Defining and Describing Nurse Practitioner and Clinical Nurse Specialist - Research Paper Example

Nursing Evaluation Advanced Practice Nursing Introduction A nurse practitioner is a nurse in advanced nursing. The nurse hasa graduate degree, either master’s or doctorate degree. A nurse practitioner is always a registered nurse, who is clinically competitive in expanded nursing practice. The nurse has good decision-making skills and experience in nursing. The duties of a nurse practitioner are performing physical examinations, requesting for laboratory tests, carrying out diagnosis, giving out prescriptions and treating patients, authorizing referrals of patients and performing complex procedures, such as biopsies and punctures. Nurse practitioners can work independently of a doctor, and can practice in various settings such as family practice, women’s health, school health, primary care, pediatrics, emergency, geriatrics, cardiology, neonatology, nephrology, and oncology (Mirr & Zwygart-Stauffacher, 2010). A clinical nurse specialist is also engaged in advanced nursing, but she specializes on a specific course to lay focus on a specific population complementing the course of study. A clinical nurse specialist can focus on a certain field, such as post-anesthesia care or certain diseases such as diabetes, hypertension, and pediatrics among others. The nurse can also specialize in working in a specific environment such as an emergence room, a recovery room, an operating room, or a general ward. A clinical nurse specialist also focuses on clinical practice, research, consulting, teaching, and management. While a nurse practitioner usually has good decision-making skills, a clinical nurse specialist is more assessment-oriented and has good assessment skills (Fulton et al, 2010). Nurse Practitioner verses Clinical Nurse Specialist The two types of nurses always rank at the top in nursing field because they practice advanced nursing. The two are quite similar in qualifications and the environments they work in, and in some countries like Canada, it is quite hard to compare and contrast. Even though the two are quite similar, there are some differences. The two can be compared and contrasted in terms of education, job roles, practice setting and medical practice. Education Both positions require master’s degree as a minimal qualification. They attain almost similar qualifications and schooling for a similar duration. However, a nurse practitioner must complete and pass a certificate program after the master’s degree to be able to study different fields of medicine. The American Academy of Nurse Practitioners together with the licensing body, the American Nurses Credentialing Center, usually provides this certificate program. This is not the case with clinical nurse specialists, who focus on specific fields only. The skills obtained during schooling are quite different. While the nurse practitioners are more oriented in decision-making, proving medications and prescriptions the clinical nurse specialist focuses more on management, education, research, and assessment of patients (Holly et al, 2012). Job Roles and Medication The nurse practitioners most of the times work under a very indirect supervision from physicians. This means that in the absence or presence of the physician, they can diagnose a patient, write prescriptions and consult the patients privately. They can work independently and treat patients in private practice. The clinical nurse specialist can also work independently, but can only provide education and nursing care to patients. They are mostly in charge of a department in a health facility, where they provide leadership to the nursing staff and indulge in research to improve the patient’s health care. Concerning medications, the major contrast between the two is that a clinical nurse specialist cannot treat or provide patients with prescriptions while the nurse practitioner can. The nurse practitioner always comes from school properly equipped with education in medicine and drug prescription. This enables them to treat effectively just like the physicians. The clinical nurse specialists have sufficient knowledge in clinical patient care and management and therefore, cannot treat or write prescriptions. However, they understand the basic principles in drug dosage and can help the physicians determine the right drug for treatment depending on the state of the patient (Holly et al, 2012). Practice Setting The two work in a similar hospital setting, where the nurse practitioners work with physicians, and the clinical nurse specialists take charge and supervise nurses. The practice setting of the two nurses is however, entirely different. While the nurse practitioner works in an environment with a physician setting, the clinical nurse specialists can be in charge of offices where they train and educate nurses, hire staff, offer patient consultation or carry out research. The nurse practitioner can help a doctor to handle some patients in case there is overload (Holly et al, 2012). Evolution of advanced nursing The need for advanced nursing started with the shortage of medical experts such as pediatricians and the lack of professional nursing. In the 20th century, the shortage of medical experts forced the nurses to chip in to help the medical experts. This raised concerns among experts, and they started questioning whether the nurses were practicing out of their scope. During