Roles of the Nurse Practitioner, Educator, Informaticist, and Administrator - Essay Example

Advanced nursing role due: Introduction In this assignment, I will review all the roles and then examine my specialty which is the nurse practitioner; focusing on the extent of practice, core competencies, certification essentials and legal aspects of the practice of a nurse practitioner. I will highlight the environment of practice, population I will work with, as well as peers and colleagues. Additionally, I will discuss the future of leadership role and participation in professional bodies. This paper will be based on current literature (books and journals), standards of practice, core competencies and certification bodies (Florida Association of Nurse Practitioners) for a nurse practitioner. Question 1: Roles of the Nurse Practitioner, Educator, Informaticist and Administrator in advanced practice nursing in regard to primary care, clinical practice, education, administration and research The nurse Informaticist role in clinical practice is to design clinical documentation for example nursing outpatient notes which are changed and used to create items like patient problem list. The nurse Informaticist role in primary care is that they expand aid and evaluate applications, processes, tools and structures that assist nurses to handle data in direct care of patients, in nursing education and research (DeNisco & Barker, 2013). A nurse Informaticist should have basic computer knowledge, must be acquitted with common applications, he or she must be able to communicate through electronic means such as email and acknowledgement of privacy and security matters. According to Mirr & Zwygart-Stauffacher, (2010), a nurse Informaticist who works in administration uses staff scheduling application. A nurse Informaticist working with nurse educators their role is to test softwares for them. A nurse informaticist working in public health is in charge of public health databases (p. 242). While the nurse educator is responsible for educating other nurses for professionalism in nursing. The nurse educator also teaches doctors and health officials on the significance of proper settings in hospitals and nursing homes to make the health of people better. According to Bastable (2008), Nurse educators as well as nurse practitioner has the role of educating patients, families as well as the public to promote health and take care of the patients (p.5). The other role of a nurse educator is to offer training to nurses in practice through continuing education, in-service schedules and staff growth to maintain and make better their clinical knowledge and teaching capacity (p.7). The nurse educator also performs the role of a clinical instructor to students to help them acquire their expected learning goals. The nurse educator also teaches nursing students to become skilled and caring professional. The nurse educator has the expertise and knowledge of the fundamentals of teaching and learning which not the case with other nursing advanced roles. On the other hand, the nurse administrator role in clinical practice, is their professional foundation dedicated to patient evaluation, planning of care, implementation and evaluation of individual care, communities and group of patients care (Wolper, 2004)). The nurse administrator is professionally qualified to train nurses for managerial positions in health care organization settings. The nurse administrator takes part in or may begin a research by providing resources and motivate research to happen. The nurse administrator could also implement research results in the nursing practice. According to Roussel (2013), a nurse administrator has the role of managing health care delivery services and acts on behalf of the nursing service (p.29). The nurse administrator mainly works in an office setting and is well equipped with knowledge and skills to aid in solving challenges encountered in information management, legal and regulatory oversight, evidence-based care and management and ethical practices. The nurse administrator manages organizations to change organizational values into the day to day operations resulting to efficient, effective and caring body. The nurse administrator has the role in leadership, evolution, implementation and evaluation of protocols, programs and services that are evidence-based and in harmony with professional standards. A nurse administrator is empowered with management skills and theory at master’s level. However, the clinical role of a nurse practitioner is to give evidence-based direct care to patients in consultation with a physician. The nurse practitioner role in education is to teach and coach the patient, family and another nursing staff to improve the health of the patient. The nurse practitioner role in administration is that they monitor daily conditions of residents of the facility the work in. The nurse practitioner working in acute care examines acute change, organizes with the patient’s doctor, takes part in meetings and works with families. The nurse practitioners role in research is that they support research by initiating clinical research questions, carry out or take part in studies, circulate and absorb findings into practice. According to White & Truax (2007), a nurse practitioner assumes the role of the clinician, educator and leader in a nursing home. In the role of the clinician, the nurse practitioner provides evidence-based patient care working together with a physician for consultations. As a leader, a nurse practitioner acts as an advocate of the patient and sets the perfects professional standards for the whole nursing staff as a nurse, educator and researcher (p.11). A nurse practitioner holds a master’s degree and are certified by a national certifying organization for example American Nurses Credentialing Center (p. 12). Question 2: Regulatory and legal requirements of a Nurse practitioner in Florida State The law limits the number of offices where physicians need to consult with a nurse practitioner if he is not physically present to give supervision on the basis of the services offered. Where primary health care services are offered, the physician is limited to supervise four offices in addition to his primary practice base. Primary health care is defined as the health services offered to patients without refer from another physician and includes obstetrical and gynecological services. However, dermatological