nursing care is usually implemented based on the care plan, therefore, assured continuity of patient care during hospitalization and discharge preparation. Care is normally documented in the Patient’s record.
Both the nursing care’s effectiveness and the patient’s status need regular evaluation. The care plan must also be modified as needed.
There are various nursing jobs for licensed and certified nurses. Each job has separate advanced practice nurse salary. According to the national salary data:
A Family Nurse Practitioner earns $73, 890 – $108,349
An Advanced Registered Nurse Practitioner (ARNP) earns $73,010 – $112,296
An Advanced Practice Registered Nurse (APRN) earns $74,537 – $114,987
A Nurse Practitioner (NP) earns $76,960 – $117,846
A Psychiatric Advanced Registered Nurse Practitioner (ARNP) earns $79,556 – $120,599
An advanced practice nurse has to follow some specific regulations in the nursing practice:
- Right to diagnose.
- Authority to prescribe treatment and medication.
- Authority to refer patients to other health professionals.
- Authority to admit and discharge patients from hospitals.
Governance of the advanced nursing practice includes:
- Establishing necessity for first licensure & retaining. This involves basic/continuing education, and competency.
- Interpreting the extent of advanced nursing practice parameters.
- Investigating licensees’ complaints and disciplinary actions.
A Diploma in Nursing was the most common path to registered nurse licensure and a nursing career, it is available via hospital-based nursing schools.
Degree in Nursing (ADN) is a 2-year degree offered by hospital-based nursing schools and community colleges that prepare a person for a more advanced practice nursing.
Bachelor of Science in Nursing (BSN) is a 4-year degree offered at universities and colleges.
Master’s Degree programs (MSN) well-prepares advanced practice nurses, nurse educators and nurse administrators.
Doctor of Philosophy programs (Ph.D.) are research-focused where graduates typically conduct research and/or teach.
Doctor of Nursing Practice programs (DNP) focus on leadership roles and clinical practice.
Education programs prepare advance practice nurses to engage in professional nursing practice crossing all healthcare settings. It is also necessary to lead in a greater understanding of political, social, cultural and economic issues that influence healthcare delivery and affect patients.
A healthy advanced practice nurse is one who regularly focuses on creating & maintaining a balance of physical, emotional, intellectual, spiritual, social, spiritual, professional and personal well-being. A healthy nurse should live life to the fullest capacity, across the illness or wellness continuum, because they are stronger role models, educators, advocates, and educators, for their families, communities, work environments, and mostly their patients.
Advance practice nurses are the most trusted profession, and capable of making a great difference! By choosing an active lifestyle, nutritious foods, living tobacco-free, managing stress, getting preventive screenings and immunizations, and choosing protective measures like wearing gloves, bicycle helmets, and sunscreen, nurses can set a good example on how to stay healthy.
The advanced nursing practice also needs a healthy working environment which is empowering, safe, and satisfying. Physical, social and mental well-being supports optimal safety and health. All nurses form a part of the patient-centered team, therefore, they should embrace the culture of safety, where they are responsible for working with a sense of accountability, efficiency, effectiveness, transparency, involvement and professionalism. All advanced practice registered nurses should mind the safety and health for healthcare workers and most importantly patients in any healthcare setting. This provides a sense of respect, empowerment, and safety to and for all people.
A health risk appraisal by HIPPA gives registered nurses real-time data on their safety, wellness and health, personally and professionally.
Optimal staffing is important to offer optimal patient care. Staffing is crucial in influencing the safety of both nurses and patients.
Ensuring adequate nursing staff levels helps:
- Reduce medication and medical errors.
- Decrease patient complications.
- Decrease mortality.
- Improve patient satisfaction.
- Reduce nurse fatigue and burnout.
- Improve nurse retention and job satisfaction.
Overall, the nursing profession or practice is a greatly respected and highly sought-after career. For those who are considering a change in careers or have just finished school and are thinking of what career path to pursue, look no further! Nursing has many benefits and advantages. From job flexibility in schedules, career and locations to personal satisfaction and meaningful work like empowering patients.