NRNP 6552 Discussion: Different Roles of the Nurse Practitioner

NRNP 6552 Discussion: Different Roles of the Nurse Practitioner

The shortage of physicians allows non-physician professionals to practice to the full extent of their education and training which gives patients more options for types of services (ANA, n.d.). Many non-physician health care providers are trained and willing to help meet this need, but are not permitted to do so because of limitations in their scope of practice. Given the shortage of primary care physicians, allowing non-physician professionals to practice to the full extent of their education and training gives patients more options and more types of services (ANA, n.d.).

National Organization of Nurse Practitioner Faculties (NONPF) Competencies Essay

Advanced practice registered nurses (APRNs) can practice to the full extent of education, training, and certification with regard to individual State practice regulations concerning requirements such as clinical supervision or mandatory collaboration with physicians. A certified registered nurse practitioner (CRNP) competencies include functioning as an independent practitioner while demonstrating the highest level of accountability for professional practice. APRN’s provide the full spectrum of health care services including health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, palliative, and end-of-life care (NONPF, 2017). Providers use advanced health assessment skills to differentiate between normal, variations of normal and abnormal findings. Diagnostic screening and strategies aide in the development of diagnosing disease. Medications are prescribed within scope of practice. Patients with acute and chronic disease are managed while providing patient-centered care that recognizes cultural diversity (NONPF, 2017).

A physician’s assistant (PA) role is comprised of primary care and specialty care in the medical and surgical field. Professional competencies for physician assistants include effective and appropriate application of medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning and improvement, and systems-based practice (AAPA, 2013).

The scope of practice for certified nurse midwives (CNMs) includes primary health care for women from adolescence through menopause, contraceptive care, prenatal and postnatal care, care of the newborn during the first month of life, gynecology, family planning services, health promotion, disease prevention, and individualized wellness education and counseling (Marzalik et al., 2018). Prescriptive authority varies from state to state (Marzalik et al., 2018).

Influence on my future practice as an APRN will come from clinical practicum and learning experiences. The PA profession is an emerging profession that provides substantial contribution to the healthcare workforce in all medical specialty areas (Kulo et al., 2021). PA’s practice under a physician giving them a broad knowledge base. This background will challenge my thought process when it comes to diagnosing and treating patients. A surgical PA would be able to provide procedural techniques such as suturing that I may not have exposure to in a primary care office setting. Though similar to an advanced practice nursing degree, the PA’s role with provide a different view and approach to treatment through their diverse training and education. A CNM can provide specific training regarding women’s health, and neonatal health. Their specified education is targeted of women’s health and allows for the expertise that the specialized field requires. A CNM will help expand my role as a Family Nurse Practitioner (FNP) by bridging primary care with women’s health. Healthcare providers educated to provide primary healthcare services such as CNM’s are projected to play a key role in meeting the demand of access to affordable healthcare since the passing of the Affordable Care Act in 2010 (Hastings-Tolsma et al., 2015). A CNM can provide me with insight into caring for a pregnant woman and specific considerations for the high-risk pregnant population. While working with an FNP during my first clinical rotation, I quickly realized the vast amount of knowledge a primary care provider must possess in order to adequately manage patients of all populations. Initiating insulin treatment for a type 2 diabetic and starting statin treatment when lifestyle modifications have not improved cholesterol levels are examples of treatment plans I learned from my previous primary care preceptor. Gaining and applying knowledge from different mid-level providers can improve practice and clinical skills to create a well-rounded FNP.

References

American Academy of Physician Assistants (AAPA) (2013). Competencies for the Physician Assistant Profession. https://www.aapa.org/wp-content/uploads/2017/02/PA-Competencies-updated.pdf

American Nurses Association (ANA). (n.d.). Scope of Practice. https://www.nursingworld.org/practice-policy/aprn/

Hastings-Tolsma, M., Tanner, T., Hensley, J. G., Anderson, J., Patterson, E., Dunemn, K. N., & Purcell, S. K. (2015). Trends in Practice Patterns and Perspectives of Colorado Certified Nurse-Midwives. Policy, Politics & Nursing Practice, 16(3/4), 97–108. https://doi-org.ezp.waldenulibrary.org/10.1177/1527154415601477

Kulo, V., Fleming, S., Gordes, K. L., Jun, H.-J., Cawley, J. F., & Kayingo, G. (2021). A physician assistant entry-level doctoral degree: more harm than good? BMC Medical Education, 21(1), 274. https://doi-org.ezp.waldenulibrary.org/10.1186/s12909-021-02725-5

