NURS 513 Discussion: How the role of advanced registered nurse transformed over time
NURS 513 Discussion: How the role of advanced registered nurse transformed over time
Re: Topic 1 DQ 1
The role of advanced registered nurse has transformed over time in so many ways. We focus on how nursing has rapidly evolved. There was the traditional Registered Nurse than over time it has evolved into many distinct categories of nursing which involved (CRNAs), certified nurse–midwives (CNMs), clinical specialists (CNSs), and nurse practitioners (NPs) then Doctor of nursing practice (DNP) (DeNisco & Barker, 2016). The shifts of scope and expectations in the 20th and 21st centuries have not change as much as we think. “Clinical nurse specialists (CNSs) have been providing care to patients with complex cases across healthcare settings since the 1960s. The CNS role originated to satisfy the societal need for nurses who could provide advanced care to psychiatric populations. Following this implementation, the usefulness of the role became apparent, and schools of nursing began to educate nurses across specialties, including oncology, medical-surgical, pediatric, and critical care nursing” (DeNisco & Barker, 2016). “Nurse practitioners have been providing care to vulnerable populations in rural and urban areas since the 1960s. The role was born out of the shortage of primary care physicians able to serve pediatric populations. Today, nurse practitioners are the largest group of advanced practice nurses. More than 192,000 NPs are licensed and practicing with some level of prescriptive authority in all 50 states. Nurse practitioners work are educated and hold board certification in a variety of specialty areas, including pediatrics, family, adult gerontology, women’s health, and acute care.” (DeNisco & Barker, 2016). Midwives are essential. “In the 1920’s when the first midwifery school began because of high mortality rates and poverty in Kentucky which led to the demand of Midwives brought about change to these rural communities.” (DeNisco & Barker, 2016). Midwives are needed more than ever in so many areas of nursing especially when pregnant women are not comfortable being in a hospital setting. Nurse anesthetists have a crucial role in nursing because they provide anesthesia during surgery. “Nurse anesthetists are licensed as independent practitioners, and they provide care autonomously and in collaboration with surgeons, dentists, podiatrists, and anesthesiologists. The shortages of physicians qualified to administer anesthesia during wartimes continued, and nurse anesthetists were the main providers of anesthesia care for U.S. military personnel on the front lines for World War I, World War II, the Korean War, and the Vietnam War; nurse anesthetists also provide care in the current conflicts in the Middle East.” (DeNisco & Barker, 2016). Describe how the role of advanced registered nurse transformed over time
Advanced registered nurse role and responsibilities will continue to evolve and emerge as the American health care system changes by technology and continued education. Nurse educators are essential for keeping registered nurses informed of all the new policies and procedures we must abide by.
References
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 9781284072570
Peer Responses
Re: Topic 1 DQ 1
Hi E,
You bring up a great point about the difficulty with being an advanced practice registered nurse (APRN). Even though its been 20 years since the Institute of Medicine released their report “The Future of Nursing: Leading Change, Advancing Health” recommending that nurses work to the full extent of their education and training, some people and regulatory bodies are still hesitant to allow this (Institute of Medicine, 2011). Describe how the role of advanced registered nurse transformed over time
My mother was a Nurse Practitioner (NP) trained in acute cardiovascular care. I remember how frustrated she would get because the physician she worked under wouldn’t allow her to do certain procedures or tests that she was capable of performing because he would rather her handle the paperwork. I find it sad that it has been such a struggle for nurses to break through these barriers to be able to do what they are capable of. I also think it does the patients a huge disservice.
References
Institute of Medicine (2011). The Future of Nursing: Leading Change, Advancing Health. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK209881/
Re: Topic 1 DQ 1
Hi M,
I really enjoyed your post and the inclusion of some of the nontraditional APRN roles. Many of these nonclinical, or nontraditional roles do require knowledge and experience beyond the bachelor’s degree level of education. I was surprised to learn that all Nurse Administrators are not required to have a graduate level degree (DeNisco & Baker, 2016). Nurse Educators are another vital nontraditional APRN role that is tasked with preparing the nursing workforce in a clinical setting (DeNisco & Baker, 2016). There has been debate about the content that should be taught to future nurse educators; whether its advanced clinical knowledge or teaching techniques. In my mind both components seem necessary to adequately do the job. I agree that the National Council of State Boards of Nursing (NCSBN) should reassess the current APRN roles. I think you hit the nail on the head when saying that reevaluating the APRN roles would better serve nurses and patients alike with our ever-evolving healthcare system. Porter-O Grady and Malloch (2018) stated that “an understanding of change and innovation is not an option for nurses but rather it is a professional obligation” (p.52). This professional obligation to transform and innovate extends to the NCSBN and their duty to redefine the APRN role.
References
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 9781284072570
Porter-O Grady, T. & Malloch, K. (2018). Leadership in nursing practice: Changing the landscape of health care (3rd ed.). Burlington, MA: Jones &. Bartlett Learning. ISBN-13: 9781284146530
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