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Role Development for Advanced Nursing Practice Essay

A1. The nursing profession has evolved significantly over the decades. One of the factors that have greatly influenced these changes has been the involvement of nurses in the development of theories and data base needed to support the advancement of our profession. In the last half of the twentieth century, nurse researchers (1950s) and nurse theorists (1960s and 1970s) greatly contributed to the expanding body of nursing knowledge with their studies of nursing practice and the development of nursing models and theories (American Nurses Association, 2010, p. 16). Like in any other research activity, a special set of skills is needed in order to conduct the research required so that the whole process can be validated appropriately.

Retaining an advanced practice nurse (APN) as a co-investigator and mentor is a vital part in the nursing process for the project to take shape (Gallagher, 2012, para. 5). The masters prepared nurse can be a key element of the research team providing guidance, expertise and ensuring that the information needed to appropriately conduct the research project is available. This professional can also help select members of the research team and find the latest up-to-date evidence based practice, journals, articles and other useful references as well as studies that can help with the task at hand. Research has greatly advanced our profession as well as helped improve the delivery of health as well as its outcomes. For this reason it is important that it is encouraged at all levels of our profession.

A2. Teamwork is important for success in any environment. Collaboration is essential for the benefit of the client as well as enhancing the effectiveness of the members of the health care team. The Advance Practice Nurse uses a team approach in developing a treatment plan for the patient by collaborating with the patient and other health care professionals (American College of Rheumatology, 2012, p. 1). In this case the advance practice nurse can be used as a collaborator that can bring ideas and experience in a variety of environments from helping guide nurses and organize patient care on a ward to being a member or resource to a multidisciplinary health care team. Providing ideas or helping train new nurses the unit can also be a way for the Master’s prepared nurse to collaborate with others. Also, in some situations; the experience and leadership abilities that this nurse holds can help guide with the formation of workgroups or unit practice councils that promotes even more collaboration amongst members of a team.

A3. As a clinician the Master’s prepared nurse usually practices in a specific field that is usually identified by the clients’ age, clinical setting or specific disease processes. Even within these divisions some of the clinicians often prefer to specialize even further. Examples of this can be those that specialize only on adults, pediatric, geriatric, inpatient only, outpatient, mental health, etc. They provide care in variety of health care settings including hospital units, ambulatory clinics, managed care practice, private practice, rehabilitation centers, home health agencies, public health centers, and long-term care facilities (American College of Rheumatology, 2012, p. 1). In many cases the Master’s prepared nurse can operate independently and some jurisdictions even grant them prescriptive authority.

A4. One of the roles that I am the most proud as a nurse is that of the patients advocate. I feel that obtaining a Master’s degree in nursing not only gives the nurse more credibility as a patients advocate, it also gives the nurse the responsibility as a leader in the profession to be an outspoken member in protecting patient’s rights as well as influencing government policy in ethical issues and the improvement of standards of care.

Advocating for and helping the less fortunate find ways to obtain health care or improving outcomes for those that already receiving it, involvement is the key. Nurses’ involvement in policy debates brings our professional values to bear on the process. (Warner, 2003) The Master’s prepared nurse’s goal as an advocate should be to fight to enhance the client’s wellbeing in every possible way, at every available opportunity. This can be achieved by being part of organization that advocate for patients’ right as well as for better working condition for our colleagues. Also, nurses could choose to get involved in politics or lobby on behalf of other nurses.

A5. The experience, training and formal education should give the Master’s prepared nurse an exceptional ability to balance helping the patient obtain the physical and psychosocial care needed. Nurses manage a healthcare consumer’s care in order to maximize independence and quality of life (American Nurses Association, 2010, p. 40). At the same time the client or family often require assistance navigating a system that has sometimes physical as well as logistical or economic barriers. Be it as a case manager or as an asset in any unit; the Master’s prepared nurse should be able to utilize the systems to ensure the patient is provided with the best care possible and the best achievable outcomes within the limitations of available resources.

A6. Before becoming a nurse I did not have an idea of how big of a variety of roles a nurse can have. One role that really surprised me was that of a consultant. A Master’s prepared nurse role as a consultant is one that can provide the nurse with a high degree of independence. They provide expert advice to other health care professionals, legal experts, employers, individuals and medical institutions. An example of the Master’s prepared nurse role is that of a Legal Nurse Consultant.

The American Association of Legal Nurse Consultants (AALNC) defines legal nurse consulting as the evaluation and analysis of facts and the rendering of informed opinions related to the delivery of nursing and healthcare services and outcomes. This role requires vast experience and being very involved with all the development of new rules and the laws that cover the nursing practice in order to be able to give expert opinions on cases and the integrity to be able to let the other professionals know if a procedure or action was performed correctly or not to standard practices. The bottom line is that as a consultant the nurse is required to give his expert advice and demonstrate expertise to the person requiring their services.

