1. What are the most important roles of APNs?
2. Do you think the current scope of APN practice should be expanded?
3. How could you describe the regulatory requirements that guide APN in your area of practice?
4. What are the pros and cons associated with APN roles?
5. What are your views on the future of the ANP profession?
Roles of APN
APN not only expands the conventional range of nursing knowledge but also contributes significantly to the advancement of the nursing profession. The integral role of APN has been likened to that of a change agent characterized by consultation and collaboration with other health practitioners (Fairman, Rowe, Hassmiller, & Shalala, 2011). Offering this service requires continual research and education organizational leadership as well as personal growth and development. The respondent outlined various roles associated with APN, which corresponded to the roles of APN mentioned in literature. The first role mentioned by the respondent in the interview is that APNs are advocates of nursing staff and patients in the healthcare settings. In this respect, APNs are positioned to play the role of frontline nurses who have the responsibility of coordinating and implementing novel strategies aimed at providing services to both patients and nursing staff. Further explaining this role, the respondent noted that APNs assist nursing personnel in various aspects including support in managing complex situations, offering nurse education, and assisting nurses during difficult case procedures. The respondent also emphasized on the importance of APNs working together with nurse executives in order to help in enhancing the professional development of the nursing staff. A similar view is held by Troseth (2012), who pointed out that APNs have the role of assessing the abilities of nurses while concurrently collaborating with them and their executives in order to develop learning experiences aimed at enhancing the skills and competence of nurses. In addition, the respondent cited the important role that APNs play with respect to mentoring novice nurses. It is important to make a novice nurse comfortable with the profession, increase job satisfaction as well as reduce the likelihood of burnout (Iglehart, 2013; Lowe, Plummer, O’Brien, & Boyd, 2012).
Another important role of APNs cited by the respondent relates to ensuring the efficient functioning of the workplace for both nursing staff and patients. In this respect, the respondent mentioned that APNs have a role of coordinating support groups for nursing staff in the healthcare settings. There is empirical support for the benefits of brief interventions (debriefing) for the nurses who have been subjected to traumatic events (Troseth, 2012). In such occasions, APNs aid in bringing together health personnel in order to help in identifying stress areas, teach nurses the various ways of coping, and determine the personnel requiring extra counseling at the individual level. These activities are important in alleviating feelings associated with helplessness, anger, and grief that nurses are likely to experience in the course of long stressful situations.
Another important role of APNs pointed out by the respondent relates to helping nurses to be updated on current research as well as an evidence-based practice associated with their specialization. In order to administer this role, APNs organize meetings and invite guest speakers from various healthcare disciplines. This underscores the importance of effective communication and collaboration with other healthcare practitioners for APNs (Institute of Medicine (US), 2011). These meetings can also entail patient care conferences, which are used in educating nurses regarding the current status of the patient.
APNs also help to develop policies aimed at assisting nurses in various issues such as pain management and development of cross-cultural care competency among others. In this respect, APNs can undertake audits regarding these issues and determine whether nurses are performing as required with respect to the identified issues. Lastly, the respondent cited that APNs advocate for improved nurses staffing in order to satisfy the demand for care services, especially with the increase in patient acuity. In this regard, APNs carefully observe and communicate with nurses in order to identify areas that are significantly impacted by low levels of nursing staffing. This role is mainly administrative and seeks to enhance better service delivery.
Policies and Regulations
The regulations and laws determining the practice environment, regulatory requirements, and license requirements for APNs vary in each state. Some states allow full practice; others have reduced practice whereas others have restricted practice (Institute of Medicine (US), 2011). Full practice is characterized by APNs being allowed to examine patients, conduct diagnostic operations, request and infer diagnostic tests, administer and manage treatments as well as prescribe medications. Under the reduced practice, the abilities of APNs to take part in at least one aspect are limited. Moreover, it involves collaboration with an outside health practitioner like a physician for APNs to offer care (Texas Nurse Practitioners n.d.).
The respondent cited that he practices in Texas; therefore, the regulations and laws governing his practice are set by the Texas Board of Nursing including the practice requirements. Texas has a restricted APN practice. In addition, the requirement for APN entails national certification in the area of specialization, post-basic APN educational level (minimum master’s level), and current registered nurses license for the state (Texas Nurse Practitioners n.d.). Owing to the fact that Texas is characterized by restricted practice for APNs, they are required to practice under the supervision of a physician. Moreover, APNs can only make prescriptions when supervised by a physician; however, these prescriptions are limited to a 30-day medication supply. APNs are also restricted from issuing prescriptions of schedule II drugs. Furthermore, prescriptions issued by APNs ought to contain the telephone number, DEA number, and address of the physician who oversaw the prescription.
Pros and Cons of APN Roles
The respondent also mentioned a number of pros and cons associated with the roles of the APN. The first important advantage related to APN practice cited by the respondent is a similar professional hierarchy and recognition as medical doctors, whereby in most cases, APNs undertake similar tasks. In this respect, APNs can head departments, sit on boards and, at the same time, teach. The second privilege associated with the APN role is the ability to make a difference in patients’ lives. As the respondent quoted, “I find it satisfying to be able to fully care for patients while at the same time help in developing treatment plans collaboratively with them.” Another positive feature of APN’s role mentioned by the respondent is diverse practice settings. The respondent stated that he has worked in various practice settings including correctional, hospital, and occupational health facilities. For him, the opportunity to practice in diverse areas was one of the motivating factors to pursue nursing. The respondent also mentioned mentor opportunities as another advantage of the APN role. In this regard, he considered it a privilege to be able to offer training and education to nurses. There are abundant opportunities to mentor novice nurses when one is an APN. Other pros mentioned include the satisfaction associated with offering primary care, availability of diverse areas of specialization, positive job outlook and a wide area for development and growth as well as high salaries.
Besides the above-mentioned pros, there was mentioned also a number of cons associated with the APN role. According to the respondent, the biggest disadvantage associated with the APN role is the long and strenuous working hours, which makes APNs susceptible to fatigue and burnout endured by physicians. The increase in the shortage of nurses and physicians has increased the workload of APNs, which often results in higher levels of stress, anxiety, and frustration. The respondent also expressed his dissatisfaction with the fact that although APNs perform the same tasks as medical doctors, their pay is often less. This discrepancy usually makes APN appear less rewarding. Another disadvantage of APN practice relates to the restrictive regulations that limit the scope of practice for APNs. States like Texas have adopted restrictive regulations regarding autonomy, collaboration, and the authority to make prescriptions.
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