...Should APNs have hospital admitting privileges? How would admitting privileges affect the role of the APN? The United States has the big opportunity to transform its health care system. The nurses play a fundamental role in this transformation. More often the advanced practice nurses (APNs) are the focus of a new wave of scope-of-practice bills. New measures are introduced to state lawmakers every year. They address issues like independent practice, doctor supervision of nurses, prescribing authority, or extended prescribing, including of controlled substances (American Medical News, 2008). In October 2010, the Institute of Medicine released a report recommending that states and the federal government remove legal barriers that prevent APNs from practicing to the full extent of their education and training. One of the barriers, that was not mentioned here, was APNs hospital admitting privileges. APNs are playing a great role in addressing access-to-care shortages and are working on the front lines of patient care. Due to health care costs, increased patients acuity and physician shortages APNs should have hospital admitting privileges. Physicians, however, worry patient safety will be compromised if APNs will work outside a physician-led team. They support advances in nursing education but testing and training differences are making them to worry (AMN, 2009). Only nurse doctorates consider themselves primary care practitioners qualified to diagnose and treat patients. But,...
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...knowledge about the rules of the roads and laws, but as the driver learns the rules and practices, then they become a safer driver (Hill, 2010). Similarly are the different levels of nursing. The new driver can be compared to the associate degree nurse (ADN) and as knowledge is mastered, the nurse continues to a baccalaureate degree (BSN) and then to an advanced practice degree (APN). The progression of academic experience promotes higher levels of patient care (Spencer, 2008). The purpose of this paper is to use scholarly research to discuss the difference in competencies between nurses prepared at the ADN level verses the BSN level, using a patient care situation to describe differences in approach to nursing care. First we will define the difference in competencies between an ADN, BSN, and APN. Differences in Competencies Educational levels in nursing hold different competencies. All nurses must pass a state board exam, regardless of their educational level, to enter the profession. There are four levels of nursing which include the ADN, BSN, APN, and clinical nurse leader (CNL). Although the CNL will not be discussed, the ADN, BSN, and APN will be discussed in detail (Cresaia & Friberg, 2010). First, we will discuss the ADN. Associates Degree (ADN) The ADN requires two years of study in nursing theory and skills. The ADN provides education for entry level of care in a hospital setting (Cresaia & Friberg, 2010). The advantages of an ADN are the strong clinical skills...
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...CHANGING HEATHCARE TRENDS Health Promotion: Changing Healthcare Trends Marla K. Clement Grand Canyon University: NRS-429V 11/8/2011 Health Promotion: Changing Healthcare Trends A trend recognized in today’s healthcare setting is that of a shift from professional dictation to patient directed healthcare. An emphasis on the treatment of disease, which was highly successful in the past, is not the answer for today's healthcare needs. Today, patient education is the primary focus with the emphasis on prevention of disease by screening for risk factors and encouraging patients to practice behaviors that foster good health. In the past patients would seek medical care only after symptoms had developed that interfered with their lifestyle. Todays’ trend reflects patients taking a proactive approach to preventing a disease after they have been exposed to the education through mass media such as commercials, the internet, or brochures obtained from clinics or physicians’ offices. With the advances in technology medical professionals are able to reach far more people than in the past. This technology has given professional nurses the ability to encourage more patients to improve their health while fostering positive behavioral changes, referred to as health promotion. Health promotion is defined as the process of empowering patients to improve their health while fostering behavioral, cognitive and emotional activities as to advocate health and well-being of the population...
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...Title: Core Competencies Necessary for the APN Role Development. Name: Course: Institution: Date: Interview with an Advanced Practice Nurse Introduction Interview with APN/CNP, Diane John Diane John, APN/CNP is a nurse practitioner at Health land, a Hawaii center for the public. She has devoted 30 years to her nursing career. She has worked as a nurse in a medical intensive care unit and as a research nurse in the study in the intensive care unit. She has been a Female Nurse Practitioner for the past 20 years where she started out as a midwife at wife care center, where she provided midwife services to women. Rationale for an engaged interview process The reason for this interview is to find out Competencies necessary for APN role development and also to get some background information of a nurse leader on a one on one basis. This information will be important because it will help us to develop leadership skills in the field of nursing. About the Diane John APN leader Diane John, APN/CNP is an attendant specialist at Health land, a Hawaii community for the general population. She has dedicated 30 years to her nursing profession. She has filled in as an attendant in a restorative emergency unit as a examination nurture in the study in the emergency unit. Interview What is the CNS nurse? The CNS is a practice for preparing advance practice nurses to be part of the clinical practice team where you work together with doctors to provide service to patients.Bringing knowledge into...
