There are four advanced practice nurse (APN) roles: Certified Nurse Anesthetist (NA), Nurse Midwife (NM), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS). The Nurse Practitioner (NP) achieves licensure based on the states board of nursing requirements. Creating a Professional Development Plan (PDP) for an advanced practice nurse is a good way to learn the regulations for licensure based on licensure, accreditation, certification, and education (LACE). Creating a professional development plan (PDP) is a helpful way to transition into the new role. A PDP will help direct your next path after completing the NP degree. The Institute of Medicine (IOM) recommended that nurses “be free to practice to the full extent of their education and training”. With the implementation of the Affordable Care Act a substantial burden has been placed on primary care physicians because of the increase of newly insured patients. The American Medical Association (AMA) “strongly supports scope-of-practice restrictions, particularly with respect to limits on their authority to prescribe drugs”.
With a growing amount of nurse practitioners functioning in the primary care setting a scope of practice has been created. The Florida Nurse Practice Act, states, “Advanced or specialized nursing practice means, in addition to the practice of professional nursing, the performance of advanced-level nursing acts approved by the board which, by virtue of post basic specialized education, training, and experience, are appropriately performed by an advanced practice registered nurse. Within the context of advanced or specialized nursing practice, the advanced practice registered nurse may perform acts of nursing diagnosis and nursing treatment of alterations of the health status. The advanced practice registered nurse may also perform acts of medical diagnosis and treatment, prescription, and operation as authorized within the framework of an established supervisory protocol. The department may, by rule, require that a copy of the protocol be filed with the department along with the notice required by s. 458. 348”.
“Advanced practice registered nurse means any person licensed in this state to practice professional nursing and who is licensed in an advanced nursing practice, including certified nurse midwives, certified nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, and psychiatric nurses”. According to the Florida Nurse Practice Act (2018), there must be a written agreement between the NP and the physician. This written agreement details the duties of the NP and what treatments may be initiated by the NP as well as what the doctor’s role will be in supervising the NP and must be kept on file with the state and updated yearly.
The consensus model creates some core competencies for the NP. A task force that was focused on population-focused NP competencies created nine entry-level proficiency areas to complement the core competencies of the FNP education; scientific foundation, leadership, quality, practice inquiry, technology and information literacy, policy, health delivery system, ethics, independent practice. By applying these additional competencies, the entry-level NP will be more involved in their patient’s care. A clinical simulation study performed using students to simulate the NP and patient roles allowing for scripted interactions that allowed for improved patient safety.
Using Benner’s Novice to Expert Model I feel that as a registered nurse (RN) I would be proficient to an expert. The reason that I feel this way is because I have been a RN for 14 ½ years. I have worked in several different aspects of nursing that have only helped to shape my nursing career for this next step. As a family nurse practitioner (FNP), I feel that I would be a novice to an advanced beginner because this would be a completely new role. I feel that at the start of my career as an NP I would work with a physician to provide competent care to my patients. Being the newest part of the practice, I would see the established patients and the patients that scheduled same day appointments. It is important to know your limitations as a new NP so that you do not get yourself over you head. I would build on my previous nursing knowledge and skills but would also need to collaborate with the physician.
It is important to build professional relationships that you will be able to network and market your new role. As an RN I have cultivated many professional relationships that I hope to be able to transition into an advanced practice role. By knowing so many physicians in my local community I hope that these relationships will allow for more opportunity for a job in my community. I do know that there is a great deal of competition for NP positions everywhere. I did search several databases such as indeed. com, monster. com, and careerbuilder. com. These sites were able to show that there are several positions available for FNPs in my general area. It is also important to join professional organizations to help with networking. In my area there is the local nursing association and there is also the state level nursing association; both of these could be beneficial to securing a position in the new role of NP.
Creating a professional development plan is an important tool to transitioning to the next level. Knowing what the licensure, accreditation, certification, and education requirements are an important part of transitioning to the next level as an FNP. It will be important to find the right employment based on the Benner model.
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