In advanced nursing practice nurse practitioners, educators, administrators, and informaticists play vital roles in shaping the future of healthcare (Bryant-Lukosius et al., 2004). Advanced practice nurses usually play the role of providers of primary care, at the forefront of ensuring preventive healthcare to the public. The healthcare industry is increasing in complexity, hence, the need for advanced nursing practice also increases. Such people are always ensuring the provision of health care to the population. Even as they work in learning institutions, advanced practice nurses are always ready to diagnose and treat patients with chronic and acute illness and also prescribe medication. The above responsibilities in nursing require individuals who are as savvy and smart as caring and compassionate (Youngblood & Beitz, 2001). The current research paper explores the four main advanced nurse practices, including nurse practitioners, nurse educators, nurse administrators, and nurse informatics. A nurse practitioner’s competency is categorized into different sections, such as scientific foundation competencies, leadership competencies, quality competencies, practice inquiry competencies, and technological and information literacy competencies. Nurse educators, on the other hand, are responsible for creating environments in laboratories, classrooms and clinical settings that enable learning to achieve desired affective, cognitive and psychomotor outcomes. A nurse informaticist will, however, find ways to improve communication and information management in nursing for cost reduction, efficiency, and enhancement of the quality of healthcare.
The Roles of Nurses
The Roles of Nurse Educator
Nurse educators are the first in line regarding advanced nursing practices. Nurse educators have the responsibility to create an environment in laboratories, classrooms and clinical settings, which facilitate learning and achieving desirable psychomotor, affective and cognitive outcomes (Parse, 1992). It is a general overview of what nurse educators do. Their sole purpose is to ensure learners in the nursing field to create a conducive environment for furthering their competencies. To do so, a nurse educator will implement different teaching strategies relevant to a learner’s requirements, needs and desired outcomes. A nurse educator will also undertake ground teaching strategies in evidence-based teaching and educational theories in order to enhance learners competencies (Bryant-Lukosius et al., 2004). In an attempt to improve oneself, a nurse educator will engage in self-reflection to gauge his or her competency and the progress of learning of the student’s. Student’s will also be required to have an understanding of information technology and use it to further the learning process. Furthermore, a nurse educator has to realize his or her responsibility to help learners develop as nurses and integrate into the behaviors and values, which should have people in their position. The main aim here is to facilitate learners’ development and socialization (Brown, 1998).
In order to achieve success in the above process, the nurse administrator will use assessment and evaluation strategies to gauge the progress of learners. Nurse administrators use different strategies to assess and evaluate learning in laboratories, classrooms and clinical settings, and other relevant domains of learning. They, however, do not take a backseat role as they can also participate in the design of the curriculum and entire evaluation of the teaching’s outcomes. Nurse educator has a little attitude to administrations as they spend the majority of their time in the educational settings. The aim of this category of nurses is to learn students to be able to handle varieties of problems in the nursing field. Therefore, they hardly engage in nursing practices like taking care of patients and diagnosing illnesses. Nurse educators are legally required to maintain work ethics such as disclosing all the relevant materials and facts to learners regarding their future positions as nurses.
The Roles of Nurse Informaticist
The role of nurse informaticist focuses on realizing ways to make a better management of information and communication among nurses in order to reduce costs, improve efficiency and enhance the overall quality of healthcare. Nurses in this field integrate data, information, and knowledge in order to facilitate decision-making in the industry. To support these information structures, information technology and information processes are utilized (Bryant-Lukosius et al., 2004). In addition, documentation plays a great role in nursing informatics; this is due to the fact that it focuses on effective communication among patients and healthcare providers. Utilized resources here include notes written in a patient’s chart, and nursing informatics seeks to improve timeliness, speed, and accuracy of patients’ charting (Brown, 1998).
Individuals who work in nursing informatics aspire to develop user-friendly and effective systems. They take into account that such systems will be used by both patients and nurses who may have little knowledge about their use. Nursing informatics include such positions as director of clinical informatics, informatics nurse specialist and clinical informatics coordinator. Regarding working conditions, nurse informaticists work in healthcare facilities, hospitals, consulting firms, universities, or organizations that develop and market healthcare information systems. However, a few of nurse informatics engage in patient care duties (Youngblood & Beitz, 2001). Majority in this group focus on developing, testing, improving and training nurses how to use the new healthcare information system. Having recognized the ability of nurse informaticists to reduce cost and improve quality care, varieties of hospitals and healthcare organizations are creating staff roles for nurse informaticists in their work settings (Youngblood & Beitz, 2001).
Moreover, the American Nurses Credentialing Center (ANCC) Informatics Nursing Board provides a certification examination that allows a reliable and valid assessment of the entry-level skills and clinical knowledge for registered nurses specializing in informatics. Once an individual completes a different eligibility requirement to take certification exams and passes, he/she is awarded the credential: Registered Nurse-Board Certified (RN-BC). This credential is valid for a period of five years, but the qualified individual can continue using it upon renewal. The ANCC certification is accredited by the National Commission for Certifying Agencies together with the Accreditation Board.
