The Nurse Practitioner (NP) is prominently involved in meeting the healthcare needs of patients in the United States. The profession came a long way since its inception in 1965. With the expansion of Medicare and Medicaid, so many people qualified for the program prompting a need for more nursing professionals. The nurse practitioners are essential members of the healthcare system involved in the provision of high-quality care.
The NP program was established to address the ever-changing medical needs of the people. Clark et al. (2015) claims that the need for professionals led to the conception of NP in 1965 to address the myriad needs of low-income women, children, elderly and the disabled. Clark et al. (2015) further report that the Nursing Practitioner (NP) was first established as a certification program before it evolved to become a master’s degree in the 1970s. The first graduates of the program worked as pediatricians after which the faculty expanded the program to include other specialist programs. Clark et al. (2015) reveal that the establishment of American Nurses Association (ANA) accelerated the recognition of NP through the certifications and nursing standards it enforced. The NP has continued to grow courtesy of the enactment of healthcare policies like Affordable Care Act that continue to create need for more nurses performing essential roles.
Function of the FNP Role
The Family Nurse Practitioner (FNP) is a graduate-educated, nationally recognized and state-certified advanced practice registered nurse (APRN). Per Clark et al. (2015), the FNP care for the medically stable patients represented from diverse age groups like infants, adolescents, adults and the elderly. They particularly provide essential care and support to adults and the elderly suffering from chronic illnesses like diabetes and high blood pressure (Clark et al., 2015). These nurses ensure the patients with chronic diseases adhere to their medication and lifestyle change remedies. In addition, the FNP manages the well-being of children and adolescents as they treat any occurring ailment to make sure they are physically and mentally fit. Clark et al. (2015) claims that FNP provide pre and post-pregnancy medical services to women. The intention is to promote health and well-being of the mother and child. The FNP also work alongside other multidisciplinary teams to provide comprehensive care to the mentally ill patients.
Significance of the FNP Role
The FNP is significant in the medical system because it focuses on the provision of quality care to the diverse patients they serve. It is reported that about 50 percent of FNP benefit from other privileges granting them power and authority to admit patients as well as order referral services (Clark et al., 2015). These nurses had in the past provided quality care with the highest patient satisfaction rates making them essential members of the profession. The essential services they offer include comprehensive care ranging from disease management, preventive services to health education and promotion. Clark et al. (2015) assert that FNP also actively engage with patients to gain a succinct understanding of their needs, diseases to offer more practical and customized medical help capable of improving patient outcomes. They are equally significant in the medical system as they provide cultural competent and sensitive care to the underserved members of the population.
FNP Scope of Practice
The scope of practice of FNP is defined by the state boards that provide certification and enforce nursing standards of practice. Per Whitehead et al. (2017), scope of practice refers to the expression stipulating the group of services and procedures that nursing professionals are authorized to perform. As outlined the scope of practice vary depending on the state. Although FNP are perceived as primary caregivers, their medicine prescription must be endorsed by physician in California. In Oklahoma, FNP have autonomous prescription authority though it has to be approved by a certified physician (Metzger & Rivers, 2014). In Washington, the FNP have the privilege to admit and discharge patients.
The APRN specialty roles include the provision of primary, acute and special services to patients. Per Woo et al. (2017), these services span from medical assessment to understand medical condition, diagnosis and treatment of injuries and illnesses reported by the patients. The APRN, especially the qualified and certified midwives provide essential primary and reproductive health to women (Woo et al., 2017). The essential services include treatment and support to mothers during and after pregnancy to ensure that both mothers and children stay healthy. The APRNs help drive institutional changes like evidence-based practice to roll-out new practices aimed at improving patient outcomes.
The FNP have lengthy history of actively engaging their patients. Per, Whitehead et al. (2017), FNP engage patients to support them understand their patients and practical measures that can be incorporated to enhance improvement. The FNP role is slowly becoming dominant because almost half of the nurses are family nurses and the role is flexible as they provide care across different ages of patients. Whitehead et al. (2017) claims that FNPs work alongside other professionals to enhance case management for long-term illnesses. The role requires specialists to perform diseases diagnosis, interpretation of tests, conduct medical assessments, offer counseling help and at times prescribe medications.
There are diverse certification bodies existing to certify the APRN roles and specializations. Metzger & Rivers (2014) report that registered nurses can choose from American Association of Critical Care Nurses (AACN) and America Nurses Credentialing Center (ANCC) for their certifications. For a nurse to be certified by ANCC, he or she must complete a graduate nursing program and be accredited by the Accreditation Commission for Education in Nursing (ACEN) (Metzger & Rivers, 2014). Additionally, the nurse need to complete 500 clinical hours in a medical setting that is aligned to the specialization of the nurse (Metzger & Rivers, 2014). Explicitly, the FNP must hold masters, doctoral or a post-graduate degree to be certified.
Nurse practitioners are allied to professional organizations to aid them access varied opportunities relating to continuous education, conferences and networking events. In addition, nurses expect job listing and consistent professional update from these professional bodies. The American Association of Nurse Practitioners (AANP) remains the dominant body unifying more than 222,000 nurse practitioners (Buerhaus et al., 2015). The vision of the AANP is to enhance the provision of high-quality care to all patients. The other notable associations include the Gerontology Advanced Practice Nurses Association (GAPNA) offering conferences for advanced practice nurses directly providing care to the elderly (Buerhaus et al., 2015). Furthermore, the National Association of Pediatric Nurse Practitioners (NAPNAP) is for pediatricians dedicated to improve the quality of care for infants, children and adolescents.
