NRNP 6552 Discussion: Different Roles of the Nurse Practitioner
The shortage of physicians allows non-physician professionals to practice to the full extent of their education and training which gives patients more options for types of services (ANA, n.d.). Many non-physician health care providers are trained and willing to help meet this need, but are not permitted to do so because of limitations in their scope of practice. Given the shortage of primary care physicians, allowing non-physician professionals to practice to the full extent of their education and training gives patients more options and more types of services (ANA, n.d.)

Advanced practice registered nurses (APRNs) can practice to the full extent of education, training, and certification with regard to individual State practice regulations concerning requirements such as clinical supervision or mandatory collaboration with physicians. A certified registered nurse practitioner (CRNP) competencies include functioning as an independent practitioner while demonstrating the highest level of accountability for professional practice. APRN’s provide the full spectrum of health care services including health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, palliative, and end-of-life care (NONPF, 2017). Providers use advanced health assessment skills to differentiate between normal, variations of normal and abnormal findings. Diagnostic screening and strategies aide in the development of diagnosing disease. Medications are prescribed within scope of practice. Patients with acute and chronic disease are managed while providing patient-centered care that recognizes cultural diversity (NONPF, 2017).  Roles of the Nurse Practitioner Essay Discussion Paper

A physician’s assistant (PA) role is comprised of primary care and specialty care in the medical and surgical field. Professional competencies for physician assistants include effective and appropriate application of medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning and improvement, and systems-based practice (AAPA, 2013).

The scope of practice for certified nurse midwifes (CNMs) includes primary health care for women from adolescence through menopause, contraceptive care, prenatal and postnatal care, care of the newborn during the first month of life, gynecology, family planning services, health promotion, disease prevention, and individualized wellness education and counseling (Marzalik et al., 2018). Prescriptive authority varies from state to state (Marzalik et al., 2018)

Influence on my future practice as an APRN will come from clinical practicum and learning experiences. The PA profession is an emerging profession that provides substantial contribution to the healthcare workforce in all medical specialty areas (Kulo et al., 2021). PA’s practice under a physician giving them a broad knowledge base. This background will challenge my thought process when it comes to diagnosing and treating patients. A surgical PA would be able to provide procedural techniques such as suturing that I may not have exposure to in a primary care office setting. Though similar to an advanced practice nursing degree, the PA’s role with provide a different view and approach to treatment through their diverse training and education. A CNM can provide specific training regarding women’s health, and neonatal health. Their specified education is targeted of women’s health and allows for the expertise that the specialized field requires. A CNM will help expand my role as a Family Nurse Practitioner (FNP) my bridging primary care with women’s health. Healthcare providers educated to provide primary healthcare services such as CNM’s are projected to play a key role in meeting the demand of access to affordable healthcare since the passing of the Affordable Care Act in 2010 (Hastings-Tolsma et al., 2015). A CNM can provide me with insight into caring for a pregnant woman and specific considerations for the high risk pregnant population. While working with an FNP during my first clinical rotation I quickly realized the vast amount of knowledge a primary care provider must possess in order to adequately manage patients of all populations. Initiating insulin treatment for a type 2 diabetic and starting statin treatment when lifestyle modifications have not improved cholesterol levels are examples of treatment plans I learned from my previous primary care preceptor. Gaining and applying knowledge from different mid-level providers can improve practice and clinical skills to create a well-rounded FNP.

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Discussion Post: Different Roles of the Nurse Practitioner

Nursing roles have been evolving, especially in the face of medical advances and shortage of medical personnel. This has created a need for nurses’ roles to be redefined, as their numbers increase and they take on more responsibilities. In fact, a new generation has been created among nurses with state regulations governing their supervision, prescriptive authority and scope of practice (Schober, 2016). Generally, advanced practice registered nurses (APRN) have a broad scope of practice that includes assessing, diagnosing and treating medical conditions, as well as prescribing medication and equipment, and ordering and interpreting diagnostic exams like MRIs and bloodwork (Zaccagnini & Pechacek, 2019). There are three main groups of APRN with distinctive roles as discussed. Firstly, are certified registered nurse practitioners (CRNP). This is a type of APRN with a nurse practitioner (NP) license. Their role is to help improve patient satisfaction, lower health care costs and address the continuing primary care shortage. They are differentiated from other APRN as they look at the patient wellbeing and health from a whole-person perspective. Besides that, they are involved in policy advocacy to improve health care and access, particularly for low income individuals, children and other marginalized groups (Stewart & DeNisco, 2020). Secondly, are certified nurse midwife (CNM). This is a licensed nurse specializing in women’s reproductive health and childbirth. They give counseling, perform annual exams, give primary care, and perform gynecological exams. Additionally, they provide parental education, prenatal care, and family planning services. Also, they offer training programs, maintain medical records, collaborate with other medical personnel in providing specialized care, educate expectant and new parents on nutrition, measure and monitor fetal development, and give intrapartum, postpartum and newborn care (DeNisco & Beauvais, 2020). Thirdly, a physician assistant (PA) works interdependently with licensed physicians to diagnose and treat diseases and illness, and to prescribe medication. They can treat patients independently of a physician. Furthermore, they can write prescriptions, order and interpret laboratory tests, assist in surgery, perform minor bedside procedures, diagnose patients, develop treatment plans, and obtain patient histories (Joel, 2018). In this respect, it is clear that CRNP, CNM and PA have distinctive roles as APRN.

References

DeNisco, S. M. & Beauvais, A. M. (2020). Advanced Practice Nursing: Essential Knowledge for the Profession (4^th ed.). Jones & Bartlett Learning, LLC.

Joel, L. A. (2018). Advanced Practice Nursing: Essentials for Role Development (4^th ed.). F.A. Davis Company.

Schober, M. (2016). Introduction to Advanced Nursing Practice: An International Focus. Springer International Publishing.

Stewart, J. G., & DeNisco, S. M. (Eds.) (2021). Role Development for the Nurse Practitioner (3^rd ed.). Jones & Bartlett Leaning, LLC.

Zaccagnini, M., & Pechacek, J. M. (Eds.) (2019). The doctor of nursing practice essentials: a new model for advanced practice nursing (4^th ed.). Burlington, MA: Jones & Bartlett Learning, LLC.

Roles of the Nurse Practitioner Essay Discussion Paper