and skin care services that include aesthetic skin care are not included in the primary health care services. In the case of specialty health care services, the physician is not allowed to supervise more than two offices together with his primary practice facility. Specialty health care is defined as health care services given to patients as a result of a referral from another professional and dermatologic and skin care services including aesthetic skin care services are not included. Dermatology or skin care services including aesthetic skin care apart from plastic surgery is allowed to supervise one other office from the primary practice location but physicians who had submitted the address of the offices before July 1, 2006 to the Board of Medicine are allowed to supervise two offices until July 1, 2011 (Florida Nurses Association, 2006). According to the Florida Nurses Association (2006), exemptions to these laws apply to physicians supervising nurse practitioners working in; - Licensed hospitals or ambulatory surgical facilities. - Conjunction with a college of medicine, college of nursing, an accredited graduate medical program, a nursing education program. - Offices where the nurse practitioner performs hair removal service. - Non-profit clinics which are not licensed as abortion clinics offering family planning services. - Rural and federally qualified health centers. - Licensed nursing home, licensed assisted living facility, licensed continuing care facility and retirement community comprising of independent living units, licensed nursing home or assisted living facility. - Facilities rendering anesthesia services in accordance to the law. - A designated rural health care facility. - A program created to maintain elderly individuals and persons with disabilities in the home or community-based setting. - University primary care student health centers. - School health clinics. - Federal, state or local government facilities. In a situation where a nurse practitioner works in an office which is not exempted from the law and the physician is not present to supervise, a clear present schedule with regular hours attended by the supervising physician, the hours not attended and the hours the office was open. This law was effected on July 1, 2006 (Florida Nurses Association, 2006). According to a report by Florida Senate (2008), the general licensure title advanced registered nurse practitioner. In Florida State, the education qualification for a nurse practitioner requires advanced studies and intensive clinical experience fit for the nurse practitioner area of practice. The nurse practitioner may carry out medical acts of diagnosis specifically enquiring about the patients medical history, treatment, prescription of medication, and operation under particular situations; when the physician is not available or in a busy setting. The nurse practitioner is regulated by the Board nursing under part I chapter 464 and is certified by the FS Florida. The law allows nurse practitioner to monitor and alter drug therapies, begin suitable therapies for certain conditions, order diagnostic tests, physical and occupational therapy. The law states that a nurse practitioner scope of practice comprise purpose which the nurse practitioner is qualified to perform, in accordance to accepted protocols and in harmony with the practice setting. A nurse practitioner is not allowed to prescribe controlled substances (Committee on Health Regulation, 2008). A nurse practitioner in Florida State is allowed to prescribe drugs within the scope of their practice, knowledge, training, and must be officially permitted by a supervising physician or dentist. Professional organizations available for membership in the state of Florida The professional organization available for membership is Florida Association of Nurse practitioners. It is a pro-active group of registered advanced practice nurses and health care advocates working together to improve access to health care to Florida citizens. As a nurse practitioner, I could also become a member of Florida Nurse Practitioner network that assists the members to network, give education and professional growth to nurse practitioners. Required competencies According to Stewart & DeNisco (2013), a nurse practitioner is required to possess the following competencies: - Scientific background competence. The nurse practitioner should be able to combine knowledge from the humanities and sciences inside the context nursing (p.8). - Leadership competence. The nurse practitioner should be able to promote the action of working with various parties in the health care system (p.8). - Quality competence. The nurse practitioner must apply the best available evidence to gradually improve the quality of nursing practice (p.9). - Practice inquiry competence. The nurse practitioner should be able to produce knowledge from nursing practice to improve the profession and patient health outcomes (p.9). - Technology and information literacy competence. The nurse practitioner should be able to merge suitable technologies to improve health care (p.9). - Policy competence. A nurse practitioner must be acquitted with interdependence of policy and practice (p.10). - Health delivery system competence. The nurse practitioner should be able to apply knowledge of organizations practices and compound systems to improve health care delivery (p.10). - Ethics competence. The nurse practitioner should be able to apply ethically sound solutions to compound issues related patients and care systems (p.10). - Independent practice competence. The nurse practitioner practices a licensed independent practitioner (p10). The nurse practitioner attains certification by the Board of Nursing. For a nurse practitioner to qualify for certification one has to present proof that: one has satisfactorily completed formal post-basic educational program of specialized or advanced nursing practice, has gone through certification by a suitable specialty board, completed a master’s degree program in a suitable clinical nursing specialty (Committee on Health Regulation,2008). Organization, population and staff members with whom a nurse practitioner will work with As a nurse practitioner, I will practice in a skilled nursing home, long-term care facilities, hospice care, academia, home care and community setting. Moreover, I will also practice in private clinics, urgent care, public health, college health