Advanced Practice Nursing Role

¶ … Advanced Nurse Practitioner

There are a number of differences explored by Hamric et al. (2013) throughout the chapter which helps differentiate the Advanced Nurse Practitioner from other nursing roles in healthcare. One that is important is the contrasts shown between the Advanced Practitioner and a nurse working in a certain field of specialization. Hamric et al. (2013) describes specialization as "the development of expanded knowledge and skills in a selected area within the discipline of nursing" (68). As such, nurses working in a specialized genre of the field have experience often specifically within that field, and lack the more generalized knowledge that comes from working within an Advanced Practice situation. Education within specialization does not always require a graduate program and can often be done by working specifically in the field of specialization. On the other hand, Advanced Practitioners must follow a broader, yet more intense level of study. APNs work towards graduate degrees that allow them a greater level of proficiency in a wider area of specialties. Thus, APNs are different from specialty nurses because "Advanced practice students acquire specialized knowledge and skills through study and supervision at the graduate level. APNs are trained to assess and react to patients more independently than specialized nurses. Additionally, a second difference discusses revolves around the notion of different roles within the larger field of Advanced Practice Nursing. The title does not mean that there is a single definition of the roles experienced by the APN. As such, Hamric et al. (2013) is right to show the clear differences between these roles. The roles of the APN differ dramatically depending on the environment in which he or she is practicing. When an individual is a clinical setting, some roles, like that of working in collaboration with patients or making innovative decisions in healthcare strategy differs from APNs working elsewhere, like in an academic setting where there is a greater importance placed on the leadership role to guide future nurses.

The text suggests that the direct care of an APN is distinguished by six characteristics: "use of holistic perspective, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence to guide practice, and use of diverse approaches to health and illness management" (Hamric et al., 2013, 76). Out of these six core characteristics, two would be especially difficult to master. First, the formation of therapeutic partnerships would be especially difficult to develop based on the level of confidence one would have to convey messages to patients in a clear and logical manner. Working with patients is one of the most difficult things to do as any level of nurse. It requires a certain degree of not only clinical knowledge, but also people skills and charisma. Working with patients is necessary to build a report that would help facilitate the successful meeting of healthcare goals. Yet, although there is some level of academic training in this aspect, the bulk of learning comes from actually experiencing working with patients, which can take years to develop. Secondly, the use of reflective practice is also hard to develop. No matter how much academic training provides models for reflection, it is actually a very difficult task to conduct. It takes the knowledge of hindsight, and also the ability to see the areas needed for improvement and then make logical strategies to work on those areas. In many instances, it is always easier for someone else to point out areas for improvement. Self-reflection is much deeper and takes a lot of experience to fine tune.

There are a number of clear and direct statements that are incredibly accurate within the texts. For example, one chapter suggests that "Leadership is not optional in APN practice, it is a requirement" (Hamric et al., 2013, 92). This is absolutely true. APNs have to take their advanced knowledge and experience in order to delegate tasks to get the most optimum conditions within the healthcare environment. Thus, they must utilize strong leadership in order to facilitate team work and communication within the group of nurses and other healthcare workers in order to succeed in meeting healthcare goals. Without leadership, APNs are unable to allow their own heightened experience and knowledge direct healthcare strategies to the most successful directions.

One widely accepted model for skill acquisition in Advanced Nursing Practice is the Skill Acquisition model, created by two brothers, Dreyfus and Dreyfus. This model helps illustrate how nursing students of all levels acquire the skills they need to keep pushing towards their goals within healthcare. There is first the Novice level, where skills are acquired primarily through mimicking the actions of others and memorizing the basic components of nursing. This is the most rigid of all levels, as the student can not use their own judgment based on a lack of experience. Next is the Advanced Beginner, also known as a stage of Competence, who has a little more perceptual freedom than the novice. Individuals with competence achieve a heightened level of competence based on their experience with real-life situations in the field. At this stage, nursing students have a degree of aspect recognition, where they can recognize patterns and respond to them independently. The third stage is known as Proficiency. During this stage, the nursing student goes beyond simply recognizing patterns to more holistic perception of how and where to acquire the skills needed for nursing in the field. The learner is finally able to draw on lessons and experiences he or she has gained in the past and use them in entirely new circumstances to come up with unique solutions. Still, the proficient learner is still learning, and they will utilize their ongoing experiences in the field to further adapt their own perceptions and actions later in their nursing career. Finally, there is the Expert, who is no longer limited by purely following rules or maxims. The expert uses his or her own library of experiences and knowledge to come up with creative solutions for individual situations that may have never been taught to them during their learning process. The expert is intuitive and innovative, adapting to his or her environment seamlessly. Out of the five levels, I believe I am in transition between the Novice and Competent level. My experience and undergraduate degree does allow me some leeway in drawing upon my own belief, but I am still limited by my need to memorize and follow the procedures and guidelines of others who know far more than me in our field. My completion of my Advanced Nursing program will catapult me into the Competent level and far into Proficiency, but it is only real life experience that will finalize my skills level at the final stage of Expertise.