the Second World War when physicians were overwhelmed, the nurse practitioners obtained the right to practice beyond caring and start curing. This only took place when physicians were overwhelmed and in other times, the nurses retreated to their supportive roles. Recognition of nurse practitioners started in the 1960s leading to the establishment of advanced nursing which brought independence among the nurses and they could practice without supervision from the doctors. Evolution of clinical nurse specialist however, dates back to the 19th century when nurse focused more on management and provision of care to patients. This changed with the introduction of advanced nursing leading to more defined roles and specialization into different fields of medicine. It is then that advanced nursing practice started (Sullivan-Marx, 2010). Educational requirements To qualify as a nurse practitioner one must earn a bachelors degree in nursing (BSN). A four-year course involves both theoretical and practical studies. Nurse practitioners are more qualified than the registered nurses are. One must therefore have additional educational qualifications. A master’s degree in Nursing (MSN) is the minimum academic requirement but one can advance to doctorate degree. The higher degree is rigorous and can take additional four years, for a person with BSN. Those with an associate degree can take additional six years since they first have to obtain a higher degree. The rigorous nature of the course is because the role of a practitioner nurse is different from a registered nurse and must be able to diagnose patients, order for tests, treat conditions and prescribe medications or even authorize referrals. The course must allow accommodation of different specialties to enhance the nurse’s ability to fit in an expanded nursing practice. Some of the classes include Midwifery, Medical Assessment and Diagnostics, Pathophysiology, Anaesthesia, Pharmacology, Psychiatry, and health informatics among others (DeNisco & Barker 2013). A clinical nurse specialist, just like the nurse practitioner must first earn a bachelors degree in nursing before proceeding for a master’s degree. Since the roles of a clinical nurse specialist are more specialized, the MSN they pursue is more specific in nature and the nurses specialize in definite fields such as psychiatry, recovery room care, anesthesia, adult health, gerontology, pediatrics, community and public health and home health. Both professions must obtain a license after registration, for them to practice. In the United States, the licensing body is American Nurses Credentialing Center. The center offers certificates according to specialty of study (DeNisco & Barker 2013). Significance of the AACN 2015 Recommendations The American Association of Colleges of Nursing (AACN) recommended the movement of the current level of qualification required for practice of advanced nursing practice, from the master’s degree to doctorate by 2015. The association calls for doctoral Nursing Practice (DNP) by educating the advanced practice registered nurses and the other nurses. The reasons for the recommended move to the DNP include the increasing demand of expertise and higher scientific knowledge in order to assure quality in healthcare. The others are shortage of doctoral prepared nurses, the complexity of patient healthcare in the modern society, increased expectations for training and educating healthcare personnel (Dreher & Glasgow, 2011). There is also a need to move in the direction other fields have for long taken. For example, Medicine that embraced MD a long time ago, Pharmacy has PharmD, Psychology with PsyD, and Dentistry, which has DDS. The association proposed DNP, even though there are benefits that will come up with such recommendations. My take is that most people may not be able to afford to attain such qualifications and advanced nursing may become understaffed. This is because such education is costly and takes a long time for one to qualify. A prospecting student who wants to do nursing may be required to take ten years to complete the course (Dreher & Glasgow, 2011). Conclusion The advanced practice nursing I prefer and would love to pursue is a nurse practitioner because I would be able to have wider scope of the nurse practice where I can provide nursing care and at the same time treat, give prescription and practice privately. I have always had a philosophy that a nurse should provide a holistic form of care to the patient. A nurse practitioner definitely has a wider scope in practice and can offer such care in a holistic approach. References DeNisco, S. M., & Barker, A. M. (2013). Advanced practice nursing: Evolving roles for the transformation of the profession. Burlington, MA: Jones & Bartlett Learning. Dreher, H. M., & Glasgow, M. E. S. (2011). Role development for doctoral advanced nursing practice. New York: Springer Pub. Co. Fulton, J. S., Lyon, B. L., & Goudreau, K. A. (2010). Foundations of clinical nurse specialist practice. New York: Springer. Holly, C., Salmond, S. W., & Saimbert, M. K. (2012). Comprehensive systematic review for advanced nursing practice. New York: Springer Pub. Mirr, J. M. P., & Zwygart-Stauffacher, M. (2010). Advanced practice nursing: Core concepts for professional role development. New York, NY: Springer. Sullivan-Marx, E. (2010). Nurse practitioners: The evolution and future of advanced practice. New York, NY: Springer Pub. Read More