Nursing Family Nurse Practitioners: Improving Quality of Care

A study published in 1976 helped to establish the meaningful difference between family nurse practitioners and traditional health care providers such as doctors and nurses. Patients reported higher satisfaction with family nurse practitioners than with traditional providers, revealing the need to integrate family nurse practitioners into the repertoire of care (Linn, 1976). Because of research like this, the value of the nurse practitioner and the family nurse practitioner in particular has been highlighted in the scholarly literature as well as in anecdotal practice.

Part of the reason for the increased awareness of the role the family nurse practitioner fulfills is the improvements in overall quality of nursing care and delivery of services. This is because the nursing profession has become fully distinct from the medical profession in ways that are well articulated. As McDowell (1984) notes, "The values of nursing must not get lost in the dominant medical culture. If they do, you justly risk the epithet of junior doctor. Patients do not need junior doctors. They need the knowledge and skills of both medicine and nursing."

I am embarking enthusiastically on a career as a family nurse practitioner because I believe in the profession and what it can do to improve quality of care. I also understand that the family nurse practitioner serves a unique role in the medical care system, as an individual who develops long-term relationships with patients and who views patient success within the greater context of family and community. Family nurse practitioners develop cultural awareness and sensitivity, in addition to providing optimal delivery of care.

Personal Reasons

My grandmother was a nurse, and my aunt is a nurse practitioner. Although neither were officially family nurse practitioners, both of my role models illustrated the ways nurses do take family issues into account when delivering care. My grandmother worked as a nurse in the army. She provided care under stressful conditions, and frequently interacted with people from various cultural backgrounds and who spoke different languages than she did. Treating soldiers outside of their family context proved challenging, but my grandmother made every effort to communicate with the patients about their lives outside of combat. When the patients were able to provide family context, it was easier and more effective to provide care that was meaningful for that individual. My grandmother practiced nursing in this way, long before she had heard of terms like "cultural competence."

My aunt was from a different generation, in which nursing was becoming more established from a scholarly standpoint. She has become familiar with phrases like "cultural competence" during her work, and is continually reflecting on the role of the nurse in the community. As a Registered Nurse, my aunt has worked in a hospital that sees a lot of economically disenfranchised people in the community. She has gone beyond the parameters of the profession to become involved in community organizations that provide outreach services for addicts and homeless people. In this way, my aunt has taught me about the need to understand context in health care. Whereas doctors only see the broken leg or cancerous lung, the nurse sees the whole person. The nurse takes into account family background, history of abuse, and other issues that might impact the patient's current situation and future ability to stay healthy. Nurse as health promoter is the primary concept that I have worked with because of my personal interaction with the two great nurses in my life.

Why Family Nurse Practitioner?

Of all the different types of nursing and areas of specialization, why would I select to be a family nurse practitioner? After all, the nursing profession is a diverse one with several different potential areas of professional practice application. There are several reasons why being a family nurse practitioner is the way I want to contribute to the profession.

For one, I strongly believe in reducing or eliminating disparity related to gender, race, or socio-economic class. As Gibson (2013)...

By taking into account family issues that pertain to socio-economic class and social status, nurses can raise awareness about the ways these issues influence health status among individuals and whole communities. Likewise, family nurse practitioners are in a unique position of understanding the impact of gender on health issues, access to care, and health status. Furthermore, I want to work with the underprivileged like my aunt does. "Nurse practitioners have been utilized to deliver primary care, traditionally in underserved areas or to vulnerable populations," (Gibson, 2013). Knowing that I could contribute to underprivileged communities, it is my express intention as a family nurse practitioner. I want to devote my energy to the populations most in need.
Second, I strongly believe that patients cannot be treated without taking their family backgrounds and current family situations into account. Nyirati, Denham, Raffle, & Ware (2012) note that most, if not all, family nurse practitioner programs "frame family as the context of care for the individual." I cannot imagine treating a patient as if he or she were not part of a family system. Family systems influence one's lifestyle choices, which in turn impact health. Mental health as well as physical health depends on the family system.

Third, I have a strong degree of emotional intelligence and cultural sensitivity that can best be applied to the family nurse practitioner setting. The family nurse practitioner is trained in cultural competence and sensitivity as a matter of course (University of California, San Francisco, 2013). Family nurse practitioners need to include family members in the decision-making process, enabling collaborative health care decisions that are more effective for patients in the long run (University of California, San Francisco, 2013). I believe that it is impossible to treat patients fully without understanding the person's life outside of medical care. That life includes ties to the community, job, language, and a host of other factors related to care.

Finally, a family nurse practitioner plays an active role in caring. The family nurse practitioner does not have a fragmented view of health care, but a holistic one. As the University of California, San Francisco (2013) points out, "In addition to conventional practice in an office, clinic, or ambulatory care center, the FNP may follow families in a variety of settings, such as school, home, work place, or hospital." A holistic vision of health care is made possible with a family practitioner approach.

Theoretical Viewpoints

As a systems theorist, I view individuals as being parts of a community rather than being isolated entities. My theoretical viewpoint will influence my approach to health care and ensure that I can deliver the best quality of care for patients. By learning about the patient's family background, I can make recommendations for health promotion on an individualized basis. Generalizing about the patient population is a faulty practice, especially in a diverse society. It is far more productive to acknowledge diversity and prepare for the future of medical care in the global community. I also appreciate that Gibson (2013) emphasizes the theory of cultural humility in the family nursing practice. "Infusing cultural humility into the family nurse practitioner curriculum, there is a greater opportunity for improved health outcomes within the minority population." These two theoretical standpoints of cultural humility and systems theory will influence my future practice.

Conclusion

Family nursing requires a great degree of patience and cultural sensitivity that cannot be taught in a classroom. I believe that I already possess the emotional, psychological, and theoretical foundations that will make me an effective family nurse practitioner. Because of my personal and theoretical backgrounds, I can apply myself fully to a profession that has the potential to improve the lives of others. In a diverse society,…