Competencies of Advanced Practice Nurse Roles

Competencies of Advanced Practice Nurse Roles

Advanced practice nurses (APNs) are registered nurses (RNs) who have advanced their education and achieved a master’s degree in nursing (Miranda Neto et al., 2018). They are also referred to as advanced practice registered nurses (APRNs). Due to their advanced training, APNs possess clinical knowledge and competencies to make treatment decisions and carry out care operations without physician supervision (Hankins et al., 2020). They have the clinical capacity to carry out disease diagnoses, make clinical decisions regarding public health, create treatment plans, liaise with other physicians on patient care, and act as nurse leaders.

APNs can specialize during their training to perform various APN roles within the healthcare delivery system as certified nurse practitioners (CNP), clinical nurse specialists (CNS), certified nurse-midwives (CNM), and certified registered nurse anesthetists (CRNA) (Hankins et al., 2020). Based on these specialties, APNs can work in various care settings such as hospitals, home care, and long-term care. This paper explores the various roles of APRNS, including CNP, CNS, CRNA, and CNM. It will also provide a personal rationale as to why I choose CNP over the other APRN roles. It will also provide details of my plans for clinical practice as a CNP and the role transition from an RN to a CNP.

APN Roles

Advanced practice nurses can specialize in training, as earlier noted, to work as CNPs, CNSs, CRNAs, and CNMs. For registered nurse to transition into APN entry level of nursing practice, they must first complete a master of science in nursing (MSN) program. They can also undertake a post-graduate in nursing, Doctor of Nursing Practice (DNP). However, the DNP is optional. The training and role for each APN specialty vary from another. The roles and educational requirements for APN roles, CNP, CNS, CRNA, and CNM, are discussed below.

Certified Nurse Practitioners (CNP)

A Certified Nurse Practitioner (NP) is an APN specialty in which registered nurses advance their education and get trained and licensed to carry out medical examinations, diagnose various health conditions, initiate treatment plans, and carry out other primary care functions (Hamric et al., 2013). A registered nurse must first complete a doctoral degree program in nursing to become an NP.

NPs work in primary care settings and are required to provide diagnoses for diseases, provide health education, and plan treatment for patients. Their roles are also focused on the provision of care practices that prevent diseases and help maintain overall population health (Cooper et al., 2019).

Clinical Nurse Specialists (CNS)

CNS requires an MSN degree or a DNP to qualify for licensure and to practice as an APN. They are focused on evidence-based care and may therefore, undertake a DNP to become specialist researchers. A CNS plays the role of leadership in the nursing department. They advocate for other nurses and are agents of change within healthcare organizations. They are also required to carry out research and develop evidence-based approaches to provide quality and affordable care. They can work as a specialist within primary care settings to collect comprehensive disease histories and diagnose and treat chronic health conditions and other acute illnesses (Cooper et al., 2019).

Certified Nurse-Midwives (CNM)

CNM is an APN specialty focused on reproductive health in women and childbirth (Hamric et al., 2013). Their roles in healthcare include the promotion of women’s reproductive health, supporting childbirth, and providing post-partum care. They are also tasked with the prevention of reproductive health issues in women (Knestrick & Russell, 2020).

A CNM must first complete a certified nursing program, a bachelor’s degree in nursing, and an MSN program to qualify for practice as an APN.

Certified Registered Nurse Anesthetists (CRNA)

CRNA is an APN certified in anesthesia. CRNAs work in acute care settings. CRNAs can work in operating rooms, obstetrics, outpatient surgery, carry out plastic surgeries, operate in dental surgeries, and in pain management. In most settings, CRNAs have the expertise to operate independently without physician supervision (Knestrick & Russell, 2020).

The training for CRNAs is the same as the other APN specialties. However, CRNAs require more experience and a curriculum focused on anesthesiology and the principles of anesthesia. They also require longer experience periods of up to 8 years to qualify as anesthesiologists and work independently.

Rationale for Choosing the CNP Role

My initial focus on a role as an APN was on NP and CNS. However, after researching both specialties, I have settled for the CNP role. Although the CNS and CNP roles are valuable in nursing and in healthcare, I personally feel that the CNP role offers more to healthcare and nursing than the CNS. My career goal is to have an impact in nursing, in healthcare in terms of quality and cost, and in nursing education. The role of a CNP gives me an opportunity to achieve such career goals.

A CNP is directly involved in primary care and gets in touch with patients at a personal level. Compared to a CNS role, which is more specialized and based on nursing, CNP’s roles are broader and mostly in outpatient care settings. They are also focused on the provision of medical services and improving care quality. The CNP’s approach to care is more holistic than other practitioners. They tend to serve more patients and focus on physical and psychosocial symptoms, thus enabling them to better understand health (Cooper et al., 2019). Through this, a CNP can develop disease prevention and treatment strategies that improve the quality and cost of care. They, therefore, contribute to the satisfaction of patients with care services. CNPs are also more likely to be involved with multi-disciplinary teams than specialized CNS nurses (Chan et al., 2020). Therefore, they contribute to the development of care practices and the RN advancement curriculum.

Plans for Clinical Practice

The NP role, compared to the other APN specialties, is quite interesting. After researching all four APN roles, I have realized the NP role has quite a broader population focus than the other roles. There are 6 possible specializations within the NP role. These include Adult-gerontology Nurse Practitioner (A-GNP), Neonatal Nurse Practitioner (NNP), Psychiatric Mental Health Nurse Practitioner (PMHNP), Pediatric Nurse Practitioner (PNP), Family Nurse Practitioner, and Women’s Health Nurse Practitioner (WHNP) (Want, 2020).

