Professional Role Paper
This is a formal paper in which the student chooses an advanced professional nursing role and explores this role in depth, as he/she will function. The Interview Paper will be used as a guide to complete this assignment. Compare and contrast the ideal and observed role according to professional guidelines, theory, and research reviewed in this course and in the literature. In other words, does actual application of practice really follow theory and literature? Make sure you provide a job description and how it relates to the domains of practice of the role. Discuss whether this role has leadership functions? Lastly, discuss how the current United States healthcare structure, in particular, the Affordable Care Act, impacts the particular role.
The paper should include:
- Title page
- Abstract (no more than 250 words)
- Analysis: compare and contrast the ideal role and how it exists, discuss how the current United States Healthcare structure, in particular, the Affordable Care Act, impacts the particular role
- Reference page (minimum of 5 references, excluding your text)
- This paper should not exceed 8 pages (excluding title page, abstract, and reference
- APA 7th ed. is the required format, double-space, 12 point font
- Please refer to the Grading Rubric for written assignments
ADD SERVICES TO YOUR PAPER
The Nurse Practitioner is an expansive clinical role that integrates nursing and medical disciplines. However, its implementation into care settings has been below expectations over the years. Therefore, the current paper compares and contrasts the ideal and real experiences for NPs. The ideal scenario is available from nursing publications, while an interview respondent provides the real-life experiences. The most glaring differences occur in reimbursement and evidence-based practice. Furthermore, the paper examines how the Affordable Care Act influences the NP role by facilitating effective care quality improvement measures and expanding practitioners’ functions in specific care settings. Hence, the paper provides useful insights to an individual aspiring to pursue the advanced nursing practice.
Keywords: Nurse Practitioner, Affordable Care Act, evidence-based practice.
The Nurse Practitioner Role
Nurse practitioners (NPs) are essential components of modern healthcare service delivery. Their advanced clinical competency complements their foundational nursing background to create a unique care experience. NPs usually have advanced academic knowledge (Masters or Doctorate degrees in nursing). Thus, they possess a vast wealth of information and clinical skills to promote health. NPs also enhance their competency through various certifications and specialty training programs. However, perhaps their greatest purpose is providing leadership within the nursing fraternity. Their elevated clinical and cultural competency allows them to lead fellow nurses in research, evidence-based practice implementation, policymaking, and advocacy. Finally, nurse practitioners assist other medical caregivers in meeting evolving, complex health needs. They utilize their unique position to deliver care in a way that neither a physician nor a registered nurse could. The NP role is still developing, and most people involved in healthcare do not yet comprehend what it entails. Thus, the current paper explores the profession’s dynamics by comparing the experiences of an NP to the expectations. Furthermore, there is a discussion on how healthcare structures, such as the Affordable Care Act, influence the NP role.
Comparison between Ideal and Real-life Role
The student interviewed an NP working at a nephrology facility to acquire their lived experiences working in the profession. The interviewee has extensive clinical experience, having worked at various levels since she began her practice in 1998. Hence, she is qualified to provide objective feedback on the NP role and facilitate a comparison between her experiences and the ideal scenario in certification reimbursement, workplace integration, job description, evidence-based practice, health policy implementation, professional challenges, and nursing ethics.
Due to the increasing demand for nursing skills, many employers reimburse their employees pursuing higher education or specific certifications. The reimbursement allows nurses to acquire relevant skills to elevate the facility’s performance (Reese, 2022). However, the respondent remarks that reimbursement by the employer is not a guarantee, and even when it happens, it could be partial. For instance, her current employer does not reimburse, while a previous one covered a third of her annual tuition fee for the BSN program. Hence, reimbursement is not as common as one may assume. Maybe the inherent high nurse turnover rate discourages employers from reimbursing them. But the overall effect is that most nurses fail to acquire their NP competencies due to financial constraints.
Ideally, nurse practitioners are leaders in their specific clinical and cultural fields. Hence, they lead their teams towards realizing their organization’s mission and vision (Lamb et al., 2018). For them to be effective, they must establish good relationships with their colleagues. The respondent shared similar sentiments. She stated that the organization’s workplace culture and existing patient-caregiver relationship made it easier to fit in the group. However, she did not mention playing a leadership role in achieving the company’s goals.
Job Description and Expectations
The American Association of Nurse Practitioners (2022) states the functions of Nurse Practitioners as ordering, performing, and interpreting diagnostic tests, diagnosing and treating acute and chronic illnesses, prescribing medication and other interventions, managing patients’ care, educating patients on disease promotion, and counseling them when necessary. The specific functions from this list depend on their clinical area of practice. Furthermore, some states allow NPs to conduct these functions autonomously, while others require collaboration with senior physicians. The interviewee stated that her functions include diagnosis, treatment planning, intervention prescription, and referrals to specialists. Hence, there is not much deviation between the ideal and practical job expectations.
