Advanced Practice Roles for Nurses
Nurse practitioners: Nurse practitioners are primary care providers during diagnosis and treatment of illnesses. NPs work independently in close collaboration with the patients usually from the same family over a period of many years.Sometimes they offer specialty care. NPs can choose to specialize further in working within a narrow segment of the population such as pediatrics, women health, neonatal care, adult gerontology or psychiatry mental health.A large number of NPs also work in various community clinics serving underserved and diverse populations.
Nurse anesthetists: Nurse Anesthetists provide care and advice relating to anesthesia delivery pre, during and post diagnostic, surgical, therapeutic and obstetrical procedure.
Clinical nurse specialists: CNSs are specialists in providing patient care and expert advice in several nursing practice specialties according to the setting such as critical care and disease of subspecialty such as oncology. The specialty can also relate to the type of care such as rehabilitation and population.
Nurse midwives:Provide primary care focusing on women health services including gynecological examinations, family planning prenatal, labor, delivery and post natal care.
An APRN can work in one of the above specialties, and their skills can fit in different work environments. APRNs are qualified to work in all health care settings including ambulatory clinics, hospitals, and long term care facilities.Many nurse practitioners prefer working in private practice often in their office. Others work under a family physician.
Scope of Advanced Practice Roles in Nursing
It’s hard to limit the scope of APRN professionals as it encompasses a variety of specialties thus widening the ceiling of the practice issues associated with care giving. Nonetheless, independent practice is the main scope across all the APRN specialties. It means that APRNs work in an enabling environment where they can provide direct care service without any supervision or compelled collaboration with the physicians. It applies to APRNs who offer their services in hospitals, private offices, patients' homes or outpatient centers.
However, all APRNs consult with, collaborate and refer to physicians. Many still practice in settings where they are in a team with doctors and other healthcare providers.
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Specific legal requirements in the state of practice on physician involvement may limit the services that an APRN will provide and areas of practice. Some of the legal requirements at times make it harder for patients to get a full range of care from nurses in advanced practice.
It is noteworthy that some jobs in advanced nursing are in a larger setting such as anesthetists who due to the nature of procedure have to work under a surgeon or doctor for them to fulfill their role. Laws at many states also restrict the movement of midwives including the certified nurse midwives thus the rules and scope may differ from one area of practice to the other.
Medicine Dispensation Advanced Practice Roles in Nursing
APRNs have prescriptive authority for some types of medication depending on their specialty and state at which they work. For example, in 45 US states, APRNs can complete the cycle of patient care on their own from diagnosis, treatment, and medication prescription after a patient checks in and for follow up visit.
State regulation on prescriptive authority falls into restricted, reduced and full practice categories. Nurses are free to prescribe these types of medicine.
- Antibiotics with proper credentialing
- Birth control pills
APRNs require individual credentialing to prescribe these drugs:
Earning a degree and certification to be an APRN comes with more tangible benefits in addition to work autonomy that an RN. It allows professionals to work more flexible schedules within business hours. Additionally, an APRN is recognized as a source of knowledge and can get teaching roles within their work settings or in the wider settings. There is an increase in abilities to participate in research, contribution and development to the advancement of their career, specialty as well as nursing field.
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