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...Collaboration between APNS, other Healthcare Professionals, and Agencies Student’s Name Institution Collaboration between APNS, other Healthcare Professionals, and Agencies Cooperation, mutual working relationship and understanding between APNs (advanced practice nurses) other healthcare professionals and agencies is critical for the improvement of health (Edwards, 2009). Such collaborative working relationship promotes research, enhances patient education, increases general public awareness and promotes correct diagnoses and treatment. In this paper. Therefore, my interest is in this collaboration (Fairman et. al, 2011). I seek to find out the ways advanced practice nurses and other groups can collaborate to improve health status and service delivery. Health agencies and organizations include researchers, medical unions, patient advocacy organizations and other associations within the health industry (Freshwater, 2002). APNs are health professionals who emphasize self-care and wellness, manage their workload, and provide diagnosis and treatment of health disorders (Johns, 2000). APNs always focus on the impact of diseases and medications on the patient and the society as a whole. APNs are registered nurses with advanced credentials; they are also certified by the relevant certification bodies (Hoyt, Proehl & Jean, 2012). The common places where APNs work include schools, clinics, health centers, physician offices, hospices, and nursing homes. APNs also work in...
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...Collaboration between APNS, other Healthcare Professionals, and Agencies Student’s Name Institution Collaboration between APNS, other Healthcare Professionals, and Agencies Cooperation, mutual working relationship and understanding between APNs (advanced practice nurses) other healthcare professionals and agencies is critical for the improvement of health (Edwards, 2009). Such collaborative working relationship promotes research, enhances patient education, increases general public awareness and promotes correct diagnoses and treatment. In this paper. Therefore, my interest is in this collaboration (Fairman et. al, 2011). I seek to find out the ways advanced practice nurses and other groups can collaborate to improve health status and service delivery. Health agencies and organizations include researchers, medical unions, patient advocacy organizations and other associations within the health industry (Freshwater, 2002). APNs are health professionals who emphasize self-care and wellness, manage their workload, and provide diagnosis and treatment of health disorders (Johns, 2000). APNs always focus on the impact of diseases and medications on the patient and the society as a whole. APNs are registered nurses with advanced credentials; they are also certified by the relevant certification bodies (Hoyt, Proehl & Jean, 2012). The common places where APNs work include schools, clinics, health centers, physician offices, hospices, and nursing homes. APNs also work in...
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...Impact of IOM The nursing profession is the largest segment of the nation’s health care work force ("Leading Change," 2010, p. 1). Nursing, as we know it is changing based on recommendation for Institute of Medicine. Increased education requirements, enabling nurses to deal with multisystem disease processes requires advanced critical thinking skills ; BSN nurses face issues with customer service and bedside nursing skills, and Advance Practice Nurses (APN) practicing to their full capacity to ,can fill in for physicians when positions are lacking in the family practice setting, In addition nursing leadership being involved in policy and legislative changes ,can only enhance our field as a profession .There is only a positive outcome for our working environment and professionalism. Education is the vital step in accomplishing the changes recommended by IOM. . The IOM report set goal of 80% of nurses must have a Bachelor of Science in Nursing (BSN) degree by 2020 and current BSN nurses should be working on MSN and Doctoral degrees. It is important that lower entry (two year, AND programs) level nursing education should stay in place, with the requirement that they continue to pursue their education post-graduation. Hospitals must offer incentives to current employees to begin working on higher education’s goals. Evidence based practice continues to support higher education and patient outcomes go hand and hand To be able to increase levels of education we must be able to...
