NSG 5000 Week 1 Assignment 4: Advanced Nursing Practice

Nursing Profession

Nursing is one of the most exciting and in-demand jobs in America today. The aim of Nurses is to work to promote health, prevent disease and help patients to cope with illness. They are the first point of contact for the patients. They are advocates and health educators for patients, families and communities. When providing direct patient care, they observe, access and record patient symptoms, reactions and progress. Nurses collaborate with physicians in the performance of treatments and examinations, the administration of medications and the provision of direct patient care.

Nurses work in an environment that is constantly changing to provide the best possible care for patients. They are continuously learning about the latest technology and medication as well as considering the evidence that their nursing practice is based upon. Because they will actually tend to spend more face-to-face time with a patient than doctors, nurses must be particularly skilled at interacting with patients, putting them at ease, and assisting them in their recovery. It is often said that physicians cure, and nurses care.

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Advanced Nursing Practice

Advanced nursing practice is an umbrella term describing an advanced level of clinical nursing practice that maximizes the use of graduate educational preparation, in-depth nursing knowledge and expertise in meeting the health needs of individuals, families, groups, communities and populations.

It involves:

Analyzing and synthesizing knowledge
Understanding, interpreting and applying nursing theory and research; and
Developing and advancing nursing knowledge and the profession as a whole.

Characteristics of advance nursing practices

In advance nursing practice, nurses build on their expertise in a speciality area, integrating and consistently displaying the below features and characteristics:

To have provision of effective and efficient care, delivered with a high degree of autonomy, to an identified population
Demonstration of leadership and initiation of change to improve client, organization and system outcomes
Deliberate, purposeful and integrated use of in-depth nursing knowledge, research and clinical expertise, as well as integration of knowledge from other disciplines
Depth and breadth of knowledge that draws on a wide range of strategies to meet the needs of clients and to improve access to and quality of care
Ability to explain and apply the theoretical, empirical, ethical and experiential foundations of nursing practice.
Use of knowledge – transfer techniques to put research-based knowledge into practice
Critical analysis of and influence on health policy.

NSG 5000 Week 1 Assignment 4: Advanced Nursing Practice

Internal challenges of advanced nursing practice

There was not enough qualified nursing faculty are available to meet the nation’s need for increased numbers of Advanced practice registered nurses (APRN), and the projections describing future shortfalls are bleak. Educational organizations find it increasingly difficult to attract qualified APRNs willing to serve in faculty roles. The demand for APRNs in both educational institutions and in a variety of practice settings has increased simultaneously, but educational institutions are disadvantaged by their inability to offer competitive compensation packages.

Constrained budgets result in compressed salaries throughout higher education systems, increasing the gap between salaries available in practice and those offered for teaching positions. The Emphasis on the role of faculty in conducting research and generating research-related revenue limits the availability of PhD-prepared APRN faculty to participate in direct clinical supervision of APRN students. One result is that the primary responsibility for APRN clinical education falls to faculty not eligible for tenure and whose salaries are typically lower than those available for APRNs in clinical practice.

Educational institutions without established faculty practice plans face additional barriers for supporting and retaining faculty who need to practice to maintain certification and licensure, in addition to teaching and meeting tenure criteria.

External challenges

The primary challenge facing APRN education from outside educational institutions is the limited number of available clinical sites and preceptors. To increase the number of APRNs prepared to practice independently and to the fullest extent of their scope of practice, nursing education programs must increase both the number and quality of available preceptors and sites. Since many existing faculty practice settings are inadequate to meet this need, educational institutions must rely on cooperative, volunteer community preceptors. There is a shortage of APRN preceptors, particularly in acute care or hospital-based specialties.

The limited availability of national funding poses a significant external challenge to successful APRN education. Increasing the capacity of educational institutions to educate APRNs requires additional funding. The current prioritization for medical education and residency training through federal support makes increasing funding for nursing education difficult. Furthermore, current research funding priorities by the National Institute of Nursing Research do not support the investigation of nursing education issues, nor do they support research about the implementation of innovative practice education models at the graduate level.

In many research organizations, nursing faculty pursuing academic careers and tenure are discouraged from pursuing clinical education research as a funded line of inquiry. Among potential APRN preceptors, there may be a lack of willingness to precept APRN students due to a lack of incentives beyond the ideals of serving the profession. Most educational institutions are unable to compensate preceptors financially for their teaching roles and are limited in the nonfinancial benefits they may provide preceptors such as faculty titles and access to educational resources. Potential preceptors may see the challenges to practitioner productivity or the additional time commitments of being a preceptor as disincentives to assuming the role. The lack of formal preparation and support for the teaching role may further discourage APRNs from being a preceptor.

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Reference

DOHWA, (2007) The Nurse Practitioner Series Vol. 2, No. 1, Department of Health Western Australia [Online] Available at: http://www.nursing.health.wa.gov.au/docs/reports/np_series_vol2_no1.pdf [Accessed 22 July 2010].

Mowat, D., (2007) Evidence-Based Decision-Making in Public Health, Ethos Gubernamental [Online] Available at: http://www.pahef.org/success_stories/ethos_iv/english/EvidenceBasedDecisionMakinginPublicHealth.pdf [Accessed 22 July 2010].

Pearson, A., Wiechula, R., Court, A., & Lockwood, C., (2007) A Re-Consideration of What Constitutes “Evidence” in the Healthcare Professions, Nursing Science Quarterly, Vol. 20, No. 1.

Shultz, J., & Shultz, B., (2004) Investigative Protocol Pressure Ulcer [Online] Available at: http://www.vpurt.org/files/INVESTIGATIVE%20PROTOCOL-F314%20updated%20Nov%202004-7%20pages.pdf [Accessed 22 July 2010].