Leadership Attributes of the Nurse Practitioner Role
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Leadership Attributes of the Nurse Practitioner Role
Running head: FINAL 1
FINAL 12
Final Project
Yoanka Rodriguez
South University
July 2017
Final Project
Advanced practice nurses (APNs) have become an essential part of contemporary health care system in the United States. These specialists have the key role in the provision of quality, safe, and cost-effective health care to broad populations. They make an invaluable contribution to the transformation of the health care system to provide better customer experience in health care institutions. The changes in the American society including demographic changes, technologic progress, and the progress in the area of policy-making to provide access to the health care services to all suggests that the roles of the ANPs will continue to evolve and gain more significance in society. Effective functioning of health care system in contemporary conditions is impossible without the contribution made by nurse practitioners, nurse informaticists, nurse educators, and nurse administrators. This final paper aims to summarize the information learned during this course concerning the significance of advanced practice nursing roles, legislative regulations that control their scope of practice, and their contribution in the area of policy-making related to health care.
Advanced Practice Roles in Nursing
Advanced nursing practice is a growing specialty in the nursing profession with the broad scope of practice. APNs work in a variety of fields and settings, including both clinical and non-clinical ones (Sun et al., 2015). These specialists engage in both direct and indirect patient care, and can become essential members of managerial teams or start their own business in family practice.
There are multiple roles in the advanced nursing practice including nurse practitioners, nurse educators, nurse administrators, and nurse informaticists. The advanced practice registered nurses (APRNs) employed in clinical practice are the certified nurse-midwife (CNM), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), and nurse practitioner (NP) (Melnyk, Gallagher‐Ford, Long, & Fineout‐Overholt, 2014). All these clinical specialists are focused on patient care quality improvement and patient outcomes facilitation (Melnyk et al., 2014). As for the difference between APN and ANP, from the information above, it can be seen that the APN is a broader concept meaning the whole specialty of advanced practice nursing, and the ANP is a more specific concept describing the specialty of nurse practitioners employed in the clinical field.
Family Nurse Practitioners
Family nurse practitioners (FNPs) are employed in primary care. Their main goal is to provide disease prevention and health care promotion services to community populations (Sun et al., 2015). These specialists have specific proficiencies, skills, and competencies to perform their daily tasks in clinical settings. FNPs serve various populations including children, women, gerontology patients, mentally ill patients, and acute care patients (Sun et al., 2015).
FNP is the very role this writer aspires for herself. Being an experienced nurse and a person with the goal to help others, this writer has seen many opportunities for herself in the field of primary care. Therefore, she decided to become an FNP. This writer’s personal philosophy is to seek for opportunities to make a difference and positive change in other people’s lives through helping them to improve their health and quality of life as a result.
Nurse Educators
Nurse educators are employed in education. These specialists focus on teaching and training nurse students to help them become qualified specialists serving broad populations. Nurse educators train the nursing workforce for a diverse, ever-changing health care environment (Sun et al., 2015). The role of nurse educators is highly important because they are the key stakeholders in the preparation of the nursing workforce able to transform the health care system and improve health outcomes for the nation.
Nurse Administrators
Nurse administrators work in nursing administration and managerial practice to facilitate effective workflow. These specialists collaborate with various members of the health care process and ensure coordinated efforts of all these professionals (Sun et al., 2015). Nurse administrators are patient advocates, policy-makers, and specialists in the use of the evidence-based practice in transforming models of care and facilitating patient outcomes (Yee, Boukus, Cross, & Samuel, 2013).
Nurse Informaticists
Nurse informaticists are the rapidly developing role in nursing, and it has been recognized as an independent profession in the recent period (Sun et al., 2015). Nurse informaticists work with information technologies and systems based on these technologies. Their goal is to help other health care professionals facilitate their working process and data processing with the use of information technologies. These specialists also work to help patients be engaged in the technological development helping to transform the health care and introduce telemedicine and other technologies in the process of care and interaction between clients and providers (Sun et al., 2015).
Selected Advanced Practice Role
Legal Regulations
This writer’s selected advanced practice role is a family nurse practitioner. Florida’s Nurse Practitioner Supervision Laws regulate the scope of practice of FNPs in the state of Florida, where this writer intends to be employed after graduation from the program. To practice in Florida as a family nurse practitioner, the main criteria include graduate education in nursing, certification for the role, and practice focused on the patient (American Association of Nurse Practitioners, 2013). To be eligible for certification for the specialty, the candidate must complete a graduate nursing program and acquire the necessary body of knowledge, skills, and competencies (American Association of Nurse Practitioners, 2013).
