Role of Advanced Practice Nurse

Role of Advanced Practice Nurse

Framework for Clinical Practice

Person/Client/Client System

Environment

Health

Nursing/APN (Factors Effecting APN's Practice and Implementation of the APN

Nursing Process)

Interrelationships of Client System, Environment, Health, and Nursing/APN

Role of Advanced Practice Nurse

Research shows that an advanced practice nurse (APN) is first of all a nurse that has been recognized as a person that has advanced education. This person is also known t knowledge and skills prepared at the masters or doctorate level. It advanced practice nurse have a broader scope of practice than Registered Nurses (RN) often performing the same duties as those that are doctors. Their primary care duties involve things such as diagnosing and managing the treatment of chronic and acute illnesses. Advanced practice nurses are the ones that keep the emphasis on advanced practice nurse and health promotion, with a stress on wellness. Advanced practice nurses may choose to work independently or in collaboration with doctors. To practice they all will have to pass what is recognized as the national certification exam and then be able to maintain a state license as an RN. In addition, they can be expert e.g. family nurse practitioners nurse anesthetists, and nurse-midwives. Advanced practice nurse's work in a variety of health care settings and are considered to be uniquely qualified in order to resolve the physician shortage as primary providers in country and underserved populations. Advanced practice nurses are next only, to the doctor in providing things like patient care.

Many are unaware that the role of the Family Nurse Practitioner (FNP) is known for being an area a is diverse and broad and continues to keep on evolving. FNPs are the guys that are known for assume a variety of roles which includes a primary care provider, clinical leader and educator, researcher. Like medical doctor Family Nurse Practitioner's are the ones that can order, conduct and solve diagnostic and laboratory test. Family Nurse Practitioner y may use pharmacological and non-pharmacological treatments (e.g. Stress reduction, weight loss) to enhance patient outcomes. Advanced practice nurse's cooperated with other health providers and refer to physicians and other providers (e.g. Physical therapy, dietician) to make the most of quality of care. The advanced practice nurse assesses and documents patient/family results and provides patient discussion to enhance the plan of care. The advanced practice nurse provides complete case management and sponsors for patients within the health care system.

Framework for Clinical Practice

In search of acknowledgment of nursing as specialists and elevation of practice upgrading aroused the nursing leaders to start wanting to come up with putting together a big collection of nursing information that will be able to lead the practice of nursing in a better direction (Delametter, 2002). Research shows that this kind of crusade can be traced back to first known Nurse, Phoebe, was mentioned in Romans 16:1. During the early years of the Christian Church, St. Paul sent a deaconess Phoebe to Rome as the first visiting nurse. She took care of both women and men (Castner, 2011). Entrenched in the pioneering labors of Florence Nightingale, nursing is every so often described as both an art and a science. Even though much of what we do in nursing is directed by empirical evidence and scientific theory, we also stem a great deal of the practice from more abstract, aesthetic knowledge for example theories founded on caring and understanding. Many experts argue they do see patients as a physical illness, they see the whole person in body, mind, and spiritual context (Villegas, 2012). Nursing necessitates that first and primary that their patients are taken care of.

Over the years, as nursing started going to the next level which involved the expansion of new technology within the field, nursing began moving to a more cutting-edge type of a profession. At that time, graduate level programs started encompassing things such as the courses that are in research. However, study was lacking theoretical outlines in order to define results of study. Soon, leaders in nursing came to the conclusion that it was the mixture of research and theory that was missing in order to convert nursing practice to knowledge (Swain, 2009). Further research shows that the new doctoral nursing programs turned out to be focused on theory development in order to address this shortfall (Castner, 2011). The Nursing field nonstop was able to advance skillfully, changing definitely for self-sufficiency in spite of outside variables that were having some kind of an effect on health care.

Lastly, Delametter (2002) introduced a lot of changes that needed to take place within the profession in order to make it as successful that is today. Establishing nursing ideas in this technique for the since nursing came on the scene has permitted a mutual outline for nursing to marry and apply meaning to research statistics that has helped describe possibility of practice for simple Family Nurse Practitioner and advanced practice nurse concentration.

