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What is Advanced Practice Nursing?

June 21, 2021
Christopher R. Teeple

Respond to the following 3 posts:
1. What is Advanced Practice Nursing?
There are many differences between nursing practice and advanced nursing practice. A Registered Nurse (RN) is a healthcare provider that comes to mind when a patient and their families seek health care. RNs specialize in treating patients and preparing them for the doctor. The duties of a RN include checking a patient’s vital signs and preparing patients to be seen by doctors. Patients and their families are educated by RNs to ensure proper follow up care. RNs are responsible for inserting IVs, administering medications, monitoring patients’ conditions reporting changes or patient needs to their doctor as well as documenting care and assisting patients with their activities of daily living. RNs will also ensure that their inpatients are well taken care of and following the doctor’s orders. RN’s ae well educated and attend nursing school and clinicals. Rn’s must pass State Boards to become a Licensed Registered Nurse (Florida National University [FNU], 2019).
Some people think that ARNP and RN are one in the same when the ARNP has much more responsibilities than a RN and require additional education and licensing. APRNs are nurses who are licensed to prescribe medications, diagnose, and treat illnesses. The scope of practice of the APRN is determined by the state in which they practice as to the practice of prescribing of medications and the supervision requirements. APRNs perform duties that are outside of the responsibilities of a RN. These responsibilities make an APRN just as capable as doctors at providing a certain amount of medical care. This is because the APRN receives an extensive amount of medical education and training.
Unlike a RN, the ARNP does not work for the doctor. The APRN works alongside doctors and is licensed to administer medication and treatment to patients as well as perform diagnostic testing and evaluates a patient’s condition in addition to the duties of a RN. The big difference between an APRN and a RN is that an APRN is fully capable of seeing patients on their own and have the authority to coordinate an entire healthcare team to plan and evaluate a patient’s care. The ARNP also has the authority to supervise other healthcare workers (Florida National University [FNU], 2019).
There are many nursing theories that can be applied to advanced practice nursing. The Self-Efficacy Theory originated from the Social Cognitive Theory by Bandura may be used by an APRN. Bandura’s theory is comprised of three factors that influence self-efficacy: Behavior, environment, and personal factors. Self-efficacy, or the belief that one can manage one’s own health, is an important goal of an APRN. The Life Perspective Rhythm Model by Joyce Fitzpatrick is modeled after the concepts of nursing, person, health, and environment. This model recognizes individuals as having unique biological, psychological, emotional, social, cultural, and spiritual attitudes. Optimum health is described as the actualization of both innate and obtained human potential, goal-directed behavior, and expert personal care. The Theory of Comfort by Katharine Kolcaba can help an APRN focus on the complete care of the patient. The Theory of Comfort is a mid-range theory that is focused on health practice, education, and research. This theory describes nursing as the process of assessing the patient’s comfort needs, developing and implementing appropriate nursing care plans, and evaluating the patient’s comfort after care has been provided. There are so many theories out there that can enhance the practice of an APRN. It is ultimately the APRN’s choice on which theories fit for their role and individuality in advance nursing (38 Greatest Nursing Models & Theories to Practice by, 2020).
References
Florida National University. (2019, August 6). What’s the difference between a RN and Advanced Registered Nurse Practitioner? Retrieved June 17, 2021, from https://www.fnu.edu
38 greatest nursing models & theories to practice by. (2020, October 12). Nurse Buff. Retrieved June 17, 2021, from www.nursebuff.com
2. There are significant differences between nursing practice and advance practice nursing.
The first difference is the level of education. Ward (2015) discussed the education of an advance
practice nurse as one that completed at a graduate level education from an accredited program
with classes in advance health assessments, advance physiology/ pathophysiology, advance
pharmacology. Practice nurses according to an article titled, What Kind of Work Do Registered
Nurses Do? (2020), are educationally prepared with entry level associates degree or a
Bachelorette degree. Joel (2018) outlined the advance practice nurse consist of clinical nurse
specialist, certified nurse-midwife, certified registered nurse anesthetist, and nurse practitioner.
An advance practice nurse can manage selected medical problems, manage uncomplicated acute
illnesses and stable chronic illnesses, and order physical and occupational therapies according to
Philips (2020). Whereas the nursing practice is completing physician orders with nursing
interventions and assessments (What kind of work do registered nurses do, 2020). Christensen
(2015), described advance practice nurses as licensed as independent practitioners that can
practice autonomously with collaboration with members of the healthcare team. Advance
practice nurses are separated from the nursing practice with the capability to order, conduct,
supervise, and interpret, diagnosis radiologic and laboratory tests (Christiansen, 2015). There is