Marzalik, P. R., Feltham, K. J., Jefferson, K., & Pekin, K. (2018). Midwifery education in the U.S. – Certified Nurse-Midwife, Certified Midwife, and Certified Professional Midwife. Midwifery, 60, 9–12. https://doi-org.ezp.waldenulibrary.org/10.1016/j.midw.2018.01.020

The National Organization of Nurse Practitioner Faculties (NONPF). (2017). Nurse Practitioner Core Competencies Content. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf NRNP 6552 Discussion: Different Roles of the Nurse Practitioner

RESPONSE TO DISCUSSION

It’s evident that the shortage of physicians and non-physician healthcare providers has led to increased responsibilities for APRNs (Advanced Practice Registered Nurses). An APRN can specialize as either a Family Nurse Practitioner (FNP) or a Midwife, depending on their training. While both of these specialized roles are sometimes underutilized in certain communities, they have the potential to save costs and improve care quality when they collaborate effectively (Casey et al., 2017). The synergy between FNPs and Midwives can play a pivotal role in reducing pregnancy-related mortality rates in the United States (Krishnaswami & Del C Colon-Gonzalez, 2019). This collaboration should emphasize mutual respect and open communication (Smith, 2016).

When it comes to maternity care, timely and comprehensive healthcare is crucial from the perinatal period through the postnatal phase. FNPs typically manage medical care, family planning, and early pregnancy management (Van Hecke et al., 2019). For more complex cases or pregnancies extending beyond the first trimester, FNPs can refer patients to Midwives or obstetricians.

References:

Casey, M., O’Connor, L., Cashin, A., Smith, R., O’Brien, D., Nicholson, E., O’Leary, D., Fealy, G., McNamara, M., Glasgow, M. E., Stokes, D., & Egan, C. (2017). An overview of the outcomes and impact of specialist and advanced nursing and midwifery practice, on quality of care, cost and access to services: A narrative review. Nurse Education Today, 56, 35–40.

Krishnaswami, J., & Del C Colon-Gonzalez, M. (2019). Reforming Women’s Health Care: A Call to Action for Lifestyle Medicine Practitioners to Save Lives of Mothers and Infants. American journal of lifestyle medicine, 13(5), 495–504.

Smith, D. C. (2016). Interprofessional Collaboration in Perinatal Care. The Journal of Perinatal & Neonatal Nursing, 30(3), 167–173.

Van Hecke, A., Goemaes, R., Verhaeghe, S., Beyers, W., Decoene, E., & Beeckman, D. (2019). Leadership in nursing and midwifery: Activities and associated competencies advanced practice nurses and midwives. Journal of Nursing Management, 27(6), 1261-1274.

Discussion: Different Roles of the Nurse Practitioner

The term ‘history’ is multifaceted, and similarly, nurses, including nurse practitioners, assume various roles within the broader healthcare framework. These roles can stem from specific interests such as women’s health or technical nursing specialties.

For this discussion, it’s essential to consider the specific skills outlined in each module of this course, defining the advanced Nurse Practitioner’s skillset. Furthermore, examining the guidelines from the American Nurses Association (ANA), NP competencies, and ethical resources from this week’s Learning Resources provides insight into how these factors shape the role of the NP.

Now, let’s delve into the distinctions among CRNPs, CNMs, and PAs and how these roles can impact the practice of FNPs.

References:

AANP. (2021). What’s a nurse practitioner (NP). https://www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner

AMA Journal of Ethics. (2021). Illuminating the art of medicine. https://journalofethics.ama-assn.org/article/physician-assistants-and-their-role-primary-care/2012-05

American Nurses Association (ANA). (n.d.). Scope of practice. https://www.nursing-world.org/practice-policy/scope-of-practice/

Ang, W. C., Abd Rahim, S. N., Abd Rahman, N. F., Muhamad, S. N., Rokimi, W. R., & Ng, S.C. (2021). Healthcare Professionals’ Experiences on Interdisciplinary Collaboration in a Medical Department of a Malaysian General Hospital. Medicine & Health (Universiti Kebangsaan Malaysia), 16(1), 246–255.

Manning, B. T., Bohl, D. D., Hannon, C. P., Redondo, M. L., Christian, D. R., Forsythe, B., Nho, S. J., & Bach, B. R. (2018). Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine. Orthopaedic Journal of Sports Medicine, 6(4), 1–7.

Staff Writers. (2021). What is a certified nurse-midwife (CNM)? https://www.nursepractitionerschools.com/certified-nurse-midwife/