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Nursing Discussion Leadership

Nursing Discussion Leadership

Nursing Discussion Leadership

QUESTION
2-part Leadership Assignment
Discussion 1:
The efforts of national professional organizations (i.e. American Association of Nurse Practitioners), national certification (i.e. American Nurses Credentialing Center), and the move toward graduate education as a requirement for advanced practice have been critical to enhancing the credibility of advanced practice nursing. In 1-page, examine and describe the barriers and challenges that have slowed the progress of advanced practice nursing in the United States. Also, compare the credibility of the early role to the role at this time. Please use evidence-based practice, research, and/or position statements to support your arguments. Also, you may use reliable electronic sources.
Sample Discussion 1:
Throughout time there has been many opportunities for nurses to gain specialty training and role advancement. This has been done during healthcare and policy reformation, changes in the economy, and when there is increase from the demands of society. But with advancements also comes challenges and barriers that nurse practitioners (NP) have faced. During this transition into an advance nurse practitioner from the role of registered nurse (RN), there is a shift from being an experience or expert RN to an inexperienced or novice level NP (Barnes, 2015). This can created a barrier by resulting in loss of confidence, impaired NP role development, and alteration in professional identity (Barnes, 2015). It is a vital challenge for role transition to be successful in order for the NP to become efficient and effective as a provider as quickly as possible. Other reasons that have been cited as barriers or challenges to the progression of the NP role are: differences in the educational preparations between physicians and NP, concerns over the ability of the NP to safely prescribe mediations like controlled substances and narcotics, lack of physician oversight, inability to control healthcare cost, and shortage of nurses leaving the role of RN to become NP (Hain, D., Fleck, L., 2014). To this day, barriers to prescriptive authority for NP remains one of the biggest issues in allowing the profession to use the full scope of their credentialing (Hamric, Hanson, Tracy, & O’Grady, 2013).
Although the main inception of the nurse practitioner role was started in the 1960s, much of the groundwork was started as early as 1893 with Lillian Wald’s work in the Henry Street Settlement and through Mary Breckenridge’s founding of the Frontier Nursing Service in 1925 (Keeling, 2015). These helped to pave the way for improvement and advancements of the nurse practitioner role and their impacts on society by doing so.
ReferencesBarnes, H. (2015, February). Exploring the Factors that Influence Nurse Practitioner Role Transition. Retrieved November 16, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323084/
Discussion 2:
Conduct a 1-page literature search and review on advanced practice nursing (or a specific APRN role) and locate articles or research that describes advanced practice nursing in other countries. What are the similarities and differences between conceptualizations of advanced practice nursing in other countries (i.e., Canada, United Kingdom, Australia, Japan, Spain, China) compared with the United States?
Sample Discussion 2:
Advanced practice nursing roles are developing and expanding across the globe as a result of physician shortages, health care costs, and initiatives to improve quality of care. Two main categories of advanced practice nurses are nurse practitioners, who practice in primary care settings providing services similar to that of physicians, and clinical nurse specialists, who usually work in hospital settings to provide leadership and educational roles. The NP role is recognized in over 40 countries. The Advanced Practice Nurse Network provides online resources of country specific practice practices. I found it interesting that in Canada, nurse practitioners possess full prescriptive authority, whereas in the United States, prescriptive authority and overall scope of practice vary by individual state mandates. In the Czech Republic on the other hand, nurses are not allowed any prescriptive authority. In Nigeria, the nursing profession is still at its infancy. Nursing is seen as a trade profession, wherein trade schools or diploma programs provide certification and no standardized exam exists. Advanced roles include nurse anesthetist and midwife programs that were developed in the 1970s, both of which are 18 month post basic nurse specialist courses. However, these roles are still obtained through training and certification programs, and not recognized as advanced education or clinical degrees.
It seems that the common theme for the introduction and expansion of advanced practice roles globally has been for the goal of providing better quality care, reaching the underserved populations, and meeting disparities in healthcare. Although the NP role in New Zealand is fairly new, as the first NP registered in just 2001, education, regulations, scope of practice, prescribing authority, and continuing competence expectations have been well established and defined. In Israel, advanced practice roles began with NP in palliative care but have since 2009 expanded to roles in geriatrics, surgery, neonatal, diabetes, pain, and family practice. These specialties were established based on national needs. The scope of practice varies between the different clinical specialties. Overall, the educational aspect is quite similar to that of the United States in regards to undergraduate and postgraduate degrees, theoretical and clinical course standards, and certification exams.
References:
Country Specific Practice Profiles. (n.d.). Retrieved November 15, 2020, from https://international.aanp.org/Practice/Profiles
Nursing Discussion Leadership