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...The Impact of the IOM Report on Nursing Lori VanDerveer-Hand Grand Canyon University October 6, 2013 The Impact of the IOM Report on Nursing Key Message #1:“Nurses should practice to the full extent of their education and training” (Institute of Medicine of the National Academies, 2010, p. 85). The impact that the IOM report has had on nursing and it’s future, as we know it has been colossal already. The report that was obtained in 2010 shows us the importance of nursing in patient centered care and the delivery of more primary care than specialty care as well as the focus of shifting care into the community instead of the acute care setting. If we as professionals can alter this shift in healthcare we will provide advanced quality care, decrease errors and provide better safety. The call for the advanced degree practitioner (APN) and physician assistant (PA) is vast; the IOM report is calling for advanced degree practitioners (APN) and physician assistants (PA) to be able to practice to the extent in which they were trained so that they may be able to take some of the burden off the shrinking medical profession and an already fragmented healthcare system. The hope is by giving the APN and PA a less restrictive role in health care it will help to streamline the fragmented healthcare system as well as significantly bringing down costs. These streamlined plans have already proved effective in the Geisinger Health...
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...Advanced Nursing Leadership South University November 17, 2012 Advanced Nursing Leadership Leadership in the Advanced Practice Nurse (APN) role is of great importance. APN leadership can impact something as basic as everyday patient care, to implementing new nursing policies and advocating for change within the nursing spectrum (Hamric, Spross, & Hanson, 2009). The role of a leader and APN go hand and hand; with a common goal to influence others, create change, and advocate for patients just to name a few (Hamric, 2009). The purpose of this paper is to identify and describe my personal leadership style, as well as discuss the attributes of leadership I feel I currently have and will need in my APN specialty. Personal Leadership Style My leadership style as identified in the quiz was Participative Leadership. This type of leader accepts ideas and opinions from others regarding decisions that have to be made or in reference to problem solving (Quiz, 2012). This leadership style inspires and encourages others to participate by utilizing the knowledge gained in their field of specialty; to obtain the best possible decision (Quiz, 2012). According to Cherry (2012), “Participative leaders encourages group members to participate, but retain the final say over the decision making process. Group members feel engaged in the process and are more motivated and creative”. This style is also referred to as Democratic Leadership. Cherry (2012) states “Researchers...
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...Reflection Paper One Advanced practice nursing (APN) can be loosely defined as an area of nursing in which nurses are required to practice at an advanced level in a specific area of interest. APN extends the boundaries of nursing’s scope of practice and contributes to nursing knowledge, and the development of the profession (Canadian Nurses Association, 2008). In order to become an APN, the nurse must obtain a master’s or doctoral degree from an accredited university in an area of concentration designated for advanced practice nursing. According to Joel (2009), there are currently four major groups of APNs: certified registered nurse anesthetist, certified nurse midwives, clinical nurse specialists, and nurse practitioners. APN focus on critical thinking, educating the public, diagnosing and treating illnesses, and prescribing medications to name a few. This paper will discuss the future of the nurse practitioner and how I, as a future adult-gerontology primary care nurse practitioner, will advocate for my patient population. Philosophy and Beliefs of Nurse Practitioners Due to the fact that nurse practitioner is a branch of advanced practice nursing, the two professions often share many of the same philosophic beliefs. The overall philosophy of both professions is centered on four key concepts of person, society, health and nursing; whereas, the core philosophy for nurse practitioners is that of individualized care where focus is on patients’ conditions, as well as, the...
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...The Future of Healthcare for the APN Rosetta Vaughn Grantham University Foundation of Advance Practice Nursing NUR506 Aimee Kirkendol RN, DNP, FNP-BC May 21, 2014 The Future of Healthcare for the APN According to the IOM report addresses nursing in all practice levels, with the greatest emphasis on advance practice. The report identifies barriers, describes new structures and opportunities, and provides overall specific vision regarding the vital contribution of advanced practice nurses to the health care system. The Department of Veteran’s Affairs (VA), the Geisinger Health system, and Kaiser Permanente are used as examples of care delivery organizations that maximize nursing scope of practice. The transformation of the VA from a hospital-based system into a primary care focused organization is based on the maximization of nurse practitioners (NPs) as primary care providers. As a result, by 2007, VA patients experienced higher quality and significantly lower-cost care compared with similar Medicare populations. Geisinger is noted in the report as an organization that that transitioned from a high-cost, specialty-focused medical facility to an organization of high value. Geisinger’s vision includes “having staff work up to the limit of their license” and to “redistribute caregiving work to increase quality and decrease cost.” Under this model, nurses in call centers shifted to primary care sites and established relationships with patients and families, resulting in...
