Cns and Cnm Roles

Nurse practitioners receive employment within the context of IP or interprofessional teams worldwide (Hurlock-Chorostecki, Forchuk, Orchard, van Soeren, & Reeves, 2013). The 2013 article seeks to describe the role of the nurse practitioner within the IP team and how the NP augments care processes. The authors attempt to examine the NP role via utilization of a constructivist grounded theory approach. The authors created a two-part study with the larger phase of the study comparing and integrating collected data.

They examined seventeen HB NPs all over Ontario, Canada using individual interviews as a main source of qualitative data collection. The role of the NP has a strong emphasis on team working and patient care. In essence, NPs promote IP work and enable collaboration as well as teamwork levels. Furthermore, they promote cohesion within the IP team. This is the first study of its kind to use the IP framework to examine the role of a nurse practitioner.

The role of the nurse practitioner in summary, is to provide the cohesion and collaboration needed for the IP to maintain its desire for teamwork and delivering high quality patient care. The next article discussing the role of nurse practitioner focuses on the NP's ability to meet the needs of patients by serving as primary care providers. The article begins by stating the primary care nurse practitioner workforce serves as the substantial part of the supply of primary care providers (Poghosyan, Boyd, & Knutson, 2014).

The authors conduct a study to determine which barriers influence nurse practitioner care and practice. By conducting a New York state-based survey to better comprehend the role of the NP, focusing on teamwork as well as independent practice, the authors discovered only 42% of NPs surveyed has their own patient panel. Aside from patient panels, the authors also discovered that improvement in teamwork comes from NP independent practice. NP independent practice means a higher degree of autonomy. Higher degrees of autonomy contribute to overall improved teamwork.

Although there is a focus on NPs and teamwork, it seems lack of being in a team improves NP performance, lending to the notion that NPs perform better on their own. Meaning NPs perform better outside of the team setting. Doctors and nurse practitioners sometimes experience tension between each other. In a 2014 NY Times article, NY Legislature passed a bill that granted nurse practitioners the right to offer primary care sans physician oversight (Jauhar, 2014). NY is just one of sixteen states that have approved it.

This means nurses are no longer required to collaborate with a physician in regards to a patient's care. Support for this measure to reach the entire country has been widespread. The reason for these changes and support for such changes is the dire need for primary-care physicians. However, primary-care physicians are expensive. Some view nurse practitioners as a cost-effective solution to the growing need. Although theoretically nurse practitioners may seem more cost-effective, the research suggests that is not the case.

In fact, some evidence points to nurse practitioners ordering more diagnostic tests than physicians would lending to a higher overall expense in healthcare. Researchers believe they do so based on the lack of training. Physicians suggest, especially in primary care, the ability to offer differential diagnosis, which is something nurses are not necessarily trained to do. Physicians believe as stated at the end of the article, that nurse practitioners should not go solo and instead remain part of a physician-led team.

Certified nurse-midwives and certified midwives (CNMs and CMs) help facilitate an alternative approach for safe home birth practices (Cook, Avery, & Frisvold, 2014). The role of the CNMs/CMs as described by an article by Cook, Avery, & Frisvold is that of a medical professional that can make home birthing safe by following home birth guidelines. These guidelines such as informed consent, client screening, peer reviews, physician collaboration, and record keeping can allow for a safe and positive experience for any expectant mother.

By reviewing the guidelines for home birthing, the article discusses the various ways in which CNMs and CMs collaborate with the healthcare community to give expectant mothers a professional and standard practice of care. Home birthing practices although possible as a CNM/CM, are more common for regular midwives. Some states do not encourage the practice of home birthing. Because CNMs collaborate with physicians and gynecologists, they may be less inclined to do home birth.

However, when it is done, CNMs frequently maintain contact with other medical professionals to decrease any potential risks for the expectant mother at home. This study provides insight into the growing area of CM/CM and home birthing. The next article deals with the practice and attitudes of CNMs in the United States. The article begins with stating the similarities registered midwives have with CNMs. However, the researchers note the marked differences in relation to intrapartum practice sites (Vedam, Stoll, Schummers, Rogers, & Paine, 2013).

Through linking information from two national surveys, they compared the practice experience, attitudes, and demographics to home birth among two kinds of North American midwives. The results provided insight into CNMs and RMs. For example, there is great variation between RMs and CNMs with regards to educational exposure to planned home birth. Other areas that saw variation was involvement with teaching and research, gynecologic and primary care, and continuity of care (Vedam, Stoll, Schummers, Rogers, & Paine, 2013).

Interestingly, CNMs form the survey data, showed dislike for home births compared to RMs. They also felt less confident performing home births. Age and experience played a factor in these attitudes. Certified nurse midwives tend to have problems concerning home births. However, in an opinion article on home birthing and the role of the CNM, the article states it is safer for healthy women to give birth at home under the care of a midwife than in a hospital with doctors (Board, 2014).

This conclusion came from Britain's National Institute for Health and Care Excellence. The main reason for this change in attitude is that doctors will more likely intervene in the birthing process by performing cesarean sections, forceps deliveries, and spinal anesthesia. These procedures can be dangerous for the mother and baby leading to surgical accidents and infection. While there has been a longstanding battle between obstetricians and midwives over birthing, midwives have gained an important role in recent years. Especially in the case of CNMs.

This is because CNMs are licensed nurses. With a minimum of a master's degree and additional clinical training, they are more qualified than regular midwives to aid the expectant mother. In several case studies, the article mentions, CNMs perform better in low-risk deliveries than obstetricians. These results may transfer to the United States. I would choose NP over CNM because I like variety. I like the idea of helping various types of patients and not just women. I also don't like the idea.