Introduction

The advanced practice nurse (APN), commonly known as an advanced practice registered nurse, coordinates and provided specialty health care as well as primary health care. They interact with the public and take care of the patients in a diversity of health institutions such as physician officers in a hospital, nursing facilities, for example, education institutions and dispensaries.  Advanced means they have a greater understanding than their correlative registered nurse, this is seen in their ability in greater decision making and expertise in the evaluation of healthcare and keeping of records, making plans and implementing them (Benner & Tanner, C. 2013). Besides, they are known to have more excellent knowledge of diagnosing as well as assessing patients. This paper comprises of an overview of the historical background of advanced practice nurse as well as a summary of an interview with an advanced nurse practitioner aimed at providing clear insight in understanding the roles of these nurses.

An advanced nurse practice has many observable and non-observable functions including dispensary and clinics. They diagnose patients as they visit a clinic and perform physical exams. It is their role to perform exams such as psychological and psychosocial functions as well as developing tests and diagnosis. An advanced practice nurse also orders lab tests and interprets the results as required. In addition, they maintain the patient’s records and ensure patients privacy and clinical compliance (Fagin, (2016). Their primary role is to check the patient’s progress and responses to various treatments as they modify treatments and take care of adjustment necessarily. Furthermore, advanced practice nurse provides patient’s consultations to those who are yet to choose what action to take as well as giving medications to patients’.They also participate in studies especially research required in any field of medicine.

Interview

I interviewed one Rhonda Mac from Mercy hospital whose specialty is a senior adult-gerontology nurse practitioner (AGNP) specifically concerned with the welfare of patients comprehensively from adolescence to old age.  According to the interviewee, the roles of AGNP include diagnosis and treatment of patients. The interviewee further states that there are several categories of advanced practice nurses including being a clinical Nurse, Neonatal Nurse who works with premature babies, Nurse Midwife who is known for providing and coordinating patients care for mothers and expectant mothers, clinical nurses, critical nurses, and dialysis nurses.

The official title position of this advanced nurse is a clinical nurse in Mercy Hospital; he does diagnosis and treatment of patients as they come in a clinic as well as performing physical exams. It is his role to perform exams such as psychological and psychosocial functions as well as developing tests and diagnosis (Bryant‐Lukosius, 2014). He also orders lab tests and interprets the results as required. He also maintains the patient’s records and ensures patients privacy and clinical compliance. His major role is to observe checking patient’s progress as well as responses to various treatments also to modify treatments and take care of plans necessarily.

The interviewee has been in Mercy Hospital as a clinical nurse since  3rd January 2017 up to date that makes a total of two years. Before then, Mac was an assistant clinical Nurse in the same healthcare. He was then promoted to his current position before being promoted. Mac was required to have at least a master’s degree in nursing, a state license as a registered nurse, and working experience of two years as a registered nurse.

Regarding the issue of preparedness, Mac states that he was ready since it is his passion to save lives and assist humanity. Although Mac’s job is fulfilling regarding salary and working environment, he is also faced with challenges (Slavitt, 2012).  For instance, he has encountered people logging into patient’s health records if he forgets to log out his computer and letting out patient’s private information to the public. This act has made him more careful.

Currently, Mac’s philosophy as a clinical nurse includes taking care of patients as a whole, using his knowledge, being companionate and caring, respectful and honest, and not afraid to ask questions to both patients and doctors. The most challenging issue this nurse goes through is making sure patients privacy is protected and stays as private as it should be and threats from online asking him to reveal patient’s medical forms and he mostly finds some people can access hospitals websites insecurely.

According to Mac, the overall impression about his organization was that it is the best place he ever wanted to be while schooling and he is satisfied by the attention patients are given in his place of work. (Miller, 2014).Given a chance to change an aspect of his role, he preferred a position with the latest information in the changing world at his disposal so he and other nurses can adequately assess and treat patients.

Implementing his research findings into practice in his daily chores in areas such as wound care, pressure ulcers, mouth care, and pain control. This occurs by interacting with the patient and the members of the public (Sheer & Wong, 2015). He believes that he is contributing to the society as well as the patients positively as he receives positive compliments from both patients and colleagues and members of the public. Every day after a long working hours he feels satisfied by what he has done.

Mac reports that advancing nursing disciplines can be done through technology. As a result, trends in health areas should be at his disposal as a nurse to effectively assist the society at large. He feels he must know what is going on out there as he is working to perform effectively.