ANSWER

Nursing Discussion Leadership
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Nursing Discussion Leadership

DISCUSSION 1.
In 1-page, examine and describe the barriers and challenges that have slowed the progress of advanced practice nursing in the United States. Also, compare the credibility of the early role to the role at this time. Please use evidence-based practice, research, and/or position statements to support your arguments. Also, you may use reliable electronic sources.

The United States healthcare reform aims to revamp the nursing sector to provide effective and reliable patient care delivery. Particularly, advanced practice nurses have been cited to be critical to the enhancement of healthcare in the nation. The Institute of Medicine, IOM report on nursing identifies that despite improvement and increase in the number of APRNs, several challenges derail the full realization of their potential. There has been the creation of nursing opportunities to provide for the education of the nurses. Challenges are also experienced during the role transition as it impacts the nurses’ functions, cope, and motivation. The nursing education programs may encounter significant problems as they strive to prepare an adequate number of advanced practice registered nurses to fulfill the long-term objective to improve the US healthcare system. Besides, there are often outdated regulations, policies, and biases that derail the APRNs from realizing their full practice potential in numerous settings. The more inherent problem is that of the shortage of nursing students and educators. Most professional nurses are often reluctant to join faculties as educators.
Further exacerbating the situation is the stringent eligibility by state regulations and specialty certification agencies. Several strategies have been identified to resolve these challenges, and they are aimed at intensifying inter-professional collaboration and restructuring or revising the curriculum. The nursing educators need to collaborate with all the stakeholders to create a reliable curriculum and drive effective change in the training of APRNs (Kleinpell et al., 2020). Moreover, the federal government may continue to fund promoting education, projects, training, and research for APRNs. The APRN program is resource-intensive and requires state of the art laboratory settings and current technology coupled with a decent educator-student ratio.
DISCUSSION2
Conduct a 1-page literature search and review on advanced practice nursing (or a specific
APRN role) and locate articles or research that describes advanced practice nursing in other countries. What are the similarities and differences between conceptualizations of advanced practice nursing in other countries (i.e., Canada, United Kingdom, Australia?
Japan, Spain, China) compared with the United States?
The APRN role has been developing globally with the collective aim to enhance healthcare as a human right. APRNs are a vital component of the United States healthcare system. Often, they are registered and educated at the master’s or post-master level of nursing training. The APRN roles are based on the USA description, and most models, such as the Canadian and Australian models, are based on it. Notably, the Australian advanced practice differs from that of the United States despite bearing several structural, educational, and functional similarities. First of all, the Australian education system is different from the American. All the nursing practitioners are accredited by the (ANMAC) whereby the completion of the ANMAC course makes one eligible for registration as an APRN. However, unlike the USA, there are no provincial or state board examinations required for registration and final licensing or accreditation. As posited by Parker & Hill (2017), the Advanced Practice Nurse’s functions across most nations, such as the United States and Australia, were identified. First of all, to lead and supervise teams within clinical settings. Besides, they ought to provide care in a particular specialty or subspecialty. They are also required for professional nursing standard clinical and care protocol. They are perceived as hubs for clinical proficiency and expertise and may often be consulted in complex clinical situations. Besides, they initiate and participate in EBP programs to improve administrative and clinical care. They coordinate these improvements and oversee implementation n facilities or even in community health.
Differences in the scope of education and functionality of APRNs globally stem from the differences in state legislation and educational requirements. However, universally, there is a need to eliminate the barriers that derail the full realization of APRNs’ potential in transforming the healthcare system.

References
Parker, J. M., & Hill, M. N. (2017). A review of advanced practice nursing in the United States, Canada, Australia, and Hong Kong special administrative region (SAR), China. International journal of nursing sciences, 4(2), 196-204.
Kleinpell, R., Kapu, A., Abraham, L., Alexander, C., Andrews, T. D., Booth, S., … & Cook, C. (2020). The use of national collaborative to promote advanced practice registered nurse- led high-value care initiatives. Nursing Outlook, 68(5), 626-636.

Nursing Discussion Leadership

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