Barriers to the APRN Role
Despite the growth of nurse practitioners profession across the United States, barriers continue limiting the practice and the ability of nurses to provide high-quality care to patients. Hain & Fleck (2014) reveal that these barriers have negatively impacted on the willingness of nurses to provide dedicated care. Foremost, the cultural barriers have made it difficult for nurses to establish trust with their patients. The differences in cultural values and beliefs interfere with the acceptance of treatment and care recommendations. The cultural biases equally cause patients to discredit nurses not from their cultural groups (Hain & Fleck, 2014). Moreover, some of the advanced practice nurses, because of scope of practice in some states, are not allowed to prescribe medicine despite the mounting concerns on their ability to prescribe in the wake of substance abuse increase.
Current and Future Trends
The advanced nursing practice role is witnessing varied trends. Currently, the nurse practitioners are undertaking additional education and training to become more independent. Besides, there is increased emphasis on the application of evidence-based guidelines to make decision supported by accurate and attestable data. Per Woo et al. (2017), with the increase in population, and the evolving patient needs, the nursing profession is presently enduring with the shortage of nurses creating employment opportunities for nurse students. Ultimately, the FNPs are slowly becoming dominant because of the flexibility and capacity of these nurses to provide care across diverse age groups.
In the future, nurse practitioners are poised to become essential members of the healthcare system as they provide dedicated care to the entire American population. Consequently, Woo et al. (2017) believe there is likely to be a peak demand for nurse practitioners because of the increasing demand for primary care as well as outpatient facilities. Finally, the need for more specialist nurse is likely to increase as the healthcare system attempts to address the diverse needs of patients drawn from different cultural groups.
Elements to Incorporate
To achieve the goal of providing high-quality care to patients, a FNP need to incorporate wide variety of competencies. Competencies refer to what nurses are needed to know once they graduate (Woo et al., 2017). The key competencies of FNP include leadership, information technology literacy, ethics, and quality care as well as practice inquiry. The leadership competencies of FNP relate to professional accountability, scholarship and advocacy (Woo et al., 2017). I intend to embrace high leadership opportunities to facilitate change and formulate policies expected to improve patient outcomes. Further, quality care competencies relate to the degree to which FNP offer services to increase desire patient outcomes. I plan to relate evidence-based findings to clinical practice aimed at improving patient outcomes.
Consequently, practice inquiry competencies focus on the application of research to clinical practice. I should be able to translate contemporary evidence into practice through elaborate leadership abilities. Brassard (2014) maintains that FNP should be able to utilize information technology tools to translate health information to varied users. I plan on incorporating varied technology knowledge to support patients understand conditions and treatments associated with diseases. Ultimately, I understand the need to comprehend the ethical implications of my actions as well as negotiate specific ethical dilemmas. The ethical knowledge is utilized during decision-making processes to understand the impacts of decisions made.
The reforms witnessed in the health care system imply that NP play and are poised to carry out significant roles in improving patient outcomes. The APRNs should be able to practice to the fullest as they attempt providing primary care based on their specialization anchored on education and training background. Expressly, the FNPs should be supported by the relevant professional organizations to provide care across different age groups. The existing institutional and professional barriers should be addressed to eliminate practice limitation. The competencies needed of nurses should be incorporated to achieve the nursing goals.
Brassard, A., (2014). Overview and summary: APRN Roles: Opportunities and challenges for practice and education. OJIN: The Online Journal of Issues in Nursing, 19(2). Doi: 10.3912/OJIN.Vol19No02ManOS.
Buerhaus, P., DesRoches, C., Dittus, R., & Donelan, K. (2015). Practice characteristics of primary care nurse practitioners and physicians. Nursing Outlook, 63, 144-153. Doi: https://doi.org/10.1016/j.outlook.2014.08.008.
Clark, L., Casey, D., & Morris, S. (2015). The value of Master’s degrees for registered nurses. British Journal of Nursing, 24(6), 328-334. doi:10.12968/bjon.2015.24.6.328
Hain, D., & Fleck, L. (2014). Barriers to Nurse Practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2), Manuscript 2. Doi: 10.3912/OJIN.Vol19No02Man02.
Metzger, R., & Rivers, C. (2014). Advanced practice nursing organizational leadership model. The Journal for Nurse Practitioners, 10(5), 337-343. Doi:10.1016/j.nurpra.2014.02.015.
Saleh, U., O’Connor, T., Al-Subhi, H., Alkattan, R., Al-Harbi, S., & Patton, D. (2018). The impact of nurse managers’ leadership styles on ward staff. British Journal of Nursing, 27(4), 197-203. Doi:10.12968/bjon.2018.27.4.197.
Whitehead, D. K., Dittman, P. W., & McNulty, D. (2017). Leadership and the advanced practice nurse: The future of a changing health-care environment. Philadelphia: F.A. Davis Company.
Woo, B., Lee, J., & Tam, W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15(1), 63. https://doi.org/10.1186/s12960-017-0237-9.