It is no secret that the current healthcare reformation is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify a way to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal…” (Bailey, Jones & Way, 2006, p. 381). The key to a successful healthcare reformation is interdisciplinary collaboration between Family Nurse Practitioners (FNPs) and physicians. The purpose of this paper is to review the established role of the FNP, appreciate the anticipated paradigm shift in healthcare between FNPs and primary care physicians, and recognize the potential associated benefits and complications that may ensue. Description of the Topic Definition The American Nurses Association (2008) has defined the FNP, under the broader title of Advanced Practice Registered Nurse (APRN), as one “who is educationally prepared to assume responsibility and accountability for health promotion and/or maintenance as well as the assessment, diagnosis, and management of patient problems, which includes the use and prescription of pharmacologic and non-pharmacologic i... ... middle of paper ... ... Mundinger, M., (1994). Advanced-Practice nursing—good medicine for physicians? New England Journal of Medicine, 33(3), 211-214. Retrieved from http://www.nejm.org/doi/pdf/10.1056/NEJM199401203300314 National Council for the State Boards of Nursing, APRN background, (2012). Report of the nursing policy and legislative efforts. Retrieved from https://www.ncsbn.org/428.htm#Nurse_Practitioner_Certification O’Brian, J. M., (2003). How Nurse Practitioners obtained provider status: History of nurse practitioners. American Journal of Health-System Pharmacy, 60(22). Retrieved from http://www.medscape.com/viewarticle/464663_2 Rashid, C., (2010). Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature review. Journal of Advanced Nursing 66(8), 1658-1670. doi: 10.1111/j.1365-2648.2010.05327.x
The model discusses the impact of new regulations on education for APRN, Licensure Accreditation, Certification & Education Document, certification and practice. The model is implemented to grasp the general understanding and definition of advance practice registered nurse APRN role, inconsistencies with state by state recognition of APRN roles, and determining eligibility for APRN licensure (Consensus Model for APRN Regulation, 2015). The consensus model definition of APRN is a nurse who is educationally rounded to assume the responsibility of assessing, diagnosis, treating, teaching health promotion and disease maintenance, acquired advanced clinical knowledge and skills to provide direct patient care, has passed a national certification examination, and licensed to practice in one of the four roles (Consensus Model for APRN Regulation, 2015).
Cipher, D. J., Hooker, R. S. and Guerra, P. (2006). Prescribing trends by nurse practitioners and physician assistants in the United States. Journal of the American Academy of Nurse Practitioners, 18, 291–296.
Nurse practitioners (NPs), one type of advanced practice nurses, are licensed by the states where they practice and certified by private boards. Nurse practitioners hold advanced degrees in clinical practice and function in a wide variety of settings and across the life span. They provide a broad array of healthcare services ranging from managing treatment plans, to prescribing medications, to implementing health promotion services. As of 2014, 205,000 NPs were licensed in the United States with 86% of those prepared to deliver care to patients in primary care settings (NP Facts, 2015). The progression of the Nurse Practitioner movement that occurred in the 1960 and 1970s emerged as a creative and
The primary barrier to nurses being able to practice at their full potential is the states varied legislation (Fairman, Rowe, Hassmiller, & Shalala, 2011). The IOM (2011) report suggests that state scope of practice regulations should model the National Council of State Boards of Nursing Model Nursing Practice act and Administrative rules to provide legal authority to practice to the accomplished level of training. The IOM (2011) report also requested a review of states laws to identify potentially anticompetitive effects that do not protect the health and safety of the public. The new recommendations are to build a common ground with interdisciplinary groups and to include a diverse coalition for the Future of Nursing: Campaign for action (IOM,
Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of Primary Care to Health Systems and Health. Milbank Quarterly, 83(3), 457-502. Retrieved from http://www.commonwealthfund.org/usr_doc/starfield_milbank.pdf
The role of the primary nurse practitioner (NP) has emerged in the US in the late 1960s. The development of the primary NP role in the US is widely perceived as a response to increased medical specialization and the accessibility to medical care ensured by Medicare and Medicaid programs. The increase in physicians’ specialization shrank the number of primary care physicians mainly in the rural and medically underserved areas. Meanwhile, access to medical care by low-income people increased the demand for primary care services. To meet this demand, nurses stepped in to breach the gap (Pohl & Tsui-Sui, 2014).
