Nursing Research Paper on APN Professional Development Plan

Introduction

Advanced practice nurses (APN) cover a wide scope of roles and responsibilities in the nursing environment and include a variety of nursing professionals in the care environment. Typically, certified nurse practitioners (CNPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) are classified as APNs. Essentially, professional development is a crucial aspect of the effective performance of these nurses. Professional development, in this context, denotes the development of skills, attitudes, and competencies required to perform the roles and responsibilities associated with APN effectively. APNs also work as nurse leaders in most of the healthcare environments in which they work, and their practical and leadership competencies are important for their tasks. This paper explores the APN scope of practice. The objective of the paper is to provide an overview of the APN job function, including the scope of practice, the core competencies, and the leadership skills required of the professionals. These elements form essential components of the professional development of the APN job function.

APN Scope of Practice

The Advanced practice registered nurse (APRN), or advanced practice nurse (APN) performs a wide scope of duties in the healthcare environment. The extent of the roles of these professionals in healthcare has been recognized over the past years, particularly with the increasing complexity of the activities associated with the nursing care environment. In the past, there had been various APN’s practice was restricted, especially due to requirements for licensure from organizations such as the Federal Trade Commission (FTC), the Institute of Medicine (IOM), and the Bipartisan Policy Center among others (American Nurses Association, 2020). APNs possess the skills to give cost-effective and quality healthcare services, an outcome that is not often felt due to the regulatory barriers to full practice authority (American Nurses Association). In the recent past, however, recognition of the contribution of APN to healthcare has increased, and these professionals have been authorized by State Nurses’ Associations to work with nurses towards realizing their full potential in healthcare service delivery.

Based on the increasing collaboration between state nurses’ associations and APNs, the state provides codes of practice that define the scope of practice for APNs. For instance, in the state of Ohio, where I intend to practice after my education, the scope of practice for APRNs is defined within chapter 4723-8 of the Ohio Administrative Code. The code presents a description of the expected qualifications of the APN and the scope of practice for the position. Additionally, the academic qualifications associated with the role are outlined in the administrative code, chapter 4723.41, and chapter 4723.41 (Lawriter, n.d.). Any person intending to practice as an APN must first be a registered nurse, having completed his/her educational qualifications, including having earned a doctorate or master’s degree with a major in at least one nursing specialty area; completed and passed the national certifying body examinations and be approved by the board; and submitted an affidavit to confirm that the person in possession of the different documents is their legitimate owner. The documents include the identification documents, and a confirmation of the age, residence, college of graduation, and any other facts that may be required by the board. According to chapter 4723-8-02, any person who intends to practice as an APN must possess the requisite skills and knowledge, which are gained through a clinical practicum in addition to advanced formal education (Lawriter, n.d.). The requirements outlined purpose to confirm the possession of the needed skills and knowledge.

APNs are authorized to practice according to their education and clinical experience, as outlined in the documentation submitted to the board. Such documents include their national certification, the license they hold at the time of practice, and the knowledge and practice of chapter 4731 of the administrative code (Lawriter, n.d.). The APN is also allowed to practice within the scope of the mandate of a registered nurse without any prohibition. In effect, it is clear that NP practice in the state of Ohio conforms to the requirements. An APN in the state of Ohio is authorized to work collaboratively with other healthcare practitioners, such as primary care physicians, to offer preventive and primary care services. Additionally, these professionals provide acute care services and promote healing within the care environment in accordance with the nursing specialty, the educational level, and certification, and in alignment with the rules of the Ohio Board of Nursing (HRSA, 2020). The NP in Ohio has the authority to prescribe Schedule III-V controlled substances as well as general prescription drugs when in collaboration with a physician. Additionally, when the patient has a terminal condition, the NP is authorized to prescribe Schedule II controlled substances. In such a case, the supervising physician should have initially prescribed the substance, and the prescription amount has to be within the maximum amount allowable for the patient in any given 24 hour period (HRSA, 2020). This practice scope allows the NPs to explore their potential in both leadership and general practice.

Nurse Practitioner (NONPF) Core Competencies

For effective practice as an APN, various core competencies are outlined in the NONPF Core Competency documents shared in the class. Understanding the core competencies can help the APNs to identify their areas of strength and weakness and optimize their strengths while minimizing the weaknesses. One of my strengths lies in the quality core competency. As a student, I have been involved in various research activities that have enabled me to build skills in collecting evidence for improving the quality of clinical practice. I have also learned to utilize peer-reviewed literature to access clinical information and direct effective nursing service delivery. Moreover, I understand the implications of care quality, access, cost, and safety on the healthcare outcomes and balance across all the variables during care delivery. With an understanding of how financing, care processes, marketing, and policy decisions affect the healthcare service quality in a healthcare environment, it is possible to deliver quality services effectively.

