PAPER ON ADVANCE NURSING PRACTICE
Increased emphasis on primary health care, new models of collaborative practice, the shift from institutional to community care, new developments in technology, and the supply and demand for various health providers with particular skills. These are the new trends in the delivery of health care that give opportunities for the expansion and creation of new roles for nurses. To better meet the changing needs of health care of patients in our modern times, the practice of nursing must continue to develop. One possible career path nurses may opt to trail is the advance nursing practice, or ANP, where nurses [registered nurses] learn additional competencies integrated in their practice as they move along the move along the field of experience and education This enables nurses to contribute to the health care system in new ways. (Canadian Nurses Association, 2002, p. 2)
What is Advance Nursing Practice (ANP) and its characteristics?
According to the Canadian Nurses Association [CNA] (2002), advance nursing practice (ANP) is an umbrella term that describes an advanced level of nursing practice that maximizes the use of in-depth nursing knowledge and skill in meeting the health needs of clients (individuals, families, groups, populations, or entire communities). In this way, ANP extends the boundaries of nursing’s scope of practice and contributes to nursing knowledge and the development and advancement of the profession. (p. 4)
CNA further explains: ANP is an expert and specialized practice grounded in knowledge that comes from nursing theory and other theoretical foundations, experience and research. It involves the deliberate, purposeful and integrated use of in-depth nursing knowledge, research and clinical expertise. It also involves integration of knowledge from other disciplines into the practice of nursing. ANP requires a depth and breadth of knowledge that enables the nurse to provide an ever-increasing range of strategies to meet the complex needs of clients. Also, ANP may, but does not necessarily, include activities that have been traditionally considered outside the scope of nursing practice. (CNA, 2002, p. 4-5)
Who are the Advance Practice Nurses (APNs)?
Advanced Practice Nurse (APN) is an umbrella term that is given to a registered nurse (RN) who has met advanced educational and clinical practice requirements beyond the 2 4 years of basic nursing education required of all RNs. There are four principal types of APNs: the Nurse Practitioner (NP), Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), and Certified Registered Nurses Anesthetist (CRNA). (American Nurses Association, 1997)
ISSUES ON APN:
Harris (1998) made a research on the role of APNs in meeting the health care needs of the 21st century patients. The research basically discussed the issue of APNs acceptance as a viable health care provider. Harris found out that that there are certain factors that favor for the broadening of APNs scope of responsibility for primary care, which include: the pressing need to contain US’ continuing increase in health care costs, the window of opportunity for advanced nursing practice (or the transformation of health care in the US), and the need to use fewer resources more effectively. Harris discussed: “Because ours is a market-driven health care system with a growing surplus of physicians, NPs increasingly find themselves in direct competition with physicians for the same primary care jobs. Hence, market-driven (rather than identical) pricing of services is necessary if NPs are to compete successfully with medically trained providers of primary care.” (Harris, 1998)
Therefore, APNs need to widen their scope of practice to better meet the needs of their possible clients. As the Pew Health Professions Commission (1995), suggested: “Advanced preparation…will permit the nursing professional to develop the information background and experience base to operate more independently, work in community settings, more effectively manage the health of patients and make an even more profound contribution to health care…. In many ways nurses are the best prepared professionals to respond to the changing system. Their training focuses on the delivery of cost effective care;…they combine clinical and managerial skills; they focus on the behavioral aspect of health more than physicians; and they are effective team workers and leaders.” (p. 49)
(Note: Advanced Nursing Practice (ANP) and Advanced Practice Nursing (APN) are used interchangeably in this paper.)
References:
American Nurses Association. (1997). Advanced Practice Nursing: A New Age in Health Care. In Nursing World. Available at: [www.nursingworld.org/readroom/fsadvprc.htm]
Canadian Nurses Association. (2002). Advanced Nursing Practice: A National Framework. Ottawa: Author
Harris, Ruth M. (1998). Advanced Nursing Practice in the 21st Century: Do We Want to Be Right, or Do We Want To Win?. In Online Journal Issues of Nursing. Available at: [www.nursingworld.org/ojin/tpc6/tpc6_2.htm ]
Pew Health Professions Commission.(1995). Critical challenges: Revitalizing the healthcare professions for the twenty-first century. San Francisco, CA: University of California, San Francisco Center for the Health Professions.
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