Advanced Practice Nursing Research Paper

Current and Future State of Advanced Practice

Changing Roles of Advanced Practice Nurses Advanced practice nurses face a challenging situation within the present health care system. For many years, such traditional health care roles as physician and nurse have been regarded as unopposed professionals. With the rapid expansion of knowledge and the raising of standard of care based on evidence-based clinical practice, the health care system in recent years has expanded its ranks to support and expand the physician and nurse roles. Specialist and subspecialist training are fast making the role of the jack-of-all-trades health professional less and less valuable due to the sheer volume of knowledge required to match the standard of care demanded…show more content…
Not only does this involve improving the working conditions of nurses but also involves political advancement in terms of agendas, policies and regulations that affect the profession as a whole. While these pose challenges for the APN as a leader in her profession, another challenge as a leader is the maintaining of an evidence-based identity separate from the other medical professions through self-regulation, role development and goal-setting. Some of the challenges advanced practice nurses face as leaders is that pertaining to establishing a solid professional identity. Bryant-Lukosius, Dicenso, Browne and Pinelli (2004) identified significant issues in the establishment of advanced practice nurses as indispensable catalysts in patient care: “confusion about APN terminology, failure to define clearly the roles and goals, role emphasis on physician replacement/support, underutilization of all APN role domains, failure to address environmental factors that undermine the roles, and limited use of evidence-based approaches to guide their development, implementation and evaluation” (p. 1). As time passes and the professional identity of the advanced practice nurse becomes more prominent, especially in the face of sweeping health care changes, these issues will eventually be addressed…show more content…
From the ill-perceived role of the nurse performing mundane tasks for physicians more than half a century ago, the establishment of advanced practice nursing as a distinct pillar in the health care system to the hybridization of the practice of both nursing and medicine as a nurse practitioner to address primary care physician shortages, it is still to be determined what non-clinical roles may arise in the future health care system. More recently, the operations of the Clinical Nurse Leader (CNL) by the American Association of Colleges of Nursing (AACN) Board of Directors arose "in response to client care needs and to the health care delivery environment" (Spross, Hamric, Hall, Minarik, Sparacino & Stanley, 2004, p. 2). The CNL, an APN who is a generalist, works at the microsystems level (e.g. outpatient clinics, hospital units) and is concerned with such tasks as developing and implementing strategies for plans of care at the preventive level, coordination of care and other administrative-related