Advanced practice nursing roles and competencies

¶ … Practice Registered Nurse is a role that goes far beyond the limited roles of regular RNs. In fact, it is based on individuals completing a graduate degree program, where their skills within the nursing field are expanded dramatically. With the greater breadth of knowledge at their disposal, APRNs are expected to work with patients, physicians, and other nursing staff and utilize problem solving evidence-based decision making skills to take control of situations like no other nursing staff can do (APRN Joint Dialogue Group Report, 2008). Three major criteria to be an APRN is the achievement of a graduate degree, utilize an evidence-based nursing approach to decision making, and provide support for others working in the field. There are a number of different types of APRNs. First, there is the NP, or Nurse Practitioner, who is largely independent in his or her skills and capabilities. Their role does depend by state, but they can make diagnoses, order specific tests, prescribe drugs and physical therapy, and provide primary care services. The Certified Nurse Midwife is specially trained in nursing and midwifery, which allows them to help women give birth. They can work in collaboration or independent of a physician. A CRNA, or a Certified Registered Nurse Anesthetist works specifically with providing anesthesia to patients. A CNS, or Clinical Nurse Specialist, works within a clinical setting. They work with patients, doctors, and other nursing staff to deliver patient care, update models of care for other RNs, and are responsible for diagnosing and treating various patient illnesses (APRN Joint Dialogue Group Report, 2008). They utilize evidence-based nursing practices in order to make more efficient decisions in the field.

The role of the Nurse Practitioner is also highly specialized. Essentially, NPs are expected to diagnose and treat a variety of patient symptoms both in collaboration and independently of physicians. They have the authority to take physical exams, order diagnostic tests, deliver orders for various treatments, prescribe medications, and to make referrals to other medical specialists working in a more specified field. They can often specialize in specific areas of medicine themselves. For example, my role is an FNP, or a Family Nurse Practitioner. The definition of this role is essentially one who "meets the healthcare needs of the family by providing health assessments, direct care, and guidance, teaching, or counseling as appropriate, particularly around family self-care" (University of California San Francisco, 2013). They work with primary care physicians and other nursing staff in order to provide the best strategies of care for families. They often work outside clinical settings as well, and can be found at schools or work environments. They follow strict standards of care which are similar to NPs in general, but focus much more on the family unit. As such, they work collaboratively with entire family units to solve the health problems of multiple members of a family.