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...High-Risk Family Assessment and Health Promotion Paper Shova Rajbhandari NUR/542 April 23rd, 2012 Tracy Kramer MSN, RNC, FNP High-Risk Family Assessment and Health Promotion Paper For High risk family assessment: Intravenous Drug users (IDUs) family is chosen Common health issues /profile among members or families from this high-risk group: Drug abuse involves the regular taking of a deleterious or noxious quantity of any drug, prescribed or illicit over a period of time (Freidman, 2003). Those people who become severely drug dependent most often need specialized treatment in order to recover. A wide range of treatment is available through private sector and public sector. Recovery treatment centers usually incorporate the family into treatment plan, which makes it more effective in their treatment of the substance abuser. > HIV positive IDU and family members > IDU has a wide range of coinfections, coinfections, comorbidities and injecting related health issues. The common health problems in this IDU family are: • Infection with blood borne viruses, including hepatitis B, C and D (delta) leading to liver diseases • Bacterial infections: tuberculosis, bacterial pneumonia, • Alcohol dependence and alcohol-related liver disease • Poly substance dependence • Psychiatric comorbidity, including depression. • Deep venous thrombosis (DVT) • Local soft tissue and vascular injuries, including skin abscesses and...
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...and the families make major decisions related to the health offers the APN a challenge and is a major issue in practice (Ingersoll, McIntosh & Williams, 2000).. Managing the expectations and the emotion of the patients and their families usually take their toll on the APN and calls for a delicate balancing act to ensure that confidence between the practitioner and the members remains. Assuring that reassuring the patients and their families that the medical practitioners and their families area doing every within the contents of the treatment plan to ensure the recovery of the patient is critical. Coping with the expectations could have an impact on the practitioners and hence interfere with the performance of the duties. The issue could also lead to stress of the caregivers. Understanding that the APN are human with feelings and families sometimes is not the case leaving the families of the patients venting their frustrations on the caregivers whenever things go wrong 2. Specific Description of The Area and why it is selected...
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...describe nursing as an exciting and always changing profession. Further, they view nursing at a crossroads with education and practice being challenged to meet the “complex needs of contemporary patients, foster healthy communities, execute prevention strategies to effectively reduce chronic disease, improve patient safety, reduce medical error, and more rapidly translate and implement the emergent scientific break throughs to patients and health care systems” (Cary & George, p. 10). In 2004, the American Association of Colleges of Nursing (AACN) endorsed the creation of the Doctor of Nursing Practice (DNP) degree as the minimum entry level for advanced nursing practice (APN). The DNP as an academic degree...
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...time to reflect on personal believes, creates a moment for an advance practice nurse (APN) to realize, and understand the need for providing patient care, with up to date knowledge. The paper aims to discuss; the overview of nursing praxis and its benefits, overview of the APN, Empiricism influences on practice, comfort theory (CT) influences, deontology influences and utilization of the praxis in practice. Praxis Overview Merriam-Webster Dictionary (nd) defines praxis as first originating from Medieval Greek, and means doing, performing or practicing a skill, art or science. Chinn and Kramer (2011), explains praxis as a freedom of knowing that makes one reach a full potential, and optimal well-being. Praxis is different from one nurse to another. Nurse expertize develops overtime, through ongoing knowledge, critical thinking skills, and how one perceive the situation. Experience encourages self-motivation and promotes change (Chinn & Kramer, 2011). APN’s encounter with each patient is different, unique, and requires self-reflection of the encounter. With the current changes in patient care needs, praxis should be geared towards the APN area of practice (Masters, 2011).The more individualized the praxis framework the higher the wanted outcome, for both the practitioner and the patient. It is critical for an APN to have a picture of the expected role in practice. Overview of Advanced Nursing Role The family nurse practitioner (FNP) is an advanced practice registered nurse...
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