Pulse Check

The “Pulse” Check. Where are you in your journey and how are you doing?

DQ2 of Week 5 is an opportunity for you to self-assess and reflect on your journey. You can write about it or you can share a created video (you-tube) expressing your navigation through the Role course. Model from the scripts in this week, but be specific to your experience.

Evaluate how you have achieved course competencies and your plans to develop further in these areas. The course competencies for this course are as follows:

Explore the historical evolution of the advance practice nurse.
Differentiate the roles and scope of practice for nurses working in advanced clinical, education, administration, informatics, research, and health policy arenas.
Analyze attributes of the practice arena such as access and availability, degree of consumer choice, competition, and financing that impact advanced practice nurses and their ability to effectively collaborate with other health professionals.
Integrate evidence from research and theory into discussions of practice competencies, health promotion and disease prevention strategies, quality improvement, and safety standards.
Identify collaborative, organizational, communication, and leadership skills in working with other professionals in healthcare facilities and/or academic institutions.
Synthesize knowledge from values theory, ethics, and legal/regulatory statutes in the development of a personal philosophy for a career as an advanced practice nurse.

When I began the course the Role of the Advanced Practice Nurse, I was unsure of the information that the course would entail. I was delighted to find that the teachings were the basics I would need to understand my role as a Family Nurse Practitioner (FNP). I was very naive to think I was knowledgeable about what my role in practice would be, when I was not. Over the last five weeks I was introduced to the history of Nurse Practitioners (NP), the roles and scope or practice for advanced practice nurses working in clinical and non-clinical settings, understanding of collaboration and communication, assess my personal philosophy that will carry into advanced practice, attributes of the FNP practice arena, and to identify when collaboration, communication, and leadership skills will be used in advanced practice. The competencies that I have achieved while participating in this course are listed below.

1. Explore the historical evolution of the advanced practice nurse.

Although the history of NP’s dates to 1860 for the Nurse Anesthetist, I was surprised to learn that NP’s did not start having formal education and specialty training requirements until years later. As a child I was very lucky to have had great health care, however I had never received care or had exposure to an NP until 1993 when I was in the Navy. At that time the NP I was exposed to was practicing primary care. Prior to that, I had no inclination that NP’s even existed.

2. Differentiate the roles and scope of practice for nurses working in advanced clinical,

education, administration, informatics, research, and health policy arenas. As I have learned from the teachings of this course there is a difference between Advanced Practice Nursing (APN) and Advanced Nursing Practice (ANP). APN is a clinical role that has direct contact with patients. The APN is a nurse who holds a master’s degree and has “expertise in areas such as diagnosis and assessment, planning and implementation, and evaluation of healthcare and record-keeping” (Nurse Journal, n.d., para. 4). Advanced Practice Nursing refers to both clinical and non-clinical providers such as Nurse Practitioners, Nurse Educators, Nursing Administration, Nursing Informaticists, and Nursing Researchers.

3. Analyze attributes of the practice arena such as access and availability, degree of

consumer choice, competition, and financing that impact advanced practice nurses and their ability to effectively collaborate with other health professionals.

The FNP in practice provides comparable, quality, and accessible health care at a reduced cost to that of a physician (Stanik-Hutt et al., 2013). NP’s are paid at about 80-85% of the cost of a physician (American Association of Nurse Practitioners, 2013). FNP’s that practice in states that have limited practice laws FNP’s must collaborate with physicians regarding patient care, medication prescribing, chart reviews, and ordering of medical devices or therapy etc. FNP’s must also collaborate with physician and colleagues when patients have health care needs that the FNP is lacking experience in. “An effective health system integrates the diverse knowledge and skills of multiple types of providers who communicate and collaborate with patients and each other and are accountable to deliver care to the patient and society” (Stanik-Hutt et al., 2013, p. 498).

4. Integrate evidence from research and theory into discussion of practice competencies,

health promotion, and disease prevention strategies, quality improvement, and safety standards.

Based on Hamric’s model the six core competencies are “Collaboration, Leadership, Evidence-based practice, Consultation, Guidance and coaching, and Ethical decision-making skills” (Hamric et al., 2014, p.44). These are guidelines used in daily practice to provide comprehensive care to a patient. FNP’s practice as holistic providers diagnosing health conditions, while promoting health and disease prevention and providing education to patients and families.

5. Identify collaborative, organizational, communication and leadership skills in working

with other professionals in healthcare facilities and/or academic institutions.

The understanding I have of this concept is a team working together, who trust each other and share information to achieve a common goal. When a member of the group exhibits leadership skills they essentially become a role model for the entire team. When making decisions that will affect the team the leader would ask for input from each team member to come to a consensus.

6. Synthesize knowledge from values theory, ethics, and legal/regulatory statutes in the

development of a personal philosophy for a career as an advanced practice nurse.

My personal philosophy as an FNP will be to provide quality, effective, and compassionate care to every individual patient. To be and advocate for my patients, their families and their health and wellness. Also, to collaborate with the entire health care team to provide the best care possible.

This course has helped me to gain invaluable insights about the advanced practice nursing roles. I have also been able to master most of the predesignated course outcomes, although I must admit that I require further development in some areas. An important area in which I have been able to learn a lot pertains to the different roles and scope of practice for nurses working in advanced arenas. These arenas include clinical, education, administration, informatics, research, and health policy arenas (Hamric, Hanson, Tracy, & O’Grady, 2014). While I was able to learn that these professionals might have different responsibilities and roles, I also grasped the nature of interdependence between the various professionals and the importance of multidisciplinary collaboration for advancing the profession and ensuring the dispensation of quality care to patients.

From the class lectures and assignments, I also gained a heightened understanding of the core competencies that apply to advanced practice nurses. These competencies can play a central role in improving the quality of care dispensed to patient and fostering the professional development of the advanced practice nurses. Some of the competencies that cut across all APN roles include effective communication, responsive leadership, coaching and mentorship, consultation, teamwork, people development, as well as respect for diversity (Goodman, Reidy, & Cartier, 2012). Among these competencies, the one that would benefit me from further improvement is diversity awareness. To improve my skills in this competency domain, I aspire to find mentorship from my superiors, enrolling in multicultural courses in addition to providing care to diverse patients where I can get firsthand account about dealing with multicultural issues in health care.

As I have further learned in this course, health promotion and disease prevention are critical aspects in the work of advanced practice nurses. Apart from improving the health of communities, health promotion and disease prevention are also instrumental for curtailing the escalating health care costs in the nation and enhancing the quality of life particularly for vulnerable populations such as the elderly, women, veterans, and racial/ethnic minorities (Swan, Ferguson, Chang, Larson, & Smaldone, 2015). I plan to take a proactive stance in fighting for the rights of these vulnerable populations to access quality care and minimize the disparities experienced by these populations. Specific strategies that I aspire to utilize to fight for these vulnerable and marginalized groups include engaging in advocacy efforts and liaising with other stakeholders such as faith-based communities to call for responsive reforms geared towards elimination of the disparities.

Overall, it is my conviction that the course has offered a solid foundation to guide my clinical practice in the future. I will continue integrating lessons learned about the importance of informatics to provide coordinated and safe care to clients.

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