Villegas, (2012) makes the point that the conceptual model is recognized "an established set of comparatively ideas and overall notions that speak to the phenomena of central interest to a discipline, the proposals that approximately define these ideas, and the intentions that state comparatively abstract and general affairs among two or more ideas." A conceptual framework can likewise be defined as "a reasonable combination of connected theories or concepts, typically made to pull together various characteristics that are relevant in the direction of a complex situation for instance an educational program or a practice setting" (Swain, 2009). Research shows that most of these conceptual definitions are suitable to the behind critical thinking and role development in the setting that is clinical. The definition of an advanced practice nurse augments implementation of practice-based conceptual outlines by the subsequent declaration "Advanced Practice Nursing is the application of an expanded range of practical, theoretical, and research-based capabilities to phenomena within the clinical setting" (Castner, 2011).

Strategies with clear descriptions endorse the practice and conceptualization of theory in the advanced practice nurse s roles and responsibilities (Swain, 2009). Villanueva (2008) also portray conceptual frameworks as well as explanations of the nursing procedure which provides a basic structure for practice and research. Today conceptual frameworks have been lengthily studied and support the profession in evidence founded care provided with positive results based on theory concept operation. An instance of one conceptual outline is Castner (2011) Clinical Practice Framework for the Advanced Practice Nurse. Castner's framework is a the backbone on which nursing research is built upon. The framework comprises the principles and molds that motivate the research. When coming up with the conceptual framework, you have to decide whether to use a qualitative or quantitative approach to the nursing research.

This project sets out to give some kind of an description of the utilization of the Clinical Practice Framework for the Advanced Practice Nurse (Delametter, 2002) The framework is put in a way that it adheres to the description of the four concepts of the nursing metaparadigm and the connection of how these all play a huge part in the field. In nursing all of these ideas are able to form the family nurse practitioner's clinical practice outline.

Systematic comparison of Neuman's major model views the client as an open system that makes the responds to stressors in the environment. Research shows that the client variables are psychological, physiological, developmental, and sociocultural, spiritual. The client system consists of a basic or core structure that is sheltered by lines of resistance (Delametter, 2002). The typical level of health is acknowledged as the normal line of defense that is made secure by a bendable line of defense. Stressors are considered to be intra-, inter-, and extra personal in nature and ascend from the external, internal, and created environments. When stressors are breaking through the flexible line of defense, the system is attacked and the lines of resistance are triggered and the system is labeled as moving into illness on a wellness-illness range. If satisfactory energy is available, the system will be reconstructed with the normal line of defense reestablished at, below, or above its earlier level. The client system regulates to stressors for that reason with flexible lines of defense and resistance. If theses stressors continue and penetrate the protective concentric circles then this leads to a client system that is unstable (Delametter, 2002). Also health ideas are what address the outcomes that derive from optimal wellness to death and illness. Family nurse practitioner communication through the nursing process of the advanced practice nurse is the ones that are wanted in order to help for reduction of negative system reaction and patient re-formation (Delametter, 2002).

The nursing concept applied to the advanced practice nurse is to achieve a stable client system because Nurses know how to expand access to care and make better quality at a cost that is much lower cost. Some systems have developed innovative care models in order to prove it, as well as nurse-managed health clinics, home visiting programs for low-income mothers, and the Transitional Care Model (TCM) (Swain, 2009). By highlighting the use of master's-equipped nurses to oversee care from the hospital to within the home, this model has been able to reduce re-hospitalizations for elderly patients with multiple chronic conditions. Research shows that using the Transitional Care Model aids patients attain better long-term health results and evade repeat hospitalizations, all at a cheap cost. Experts agree the program does need more nurses in order to develop some innovations.

Person/Client/Client System

The research explains that each client system is unique, a composite of characteristics and factors within a given range of responses that are contained within a basic structure. Experts also make the point that many known, unknown, and universal stressors exist. Each of these stressors differs in its potential for troubling a client's usual constancy level or normal LOD (Line of Defense).

When it comes to the clients, the particular inter-relationships of client variables at any point in time can affect the degree to which a client is protected by the flexible LOD against possible reaction to stressors (Villanueva, 2008). With that said, research shows that each client / client system has evolved into a typical range of replies to the environment that is referred to as a normal LOD. The normal LOD at times, is able to be used as some form of a standard from which to evaluate health deviation.

It is also interesting to note that when the flexible LOD is no longer adept of protecting the client / client system against an environmental stressor, the stressor then starts to do things such as breaking through the normal LOD. The client whether in a state of illness or wellness, is a lively compound of the inter-relations of the variables. Also, it is important to understand that wellness is on a range of obtainable energy in order to support the system in a perfect state of system stability (Villanueva, 2008). Along with understanding the system stability, implicit within each client system are internal resistance factors recognized as LOR, which basically function to realign and stabilize the client to the typical wellness state.

