APRN Consensus Model on APRN Practice

The emergence and evolution of Advanced Practice Registered Nurses (APRNs) represent a transformative force within the landscape of modern healthcare. Learning about the evolution of nursing practice and how nursing roles have changed is important to ensure the demands of patients are met (Melo et al., 2023). From the foundational concepts that underpin their practice to the intricate processes of licensure and certification, this essay delves into the intricacies that shape the professional identity of APRNs.

Advanced Nursing Practice and Advanced Practice Nursing

Advanced Nursing Practice (ANP) and Advanced Practice Registered Nursing (APRN) are two widely used concepts in modern nursing that explain different nursing roles. The International Council of Nurses (ICN) is one of the accredited bodies that have provided a guideline on the differences between these two concepts. ICN specifically outlines how ANP and APN functions in relation to educational preparation, nature of practice, and regulatory mechanisms beyond that of an RN (Scanlon et al., 2023). An advanced nurse practitioner is a term that is used to refer to nursing practice that is considered an extension or an expansion beyond the original scope of registered nursing (McNelis et al., 2021)). For example, those who hold a master’s degree have education beyond the RN scope and qualify to be in an ANP role.

Unlike ANP roles, APN roles have clearly defined education, practice, and regulation guidelines. APN practice demands post-graduate education to ensure these nurses are equipped with superior instructive and medical knowledge. According to ICN, the APN roles include Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), and Advanced Practice Nurse (APN) (Scanlon et al., 2023). The minimum education requirements and regulatory requirements for these nurses are not required for the ANP role. In addition, the ANP roles may include categories like nurse educators, nurse researchers, and nurse administrators which is not the case for the APN roles. Regarding nursing care delivery, ANP roles may include direct patient care, education, research, leadership, and administration within various healthcare settings (Melo et al., 2023). For the APN roles, these nurses are focused on diagnosing illnesses, managing patient care, ordering tests, prescribing medication, and performing certain procedures within their scope of practice.

Nurses in the advanced nursing practice role usually focus on providing care to a variety of patient groups. For example, these nurses specialize in areas of adult gerontology, psychiatry, pediatrics, and women’s health (Scanlon et al., 2023). The requirements for licensure for ANPs include advanced education, national certification, and sometimes special exams that must be passed specific to the role. For APRNs, advanced nursing practice and licensure are coordinated by state boards of nursing. These individuals must meet educational and certification requirements outlined by respective state regulatory bodies (McNelis et al., 2021). In summary, Advanced Nursing Practice encompasses a broader array of advanced nursing roles beyond those of APRNs.

Population-Focused Roles

Population-focused roles in advanced nursing practice involve providing specialized healthcare services and implementing interventions tailored to specific populations or communities. Advanced nurse practitioners can specialize in various populations including adults, pediatrics, neonates, women, and families (Melo et al., 2023). For example, my ANP role is that of a family nurse practitioner (FNP) which deals with the health of individuals and families across the lifespan. According to the American Association of Nurse Practitioners, an FNP provides a wide range of family-focused healthcare services to patients of all ages, including infants, adolescents, adults, and seniors (Deering, 2023).

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In Michigan, FNPs treat individuals from infancy through adulthood, while developing long-term relationships with their patients during their careers. FNPs in this state utilize restricted practice authority whereby the practitioner provides care under the supervision of a licensed physician (Spring Arbor University, 2020). Focusing on primary care populations, FNPs serve as the first point of contact for patients seeking healthcare services. They manage common health problems, conduct health assessments, provide preventive care, order diagnostic tests, prescribe medications, and coordinate care for patients within the primary care setting. These nurses also recognize the interconnectedness of family members’ health and well-being. Lastly, a nurse in the FNP role addresses the health of vulnerable populations in rural and urban communities (Deering, 2023). These include low-income individuals, uninsured or underinsured populations, immigrants, refugees, and homeless individuals.

Certification

Certification is an essential component of the Family Nurse Practitioner (FNP) role that demonstrates the attainment of advanced knowledge, skills, and competencies necessary for services to populations served. To be certified as an FNP, the first step will involve obtaining an RN license and experience (Deering, 2023). Upon completion of the BSN degree, the individual must enroll in a Master’s program, and upon graduation, the nurse is eligible for licensure. The individual must take an exam for their FNP certification administered by the American Academy of Nurse Practitioners (AANP) Certification Board or the American Nurses Credentialing Center (AANC) (Spring Arbor University, 2020). Upon passing the exam, the individual must submit their application for licensure to the respective state board of nursing. For example, my application will be made to the Michigan State Board of Nursing.

LACE Discussion

Licensure, Accreditation, Certification, and Education (LACE) are important aspects that guide the practice of FNPs. My licensure plan for the FNP role will involve finishing the current program and applying for the American Nurses Credentialing Center (AANC) exam. This license will be valid for two years and renewal will require attainment of at least 25 hours of continuing education since the license was received (Spring Arbor University, 2020). For accreditation, it is essential to seek an MSN degree that is recognized by national programs like the Commission on Collegiate Nursing Education (CCNE). This body has already ensured that my current program’s curriculum and expectations meet the national standard of excellence. As discussed earlier, certification of my FNP will require submission of my valid RN license. I will be required to pay associated fees for licensure as an FNP to my state board to receive a practice license. Regarding the aspect of education, I will be required to complete my MSN program to meet the educational requirements necessary for licensure.

State Specific Implications/Barriers

Obtaining an FNP license in Michigan is subject to various state implications. First, Michigan allows FNPs to practice under restrictive legislation meaning that independent practice is limited. Following this limitation, means that FNPs will collaborate with physicians to plan patient care (Spring Arbor University, 2020). Another implication for the FNP role in Michigan is maintaining certification through continuing education and professional development. The state requires those renewing their license to attain a minimum of 25 hours of continuing education in courses that cover pharmacology, pain management, and clinical applications (Spring Arbor University, 2020). Lastly, the FNP in Michigan may encounter certain reimbursement policies. For example, fee-for-service reimbursement is based on the limits and rates associated with physician services. Understanding these dynamics of practice is essential for FNP practicing in Michigan.

References

Deering, M. (2023). Family Nurse Practitioner (FNP) Career Overview. Nurse Journal. https://nursejournal.org/nurse-practitioner/fnp/

Melo, M. D. M., Silva, I. P. D., Freitas, L. S., Mesquita, S. K. D. C., Sonenberg, A., & Costa, I. K. F. (2023). Family Nurse Practitioners: An exploratory study. Revista da Escola de Enfermagem da U S P, 57, e20220362.

https://doi.org/10.1590/1980-220X-REEUSP-2022-0362en

McNelis, A. M., Dreifuerst, K. T., Beebe, S., & Spurlock Jr, D. (2021). Types, frequency, and depth of direct patient care experiences of family nurse practitioner students in the United States. Journal of Nursing Regulation, 12(1), 19-27. https://doi.org/10.1016/S2155-8256(21)00021-1

Scanlon, A., Murphy, M., Smolowitz, J., & Lewis, V. (2023). Advanced Nursing Practice and Advanced Practice Nursing roles within low and lower-middle-income countries. Journal of Nursing Scholarship, 55(2), 484–493.

https://doi.org/10.1111/jnu.12838

Spring Arbor University. (2020). Become an FNP in Michigan: Everything You Need to Know.

https://online.arbor.edu/news/fnp-in-michigan#:~:text=The%20FNP%20Designation%20Explained&text=As%20advanced%20practice%20nurses%2C%20FNPs,that%20comes%20with%20the%20role.