week 3 project
1
10
Advanced Practice Nursing Role
South University Online
NSG 5000
Dr. Antonieta Alteza
Professional Practice Paper
Family nurse practitioners are nurses who operate either autonomously or in cooperation with other health care providers to supply family-centered care. FNPs deliver a large number of health care services that are related to the family unit. These services range from disease avoidance and health promotion to counseling and educating across generations. Thanks to graduate-level education, nurses are allowed to make diagnoses and address the complex health issues of the body and mind ("Role & scope," n.d.). FNPs' education partnered with training enables them to serve as policymakers or administrators. The interviewee for this paper is Roger Prucal, certified FNP who works at the Gastroenterology Department Medical Faculty Associates. The interview was held on 4th February 2019. It is worth noting that the GW Medical Faculty Associates is a non-profit, physician-led practice group that was established in July 2000.
Type of Organization, Type and Number of Clients
The Medical Faculty Associates at GW was once a part of the George Washington University and now has become the most significant physician practice in Washington DC metro region and employed around 750 health care professionals. The organization is a leading healthcare institution and is complemented by a network of community-based practices in the metropolitan area. The MFA has some international programs as well as the KatzenResearch Center, The GW Heart, Vascular Instituteand the Breast Care Center which are based in Washington, DC. The organization serves all kinds of populations who require medical treatments and who are looking for specialty treatments. The MFA also aims to be a low-cost community clinic intended to care for patients on Medicare, the underinsured, and uninsured patients. The organization is committed to accepting referrals from community health clinics that have limited resources, short funds, disadvantages in computer science, Etc. Inter-professional collaboration and trans-disciplinary work are the keys to success in those clinical settings (Hamric et al., 2014).
The interviewee provides his services to the adult population only, addressing both acute and chronic conditions, although he mainlydeals with chronic conditions. The Medical Faculty Associates offer ambulatory care in health management, disease prevention, continue medical care and emergency room referrals. Some typical conditions the department of Gastroenterology treats are: reflux disease, acute and chronic gastritis, esophageal and gastric cancer, and post-operatory follow up. ABC serves approximately 10-15 patients per day. As for the average number of clients per year, in this area, it considerably varies. The number of patients per day in the GW hospital ER department is two hundred.
Qualifications of the APN Role
Advanced Practice Registered Nurses (APRNs) have become an important integral part of the healthsystem. Due to the importance of APRNs in taking careof ongoing and future health needs of patients, a consensus model for APRN regulation was developed and completed through the APRN Consensus Work Group & the National Council of State Boards of Nursing APRN Advisory Committee (Consensus Model 2008). The APRN Regulatory Model applies to all elements of LACE.
All of the above componentsare indispensable for the implementation of the model.The APRN model includes the following elements: Licensure, accreditation, certification, and education (LACE).
District of Columbia
The District of Columbia implements the LACE elements in the following ways:
Licensure: Board of Nursing of the District of Columbia is responsible for licensing APRNs and their specific focus of practice.
The Commission does accreditation on Collegiate Nursing Education (CCNE).
Certification: obtained through multiple approved certifying agencies for Family Nurse Practitioners, and this includes American Nurses Credentialing Center Certifications or American Academy of Nurse Practitioners Certification Board Certifications
Education: The District of Columbia offered accredited programs that lead to APRN licensure. These programs are provided by George Washington University, Georgetown University, The Catholic University of America and Howard University. Among these programs, George Washington University.
The professional qualified for the advanced nursing role in the District of Columbia needs a credential agency and NPI number. Regulatory structure is full practice in the District of Columbia. Licensure laws and state practice allow FNPs to conduct physical examinations, make diagnoses, interpret laboratory tests, make prescriptions and manage treatments. The Board of Nursing is the regulatory agency in the District of Columbia.
Advanced nursing roles allow FNPs to focus on holistic care based on reflexive practice, evidence, and therapeutic associations. Nurse practitioners depend on their scientific skills, using research and their experience to improve patient outcomes and develop better health care approaches. FNPs provide quality healthcare to meet the patient's needs, minimize the risk and maximize compliance within the cultural diversity in their environment. Advanced nursing roles advocate and support ethical policies that promote equity, access, and quality regarding patient care. NPs use technology systems to improve healthcare and provide personalized and quality care (Hamric et al., 2014).
District of Columbia Board of Nursing (DCBON)
In the District of Columbia, family nurse practitionersare under the supervision of the DCBON,which are regulations to guide the functions of the family nurse practitioner. Eligibility includesholding a masters or postmasters degree, achieving national certification and maintaining continuing education. In the District of Columbia NPs can practice without the supervision of a physician. Thereforeit is said that they practice with full autonomy. This allows NPs to have a variety of frameworkssuch as private practices, community-based clinics, hospices, and hospitals. Regarding employment options, they can be salaried/hourly employees or self-employed.
