Family Nurse Practitioner in Primary Care - Assignment Example

Family Nurse Practitioner in Primary Care Sonya L. Hicks South MSN Program This paper is about family nurse practitioner program. The paper discusses the roles of nurses. Furthermore, the support required from the government along with recommendations are discussed. keywords; nurse. government Family Nurse Practitioner in Primary Care The Family nurse practitioner program was first introduced in 1965 as a non degree certificate training program. It was co-created by a nurse educator named Loretta Ford (EdD, RN, PNP) and a physician named Henry silver (MD at University of Colorado) (Gretchen 2012). At first the curriculum was composed of programs which focused on disease prevention, health promotion, and the health of families including children. The reason behind starting such a program was to meet the increasing demands of primary care services of the society because the nursing potential was almost nil in this particular field. The program was widely opposed by physician and nurses and many people from the nursing profession, their objection was regarding the title of the program as they believed that it is something very ambiguous and such training programs in primary care will easily “control and devour nursing education and practice” (O’Brien, 2003). With the passage of time, primary care programs for nurses have grown and have been classified into different programs: Women Health Nurse Practitioner, Family Nurse Practitioner, Neonatal Nurse Practitioner, Adult Nurse Practitioner, Pediatric Nurse Practitioner, Acute Care Nurse Practitioner, Geriatric Nurse Practitioner and Psych-Mental Health Nurse Practitioner. A family nurse practitioner is a registered nurse with a Bachelor of Science in Nursing and Masters of Science in nursing degree. A family nurse practitioner is also a qualified and competent member of the healthcare sector, who is ready to fill a sensitive position of family nurse practitioner in primary care to provide services to meet the demands of the society. Family Nurse Practitioners have proven their efficiencies and effectiveness in providing high quality and cost effective health care services and health care consumers have also sensed the importance and value of a good service. A family nurse practitioner has several roles to choose from as a base for her career. FNP is able to serve the population living in both urban and rural areas such as hospitals, public health departments, physician offices, HMOs, community health centers, nursing homes, home health agencies and student health clinics. FNP is capable of providing them health care in acute illness, high blood pressure, headache, diabetes, chronic illness and obesity (Zerwekh. & Claborn., 2004). ADVANCED PRACTICE ROLES IN NURSING After the completion of nursing program/studies, nurses have many choices of roles to choose from as a final field to start practice. For a nurse practitioner, there are three key categories to work in: clinical settings, nurse educator and nurse administrator. The latter two are conducted in a non-clinical setting. A detail analysis of the three categories is as follows. Nurse Practitioner (Clinical Setting) This is the main role of a nurse which is solely based on clinical settings under which a nurse practitioner is liable to diagnose and treat diseases as well as to provide measures for the prevention of the disease. In this role, nurse practitioners are responsible to ensure a healthy society by giving advices on health care, infections and sexually transmitted diseases while treating a patient for any other health issue. In this regard a nurse practitioner is responsible to educate public about their health by providing them information related to different health issues. Nurse practitioners are found engaged in counselling with patients and their relatives to prepare them for any sort of situation as an outcome of the treatment, i-e news about terminal disease or death. Nurse practitioners have to build strong and friendly relationship with patients and their family and friends through concrete and effective communication. The most important responsibility of a nurse practitioner is to carry out a proper plan and implementation plan to discuss with patient and patient’s family for positive outcomes ((Department of Health and Human Services HRSA, 2002). Nurse Administrator (Non-Clinical Setting) As the name implies, a nurse administrator is a nurse working on a position to manage and control administrative responsibilities of a health care facility. Most of the responsibilities of a nurse administrator are the same as a manager of any other field has, but the only difference is that for such a position, it is important to have a nursing degree because a nurse can better understand the field of medicine as compared to the person with management degree. The key to the effectiveness of this role is that a nurse administrator must have know how about care policies present, the delivery models that can be used, the risks that are anticipated and how to manage them as well as patient safety and case management. A nurse administrator has to build positive relationship with both health care customers and with the staff of health care facility as well. For fulfilling the requirements of this role, a nurse must have additional management skills related to finance, marketing, human resource and IT. She must know the degree of professionalism, planning, controlling, and leadership to perform her duties effectively while ensuring adherence to ethics (The American Organization of Nurse Executive, 2005). Nurse Educator (Non-Clinical Setting) In this role a nurse is required to incorporate the functions of a teacher to her regular skills, so that she could better provide information and knowledge to nursing students and in some cases to fellow nurses in case of any amendments and updates to the course contents. A nurse educator is responsible to review additional literature to effectively handle theoretical part of nursing whereas a practical part is handled by a nurse practitioner or a nurse administrator. The key role of a nurse under this category is to design curriculum and its proper assessment and evaluation of the outcomes related to the course. Leadership and socialization are additional roles