Mac’s career future plans are to achieve a high degree in nursing as well as see to it that the welfare of the patients is taken care of at the best of his knowledge. He plans to make his expertise to less fortunate countries and assist other nurses as well as patients. (Manle, 2016). Technology will be creating feedback platforms and keeping track on emerging issues in society. Forthwith, an advanced digital record of patients will names and progress will be initiated.

An adult-gerontology nurse practitioner (AGNP) has essential roles in the welfare of health issues, handling patients from consultation to diagnosis to assigning treatment is basically the roles of a nurse in a clinic .personal value and philosophy of nurses is also a role a nurse has to meet on a daily basis to ensure effectiveness in the field. Research and its practice is a delicate issue that should be handled with a lot of care and seriousness. The job is met with challenges like long working hours which is as a result of a shortage of advanced practice nurse in schools and hospitals which can be handled by encouraging young ones to pursue nursing. Being an AGNP is enjoyable and life fulfilling.

Moreover, it comes to my attention that an advanced nurse is involved with the most aspect of patient care they, therefore, have an added advantage of gaining more knowledge on the responsiveness of treatment from patients. This enables them to get a detailed understanding of each patient health wise and attain historical background as well. Advanced nurse practitioners are also used as a link between the patient and the staff by asking them how the patient is, diagnosis and treatment. Through this, the nurse attains a lot of knowledge. I also learned that AGNP assists other nurses with their technical skills and teaching them.

However I noticed advanced practice nurse had no clearly defined role, they happen to handle any problem in the clinic, clear roles are essential if the value of care and quality are to be improved. Their schooling had not prepared them adequately to the work they handle currently but through their patience and constant learning through practice in clinics; they can provide expected services.

An advantage of being an advanced nurse practitioner is the fact that one can perform many duties of a physician while still retaining their previous work in a hands-on nursing capacity. They treat the different specified problem from patients and also form plans of the patient health-wise through managing patient’sneeds. Patients tend to trust them, and a great relationship is made therefore can look at patients health for a long term.

Advanced nurse practitioner treats patients on a preventive basis since they observe the life of the patient and health and also has an added advantage due do working together with experienced doctors to consult. It is a higher profiled role as compared to another registered nurse one bypasses the great internships and medical school required for doctors in medicine, they are absorbed in the job market in a shorter period. Moreover one can specialize in a specific medical field as doctors do. Like any other job being an advanced nurse practitioner has its stress. These nurses have a closer level to that of doctors that means they face similar risks of negligent professional behavior. Its insurance is so expensive and nurse practitioner does not have an equal salary like doctors/much of their income is cut off to ensure the cover.

Some states restrict this advanced nurse practitioner from signing prescriptions and also they are required to work under a doctor. This prevents them from practicing to their highest level.This can be a significant problem when one wishes to relocate to another state.

Conclusively, this study has been helpful in understanding various issues concerning the AGNP. It has built knowledge and will be used for facilitating learning. AGNP are very useful in clinics, and it could never be done without them. I cannot imagine a world without advanced nurse practitioners. I have gained knowledge and clear insight on what it entails to be an AGNP, this leads to encouragement to me as I pursue the nursing journey. Patients have been able to access urgent appointments thus becoming much more satisfied by AGNP.

References

Benner, P., & Tanner, C. (2013). How expert nurses use intuition. AJN The American Journal of Nursing, 87(1), 23-34.

Brandon, A. F., Schuessler, J. B., Ellison, K. J., & Lazenby, R. B. (2016). The effects of an advanced practice nurse led telephone intervention on outcomes of patients with heart failure. Applied Nursing Research, 22(4), e1-e7.

Bryant‐Lukosius, D., DiCenso, A., Browne, G., & Pinelli, J. (2014). Advanced practice nursing roles: development, implementation, and evaluation. Journal of advanced nursing, 48(5), 519-529.

Fagin, C. M. (2016). Collaboration between nurses and physicians: No longer a choice. Academic medicine: journal of the Association of American Medical Colleges, 67(5), 295-303.

Manley, K. (2016). A conceptual framework for advanced practice: an action research project operationalizing an advanced practitioner/consultant nurse role. Journal of clinical nursing, 6(3), 179-190.

Miller, S. K., Alpert, P. T., & Cross, C. L. (2014). Overweight and obesity in nurses, advanced practice nurses, and nurse educators. Journal of the American Academy of Nurse Practitioners, 20(5), 259-265.

Sheer, B., & Wong, F. K. Y. (2015). The development of advanced nursing practice globally. Journal of Nursing Scholarship, 40(3), 204-211.

Slavitt, D. B., Stamps, P. L., Piedmont, E. B., & Haase, A. M. (2012). Nurses’ satisfaction with their work situation. Nursing Research, 27(2), 114-120.

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