also prescription authority for nonpharmacologic and pharmacologic treatments as well as
education and counselling patients (Christensen, 2015).
There are many theories that support the advance practice nurse. Watson’s caring theory
and her caring caritas gives the foundations of a relationship of the advance practice nurse and
the patient. Watson (2008), says the work of the nurse is to practice of loving-kindness, be authentically present, develop and sustain a helping-trusting relationship with the patient, supportive of expressed positive and negative feelings, and create a healing environment.
Benner’s novice to expert applies to the advance practice nurse as we advance our
education and knowledge. This is theory expresses how an advance practice nurse gains
knowledge and advances in their practice field. Alligood M(2014), explains how Benner also
expands on her philosophy with her domains of the nursing practice. Benner philosophy of
domains of the nursing practice include a helping role that is grounded in a healing relationship
(Alligood, 2014). Benner’s domains of the nursing practice is to provides comfort and invite the
patient to be an active participant and in control of their care (Alligood, 2014). The other
domains contain teaching, monitoring, management, quality health care practices, and
competencies (Alligood, 2014). Benner has a focus on developing an understanding of intuitive
acuity, clinical judgement, skills, ethics, and continual expertise learning (Alligood, 2014).
Imogene King’s theory of goal attainment is applicable to the advance practice nurse with
the Theory of goal attainment. King’s theory of goal attainment focuses on communication,
setting goals, exploring means, and agreeing on means to achieve the goal (Alligood, 2014).
King describes the nurse-patient relationship as a hand-in-hand partnership to meet goals of
obtaining good health (Alligood, 2014).
Reference:
Alligood, M.R. (2014). Nursing theory: Utilization & application (5th ed). St. Louis, MO:
Elsevier Mosby. Christensen, D. (2015). Advance practice nurses evolve healthcare solutions. ONS Connect, 30 (1), 26-30.
Joel, L.A. (2018). Advanced practice nursing: essential for role development. Philadelphia: F.A.
3. Advanced nursing practice, as defined by the International Council of Nurses, is a field of nursing where boundaries of nursing scope of practice are extended and expanded to make certain that advancement of the profession is continuous. Advanced Practice Nurses (APNs) or Advanced Practice Registered Nurses (APRNs) have to complete a master’s or doctorate which allows them to pursue roles in higher levels of their field. These titles allow nurses more self-governance and versatility in their work, and in taking care of patients.
Advanced Practice Nursing allows a nurse to play more roles than in nursing practice. In advanced practice nursing, nurses can act as leaders to other nurses and medical assistants. They can also improve patient care and plans of treatment alongside other advanced practice practitioners in their place of work. Nursing practice allows a nurse to only perform patient care duties. There is a difference in licensing and certification. In advanced practice, nursing one must be certified by both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP). For nursing practice, the only required certification is from the Board of Nursing in the state where the nurse works.
In nursing practice, collaboration with physicians, and sometimes supervision, depending on the state, is a requirement. Advanced practice nursing provides more self-governance than nursing practice. Supervision is not a requirement, but one should work in collaboration with other nurses, physicians, and hospital administrators. Levels of education are also different. For advanced practice nursing, a doctorate or a master’s degree is needed, but in nursing practice, the requirement is registration as a nurse and holds a Bachelor of Science in Nursing (Hibbert, 2017).
Advanced Practice Nursing has been a major step in transforming nursing so as to improve patient care. APRNs play key roles in chronic disease management and increasing access to primary care. They are also able to practice the full extent of what they were trained to do, the education they acquired, their knowledge and skills and, their competencies. APRNs are also required to collaborate with different professionals in a healthcare organization and this encourages, improves, and promotes interpersonal and inter-professional collaboration in the organization. Having an advanced practice will allow nurses to be considered for important leadership roles where these nurses can use their expertise and experience to assist in setting or influencing policies that will directly improve healthcare’s main focus, saving lives and patient care.
Nursing theories are vital in nursing practice and ensuring proper patient care. APRNs apply these theories in their practice a lot. Watson’s Theory of Human Caring is a good example. These nurses can apply Caritas #4 which is developing and maintaining a helping, trusting, original and caring relationship with patients by providing primary care to particular patients. The Synergy Model is another nursing theory that APRNs can use in their work. The central idea of this model is that a nurse’s competencies stem from his/ her patient needs, and these competencies can be developed by further training, like the case for APRNs.
Reference
Hibbert, D., Aboshaiqah, A. E., Sienko, K. A., Forestell, D., Harb, A. W., Yousuf, S. A., Kelley,

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