The nurse practitioners, registered nurse technicians, nurse midwives, and nurse anaesthetists, all have an important role in the health care system and settings. APRNs are considered as the primary care providers and are at the forefront of the public provision of preventive care services. The nursing literature describes the leadership qualities are important for the APRNs to help patients in the healthcare settings. Patients and healthcare professionals rely on clinical leadership skills rather than the role of a formal leader. NONPF is an organization that provides continuous support throughout to the nurses through the development of competencies, evaluation methods, and strategic alliances and help in the nursing practices.
Nursing is a challenging profession, where nurses are required to meet professional standards of nursing, irrespective of the country they practice their profession in. APRNs are the primary care providers and are at the forefront of the public provision of preventive care services (Institute of Medicine (US) Committee, 2011). The programs of APRNs range from primary and preventive treatment to mental wellbeing and childbirth to anaesthesia. Additionally, clinical leadership is related to nursing professional activities that provide direct bedside care, which is different from the traditional notion of nursing leadership. Acquisition of professional leadership skills is also important for nurses who give direct treatment to patients. This allows nurses to direct and support the provision of care to patients and healthcare teams (Institute of Medicine (US) Committee, 2011). The National Nurse Practitioner Faculties Organization (NONPF) is the only organization specifically dedicated to promoting the education of high-quality nurse practitioners (NPs). NONPF makes sure that the NPs are competent in providing a significant amount of treatment, and they must be efficient, important, and creative in their practices. NONPF also helps the nurses to evaluate and influence policy decisions that have an impact on the education and practice of an NP (NONPF, 2019). This essay aims to understand the role and competencies of an APRN and their leadership skills.
This model is focused on five questions that encourage the nurses to break their experiences and focus on the standard processes and their performances. John (1995) used this model of reflection and encouraged the reflective practitioner or the nurses to changed and strengthened their practice by following the standards of nursing. The reflection model helps the nurses to learn from their experiences and be efficient in taking care of future patient care plans (Bulman & Schutz, 2001).
Nurses in the role of a family nurse practitioner (FNP) usually get certifications to deal with specific groups of patients. FNP specializes in maternal and child health care are responsible to play an important role in the early identification and prompt treatment of postnatal depression (Shidhaye & Giri, 2014). During my postings in the maternal and child care department, I had encountered a patient who had delivered the baby and was suffering from postnatal depression. I had a dietician and a counsellor in the team. As I was the first person to be interacting with the couple, the first line of information was provided to me. But I was not able to convey the feelings of the couple to my team members. I faced difficulties in explaining the couple problems to the team members. I was in a great dilemma and was not able to help the couple instantly.
Being the FNP it was my responsibility to make the couple comfortable and explain to them the next line of action. I was also responsible to arrange resources for further health care proceedings for the patient. Since I got a little nervous seeing the mother in such a condition, I found myself emotionally incompetent in handling the situation. This made my team also unorganized as I could not explain to them my feelings and the patient care of plan to the team members.
The incompetency in a particular situation arises because I was not able to show my leadership skills in guiding my team members. I was not able to guide the patient about the next steps in the procedure which made the patients even more uncomfortable and they started losing confidence in their choice of coming to the health care setting.
The patient was already going through post-partum depression and was anxious about the baby and her health. I could have been more confident in handling all the situations by making the mother more comfortable by building a good rapport. My low confidence and fumbling made them worried about the baby. I could have been a good team member by conveying the concerns of the patient effectively which I had completely missed in the situation.
I learned that to be an efficient worker in a multidisciplinary team one has to be a good leader. Leadership skills are tested regularly using logical thinking for problems that need to be solved. Leaders make important decisions that could have effects that could affect patient lives. Specifically, leadership in health care is a critical ability of a professional that allows the professionals to efficiently manage the ever-changing and dynamic healthcare system in solving challenges and making decisions related to the quality of services and access to health care.
APRNs diagnose and treat the diseases, educate the public on health issues, handle chronic diseases and participate in ongoing education to keep ahead of any methodological and technological advances in the field. The initial nursing education and certification required for all Registered Nurses (RNs) are the same but the APRNs have a Master's degree. Nurse Practitioners offer primary, urgent, and advanced lifelong health services through the diagnosis, evaluation, and treatment of the health condition (Poghosyan & Carthon, 2017). The APRNs showed to had a positive effect on medical quality, the satisfaction of the patient, positive clinical outcomes, and the costs in emergency and critical care settings, which is significant as the population ages and chronic diseases are increasing day by day (Institute of Medicine (US) Committee, 2011).
The way in which APRNs implement meaningful improvements in the health care system is by taking advantage of the ability to become FNPs. Family nurse practitioners (FNPs) are registered nurses (APRNs) of specialist, nationally accredited and state-licensed advanced practice for medically stable patients through all the age groups, including children, teens, adults, and aged people. The certifications are provided by the American Nurses Credentialing Center (AACN) or the American Nurse Practitioners Association (AANP) and display the competence of a practitioner. An FNP nurse is a specific variety of nurse practitioners (NPs) and can be called FNPs, APRNs, or NPs.