The Roles of Nurse Administrator
A nursing administrator works in virtually all healthcare environments. In this regard, nurse administrators often manage a specific unit in the organization or a team of nurses. These nurses have adequate training in their respective fields and learn to hold their teams accountable for their actions and failures (Youngblood & Beitz, 2001). The major aim of a nurse administrator is to ensure his or her team works collaboratively to achieve desired outcomes. Such kind of nurses are essentially team leaders and act on what their teams have done. Nurse administrators can at times interact directly with their patients but are usually assigned managerial duties. As managers, they assume the top position in a healthcare organization and they the ones to whom other employees in a healthcare setting report. A nurse administrator has different responsibilities including:
· Establishment and documentation of administrative procedures for the entire nursing team.
· Promotion of the development of their nursing staff.
· Ensuring overall responsibility for the entire nursing patient care.
· Ensuring economical budgeting and maintenance of standard guidelines in the workplace.
· Patient consultation and troubleshooting.
· Employee counseling and team-building exercises.
· Analyzing diagnosis decisions and nursing treatments by team members.
· Allowing effective communication between nursing and practice staff.
· Scheduling and supervising all team players.
As has been stated previously nurse administrator focuses majorly on administrative functions of the organization and hardly interact directly with patients. However, nurse administrators possess a range of knowledge regarding patient care as they often engage in consultation and must also know the practical aspects of healthcare. Nurse administrators master the knowledge of nursing protocol and procedures and are highly trained. In their capacity, they function as pivotal leaders in a healthcare organization but can also aspire for the executive position since all that is required is leadership skills and focus. Nurse administrators work best when managing people and processes rather than attending patients (Dossey et al., 1995). To become a nurse administrator, an individual must hold a bachelor’s or higher education degree in nursing. He/she must further possess a current active RN license within an identified locality in the United States. Furthermore, an added advantage is when a person has been in a mid-level administrative or higher administrative positions and has taken a faculty position handling graduate students in nursing. However, a master’s degree in nursing administration surpasses all the requirements (Youngblood & Beitz, 2001).
The Role of Nurse Practitioner
A nurse practitioner is the most common position in the nursing industry. A nurse practitioner, commonly referred to as NP, is an advanced practice registered nurse (APRN) who has completed advanced clinical education and coursework better than it is required for a normal registered nurse (RN). The International Council of Nurses defines a nurse practitioner as a registered nurse who has gained decision-making skills, the knowledge base and clinical competencies for higher practices beyond that of a registered nurse (RN). This characteristic is well determined by the context in which such a person is qualified to practice (Thomas et al., 2012). In the United States, owing to state-regulation of the profession, care provided by nurse practitioners vary while they are largely limited to credentials and education qualifications. Some nurse practitioners aspire to work independently as physicians to be consulted at a personal level. However, some states require collaborative agreements with qualified physicians for a person to practice as a health practitioner. The degree of such collaborative agreements, the roles, responsibilities, duties, pharmacological recommendations, nursing treatments, also varies widely depending on a state’s certification procedures. Nurse practitioners, therefore have a range of roles, which may include the following:
· Diagnosis of medical conditions, treatment, and evaluation of a patient’s progress for both chronic and acute illnesses.
· Looking for patients’ histories and carrying out physical examinations.
· Performing and ordering diagnostic studies, such as x-rays and lab tests among others.
· Prescribing medication for acute and chronic diseases.
· Providing family planning services and prenatal care.
· Providing special and primary care services care involving health-maintenance for adults and regular follow-ups (Dossey et al., 1995).
Required Competency for Nurse Practitioners
Scientific Foundation Competencies
These are the characteristics that allow nurse practitioners to critically analyze the data and information required to improve practices in nursing. Furthermore, such competencies allow practitioners to successfully integrate knowledge from the sciences and humanities into the context of nursing for decision-making (Thomas et al., 2012). Scientific foundation competencies also enable nurse practitioners to translate other forms of knowledge and research into useful information in order to improve health practices. Finally, practitioners develop new and better approaches after integrating theory and research into the field of nursing.
Leadership is all about taking initiative in nursing. With leadership competencies, practitioners assume advanced and complex leadership roles to pioneer and guide change in the organization. They lead at the forefront to enhance collaboration between different stakeholder to improve patient care (Thomas et al., 2012). In addition, practitioners should demonstrate leadership skills that show reflective and critical thinking. As leaders, they have a further advocate for improved quality, cost and access to effective healthcare services.
Regarding quality competencies, nurse practitioners use the most appropriate and available evidence to regularly improve the quality of healthcare practices. Quality competencies come with an evaluation of the existing relationship among safety, cost and quality and their effects on healthcare (Thomas et al., 2012). Nurse practitioners also have to anticipate variations in healthcare practices and formulate strategies for facing future uncertainties.
Practice Inquiry Competencies
These are the competencies that allow nurse practitioners to be at the forefront of translating knowledge into practice. Nurses have to engage in day-to-day activities with specialists in order to generate the knowledge required for improving patients’ outcomes and practices. Nurse practitioners also should lead to practice inquiry either individually or with the help of a competent team (Thomas et al., 2012).