My other strength is in the ethics competency. In this regard, I have developed proficiency in various practical aspects related to work ethics, including understanding the ethical implications of decision making, integrating the ethical perspectives in decision making, and applying ethically sound solutions when it comes to solving problems. With a comprehension of the ethical code of practice in the state of Ohio, I am certain that I will be capable of delivering quality and safe service to patients.

Despite my strengths, I have weaknesses in two competencies, namely, technology and information literacy and independent practice. Some of the dimensions of the independent practice competency include the ability to work independently as a licensed practitioner, demonstrate a high quality of professional accountability, offer the entire spectrum of patient care services independently, and independently employ various diagnostic strategies in the care. Since I am still a student and thus unlicensed, I am still unable to satisfy the expectations of independent practice fully. Nevertheless, I am certain that through education, I will be able to realize this competency fully. In terms of technology and information literacy, the range of expectations includes the ability to incorporate technology in nursing practice, translating the scientific and technical health information for the benefit of the patient, decision making based on information literacy, and coaching patients and caregivers towards behavioral change using technology among others. These skills are built during practice and go hand in hand with independent practice. Furthermore, different healthcare facilities have different technological systems that require one to be aligned with.

Leadership Skills

Nurse practitioners work within a complex environment in which besides providing conventional clinical services, they also provide leadership to other nurses due to their professionalism. The nursing environment itself is sufficiently complex to warrant the possession of certain leadership skills through which the APN can foster progress in patients’ care. One of the leadership skills that I believe I have gained through this program as well as personal initiative is communication. As an NP, communication skills are mandatory as they foster the development of professionalism in nursing practice. Communication enables the NP to collect information on evidence-based practice and apply it to the nursing environment.

Another skill that I have gained over time is that of optimism. Informal leadership provided by the nurse to the patient requires an understanding of what the patient is going through and the ability to encourage the patient to see a better future. Accordingly, Lamb et al. (2018), assert that a nurse should have the leadership role of encouraging the heart. I believe I have built the capacity to work effectively with the available resources to build hope in patients. Lastly, I have a very strong resolve for work. The APN nursing role is very tasking because the workload can be pretty demanding. It requires an individual with strong resilience to serve as both a leader and to deliver actual clinical practice. Over time, I have realized that I have tenacity, and I am capable of handling demanding workloads while at the same time maintaining my positivity. As mentioned, I have several weaknesses. Nevertheless, many of them are because of the fact that I have not finished my training. I am confident that by the time I complete my training, I will have overcome these weaknesses.

In order to advance in these leadership skills, transformational leadership will be most appropriate for the NP profession. Transformational leadership helps to motivate both leaders and their followers to higher moral standing and better ideas, and requires the development of a strong sense of internal values and ethics (Doody & Doody, 2012). As such, I would want to embody transformational leadership in my practice, through its four components namely, individual consideration, idealized influence, intellectual stimulation and motivational inspiration. I am certain that this leadership style will allow congruence between holistic and collective insight, fostering openness between the provider and the patient and his/her family. Alternatively, I could use complexity leadership as my style to foster my understanding of leadership and its implementation in a complex environment such as that surrounding the NP profession.

Conclusion

Advanced practice nurses have a lot of responsibilities, especially because of an ever-expanding scope of practice within the contemporary healthcare environment. The Ohio administrative code outlines the scope of practice of the APN, including their prescriptive authority, and the code is expected to guide nurses, such as myself, in clinical practice in the state. The ability to deliver value in accordance with the nursing code of practice requires possessing various competencies and leadership skills. Out of these capabilities, I am skilled in ethics and quality service delivery and potentially weak in independent practice and technology and information literacy. I believe that through education and practice, I will be able to gain the skills and competency required for independent practice.

References

American Nurses Association (2020). Advanced practice registered nurses (APRN). Retrieved from www.nursingworld.org/practice-policy/aprn/

Doody, O. & Doody, C.M. (2012). Transformational leadership in nursing practice. British Journal of Nursing, 21(20), 1212-1214. Retrieved from www.ncbi.nlm.nih.gov/pubmed/23132001

Health Resources and Services Administration (HRSA) (2020). Ohio scope of practice policy: State profile. U.S Department of Health and Human Services. Retrieved from scopeofpracticepolicy.org/states/oh/

Lamb, A., Martin‐Misener, R., Bryant‐Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open,5:400–413. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC6121481/#__ffn_sectitle

Lawriter (n.d.). Chapter 4723-8: Advanced practice registered nurse certification and practice. Ohio Laws and Rules. Retrieved from codes.ohio.gov/oac/4723-8