Introduction
With the growing number of patients requiring medical care, the need for nurses to receive advanced levels of education has grown to be more autonomous in caring for patients. Namely, additional licensing correlates with the requirement of more responsibilities based on the skills and knowledge obtained through education and practice. In this paper, advanced nursing practice will be discussed from the perspective of the scope of work, role, certification, and potential barriers correlated with advancements in nursing practice.
The Difference Between ANP and APRN
Both similarities and differences exist regarding Advanced Nursing Practice (APRN) and Advanced Practice Registered Nursing (RN). In terms of similarities, both APRNs and NPs are responsible for providing high-quality, patient-centered care and adherequiresring to professional and ethical standards (Litchman et al., 2018). Fulfilling the roles of NPs and other APRNs requires earning a master’s diploma or more advanced degrees and can incorporate patient assessments.
The role differences between NPs and the other three types of APRNs, including CNMs, CNSs, and CRNAs, are all-encompassing. The dissimilarities are structural; as an APRN role, NP includes specialization peculiar to a certain client demographic, including pediatric, geriatric/adult, neonatal, and other care providers, whereas the remaining APRN specialties are focused on nursing types rather than particular demographics (Nurse Journal Staff, 2022).
First, NPs’ roles commonly revolve around advanced care provision and working in teams, whereas CNSs can often focus on administrative tasks, health research, and care improvement or staff education endeavors. Second, compared to CRNAs, NPs are involved in caring for patients in a broader range of ways and settings; CRNAs’ responsibilities revolve around anesthesia administration or providing qualified anesthesiologists with assistance. Third, while NPs specializing in women’s health can work with pregnant patients and treat female-specific disorders, they are not qualified to supervise childbirth like CNMs.
Population-Based Roles for FNP in Primary Care
Advanced practice registered nurses can specialize in numerous groups of patients, providing them with a wide range of services. Moreover, nurses often perform medical, economic, managerial, and organizational tasks in modern medicine. Torrens et al. (2020) note that the core functions of APRNs are primary patient assessment, diagnosis, prescribing, ordering tests, and patient education. In addition, nurses with advanced education often supervise other nurses.
Family nurse practitioners provide primary care to patients of all ages, from infants to the elderly. Given the broad group of patients served by FNPs, the range of competencies of these professionals is also quite extensive. They treat patients with viral and chronic diseases like diabetes or high cholesterol. Li and Jones (2021) note that in primary care, FNPs often serve as the “usual source of care (USC)” (p. 829). In addition, family nurse practitioners are responsible for educating the patient about healthy lifestyles, nutrition, exercise, and the need for vaccination. A study by Li and Jones (2021) shows that more patients receive vaccinations after visits to the FNP. FNP’s tasks include the interaction and coordination with other nurses, as well as the creation of educational materials for colleagues and patients.
Upon graduation, I want to work in an outpatient clinic serving the Somali community. The Somali community in Minnesota is the largest in the U.S. Health problems among community members are most often associated with stress due to a change in environment and limited social interactions. Therefore, in addition to direct medical services, the FNP for this population category should also partially fulfill the role of a social worker, contributing to their adaptation. An important place in the work of FNPs with the Somali community is occupied by the process of educating patients and explaining the nuances of the health care system of the states.
Certification Opportunities
ANPs can expand their options by receiving additional training and becoming an APRN. According to the American Association of Nurse Practitioners (2022), to become an FNP, a registered nurse must apply to and graduate from an appropriate accredited program. Two organizations that offer certification for family nurse practitioners are the American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP).
Licensure, Accreditation, Certification, and Education Plan
To obtain a state license to provide medical services to patients, nurses must complete a graduate program accredited by the authorities by specialized organizations. Organizations providing accreditation for educational programs for advanced practice registered nurses must be recognized by the U.S. Department of Education or the Council for Higher Education Accreditation. During training, APRNs must complete specialized courses to deepen their knowledge of human physiology, pathophysiology, and pharmacology.
I graduated with BSN in 2020 and have been working as a nurse for about three years. Therefore, I have a registered nurse license, a prerequisite for obtaining APRN licensure. I am currently in the FNP program to gain the more specific knowledge of health assessment, physiology, and pharmacology required in the practice of APRNs. The Minnesota Board of Nursing accredits my program so I can get certified and licensed to provide medical services upon completion.
After completing the FNP program, I must pass an exam for the skills and competencies required for APRNs. American Association of Nurse Practitioners (AANP) certification is a more comprehensive exam for FNPs since it has more detailed questions about the medical ambassador provided by the family nurse practitioner. In particular, the test contains questions about assessment, diagnosis, development of a treatment plan, and evaluation of the measures taken. After certification and licensing, it is necessary to constantly maintain the knowledge level to meet modern standards of nursing practice.
Implications and Barriers
Becoming an APRN is a significant career advancement in nursing. Through continuing education, nurses gain knowledge and skills in managing a healthcare facility and caring for patients, allowing them to take on leadership positions. However, specific barriers may arise in the work of advanced practice registered nurses. These barriers result in difficulties in implementing APRNs in medical practice and reduce awareness of APRN competencies among physicians and patients.
All barriers can be conditionally divided into internal and external. As Torrens et al. (2020) noted, one of the most common problems for APRNs is that hospital management, physicians, and other nurses do not fully understand the role of APRNs. As a result, their ability to act autonomously and independently is often eroded, and restrictions are placed on their practice. In addition, APRNs are often unsure of their competence and ability to provide medical care to patients independently of the doctor.
The external political aspect is of great importance, including specific restrictions that U.S. law imposes on APRNs in prescribing and ordering tests. For example, some Minnesota pharmacology laws severely limit the ability of APRNs to define a patient’s medication. Although a course in pharmacology is required for certification, and prescribing patients’ medications is the purview of APRNs, many hospitals need nurses to take additional courses. In addition, the list of diseases that require G.P. in the Minnesota health care system is still quite extensive. However, the Minnesota APRN Coalition is actively working to resolve these issues.
Conclusion
Education in the field of nursing has expanded significantly, and nurses have received new opportunities for development. Through additional medical education, nurses can provide patients with services previously only the responsibility of doctors, such as diagnosing, choosing a treatment plan, and prescribing necessary drugs. Therefore, APRNs help to reduce the workload and number of patients per physician, thereby improving the overall quality of medical services.
References
American Association of Nurse Practitioners (2022). Nurse practitioners in primary care. AANP. Web.
Li, Y., & Jones, C. B. (2021). Care received by patients from nurse practitioners and physicians in US primary care settings. Nursing Outlook, 69(5), 826-835. Web.
Litchman, M. L., Schlepko, T., Rowley, T., McFarland, M., & Fiander, M. (2018). A scoping review of Advanced Practice Registered Nurses Consensus Model outcomes. Journal of the American Association of Nurse Practitioners, 30(12), 710–723. Web.
Nurse Journal Staff. (2022). NP vs. APRN: What’s the difference? Nurse Journal. Web.
Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the Advanced Nurse Practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies, 104, 103443. Web.