According to the DCBON, NPs can write prescriptions. To be valid, anNPI number has to be printed on orders for the prescriptions to be dispensed. In the District of Columbia, NPs can also prescribe medicationswhich include some controlled substances. They can prescribe up to five refills of controlled medication, but they cannot prescribe controlled substances to relatives or individuals close to them. If a nurse practitioner does not practice for more than two years, she/he has to take an NP refresher course that requires substantial continuing education hours. NPs that needto renew their licenses in the District of Columbia will need to provide evidence of 15 hours of continuing education, and there must be a pharmacology component. (DCBON, 2017).
Interview Questions
1. Why do you choose to be an FNP instead of another specialty?
Concerning the career path, ABC opted for becoming an FNP because the field is increasingly diverse and fascinating. The specialty is not about being bored or wishing to go home as soon as possible. He has to work directly with people of different ages and cultures, and with a wide range of medical issues. One day he can help a pregnant woman to address GERD and another day he may be assigned to assist an older adult in staying mobile.
2. Could you please Outline your roles and duties as an FNP?
As an FNP, ABCis responsible for writing prescriptions, diagnosing, and treating both acute and chronic diseases. In addition to this, he also records patients' diagnoses and medical history to ensure comprehensive care across the lifespan. Another one of his duties is patient education. ABC is expected to communicate with patients regarding their treatment plans and disease management, and he is also the one who recommends further medical care. When it comes to taking medicines, he explains side effects and interactions with other medications.
3. What is the most challenging aspect of being an FNP?
The most challenging aspect of being FNP is staying calm and maintaining concentration when handling emergencies.
4. How do you handle emergencies?
ABC stays focused on the present moment, evaluating what needs to be done. It is destructive to think about possible legal liability or what somebody else’s opinion might be when it is necessary to focus on the issue at hand. The interviewee believes that prioritization is the key to managing emergencies in an effective and timely manner.
5. How do you handle mistakes such as an initially incorrect diagnosis?
ABCholds the opinion that providers are all humans and mistakes happen in health care settings, but how a professional act in response to them is of utmost importance. For example, in the case of an incorrect diagnosis, it is crucial to admit one's own mistake, make relevant conclusions, and avoid it in future practice. Having said this, ABC acknowledges that it is necessary to think about how to correct the error as quickly as possible, thereby making sure that a patient will not suffer from any serious adverse effects.
6. Describe a scenario where you went above and beyond to provide ideal patient care?
During the interview, ABC shared some valuable insights he gleaned from the cases where he provided outstanding patient care. For example, he always tries to make his patients laugh. It is especially helpful when a patient faces serious health concerns that may lead to psychosomatic health issues. He enjoys sharing different stories to improve the psychological wellbeing of his patients, thereby fostering a holistic approach to treatment and disease management.
7. How do you handle patient-practitioner conflict in your field of work?
Handling conflicts between patients and practitioners is another critical consideration in Mr. ABC’s practice. More specifically, he aims to better comprehend the patient's cultural, ethnic, educational, and social background before making any assumptions. It is essential to avoid judgmental attitudes and to listen to the patient's complaints, which would powerfully promote provider-patient relationships.
8. Where do you perceive the FNP roles in five years?
The interviewee claims that the role of the FNP will not significantly change in five years. Nevertheless, he believes that more states will provide the full practice to practitioners.
9. How do you assess success in this position?
He also suggests that the success in the given position can be measured only by clinical outcomes of the patients. Other indicators of a successful practiceare the relapse rates, patient satisfaction rates, and new career opportunities.
10. What advice would you give prospective students regarding optimally preparing for the FNP field?
For all those who are planning to enter the FNP field, ABC advises them to come prepared and be ready to commit to continuous learning. The area is continuously evolving with innovations and new approaches. Therefore, it is essential to follow new trends in the industry.Moreover, the interviewee believes that confidence is the key for a student to prepare himself/herself for the role of an FNP. Confidence comes with both knowledge and experience. Finally, developing the ability to keep the lines of communication open with different people is also essential for optimal preparation and successful practice. When a patient trusts his/her practitioner, the chances for optimal outcomes substantially increase.
References
APRN Consensus Work Group &t the National Council of State Boards of
Nursing APRN Advisory Committee. (2008). Consensus model for
APRN Regulation: Licensure, accreditation, certification & education.
https://www.ncsbn.org/Consensus_Model_for_APRN_
Regulation_July-2008.pdf
District of Columbia: Information and resources for District of Columbia NPs (n.d.). American Association of Nurse Practitioners. https://www.aanp.org/advocacy/district-of-columbia
Hamric, A., Hanson, C., Tracy, M., & O’Grady, E. (2014). Advanced practice nursing: An integrative approach. (5thed). Elsevier.