Operating as an FNP makes it possible for APRNs to be primary care providers in the nursing homes, hospitals, and in private practice. An FNP is a registered nurse with advanced experience and a form of the mid-level practitioner. FNPs are qualified to evaluate patient needs, coordinate and interpret diagnostic and laboratory testing, diagnose illness, devise care plans and administer them (Poghosyan, Norful & Martsolf, 2017). Their services also include basic disease prevention, care management, and health promotion, but does not have the profundity of experience required to understand more complicated conditions. The judicial authority determines the scope of practice for an FNP. In some cases, FNPs are expected to operate under a physician's supervision, while in some cases, they may practice independently.
FNPs also collaborate with other clinicians to manage the problems of their patients and provide long-term illness and injury case management. Typical tasks include diagnosing of the health issue, order and interpret medical tests, carry out assessments, receiving therapy, and occasionally prescription of the medicines. FNPs in fields such as women's health, cardiology, and neurology receive an additional certification (Stephen & Vijay, 2019). FNPs are used in several settings due to their large knowledge base and patient population expertise, including the independent practices with other NPs, major hospitals, community clinics, physician’s offices, schools, local health departments, and other outpatient care facilities (Trim, 2004). There are some rural and urban areas of the country, where the physician is not accessible to the people because of the shortage in numbers of the physicians, in such areas FNP nurses provide the healthcare alone or in assistance of a physician. Because FNPs were educated in health diagnosis and evaluation, pharmacology, and physiology so at times they act as a primary service provider and can practice autonomously (Poghosyan, Boyd & Clarke, 2016).
NP's are trained and regulated from time to time. The scope of practice for family nurse practitioners is determined by the state licensing authority, and the regulations for them are different in states. FNPs are kept accountable by clinical outcome reviews, peer review, and standards for professional development according to AANP (AANP, 2019). The FNPs are taught to be leaders and educators for patient welfare and needs and policy advancements in health care.
Worldwide, healthcare settings and systems face many dynamic and multifaceted challenges in delivering high-quality, secure, and cost-effective treatment for the patients. Many of the issues that need to be tackled are the ever-evolving technologies, the increased acuity of disease patients, technological advancement, and the rise in health care costs. Hence, I need to maintain and enhance the quality of care delivered and make my position a reliable one for all members of the team. Also, I need to increase my reliance as nurse practitioners which can increase service quality and accessibility in primary healthcare settings. I would also like to work on my leadership skills as a nurse practitioner in primary health care.
The main objective of this study was to explore the various frameworks and processes placed in place to support the advancement of the practice of primary health care nurses in different healthcare settings and to establish a realistic model for identifying and organizing effective support practices. APRNs are nurses who meet the standards of the advanced clinical and educational practice, who also offer care in community-based environments. The leadership skills of a nurse show the critical ability to handle the situations and the dynamic everchanging environment of the hospital settings. The FMN should have the capability to solve the challenges and make decisions related to the quality of healthcare services and access to it. It is therefore important that the nurses are well prepared and qualified to make the right decisions at the right time for the health benefit of the patients.
AANP. (2019). Standards of Practice for Nurse Practitioners. Retrieved from https://www.aanp.org/advocacy/advocacy-resource/position-statements/standards-of-practice-for-nurse-practitioners
Bulman, C., & Schutz, S. (2001). Reflective Practice in Nursing. Retrieved from http://zu.edu.jo/UploadFile/Library/E_Books/Files/LibraryFile_151614_52.pdf
Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US).
NONPF. (2019). National Organization of Nurse Practitioner Faculties. Retrieved from https://www.nonpf.org/
Poghosyan, L., & Carthon, J. (2017). The Untapped Potential of the Nurse Practitioner Workforce in Reducing Health Disparities. Policy, Politics & Nursing Practice, 18(2), 84–94. https://doi.org/10.1177/1527154417721189
Poghosyan, L., Boyd, D. R., & Clarke, S. P. (2016). Optimizing full scope of practice for nurse practitioners in primary care: A proposed conceptual model. Nursing Outlook, 64(2), 146–155. https://doi.org/10.1016/j.outlook.2015.11.015
Poghosyan, L., Norful, A. A., & Martsolf, G. R. (2017). Primary Care Nurse Practitioner Practice Characteristics: Barriers and Opportunities for Interprofessional Teamwork. The Journal of Ambulatory Care Management, 40(1), 77–86. https://doi.org/10.1097/JAC.0000000000000156
Shidhaye, P., & Giri, P. (2014). Maternal depression: a hidden burden in developing countries. Annals of Medical and Health Sciences Research, 4(4), 463–465. https://doi.org/10.4103/2141-9248.139268
Stephen, S., & Vijay, V. R. (2019). Metamorphosis of nursing profession: an Indian perspective. Journal of Global Health, 9(2), 020314. https://doi.org/10.7189/jogh.09.020314
Trim S. (2004). Research on nurse practitioner role underway. Nursing New Zealand (Wellington, N.Z.: 1995), 10(2), 28.
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