Over time, the concept of advanced nursing practice has changed. The expectation is that it will continue to do so. The reason for this is its dependence on what stakeholders understand as the scope of practice. Through the years, the scope has developed to respond to the changing social and health needs of the society. The models of healthcare delivery also have changed. Many competencies and skills fall under the realm of advanced practice but are gradually becoming essentials for the contemporary practice of every day. There exist multiple models and definitions regarding advanced practice. Different settings define them differently. Nonetheless, advanced practice nurses (APNs) have a type of specialty practice and have education up to master’s level. They also have competency in practice with expert skills and knowledge. Unlike other nurses, APNs have the authority and freedom to act and make autonomous decisions in diagnosis, assessment, and treatment (Duncan and Nelson, 2015).
The choice to become an advanced practicing nurse (APN) differs among different nurses. The purpose of this discussion is to discuss reasons and specialty for nurses’ decisions to pursue the advanced nursing role. It also aims at differentiating education, history, practice, and the role of differences between non-clinical and clinical master’s prepared APN. In addition, the paper aims to describe the four roles that define advanced practice nursing, as well as the requirements of each. Finally, it aims at identifying the impact of pursuing advanced practice role in the career of a registered nurse (RN).
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"Role of Advanced Nurse".
There are several fields available for registered nurses (RNs) that they can choose in taking their advanced practicing nursing (APN). For example, there are community health, nursing research, pediatrics, and even health assessment nursing, among many others. However, scholarly findings indicate that palliative care is a growing specialty that needs APNs (Gibson, 2016 and Camal, 2017). Thus, the specialty of choice is palliative care. It regards a specialized medical care for people with severe illnesses who are at their end-of-life stage. It focuses on relief from stress and symptoms of the condition. There are many reasons why RNs should undertake APNs. One of them is to expand ones’ interest and professionalism. According to Camal (2017) and Duncan and Nelson (2015), APNs have autonomy in decision-making. Therefore, one will expand their knowledge and skills in the specialty of choice and become more autonomous than before. In addition, it promotes leadership for the practicing nurse. Leadership is an important concept in nursing and opens up opportunities for advancement. APNs have such opportunities for improvement. Relatively, APNs are a part of the elite group. Thus, by pursuing it, one gets a sense of belonging in the team.
Clinical and non-clinical master’s prepared advanced practicing nurses (APNs) have differences. First, a clinical nurse is a nurse specialist (CNS) that has a doctorate or a master’s degree in a particular specialty. According to McDonnell et al. (2014), they have direct involvement with a patient. However, a non-clinical nurse does not have a direct association with a patient. The history of their education is also different. For example, a clinical master’s prepared APN has to have a Bachelor’s degree in nursing, while it is not so for a non-clinical one (McDonnell et al., 2014 and Gibson, 2016). A clinical nurse specialist (CNS) undergoes advanced educational expertise and preparation in a particular specialty. The same is not applicable to a non-clinical master’s prepared APN because they do not involve directly with the patient. Accordingly, a clinical APN has a unique role to play in healthcare provision, which is to improve healthcare quality. On the other hand, the primary function of a non-clinical master’s prepared APN is to conduct a robust assessment of the nursing environment (Gibson, 2016).
The four roles that define advanced practice nursing (APN) are Nurse Practitioners (NP), Clinical Nurse Specialists (CNS), Certified Nurse-Midwives (CNM), and Certified Nurse-Anesthetists (CNA). For a nurse to qualify for any of the four roles, they must be an advanced practice registered nurse (APRN). For one to be a Nurse Practitioner (NP), they must have a practicing certificate. However, a special group of nurses that cares for acute patients in various fields does exist, known as Acute Care Nursing Practitioner (ACNP). The difference between ACNP and NP is that the former has more experience in the field chosen for providing specified health care, making him/her an expert. For one to be an ACNP, one must obtain at least a Masters, postgraduate diploma or Doctorates in the specified field.
For one to be a CNS, they must have a master’s certificate. For one to be a CNM, they must have a certificate in midwifery. Finally, to be a CAN, one must have a post master’s certificate in anesthetics (McDonnell et al., 2014, and Ellerbe and Regen, 2012). It is important to know that APRNs receive their practicing licenses from the state board of nursing to give patient care within their roles and population of patients in focus, being that different states have different authorizes to prescribe practice and medication independently.
Ellerbe and Regen (2012) note that a registered nurse (RN) can advance their career if they take up a master’s level to become an advanced practicing nurse (APN). It propels their nursing profession into new levels that provide them with opportunities to better their skills and knowledge. It will also open opportunities to move to the doctorate level and becomes nursing specialists. In addition to that, it will enable them to be in high demand for their services, which will increase their salaries and serve a large number of patients, making a significant difference in the lives of many in the process.
The discussion evaluates four critical concepts of advanced practice nursing (APN). First, it identifies the specialty of choice as palliative nursing and the main reason for undertaking a master’s prepared APN is to gain autonomy in practice, advanced nursing knowledge and skills. It then evaluates the differences between clinical and non-clinical master’s prepared advanced practicing nursing. The main difference is that the former has direct contact with the patient while the latter does not. The four roles that define nursing practice are Nurse Practitioners (NP), Clinical Nurse Specialists (CNS), Certified Nurse-Midwives (CNM), and Certified Nurse-Anesthetists (CNA). They have different qualifications. Finally, undertaking advanced practicing nursing role enhanced the career of a registered nurse, opening new opportunities for them in the process.
