APA is defined as having advanced specialized clinical knowledge and skills through masters or doctoral education that prepares these people for specialization, expansion and advancement of practice. From the above definition specialization refers to ones concentration in one part of the field of nursing.
On the other hand expansion refers to the acquisition of new practice knowledge and skills including knowledge and skills legitimizing the role autonomy within area of practice that overlap traditional boundaries of medial practice/.
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Advancement in this context involves experience and specialization that is characterized by the integration of theoretical research based and practical knowledge that occurs as part of graduates’ education in nursing. (Michaelene, 2006)
The advanced practice nurses are currently being deployed to the rapidly challenging health care system. APN are employed in areas such as the community health government hospitals, nursing homes, clinics all over the world. APN functions as educators, consultants’ researchers, policy makers and outstanding clinicians in the areas. (pg 20)
Advanced practice nursing in my own view is an exiting career of choice with many opportunities and challenges. The rise in technological advancement has produced remarkable assistance in helping the health sector in easier diagnosis of diseases.
The word APN designates four roles in the nursing world; the nurse anesthetics, nurse midwives, nurse practitioners and nurse specialists. (pg 25) In other descriptions it only refers to the broad category of nurse practitioner and nurse specialists.
In this disruption, the clinical nurse specialists are registered nurses usually at the graduate level school. They demonstrate excellence in a focused area of nursing practice and are the models for quality health care. These practitioners are registered nurses who have achieved the level of education required for additional registration as nurse practitioners with the association of nurses.
Their skills are learned through graduate nursing education and substantial nursing practice experience. These groups provide healthcare services from a holistic nursing perspective combined with a focus on the diagnoses and treatment of acute and chronic illness including prescribing medication. (Wales Nurses consultation paper, 2007)
Nurses play an important role in the health sector through ensuring the welfare of patient is taken care off in the hospital. The beliefs and actions statement for advancement is important in the nursing community in realizing their personal potential.
There are certain challenges that face the profession. Identification of such challenges would be an important step in facing the future within the profession. The basic purpose of nursing is the well being and care of patients.
This could mean different when analyzed in different contexts. But regardless of the context this decisions and actions of the healthcare profession should always be based on an individual; need for halt promotion, cure or palliative case, support, advice or conform and involve the patient fully in determining what these needs may be and how they may be met.
This paper provided the opportunity to examine barriers and shelters mode for advanced practice role enactment that will provide an appropriate framework for may advance practice nurse role.
STATEMENT OF FUTURE PROFESSIOANL ROLE
I would like to be a family nurse practitioner. This is my effort in realizing and exploiting the potential in me. I clearly understand the nature of caring needed by the professional to my particular patents and my developing a unique relationship between my profession and my patent will portray the highest dignity is required.
THEORETICAL ROLE FOR ADVANCED ROLE EANACTMENT
Advanced Nursing practice encompasses all the practices including; knowledge, their skills in practice education & research. This is much different from the description in terms of performance of medial tasks.
Skill acquisition theory also referred as the hermeneutic model has been referred by Benner & Wrubel to study expertise in clinical nursing practice. Banner urges that experienced nurses often use the nurse-patient relationship and knowledge of a patients response patterns to make clinical judgments about patients care. (Michaelene, 2006)
Benners definitions of clinical judgment particularly at the level of expertise practice, has been expanded to include both deliberate analytic thinking and non conscious holistic discrimination of patients clinical states. In this model experts judgment include ethical decision making on what is good or right.
This is achieved through extensive knowledge from practice, emotional engagement with patients and with one understanding of specific contents for care.
In my Advanced Practicing Nursing (APN) the hermeneutic model describe what I would really expect to add in a profession. Through use of common sense, understanding, skilled know how, similarity recognition and deliberative rationality is key assets that I intend to use to achieve the best skills to run the profession.
To be able to recognize patents needs and after better health care I would use my intuition to analyze complex issues. Intuition can be defined as the capacity to analyze complex data simultaneously discerning patterns and act of hypotheses without necessarily naming all the factors involved in their decision making.
This will require my in-depth understanding of the complex experiential knowledge which I have accumulated in practice. By combining this attributes and understanding the best patient-interaction method would enhance my effectiveness to offer effective care.
My strong points on t he above theory are based on the following understanding that professional education is not just about knowledge and skills to perform tasks, no matter how complex it is much more about socialization and internalization of the values and codes of profession behavior and practices, both on and off my duty.
The professional education takes the lay novice and enables them to be specialists with identity, so that work is not just a job to me by a responsibility. I also understand that knowledge is gained by acquiring it and should not be static, but used for the benefit of the society. I will ensure that my knowledge and skills are in tandem with the role I play as a family nurse.
Another model of skill acquisition was described by Ham, 1998, Laura & Salentera 2002, in which they pointed out on the range of analytical thinking approaches with a carrying degree of analytical and intuitive thinking. (Neubauer, 1998).
This theory of discussion making, the features of the task to be accomplished are thought to determine the degree of intuition and the analyses used by the decision maker.
These features of the task are viewed to be outstanding; the complexity of task structure (number & redundancy of cases); the ambiguity of task content (availability of organizing principles, familiarity with the task, and possibility of high accuracy); and the form of tasks presentation (task decomposition, signal definition & response time).
The model assumes that greater analytical thinking is related to fewer cues and more complex procedures for combining evidence to result in correct answers.
The cognitive model would be achieved in my organization capabilities that I pose; my greater task familiarity and my high accuracy will be a greater contributor to my reasoning.
I will intend to use my in-depth knowledge on the profession and inborn knowledge for greater analytic thinking. I will also ensure that I fully understand the task that I would intend to undertake in the hope of making the right decisions.
The above theory supports my beliefs that the decision and action that I undertake as a health practitioner should be base on an individual patient need. This is in addition to involving my patients in decision making which concerns their care thereby promoting healthy lifestyles and self management of health.
The advanced practice nursing as we have seen has been consistently characterized as based in holistic persecution , the formation of partnership with patients or pollutions the use of research and theory to guide practice and the use of diverse approaches in health and illness management.
And as Banner identified the domains or expert practice, my Advanced Practice Nursing (APN) would be based on nothing less but even more of the following, having and helping role, monitoring functions of diagnostic and patient monitoring, good and defective management of rapidly changing situations, teaching coaching factors and monitoring therapeutic interventions and regiments; monitoring and ensuring that offer quality health care services and lastly acquire the best organizational and work-role competences.
‘Consultation paper’ Designed to Realize Our Potential’: a ‘beliefs and action’ statement for nurses, midwives and specialist community public health nurses in Wales for 2007 and beyond. Retrieved on February 22, 2008 from: <http://www.ecoliinquirywales.org/dphhp/publication/professionals/nursing/realising-potential/potential-consultation-e.doc?lang=en
Michaelene, P., Jansen, M., & Zwygart, M. (2006). Advanced Practiced Nursing: Core Concepts for Professional Role Development, Springer Publishing Company
Neubauer, J. (1998).Personal development, A lifelong journey. Advanced practice nursing quarterly 3, 1-9
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