Many specialists qualify Florida’s Nurse Practitioner Supervision Laws as the strictest supervision systems in the United States (Sun et al., 2015). This law requires that the family nurse practitioner’s activity is supervised by the medical doctor of practice (American Association of Nurse Practitioners, 2013). The MD must be present in practice for at least two times a week, and all patients in practice are to be informed about the hours of the doctor’s presence. The rest of the time, the MD can supervise the FNP on the phone or via the Internet connection (American Association of Nurse Practitioners, 2013). FNPs are not allowed to sign death certificates, but they can sign handicap parking permits (American Association of Nurse Practitioners, 2013).
Florida’s Nurse Practitioner Prescribing Laws is another significant regulation that establishes the legal foundations for the role of the family nurse practitioner in Florida (American Association of Nurse Practitioners, 2013). This law makes the provision that the FNP is allowed to prescribe medicines under the supervision of the medical doctor and only according to the skills and competencies acquired in the nursing school (American Association of Nurse Practitioners, 2013). For example, in Florida, FNPs can prescribe antibiotics, but they do not have the authority to prescribe controlled substances (American Association of Nurse Practitioners, 2013). Besides, family nurse practitioners in Florida are not allowed to use forms pre-signed by the physician and utilize of the DEA number of the physician as provided in Florida’s Nurse Practitioner Prescribing Laws (American Association of Nurse Practitioners, 2013).
The Professional Organizations Available for Membership
As for the professional organizations available for membership for family nurse practitioners, the list is quite broad. FNPs can join the American Association of Nurse Practitioners, the National Organization of Nurse Practitioner Faculties, and American College of Nurse Practitioners (Yee et al., 2013). More options include basic nursing organizations in the United States including the American Nurses Association and National League for Nursing. NPs can also join American Association of Critical-Care Nurses, American Nurses Credentialing Centre. International Council of Nurses, National Council of State Boards of Nursing, and the Joint Commission for Accreditation (Yee et al., 2013). Since nursing organizations in the United States are quite multiple, it is difficult to mention them all in this project. So, only the most significant were listed. Nevertheless, professional nursing organizations for nurse practitioners are manifold and can have a narrowed focus of interest to address the needs of specific patient populations and specialties (Yee et al., 2013).
Required Competencies
The required competencies for FNPs address the clinical domain, first of all, since these professionals work in direct patient care. Excellence in direct clinical practice provides a foundation necessary for these professionals to execute competencies; consultation, guidance, coaching, and leadership within organizations. Family nurse practitioners, therefore, need substantial clinical experience and expertise in the field of direct patient care including the competencies of health assessment diagnostics, disease management, patient education, and health promotion (Sun et al., 2015). Florida Board of Nursing (2017) establishes that the FNP must possess the advanced clinical knowledge, skills, and clinical experience, advanced knowledge of pathophysiology and pharmacology, health maintenance and promotion competencies, advanced clinical research skills, policy making competencies, advanced leadership competencies, business literacy, and managerial skills.
The Organization and Setting, Population, and Colleagues with Whom This Writer Plans to Work
This writer is a business oriented person. She loves working with patients and understands that patients are also customers. In the long run, she plans to open her own practice in her community that badly lacks primary care providers due to the increased needs of the local population Before this goal realization, this writer would like to actualize her skills while collaborating with experienced nurse practitioners and medical doctors in one of the health care centers in her city. She is interested to master the practical skills in the area of administration, collaboration facilitation, budgeting policy making, and health care systems operation. Afterward, this author would like to open her own primary care office, where she will serve families with diverse needs. The focus of this center will be to help people improve their quality of life through continuous health promotion.
Leadership Attributes of the Nurse Practitioner Role
Upon the offered test completion during this course, this writer has learned that her leadership style is democratic leadership (Cherry, 2016). This result was quite expected since this author believes that democratic leadership provides the optimal opportunities for excellent performance of team members. As a democratic leader, this writer’s strong skills and competencies include emotional intelligence, excellent relations building skills, delegating skills, excellent communication skills, decision-making skills, and teaching abilities.
Transformational leadership is another successful leadership style. A row of specialists believes this style to be the best leadership style in today’s conditions of the rapidly changing health care landscape (Wong, Cummings, & Ducharme, 2013). Defining transformational leadership, it can be said that this leadership style is a leadership that changes and transforms people (Wong et al., 2013). It is concerned with values, emotions, ethics, standards, and long-term goals. It includes assessing followers’ motives, satisfying their needs, and treating them as full human beings. Transformational leadership involves an exceptional form of influence that moves followers to accomplish more than what is usually expected of them (Wong et al., 2013). As for this writer’s intended leadership style she would like to embrace, transformational leadership skills building in herself is her intent. Applying this leadership style to the domain of FNPs practice, its effectiveness is high because it allows to empower and motivate team members to their highest capacity (Wong et al., 2013).