When comes to the client, primary prevention connects to G.K. that is applied in client intervention and assessment, in identification and decrease of likely or actual risk factors. Secondary prevention narrates to symptomatology succeeding a reaction to stressor, suitable ranking of intervention significances and treatment to decrease their noxious properties. When it comes to the Tertiary prevention, it relates to adjustive processes which are taking place as reconstitution starts and upkeep factors move the back in circular manner toward primary prevention (Villegas, 2012). Another interesting thing is that the client as a system is in dynamic, constant energy interchange with the environment.

Environment

The environment is considered to be a vital arena that is relevant to the system and also its function. Research shows that the environment is something that may be looked at as all factors that are affected and are simply affected by the system. However, the internal environment is something that exists within the client system. It is interesting to note that every one of the forces and interactive influences that are solely inside the boundaries of the client system are what make up this environment. An environment that is recognized as being created (intrapersonal, interpersonal, and extra personal) is something that is put together from the exchange of energy from the external and internal environments and is watched through the changing scene of the five system variables (Swain, 2009). The patient may or may not be conscious of the five variables that influence the response to the stressors and how the resistance and lines of defense alter to bring the body back into constancy. The health care provider's role is to assist the patient in making sure that they are recognizing the negative and positive created environment and help with movement toward a wellness range. Since the patient is an open system, there is continuous collaboration with the complete environment. As mentioned earlier, the environment can be an internal and external.

Also as mentioned, stressors are the forces that are created by the environment. Most of the time, these stressors are tensions that are able to produce certain alterations in the normal flow of the environment. The research also shows that these stressors can be:

1. Intrapersonal -- takes place within the self and includes of man as a psycho-spiritual being

2. Interpersonal -- happens among one or more individual and comprise of man as a social being

3. Extra personal - take place outside the individual and may consist of environmental factors

Health

Health is defined as the condition or degree of system stability and is looked at as a continuum from wellness to illness (Castner, 2011). The research shows that when system needs are met, optimal wellness is what exists. When needs are not content, illness occurs. When the energy needed in order to support life is not obtainable, death then takes place.

The main focus of nursing is to define the suitable action in situations that are stress-related or in relation to likely responses of the client or client system to the stressors. Nursing interventions are what are intended at assisting the system to adjust or adapt and to restore, retain, or support some grade of stability among and between the client system variables and also the environmental stressors with a focus on being capable of conserving energy.

When it comes to health as being equated with wellness, health/wellness is described as "the condition in which all subparts and parts (variables) are in agreement with the entire of the client (Villegas, 2012)." The client system is what moves in the direction of illness and death when more energy is needed than is obtainable. The client system moved in the direction of wellness when more energy is accessible than is desirable. This nursing-based model includes a traditional medical model joint with a nursing-based model which challenges to make a contemporary day provider accessible to serve the present population in this changing health care environment (Villanueva, 2008). This will raise the Advanced Family Nurse Practitioner's posture in practice and promoting optimistic health outcomes.

Nursing/APN (Factors Effecting APN's Practice and Implementation of the APN

Nursing Process)

A created environment (intrapersonal, interpersonal, and extra personal) is developed

From the exchange of energy from the internal and external environments and is viewed through

The kaleidoscope of the five system variables. The client may or may not be aware of the five variables that influence response to stressors and how the lines of defense and resistance adjust to bring the body back into stability. The health care providers role helps the client recognize the positive or negative created environment and assist with movement toward a wellness continuum. Since the client is an open system, there is constant interaction with the entire environment (Castner, 2011).

One of the factors that effects APN are the ethics. Ethics is an essential component of graduate education in nursing. Research shows that the education of nurse practitioners for advanced practice will need to be build upon students' previous academic and clinical experiences associated to ethics. On the other hand, a review of the literature discovered that no studies have been published unfolding the starting point ethics-related knowledge of graduate students who are beginning their coursework for advanced practice as nurse practitioners (Castner, 2011). An emergent body of nursing knowledge mirrors rich influences of nurse theorists, nurse ethicists, nurse clinicians, and nurse educators. The significance of ethics in nursing is further validated by academic and professional standards, as well as the American Nurses Association Code of Ethics for Nurses with Interpretive Statements, which starts ethics as "an integral part of the foundation of nursing"