Technology and Information Literacy Competencies
Knowledge management is vital for success in nursing. This category of competency allows practitioners to appropriately integrate different available technologies in the field of nursing for efficiency. Nurse practitioners should have a deal with scientific and technical health information required for various needs in the workplace (Thomas et al., 2012). Furthermore, they have to be able to show the information literacy skills required for a host of decision-making situations. Nurse practitioners have the ability to contribute to the design of healthcare information systems that promote quality, safety, and cost-effective care.
Policy competencies allow nurse practitioners to show an understanding of the relationship between policies and practice. Policies in healthcare should be ethical and promote access, quality and equity in all aspects. For this reason, nurse practitioners having policy competencies have to analyze ethical, social and legal factors influencing the development of healthcare policies (Thomas et al., 2012). Finally, nurses can assess the implication of health policies in nursing before advocating for their use.
The organization, setting, and population with whom to work.
As previously mentioned, nurse practitioners have advanced and complex roles and their qualification differs from those of regular nurses. However, they work and operate in similar environments just like other nurses. The difference in qualifications and competencies allows the practitioners to work on a range of fields. Nurse practitioners acquire their competency with the help of mentoring patient care experiences with major emphasis on inter-professional and independent practices (Naylor & Kurtzman, 2010). They work in all kinds of healthcare organizations and hospitals as their duties range from patient care to leadership responsibilities. Since they can diagnose and make treatments, they are mostly found in hospitals. Nevertheless, the fact that they can integrate a team to work collaboratively implies that they also take managerial roles. In addition, it is previously mentioned that nurse practitioner participates in designing healthcare information systems, what puts them in a pole position to influence the work of the entire system (Naylor & Kurtzman, 2010).
Similarly, there are no limits of the population with whom nurse practitioners work. The nature of their job means that they interact with almost everyone in a healthcare setting. For instance, diagnosis and treatment require an individual who can handle all the types of patients, and this is what nurse practitioners do the best. They also work with professionals in designing healthcare information system. As a result, nurse practitioners are qualified for all duties available in the field and have no restriction on what to do (Naylor & Kurtzman, 2010).
Leadership Attributes of Nurse Practitioners
Lewin’s study provides three types of leadership styles and the one which I possess is the participative or democratic style of leadership (Cherry, 2013). I believe this is the most effective style of leadership as it incorporates everyone in decision-making. As a leader, I not only guide groups and teams to the achievement of the goals but also take part in doing most of the duties. For instance, Lewin’s study about leadership styles found that children subjected to this type of leadership had contributions of much higher quality even though they were less productive than members of the authoritarian category. However, I may need to develop leadership attributes such as intellectual stimulation and individualized consideration (Cherry, 2013). Intellectual stimulation implies that as a leader, I will not only challenge the status quo but also will inspire employees to be more creative. To achieve this, I need to study different fields related to healthcare and understand best practices that encourage creativity. Regarding individualized consideration, I will need to offer encouragement and support to my followers.
Health Policy: Drug Shortage
Drug shortage is currently an issue of high concern in nursing. Complex market relations have made it difficult for private sector leaders and the government to address the issue of drug shortage. Drug shortages not only reduce the quality of patient care but also result into indirect costs on the entire system by requiring money and time to be spent looking for alternatives, modifying drug usage protocols or rescheduling procedures (Stencel, 2014). Furthermore, there are cases when medicines cannot be substituted hence drug shortages have dire consequences on patients. Recognizing this problem, political leaders and healthcare professionals have taken different steps to mitigate the shortage of drugs. This policy affects practitioners’ duties directly as it affects the treatment of diseases. There is not much what nurse practitioner can do with drug shortage as there are limitations. However, the efforts to mitigate drug shortages have been made by the Food and Drug Administration with the help of Congress. Such efforts have largely focused on regulatory matters. Nonetheless, this paper proposes continued communication and collaboration between different stakeholders in healthcare and the government so that everyone is on the alert as far as drug shortage is concerned (Stencel, 2014).
Advanced practice roles have really essential meaning for the success of activities in the nursing field. This research identifies four main advanced nursing practice roles, which are: nurse practitioners, nurse educators, nurse administrators, and nurse informaticists. For instance, a nurse practitioner’s competency is categorized into different sections, such as scientific foundation competencies, leadership competencies, quality competencies, practice inquiry competencies, and technological and information literacy competencies. A nurse practitioner is the selected advanced role for this paper and involves a host of competencies, such as scientific foundation, leadership, and policy competencies. Furthermore, nurse practitioners work in virtually all healthcare environments as they engage in different practices. They interact with everyone in the field as their knowledge is necessary for all the aspects. The International Council of Nurses defines a nurse practitioner as a registered nurse who has gained decision-making skills, the knowledge base and clinical competencies for higher practices beyond that of a registered nurse (RN). In a different perspective, this paper identifies drug shortage policy as the issue of the highest concern affecting nurse practitioners. It recommends more communication between all the stakeholders in nursing and also it recommends the government to enhance awareness of drug shortages and take relevant measures.