Often time, nurses has been viewed by patients, their family members and the medical team as basic emotional care givers, pill crushers or cart pullers and not as healthcare professionals who are more interesting in health promotion, disease prevention and better patient outcomes. They also often forget the emotional, physical, mental, and caring part that is involved with the profession. And to make matters worse, nurses are continued to be viewed as a threat by doctors more than ever before especially with the opening of Nurse Practitioners programs.
Primary care services are an important focus of improving health outcomes in this country. These essential preventive services save lives and improve the quality of life by detecting health problems early. Visits to a primary care provider can help promote health by allowing patients qualified guidance in their decision making, encouraging family involvement, and putting patients in touch with community resources. Since the inception of the first Nurse Practitioner (NP) programs in the 1970’s, these providers have been providing primary care services to patients across the lifespan, typically with an emphasis on underserved populations. Just as long, there has been considerable resistance to NPs being allowed to practice by physician groups
One of the biggest conflicts between Advanced Practice Nurses and physicians has been in the news as of late. The struggle to gain full autonomy over prescriptive rights and practice independently of physicians. Doctors and nurse practitioners with who they work face many different conflicts. Conflicts can develop within the individuals as they change their professional self-images. Each doctor-nurse team must develop new ways of working together and must do so against a background of longstanding professional territoriality. Similar struggles have been felt within schools and hospitals (BATES, 2014 Rev.)
providing both direct patient care and clinical leadership, at a lower price but at the same quality as primary care physicians do.(Lathrop & Hodnicki, 2014).Furthermore, new EBP showed that the patients are at least as satisfied with care at the point of first contact with nurse practitioners as they are with that from doctors.(Horrocks, Anderson, & Salisbury, 2002)
I love that the scope of the Family Nurse Practitioner (FNP) is so extensive because I have a thirst for continual learning and career development. I enjoy trying out different fields of nursing, evident by my varied work experience to this point. As a FNP I can continue to satiate this desire to try different fields. In addition to working in primary care I’d like to practice a mixture of the following FNP sub-specialties during my FNP career: endocrinology, pain management, surgery, palliative care, hospice, genetic counseling, education, and research.
Over the years nursing roles have expanded and has significantly overlapped with medicine. This has led to the rise of Advanced Practice Nursing (APN). An Advanced Practice Nurse (APN) is a registered nurse that has acquired enhanced knowledge and skills through the successful completion of an organized program of nursing education at a Master’s degree level, and has been certified by the Board of Nursing to engage in the practice of advanced practice nursing. The APN essentially has expanded upon their skill set and the ability to provide accurate assessments, diagnose patients and plan and implement care. Advanced practice nurses exercise a higher level of autonomy to include: decision making, managing individual and group care, collaborations with clients, manage physical and labor resources, act ethically within the boundaries of the law, and prescriptive and referral authority. They also have the authority to admit patients to health care
Nurse practitioners (NP) are healthcare providers that are licensed and practice in an arrays of healthcare locales. According to the Association of Nurse Practitioners (2015), nurse practitioners can practice as autonomous practitioners in acute, ambulatory, and long-term facilities as either a primary providers or specialty providers. Each nurse practitioners’ state board of nursing plays a considerable role in their scope of practice with focal point on the community at large fortification and healthcare safety. Furthermore, the ability of the nurse practitioners to practice to fullest extent of their knowledge are structured, or governed and regulated by state law and the individual’s state Board of Nursing scope of practice (Xue, Ye,