How Has My Practice Changed in Terms of Autonomy - Personal Statement Example

How Has My Practice Changed in Terms of Autonomy What Exactly a Nurse Practitioner is? A Nurse Practitioner is a ‘Registered Nurse’ who is professionally qualified with a degree and training for diagnosing and general medical conditions. A nurse practitioner has held a wide variety of role in medical sciences and has much more autonomy in his practice. They are more or less in a same position to provide patient a care that is generally provided by a physician. They are always in good and close relationships with the patient and are there to provide specialized care to their patients. Nurse practitioners are specially trained in different areas of medicine and provide services in their area of expertise. They also act as a psychiatric in some cases as their main focus is on the prevention of illness and they do so by educating their patient about his illness and the causes which help him to take preventive measures to avoid illness. The Practice and Autonomy of a Nurse Practitioner The can provide services to patients of all ages, they can treat acute as well as chronic conditions. They also have discretion to provide medications and therapies to their patients. The three primary function of practitioner are to provide prevention, wellness and education to their patients. Their scope of working broadens when they take into care the effect of patient’s illness to the people around him along with a focus on patient’s condition. This preventive style of care helps reducing the future illness, medications and therapies to the patients and hence lesser expensive treatments. Nurse practitioner may easily provide diagnosis and management facilities to their patient for diseases such as Pneumonia, BP, or Diabetics. This autonomy comes from the specialized training that they receive in their particular area of interest during their degree program for Nurse Practitioner. They are also allowed to obtain medical histories of their patients under care and to decide upon and conduct the type of medical examination they think is appropriate for the patient. They are also allowed to prescribe diagnostic studies such as lab tests, x-rays etc to help gain an insight of the causes of patient’s illness. They are also entitled to refer patients to physicians if needed or other professionals for better treatment of patient’s illness. And for the reason they have good relationships with most of the physicians and surgeons. Pursuing nurse practitioners as a profession also brings some interference and questioning to your efforts from other medical professionals around you. It is not always the case that the services of a nurse practitioner will be welcomed. Medical professionals some times think nurse practitioner as a threat to their scope of working. Specially the diagnosis and the referral part of working of a nurse practitioner is always questioned and a clear-cut definition of a nurse practitioner’s role is yet to be outlined. “There are times that the autonomy of the nurse practitioner is directly challenged by other medical professionals that it is it sometimes difficult for a nurse practitioner like me to work on some specific cases (Wadsworth et al, 2002)”. Many medical professionals refuse a nurse practitioner’s judgments and decisions just because of the fact that he/she does not a doctor written with his name. According to a study conducted by the RNC Nurse Practitioner Association, refusal to honour the referrals and diagnosis made by nurse practitioner is quite common. “About 44% of the nurse practitioners surveyed by the association reported that their request for X-rays and referrals were refused on the basis that these request and referrals are made by ‘nurses, not by doctors’ (Jane Ball, 2006)”. The refusal from some medical professionals and service providers to honour the requests made by nurse practitioner creates a big obstacle in the practice of NPs’ profession. It is sometime not only frustrating but also discouraging to the passion of a NP towards his or her profession and it is difficult to let go all the negative effects of such refusal and commit themselves to the care needed by their patients. A general nurse do no assume direct responsibility regarding the diagnosis and management of patient’s illness since they only have to take orders from the attending physicians and are always controlled by authorities for their actions during their services. This is not the case for nurse practitioners. The autonomy they enjoy during their practice also brings in loads of responsibilities and accountabilities on their shoulders for their every action and decision that are related to the management of patient’s illness. The autonomy that I enjoy as a nurse practitioner is the pivotal point when it comes to the exercise of my profession. “The autonomy that I enjoy as a nurse practitioner is laden with a lot