of a nurse to ensure psychomotor development, effective communication and foster positive relationship with learners and co-workers (National League for Nursing, 2005). Nurse Informacist Nursing informatics bases its focuses on the discovery of new methods in order to improve information management as well as communications in nursing. This is done not only to improve efficiency but also improve on the quality of patient care as well as reducing (Explorehealthcareers.org, 2014). Key are of work include: To construct an inter-operable national data infrastructure Research methodologies Information presentation Retrieval approaches Addressing inter-professional work flow requirements all over respected care sites and locations Management & vision Defining healthcare policy for the development of the health sector (Amia.org, 2014). REGULATORY AND LEGAL REQUIREMENTS FOR FAMILY NURSE PRACTITIONER Regulatory and legal requirements for nurse practitioners are ensuring a safe, fair and disciplined health care system. Board of nursing of a state is liable to make laws and regulations for nurse practitioners, however, in some states board of medicines are also making rules for nurse practitioners. The regulations and legal requirements for nurse practitioner include requirements for holding a professional license, conditions for license suspension, the nurse’s qualification requirements for practice, collaboration or supervision requirements, practice standards and requirements of educational programs. In every state there are different regulatory and legal requirements for a nurse practitioner imposed by the governing body/board of nursing of the state. Common requirements for starting practice as a nurse practitioner in any state it is important to have RN (Registered Professional Nurse) license and should meet the educational requirements. The State government is free in making any type of changes in the laws and legal requirements for a nurse practitioner (Phillips, 2005). For Family Nurse Practitioner an RN license is essential in order to serve patients as primary and specialty health care provider. My selected organization is a family nursing organization such as Family Practice Clinics. I feel I am well structured, multifaceted, patient and able to face any type of patient. A Family Nurse Practitioner must have a mentality and patience with which she can deal with patients from 0-90 age group. The Nurse Practice Act Section 34-21-84 has clearly stated the joint committee would have authorities to recommend regulations to a state’s Board of Nursing regarding collaborative physicians nurses. According to Nurse Practice Act Section 34-21-85, an advanced practice nurse should avoid acting against Article 5 rules as the act clearly stated the conditions for the termination of the license by the Board of Nursing (American Nurse Association, 2010). LEADERSHIP ATRIBUTES OF THE ADVANCED PRACTICE ROLE For advanced practice role, it is crucial for a nurse to have a delegative and participative leadership traits. A leader with participative traits means he/she is involved with her team and colleagues in a decision making process while retaining the final say in their hands. Participative leadership style encourages cooperation, coordination and open communication among team members and colleagues group members to come up with new ideas. The advantage of this leadership style is that it ends up with effective and accurate decisions at the execution of a decision making process. I always welcome to the suggestions of my group members according to their knowledge. In this regard the rest of my leadership traits are delegative, as I understand that leaders must be participative because the authoritative style of leadership leads to conflicts and disputes with team members and increasing a sense of dishonesty in them (Marquis & Huston, 2009). An effective leader has a set of distinctive qualities such as patience, courage, ability to handle stressful situation, effective communication and integrity (Covey, 1989). Luckily I possess all of these traits, though there are some areas in which I have to work on myself to become an effective leader as in some areas I am acting like “in the box” where my efforts sometimes doesn’t matter for others (Institute, 2002). Being a graduate level practice nurse, I must have to develop cultural competencies to meet the demands of the diverse cultures of patients, which is only possible through making strong bonds with co-workers and to improve knowledge by reading books. A practice nurse needs to balance her personal and professional life because a collision between the two can result in serious personal and professional issues. I need to develop leadership qualities like taking initiatives and self confidence, as in many situations I usually plotted my decisions on the knowledge and suggestions of others. In most cases, I had to work in comfort zones and in case of any form of disappointment, surrendering was my first choice. With the expectations tied to the nursing role in the realization of outcomes, there is a need to have self-confidence and risk-taking mentality (Swansburg, 2002). For developing missing leadership traits and attributes, I am finally searching for a good coaching center, as an adequate coaching helps nurses in developing their leadership attributes while helping them in managing their leadership roles effectively (Serio, 2014). Coaching centers have an environment similar to the workplace where a nurse or a learning leader is allowed to cultivate their skills through learning from available opportunities. For improving leadership styles, I also have found some effective books on the issue and I am pretty sure that such books will help me in polishing my leadership traits. “Leadership and Self Deception: Getting out of the Box” by A bringer Institute is my first step in climbing the tree. This book really helped me in understanding my weak points and also helped me to polish them with the help of its real world examples. I am also searching for some other books on the same topic. HEALTH POLICY AND THE ADVANCED PRACTICE ROLE There are different types of health policies in a country or state to ensure a healthy society while minimizing the costs of health services. Now days, a health policy issue that is widely in discussion