My plan for clinical practice as an NP is to impact nursing practice in a way that improves clinical practices and the care conditions for both the staff and patients. I intend to develop processes and practices that improve care quality and patient experiences within my specialty. I will always be critical in analyzing the existing practice approaches and improving the practice based on evidence and empirical evaluations.

Role Transition from RN to NP Role

The transition from the RN role to the NP role requires advanced education and training and the development of new competencies. Moving from RN to NP level means more responsibilities and a career change that can be stressful. However, the transition is beneficial as it provides new opportunities as a nurse. The transition from an RN to an NP role means more autonomy and an opportunity to develop my approaches to holistic health and advance research in nursing practice. The transition is also rewarding as it increases the remuneration as I get more experience. It will also improve my satisfaction with my career as I get to explore and develop my personal approaches to nursing and have them adopted by the nursing and healthcare systems.

Various factors may impact the transition. Two of the factors include the anxiety related to the advanced role as a nurse due to the difference in experiences after transitioning from the RN to NP and the sense of purpose in the new role. The transition from an RN role to an NP role means a change in duties, roles, and responsibilities or a transition from care settings. Such change can create anxiety and have an impact on the efficiency of the transition. However, the sense of purpose in the new role has an impact on the transition (Barnes et al., 2020).

The factors that influence the role transition can positively or negatively impact the transition from RN to NP. To overcome any difficulties in the role transition, Whitehead et al. (2022) suggested the integration of novice NPs into multi-disciplinary teams, offering sufficient mentorship and preceptorship support and engaging them in continuous professional development. I will be fully engaged in the multi-disciplinary practice, ask for assistance whenever in need, and also invest in exploring the role and competencies of an NP to better understand my roles and what is expected of me.

Conclusion

The transition from an RN to an APN gives a nurse an opportunity to specialize in four distinct roles in nursing and gain more autonomy. However, the transition requires obtaining a higher education level, mostly a master’s degree in nursing or higher. The transition optimizes nursing practice and helps meet the needs of the evolving healthcare system. The transition from an RN to an ANP role, for instance, the transition from an RN to an NP, is influenced by different factors. However, evidence-based strategies can be applied to support the transition. Conclusively, the transition from RN to a new APN role is an opportunity to meet and overcome new nursing challenges, develop new experiences, and improve overall nursing practice.

 References

Barnes, H., Covelli, A. F., & Rubright, J. D. (2022). Development of the novice nurse practitioner role transition scale: An exploratory factor analysis. Journal of the American Association of Nurse Practitioners, 34(1), 79-88.

Chan, T. E., Lockhart, J. S., Thomas, A., Kronk, R., & Schreiber, J. B. (2020). An integrative review of nurse practitioner practice and its relationship to the core competencies. Journal of Professional Nursing, 36(4), 189-199.

Cooper, M. A., McDowell, J., Raeside, L., & ANP–CNS Group. (2019). The similarities and differences between advanced nurse practitioners and clinical nurse specialists. British Journal of Nursing, 28(20), 1308-1314.

DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession: Essential Knowledge for the Profession. Jones & Bartlett Learning.

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2013). Advanced practice nursing-E-Book: An integrative approach. Elsevier Health Sciences.

Hankins, A., Palokas, M., & Christian, R. (2020). Advanced practice nurse professional advancement programs: a scoping review protocol. JBI Evidence Synthesis, 18(1), 108-114.

Knestrick, J. M., & Russell, N. G. (2020). Advanced Practice Nursing in the United States. In Advanced Practice Nursing Leadership: A Global Perspective (pp. 155-163). Springer, Cham.

Miranda Neto, M. V. D., Rewa, T., Leonello, V. M., & Oliveira, M. A. D. C. (2018). Advanced practice nursing: a possibility for Primary Health Care? Revista Brasileira de Enfermagem, 71, 716-721.

Want, D. R. (2020). Identification of Primary Care Nurse Practitioner Clinical Procedural Skills Used in Practice: Examination of Frequency of Use, Importance of Skill, and Training for Skill. The Catholic University of America.

Whitehead, L., Twigg, D. E., Carman, R., Glass, C., Halton, H., & Duffield, C. (2022). Factors influencing the development and implementation of nurse practitioner candidacy programs: A scoping review. International journal of nursing studies, 125, 104133.

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Directions
Introduction: Provide an overview of what will be covered in the paper. An introduction should include general statements on advanced practice nursing roles, general statements on the role transition from RN to APN, and identification of the purpose of the paper.

Four APN Roles: Describe the role, educational preparation, and work environment for the four APN roles (CNP, CNS, CRNA & CNM).
Provide support from at least one scholarly source.
Rationale for Choosing CNP Role: Describe your rationale for choosing the CNP advanced practice role versus one of the other roles.
Plans for Clinical Practice: Discuss your plans for clinical practice after graduation. Explain how your understanding of NP practice has changed after researching the four ANP roles.
Role Transition: Discuss your transition from the RN role to the NP role. Describe two factors that may impact your transition. Discuss two strategies you will use to support a successful transition from the RN to your NP role. Provide reference support from at least one scholarly source. The textbook is not a scholarly source.
Conclusion: Provide a conclusion, including a brief summary of what you discussed in the paper.