clinics, internal medicine clinics and home health. I aim to provide care to the aged and young who are healthy and ill. The population age group will begin with adolescents until death. As written by White & Truax (2007), a nurse practitioner may be hired by health organizations, a physician, and insurance companies or set up their own business in accordance to state regulations. Furthermore, independent nurse practitioners work in accordance to the state’s nurse practice act (p.12). As a nurse practitioner, I will be expected to work with other health care practitioners, physicians, individual patients and community. In addition, I may fulfill medical acts in supervision of a medical physician, osteopathic physician and the dentist inside the framework of existing protocols; that state the medical acts to be performed and the conditions for their performance. Question 3: Determine your leadership style: According to the leadership quiz results, my leadership style is participative and delegative (About.com, 2014). Currently, the leadership attributes that I possess are: superb communication skills, team building, management and outstanding technical skills, personal integrity, strategic vision and personal skills (Kelly, 2012). How to attain and evaluate the missing attributes in regard to leadership To attain and evaluate the missing attributes, I will use problem-solving methods to maintain efficiency from members and make better group recognition. I will also focus on being an active and leave the effect of inspiration on my colleagues. I will also concentrate on maintaining qualified standards and give room for the gradual development of able experts (Rigolosi, 2013). Question 4: The policy on drug shortages According to Robert Wood Johnson Foundation, the current policy states low repayment of the money spent on generic sterile injectable drugs from Medicare Part B brought about when the law was changed in 2003. As a result of this, the manufacturers, and physicians moved to higher cost drugs hence making the money put in production of cheaper generic drugs to diminish. This leads to growing market concentration and results to shortage of drugs. According to the report, to bring change to the policy some players have fought for an increase of Medicare Part B reimbursement rates. To achieve this increase, laws have been initiated to change Medicare Part B repayment policy (Stencel, 2014). Provide the process required to make a change with key players and parties of interest To process required to stop drug shortage is to have a keen look at the regulatory matters which could be giving support to more communication between stakeholders, accelerate careful thought of new drugs and give permission for drugs to be imported from other countries by Congress and Food and Drug Administration body (Stencel, 2014). How I could influence the effort to change in policy As a nurse practitioner I would advocate for change in policy through congress or the Food and Drug Administration body by making it clear that the shortage of drug not only affects the care of patients but also bring about indirect costs on the health system. It is imperative for the relevant governing bodies to understand that some drugs cannot be substituted and even for those that have substitutes it involves modification of drug usage protocols (Stencel, 2014). How an implementation of health care policy will have an effect on health care If change in policy is implemented, my prediction of the effect on health care quality is that drug shortages will be no more. This could lead to availability of generic sterile injectable drugs. Which could lead to lead to longer quality of life; saving time wasted for rescheduling medical procedures. This could aid in saving the lives of patients fighting chronic illnesses, others struggling with an infectious illness and others set to undergo surgery (Stencel, 2014). References About.com (2014). Quiz - Whats Your Leadership Style?. Quiz - Whats Your Leadership Style?. Retrieved August 25, 2014, from http://psychology.about.com/library/quiz/bl- leadershipquiz.htm Bastable, S. B. (2008). Nurse as educator: Principles of teaching and learning for nursing practice. Sudbury, Mass: Jones and Bartlett. Committee on Health Regulation. (2008, October). The Florida Senate. http://www.floridanurse.org/arnpcorner/ARNPDocs/InterimReportPrescribingControlledSubstances.pdf.. Retrieved September 16, 2014, from http://www.floridanurse.org/arnpcorner/ARNPDocs/InterimReportPrescribingControlledSubstances.pdf. DeNisco, S., & Barker, A. M. (2013). Advanced practice nursing: Evolving roles for the transformation of the profession. Burlington, Mass: Jones & Bartlett Learning. Florida Association of Nurse Practitioners, Inc.. (n.d.). Florida Association of Nurse Practitioners - About Us. Florida Association of Nurse Practitioners - About Us. Retrieved September 16, 2014, from http://flanp.org/about-us.html Florida Nurses Association. (2006, September). Florida Nurse Practitioner.http://www.floridanurse.org/arnpcorner/ARNPDocs/FloridaNursePractitionerScopeAugust2006final.pdf.. Retrieved September 16, 2014, from http://www.floridanurse.org/arnpcorner/ARNPDocs/FloridaNursePractitionerScopeAugust2006final.pdf. Kelly, P. (2012). Nursing leadership & management. Clifton Park, NY: Cengage Learning. Lockwood, W. (2013, July). Florida’s Laws and Rules for Nursing. http://www.rn.org/. Retrieved September 16, 2014, from http://www.rn.org/courses/coursematerial-10013.pdf Mirr, J. M. P., & Zwygart-Stauffacher, M. (2010). Advanced practice nursing: Core concepts for professional role development. New York, NY: Springer. Roussel, L. (2013). Management and leadership for nurse administrators. Burlington, MA: Jones & Bartlett Learning. Stewart, J. G., & DeNisco, S. M. (2013). Role development for the nurse practitioner. Burlington, MA : Jones & Bartlett . Stencel K. (2014, September 11). Drug Shortages. RWJF. Retrieved September 16, 2014, from http://www.rwjf.org/en/research-publications/find-rwjf-research/2014/09/drug-shortages-.html White, B. S., & Truax, D. (2007). The nurse practitioner in long-term care: Guidelines for Rigolosi, E. L. M. (2013). Management and leadership in nursing and health care: An experiential approach. New York: Springer. Wolper, L. F. (2004). Health care administration: Planning, implementing, and managing organized delivery systems. Sudbury, MA: Jones and Bartlett Publishers. Read More