among peers and health care professional is the increasing costs and demand of long term care. The reason why this is an important issue is that the US spending on the health sector is thrice as much as the spent in 1990 and around about eight times more than they did in 1980. Furthermore, with respect to GDP, the US spends 6% more than other developed countries average. Even though the spending is going so high the Americans are not any healthier (RWJF, 2014). A research was conducted in this regard, according to which in 2010, in America, there were 40 million people from the age group 65 or above and by 2050 the figure is expected to reach to 88 million (Freundlich, 2014). This is a really a serious issue as in such a huge population seven out of ten will receive long-term health care services. However, the cost will be huge enough as it is also expected that additional to the population of 65 age or older, the number of people from the age group 85 or older will also jump to 19 million by 2050, which was only 5.5 million in 2010 (Freundlich, 2014). Now the issue is how the nation will pay for the costs of such a huge population. The US spending on long-term health care services were reached to $210.9 billion in 2011 making 1.4% of the gross domestic product. Most of the costs were paid by the US government and 21.5% percent of the total long-term health care was paid by patients and their families. The costs of long-term health care are increasing rapidly and hence families are searching for less costly alternatives. On average basis nursing home stay cost $84,000 per year and assisted living care cost $42,000 per year (Freundlich, 2014). Such an increasing costs are difficult to pay for older age people because most of the older people live alone, have low income and have relatives other than spouse who are not ready to pay such a huge amount for them. As a solution to these increasing costs, the US government had already launched certain programs such as Medicaid (40%) and out of pocket spending (26%) (Feder. Komisar. &Niefeld, 2000). Required a Change in Policy Though, the current health care policy is effective enough and to make it more suitable, the federal government of the US increased spending on Medicaid but this is not an effective solution for this issue. The US government needs to look at certain other solutions to ensure long-term health care to every old citizen of the United States. Health Care Insurance US government should impose a law under which every person, who has a good job and has at least of 22 years of age needs to insure himself with Medicaid. Under such an insurance program US government should cut a specific amount or percentage of the total income of each individual. This will help Medicaid to fulfill the costs of providing long-term health care services and will also help individuals to save a significant amount for their health needs. Under this program, US government can make such an insurance amount transferable to any close relative of the insured in case of sudden death however, should be used only for health care purposes. Such a program will reduce the burden from the US government and will improve the conditions of long-term health care services. Flexibility in Federal Law The Federal government of the United States should grant flexibility in designing long-term care programs. States should set flexible eligibility criteria for Medicaid and out of pocket spending and should design simple and easy application procedures. Moreover, States should offer different levels of health care services such as home care services as well as personal care programs. They should also set a specific number to enroll each year in such programs by setting specific criteria. This will simplify the procedure and will help the government to treat those who cannot pay for health care services (Feder. Komisar. &Niefeld, 2000). The Government should build specific nursing homes for elderly people to avoid the high costs of home health care services. Home health care services are costly enough that costs $20 an hour therefore; if the government builds some nursing homes for older people they can save a huge amount (Freundlich, 2014). Government should install the latest and technologically advanced equipments in hospitals and health care facilities to ensure quick recovery. This will also reduce the costs of long-term health care services. Conclusion The nursing profession has a critical role to play in the society. Although a lot has been done in order to safeguard the profession and let it profession, there is still a lot to be done. The support of the government in this regard is very crucial. To implement all the required changes, the government must create a committee with an aim to revise all the available options while developing actionable plans. References American Nurses Association (Ed.). (2010). Nursings social policy statement: The essence of the profession. Silver Spring, Md: American Nurses Association. Institute, Abringer. (2002). Leadership and Self Deception: Getting out of the Box. eBook. Berrett-Koehler Publishers. Lowe, G., Plummer V., O’brien A.P. & Boyd, L. (2012).Time to clarify – the value of advanced practice nursing roles in health care. Journal of Advanced Nursing 68(3), 677–685. doi: 10.1111/j.1365-2648.2011.05790.x N, Freundlich. (2014). Long-Term Care: What Are the Issues? Journal of Health Policies, Retrieved from: http://www.rwjf.org/en/research-publications/find-rwjf-research/2014/02/long-term-care--what-are-the-issues-.html Serio, I. J, (2014). Using coaching to create empowered nursing leadership to change lives. The Journal of Continuing Education in Nursing, 45(1), 12-3. Gretchen. (2012, November 29). Nurse Practitioners: What Should I Know?. KCA Neurology. Retrieved July 6, 2014, from http://kcadocs.com/nurse-practitioners-what-should-i-know/ RWJF,. (2014). Health Care Costs. Retrieved 7 July 2014, from http://www.rwjf.org/en/topics/rwjf-topic-areas/health-policy/health-care-costs.html Amia.org,. (2014). Nursing Informatics | AMIA. Retrieved 7 July 2014, from http://www.amia.org/programs/working-groups/nursing-informatics Explorehealthcareers.org,. (2014). Nursing Informatics | explorehealthcareers.org. Retrieved 7 July 2014, from http://explorehealthcareers.org/en/Career/91/Nursing_Informatics Read More