Advanced Practice Registered Nurses

Nursing Education Two relatively brief and recent articles by the Institute of Medicine (IOM; 2011a, b) offer some intriguing solutions regarding the future of the nursing profession, particularly advanced practice registered nurses (APRNs).

The gist of both of these brief reviews is basically that in order to keep up with the demanding healthcare needs and changes in the healthcare system the nursing profession should: (A) stress higher levels of education across the board for its practitioners and (B) should be given more leniency as to the scope of its practice (in other words the scope of nursing practice should be broadened).

It is interesting that the nursing profession should be held to a higher standard of education in the context of a diminishing number of new nurses coming into the field each year (Buerhaus, Staiger, & Auerbach, 2009). From an ethical standpoint no healthcare professional should be allowed to practice outside the scope of their training and education; however, physicians tend to advocate for a position that places them at the top of the hierarchy and the nursing profession as subservient to them.

This power struggle will continue if nurses advocate for increasing levels of education, expanded practice guidelines, and more control in treating patients. From an ethical standpoint there really needs to be a clear -- cut designation between the competencies of APRNs and physicians. However, if nurses let physicians decide these designations then nothing will change, this must be a collaborative effort.

Without an advanced education in the field of nursing I cannot improve my abilities and skills, seek positions that allows me to be of the greatest benefit to the patients I treat, and am unable to further the goals of the nursing profession in regards to defining our unique role as medical professionals. My options for employment increase substantially as I further my education and skill set. Higher education and lifelong learning is the first step to meeting these personal and professional goals.

Unless we as nurses meet these challenges on a level playing field (with advanced education and skills) we will continue to be unable to define our profession as one with needed and unique contributions in all areas of healthcare. Secondly, the move towards increasing the educational levels of the nursing profession requires quite a bit of funding. Nurses, many of whom are already overworked, may not see the utility in furthering their formal education unless funding is provided.

In order for the field of nursing to reach the desired educational stratifications recommended by the IOM (2011b) there must be better financial aid and practical incentives for nurses to meet these recommendations, otherwise the drive to further the profession may just lead to burnout and a majority of current practitioners will simply continue maintaining their continuing education requirements.

By continuing my education in the nursing profession I also place myself in a unique position to lobby for improved sources of funding for my own education as well as continued education for my peers. In addition, by opening up new sources of funding for education in nursing we also can develop more opportunities for people interested in a nursing career by way of expanding both the quality and number of nursing programs but also the number of new slots per program.

As I increase my education and level of competence I also help to further the profession by becoming a nurse educator. This designation allows me to affect the field in a much broader manner. First, nurse educators by virtue of their expertise, need to form collaborative partnerships with nursing educational programs in order to make sure that the quality of education is based on evidence-based practice.

In addition, nurse educators need to partner with healthcare organizations linked to these educational institutions to make sure that the standard of practice is implemented in both. This would require changes to the curricula and updates to the curricula to support problem -- based learning and competency -- based practice. Nurse educators are the main line of defense for the future of APRN training and competency.

Nurse educators can also be crucial in helping to establish federal funding for APRN clinical education and to ensure that this training is at the same level as graduate medical education as well as attracting potential students. If nurse educators do not form these partnerships and ensure that the training methods are up-to-date and remain standardized who else will? I strongly believe that if not us no one else.