A7. The Master’s prepared nurse role as a change agent requires the nurse to use the skills, experience and leadership abilities in order to influence not just other people; but the organization as a whole in order to benefit the client, other nurses as well as the organization. As humans we sometimes are reluctant to change. How many of us have noticed that something that we do in our line of work could be changed to make it easier to use, done more effectively or in less time only to hear someone say; “but we have always done it that way”? Change is something that doesn’t happen unless time and energy are focused on influencing changes in policy.

Many of us think that in order to affect change we will need to get involved in unions or political activism. However, experience shows that change can be achieved every day, even on a smaller scale, by collection of evidence for research in order to create changes in practice, participation on unit practice council or even making simple suggestions to leaders about how to improve operations in the work areas. The master’s-prepared nurse needs to work within and affect change in systems (American Association of Colleges of Nursing, 2011, p. 21). The Master’s prepared nurse can assist members of the unit or institution by guiding them through the evidence collection process, providing research to back up positions or opinions about a specific subject as well as providing expert advice on how to proceed in order to be an effective change agent.

A8. Master’s prepared nurses are many times required to fill multiple roles at the same time and this is often how they can be the most effective in order to improve healthcare delivery and outcomes. These nurses at their different positions are sometimes able to follow a patient from the point where medical care initiates to the point where the patient is discharged from the institution. In some cases in which the nurse may work at a Patient Centered Medical Home or similar setup, the nurse has the ability of continuing to observe the patient and educate as well as monitor the client during an extended period of time. In my opinion, this situation brings the opportunity to most effectively utilize the nursing process in order to improve health care delivery and outcomes for their clients.

However, if the nurse does not have the ability or her role does not have the magnitude of visibility over the client mentioned earlier; the same goal can be achieved through work groups or information sharing amongst members of the different sections in a health care facility and even in coordination with other institutions that care for the same client or group of clients. In the last decade facilities have been using the Clinical Nurse Leaders (CNL) to help achieve the improvements needed within them. The vision for the Clinical Nurse Leader role began in 2003-2004 in response to the quality and safety reports of the Institute of Medicine (Reid & Dennison, 2011, para. 3). This is just another way that the Master’s educated nurse can continue to influence and help improve healthcare delivery and outcomes as well as influence the healthcare system for the benefit of all.

A9. The importance of negotiation skills can be noted in all aspects of life. From in our day to day activities, to more complicated transactions; effective negotiation is a key aspect of success or failure in anything we do that requires participation of others. In my opinion, knowledge, experience, how a person is able to present themselves and their ability to utilize negotiation skills effectively can have a great effect in helping earn a client’s trust. Once that communication bridge and that openness exist the nurse is able to present ideas that can benefit both the client as well as the nurse.

It is also important that the nurse uses those negotiation skills in order to be more effective when advocating for the patient when working as a member of a health care team. Nurse Case managers negotiate the need for community services or nursing homes with the physician and the patient and family. (Cohen & Cesta, 2005, Chapter 26) This is just another example of using negotiation to influence positive results and why the Master’s prepared nurse should have and continue develop and practice negotiation. Continuing in this way to lead and influence others and advocating for the patient.

A10. After much reading about all the different subjects I have become more familiar with each one of them. I also realized my need to enhance my knowledge of some of these roles in order to eventually graduate and become a successful Master’s prepared nurse. I understand also, that not one role is probably more important than the other and that our individual personalities may play a very significant factor on which one we may be stronger at. However, the more we know about these roles the better we will be able to implement them, utilizing a more holistic approach in providing care for our clients and improving health care delivery and outcomes.

References
American Association of Colleges of Nursing. (2011). The Essentials of Master’s Education in Nursing. Retrieved from http://www.aacn.nche.edu/education-resources/MastersEssentials11.pdf American College of Rheumatology. (2012). The Role of the Advance Practice Nurse in the Management of Rheumatic Disease. Retrieved from http://www.rheumatology.org/practice/clinical/patients/healthprofessionals/advanced_practice_nurse.pdf American Nurses Association. (2010). ANA Nursing Scopes and Standards of Practice (2nd Ed.). Retrieved from http://wgu.docutek.com.wguproxy.egloballibrary.com/eres/coursepage.aspx?cid=66&page=docs [Article]. RN Journal. Retrieved from http://www.rnjournal.com/journal_of_nursing/conducting_nursing_research.htm Cohen, E. L., & Cesta, T. G. (2005). Nurse Case Management From Essentials to Advanced Practice Applications (4 ed.). St. Louis, Missouri: Elsevier Mosby. Kramer, M., & Schmalenberg, C. (2003, July 2003). Securing “good” nurse physician relationships [Abstract]. Nursing Management. Retrieved from http://bmhlibrary.info/34.pdf [Literature Review AHRQ Publication No. 05-0053]. Retrieved from http://www.ahrq.gov/: http://www.ahrq.gov/qual/medteam/ The Inline Journal of Issues in Nursing, 16(3). http://dx.doi.org/10.3912/OJIN.Vol16No03Man04 Warner, J. R. (2003). A Phenomenological Approach to Political Competence: Stories of Nurse Activists [Journal]. Policy, Politics, & Nursing Practice, 4(2), 135-143. Retrieved from http://ppn.sagepub.com/content/4/2/135.short


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