Health Policy and the Role of Nurse Practitioner
The information provided in the subheading “Legal Regulation” provides multiple details proving the fact that the scope of practice of NPs in Florida is being restricted. The state of affairs with the scope of NPs in Florida is unfortunate for the residents because the need for the primary care providers in this state is the biggest among all locations in the country, but the scope of FNPs’ practice is the most restricted (American Association of Nurse Practitioners, 2013). This unfortunate situation is a paradox of the health care system in Florida. While patients in Florida badly need quality, safe, and cost-effective health care provided by nurse practitioners, the policy-makers and legislators seem to be blind to the citizens’ basic needs.
The topic of interest here is full prescriptive authority for nurse practitioners in Florida and possible resulting changes to access to health care when NPs have more autonomy. NPs who work in primary care show patient outcomes equal to or better than physicians (Aiken et al., 2016). More than 40 years of studies show that NPs perform safely in practice (Aiken et al., 2016). The outcome related to full prescriptive authority for NPs is increased access to health care in Florida. This author believes that having proponents fighting for prescriptive authority for NPs is an important area that needs further support. Be it through studies or arguing the topic in legislative hearings, the NPs in Florida are not being used to their fullest capability. With the shift in healthcare policy towards more cost-effective care, it is fundamental that the decision-makers need to investigate ways to improve care while implementing cost-saving techniques.
A study would need to be performed over at least two years depicting the percentage change in access to healthcare when NPs are afforded full practice authority. To evaluate the study descriptive statistics and inferential statistics may be used. Descriptive statistics describe the population studied and the instruments used in the study. Scores or percentages may be compared using measures of central tendency.
This writer could lead the effort to make the change in policy by providing the results of the above-mentioned study to policy-makers in Florida. This could be done by means of involving interest groups such as the American Association of Nurse Practitioners in order to have a stronger voice in society. Continuous communication and cooperation with the policy-makers in the state will be necessary in order to lobby for the interests of NPs. This writer also plans to use the resource of the social pressure by the wide public. This source is powerful when it comes to affecting the decision-making process in politics. Since the wide public’s interest to improve the citizens’ health and NPs’ interests to have a broader scope of practice coincide, this author believes in success of the above-described efforts.
Conclusion
In conclusion, it should be pointed out that advanced practice nurses have become essential specialists in contemporary reality of the health care system in the United States. It is imperative that APNs be recognized as a vital source for bridging the gap in health care and be allowed to accommodate full patient care. These specialists have important roles in direct patient care, advocacy for patients’ interests, customer experience facilitation, optimization of management, and policy-making to help the vulnerable populations. This writer has shared her plans regarding her further career development as a family nurse practitioner. With an increasing shortage of primary care physicians, the role of the FNP will become more vital in meeting the demands of the cost-saving health care. Currently, the need for nurse practitioners in the state of Florida where she plans to be employed is significant, but their scope of practice and the policy regulating it is an immense concern because it appears that the law intended to benefit the population actually harms it by limiting their access to the quality primary care provided by NPs. This writer believes that NPs in Florida need to continue to unite their interests using interest groups to achieve the positive change in the legislative field in order to broaden their scope of practice and acquire an opportunity to serve diverse patient population to promote their wellbeing and improve the quality of life.
References
Aiken, L.H., Slone, D., Griffiths, P. Rafferty, A.M, Bruyneel, L., McHugh, M., Maier, C.B., Moreno-Casbas, T., Ball, J.E., Ausserhofer, D., & Serveus, W. (2016). Nursing skill mix in European hospitals: Cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality and Safety. doi: 10.1136/brnjqs-2016-005567
American Association of Nurse Practitioners. (2013). Legislation/ regulation. Retrieved from https://www.aanp.org/legislation-regulation
Cherry, K. (2016). What’s your leadership style? Learn more about your strengths and weaknesses as a leader. Retrieved from https://www.verywell.com/whats-your-leadership-style-3866929
Florida Board of Nursing. (2017). Advance registered nurse practitioner. Retrieved from http://floridasnursing.gov/licensing/advanced-registered-nurse-practitioner/
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15. doi: 10.1111/wvn.12021
Sun, V., Olausson, J. M., Fujinami, R., Chong, C., Dunham, R., Tittlefitz, T., … & Grant, M. (2015). The role of the advanced practice nurse in survivorship care planning. Journal of the advanced practitioner in oncology, 6(1), 64-8. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577035/
Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of nursing management, 21(5), 709-724. doi: 10.1111/jonm.12116
Yee, T., Boukus, E. L. L. Y. N., Cross, D., & Samuel, D. I. V. Y. A. (2013). Primary care workforce shortages: Nurse practitioner scope-of-practice laws and payment policies. National Institute for Health Care Reform Research Brief, 13, 1-7. Retrieved from http://www.floridanurse.org/arnpcorner/ARNPDocs/NIHCR_Research_Brief_No._13.pdf