Nurse Practitioners should be stewards for evidence-based practice (EBP) implementation (Lamb et al., 2018). They can implement EBP in two ways: a case-to-case basis or a systematic approach. Case-to-case EBP implementation involves using evidence to improve the health outcomes for individual patients depending on their clinical and sociocultural dynamics. Meanwhile, a systematic approach entails creating facility-wide or community-based interventions to address specific problems, such as medication errors, nosocomial infections, poor health literacy, etc. The respondent engages more in the case-to-case EBP implementation. She engages chronic kidney disease patients individually and develops treatment plans that work for them. Thus, the facility is not optimizing the NP’s competency in leading or participating in large-scale EBP interventions.
Health Policies for Care Quality and Patient Safety
The huge clinical responsibility that NPs bear warrants that they comply with facility policies for promoting care quality and patient safety. The respondent confirms this position by elaborating how the organization curbs infection control among immuno-compromised patients. For instance, she must comply with vaccine mandates for illnesses such as the flu and COVID-19 to limit the chances of spreading them to patients. The organization also has strict policies to avoid overcrowding in the waiting area. Finally, the respondent follows the facility’s policies on the use of EHRs and HIPPA guidelines to ensure patients do not suffer emotional damage due to failure to maintain privacy and confidentiality. This experience aligns with the expectations since most of these policies are time-tested. Hence, all the NP needs to do is uphold them in their practice.
Challenges and Strategies to Overcome Them
NPs encounter a bias from fellow caregivers and patients. Often, people compare them to physicians, and when they find them lacking in some area, they dismiss their competency. Furthermore, NPs are still struggling to practice independently in states where the nursing boards are yet to grant them full-scope practice authority (Brom et al., 2018). Thus, they must confer with a senior physician, who may unduly influence their decision-making. Other general challenges include immense workload and the ever-changing landscape of healthcare technology. The respondent cited time management as a major challenge. Furthermore, some doctors undermine her opinions, creating discord within the professional team.
Resilience is essential to overcoming most of these challenges. As the respondent stated, he was open to positive criticism. Furthermore, she stood her ground when a conflict emerged between her and a senior physician. Eventually, her decision was correct, and many colleagues agreed with her course of action. Thus, while the NP role continues to expand, practitioners must remain steadfast. They must be willing to accept sincere criticism but also filter out prejudices.
Like all other caregivers, NPs experience ethical dilemmas. The respondent exemplified the ethical challenge by narrating her battle between beneficence and maintaining patient autonomy for one of her patients, who was also her cousin. Such dilemmas are common in all clinical settings, and NPs must develop an astute ethical identity to balance the competing obligations.
The Affordable Care Act
The Affordable Care Act has shaped modern NP practice. For instance, it has expanded NP’s role in specific scenarios. For example, ACA offers reimbursement benefits to facilities with low readmission rates for non-chronic diseases. Hence, stakeholders developed care transition interventions, such as the Community-Based Care Transitions Program (CCTP) (Cleveland et al., 2018). This program requires at least one NP, whose job includes making post-discharge phone calls and making home visits. Additionally, the ACA supports the implementation of full practice authority for NPs. Most states that adopted the ACA also granted full-scope practice authority to their NPs (Brom et al., 2018). Consequently, these states enjoy more comprehensive care strategies and interventions, resulting in improved healthcare outcomes.
The Nurse Practitioner role is slowly becoming crucial to modern healthcare delivery systems. The NPs are uniquely qualified to epitomize nursing disciplines and combine them with medical knowledge and skills. Consequently, Nurse Practitioners facilitate a dynamic approach in health promotion. Nonetheless, the profession is still not where it should be. Some glaring gaps in employer reimbursement, acceptance of other caregivers, and evidence-based practice implementation result in NP underutilization. The ACA provides an avenue for a more efficient and effective NP role, but only if state nursing boards embrace it.
American Association of Nurse Practitioners. (2022). What’s a Nurse Practitioner (NP)? https://www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023
Cleveland, K. A., Motter, T., & Smith, Y., (2019). Affordable Care: Harnessing the Power of Nurses. The Online Journal of Issues in Nursing, 24(2), 2. https://doi.org/10.3912/OJIN.Vol24No02Man02
Lamb, A., Martin-Misener, R., Bryant-Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open, 5(3), 400-413. https://doi.org/10.1002/nop2.150
Reese, D. (2022). 10 Best Ways To Get Nurse Practitioner School Paid For. https://www.nursingprocess.org/best-ways-to-get-np-school-paid-for.html