of responsibility and accountability (Jones, 1996)”. On the patient’s side, there are still some doubts in the mind of patients about the efficiency and professionalism of Nurse Practitioner. They still confuse between a general nurse and a nurse practitioner. And for the reason we often find patients who refuse to follow the management plan prepared by a nurse practitioner and demand to attend them during their illness. The need is to educate people of the roles, responsibilities, qualifications, expertise and professionalism of Nurse practitioners so that they may build their trust on nurse practitioners. The quickly changing world has brought forward a number of activities that are now considered and accepted as general duties and tasks need to be performed by a nurse practitioner “Collaborating with physicians and other health professionals as needed, including providing referrals Counseling and educating patients on health behaviors, self-care skills, and treatment options Diagnosing and treating acute illnesses, infections, and injuries Diagnosing, treating, and monitoring chronic diseases (e.g., diabetes, high blood pressure) Obtaining medical histories and conducting physical examinations Ordering, performing, and interpreting diagnostic studies (e.g., lab tests, x-rays, EKGs) Prescribing medications Prescribing physical therapy and other rehabilitation treatments Providing prenatal care and family planning services Providing well-child care, including screening and immunizations Providing health maintenance care for adults, including annual physicals (women health channel, 2007)” Since Nurse practitioner can pursue a career in many professional settings, the kind of roles and responsibilities expected to be assumed by a nurse practitioner varies a lot. A nurse practitioner may be found working in: “Private Offices Walk-in clinics Community Clinics Health Departments School/College Clinics Hospitals Home Health Care Agencies Nursing Homes Health Maintenance Organizations (npcentral, 2004)” For example, working in a hospital can be very difficult for a nurse practitioner. “The extent and limitations of the role of the nurse practitioner is yet to be defined (Royal College of Nursing, 2005)”. Situations occur in hospitals when a nurse practice has to decide whether to start management of a patient’s illness or to wait for physicians. The practice and the teachings nurse practitioner has demand him to manage the patient autonomously but the rules and policies of hospitals require him to wait for physicians and doctors. The situation becomes more crucial when there is an emergency case and the decision has to be made to save patient’s life. The autonomy is very enjoyable for a nurse practitioners since he may work independently without much restrictions and limitations within the scope of expertise he has inherent from his specialized qualifications. But this also prepares me to assume responsibilities for all the good and bad consequences of the actions and decisions made by me. A nurse practitioner needs to be mentally mature to effectively utilize the autonomy his or her profession provides him but at the same time he should be tough enough to go through the pressures of consequences and situations that arise during his practice. The thing that can help a nurse practitioner better manage his cases is to maintain a personal record of all the cases and the activities performed during those cases to defend his services at any later time during his career. The profession of a Nurse Practitioner has taken some interesting turns so far and some of these turns are very challenging indeed. It may take some time before the role of a nurse practitioner will finally be given a clear cut definition but what is really good about it is that nurse practitioners are already given some degree of autonomy to exercise their professions and do something to speed up the process of delivering efficient and effective healthcare services to people. References Jane Ball, (2006). “Nurse Practitioners”. Retrieved on June 15, 2007 from: http://www.nursepractitioner.org.uk/documents/NPA%20survey%202006%20report%20.doc Women health channel, (2007). “What is a Nurse Practitioners”. Retrieved on June 15, 2007 from: http://www.womenshealthchannel.com/nursepractitioner.shtml Npcentral, (2004). “About NPs”. Retrieved on June 15, 2007 from: http://www.npcentral.net/consumer/about.nps.shtml Jones M (1996). “Accountability in Practice: A guide to Professional Responsibility for Nurses in General practice”. Quay Books, Dinton Royal College of Nursing (2005). “Competence in Nursing: Nurse Practitioner”. Retrieved on June 15, 2007 from: http://www.rcn.org.uk/publications/pdf/NursePractitioners.pdf Wadsworth L et al (2002). “The nurse practitioner’s role in day case pre-operative Assessment”. Retrieved on June 15, 2007 from: http://www.nursing-standard.co.uk/archives/ns/vol16-47/pdfs/v16w47p4144.pdf Read More