Advanced Practice Nurse Roles, Advocacy, and Leadership

Introduction to the Advanced Practice Nurse

The Advanced Practice Nurse (APN) is a registered nurse with advanced clinical education, experience, management training, and an expanded scope of practice. This role involves a level of practice that requires advanced skills not only in clinical knowledge, but also in the managerial tasks of planning, implementation, and strategic thinking, as well as increased responsibility for the diagnosis and evaluation of patients. The APN role has expanded due to a number of cultural and economic changes that often limit a physician's time with individual patients (Association, 2010).

As an advocate for the nursing profession, the APN is expected to demonstrate the kind of acumen that not only rises above basic nursing, but proves invaluable to the physician. The high standards expected in clinical knowledge, managerial ability, and performance place APNs as leaders in their field. This leadership role certainly impacts the day-to-day medical environment, but more than that, it extends as a form of role modeling for LPNs, RNs, and nursing assistants. It also provides medical technologists, hospital administrators, physicians, and specialists with a way to feel comfortable with the APN's role and to understand the validity and value of such a position within the medical community.

The APN as Advocate for the Nursing Profession

In addition, the APN's advanced training and abilities serve as a public forum for the new paradigm of professional nursing. The advanced commitment, capability, and services now offered as part of the APN's regular duties can be seen by patients and the public as exemplary demonstrations of what it means to be a modern nurse (Mezibov, 2002).

Despite the fact that most medical professionals face significant time constraints, there is a clear need and expectation that nurses of the APN's caliber participate not only in internal medical activities, but also in community outreach and other professional activities such as conferences and discussion panels. Participation in professional activities is also one of the few ways the APN can successfully integrate research into their practice. The expectation for this field is that a continued portion of the APN's career will be devoted to new research activities that enhance the profession.

While it is sometimes difficult to make time, obtain the proper authorizations, and secure adequate support, clinical practice often provides a rich environment for research that would be difficult to access without an attachment to a hospital or clinic. Evidence-based research serves the dual purpose of enhancing the profession and informing local stakeholders about issues that may be pertinent to their own lives. Moreover, public awareness that a particular research initiative is underway often attracts additional funding to the organization. The participation in ongoing academic research, coupled with involvement in professional nursing organizations, combines to form a paradigm of continued learning and competency (Evans, Lang, and Medoff-Cooper, 2004).

Professional Activities and Evidence-Based Practice

By the very nature of their education and experience, and the emphasis on modern holistic healthcare, health promotion, and community engagement, APNs are exceptionally well positioned to provide affordable, expert, and efficient healthcare to a contemporary, diverse population. Because of this, and because of the rapid pace at which medical science evolves, it is necessary for the APN to continuously develop knowledge and skills throughout their career.

Nursing knowledge is sometimes referred to as the power base of the medical profession. This assumes a responsibility for both practicing and academic nurses to actively develop their competency not only in core areas, but also in a broader set of skills encompassing new technologies, clinical practice advances, and scientific developments as needed. Unlike many careers in which only a fraction of academic preparation is ever applied on the job, nursing — with one or two exceptions such as certain advanced mathematics or chemistry concepts — draws on almost all of its foundational knowledge in some form on a daily basis.

This reality requires that advanced levels of nursing, including the APN and physician's assistant, become substantive pillars of the nursing discipline. To achieve this, attendance at seminars, demonstrations, and refresher courses in managerial and clinical practice is not only necessary but typically required for most certifications. This advanced education keeps nurses current and also allows them to branch into different sub-fields. For example, an emergency room nurse may focus on mental health or oncology and earn certifications that make them even more valuable to their organization (Arslanian-Engoren, Hicks, Whall, and Algase, 2005).