The transition from RN to NP provides some insight into NP roles. Probably the most obvious is the transition from care provider to care prescriber (Barnes, 2014)
5-26). The common roles associated with the CNS position is helping care teams coordinate patient care, mentoring nurses in the administration of patient care, identifying patient care issues, and offering solutions (Goudreau et al
Advanced Practice Nursing Roles: NP vs. CNS As of March 2008 there were approximately 3 million licensed registered nurses (RNs) living and working within the United States according to the Health Resources and Services Administration (HRSA, 2010, p
This emphasis has led to fewer CNS graduates, despite continued CNS shortages in some geographic locations. In addition, several academic nursing departments terminated their CNS programs during the 1980s, although this trend has begun to reverse in recent years (Muller, McCauley, Harrington, Joblonski, & Strauss, 2011)
Unfortunately, a few NPs will never fully transition to the role of NP for a variety of reasons, including insufficient moral and structural support from colleagues, mentors, and employers. Rural NP Roles The needs of rural patient populations are somewhat distinct compared to their urban counterparts (Schmidt, Brandt, & Norris, 1995)
Collaborative arrangements with area physicians, clinics, and hospitals allow most NPs to provide complete primary care services within the practice setting and through referrals. Hospital-Based NPs Over half of all the registered NPs in Canada work within the Ontario Province (Van Soeren, Hurlock-Chorostecki, & Reeves, 2011)
Important to the ruling, is the judges decision that 'actions speak louder than words' with it being reported that "the judge ruled that 'it does not matter' whether Reynolds intended to single out children and get them to smoke. The fact that it did not adopt 'reasonable measures' to shield young people from its advertisements represented a breach of the company's responsibility to help reduce youth smoking" (Winter)
The role of the patient is accepting with the decisions made by the nurse and suffering the consequences. The patient takes part in the process of slowly reaching the decision that euthanasia is the only alternative available (Ekman, et al
In the study by Needleman & Minnick (2009) pertaining to nurses' dilemmas in patient's care, most of the situations are linked with moral distress, extending life and performing pointless tests and treatment on fatally ill patients. The emotional feeling of dissatisfaction and distressed in providing end- of- life care comprises the overuse of life-supporting technologies, a deep sense of responsibility for patient's well-being, and a need to alleviate suffering (Pearson, 2009)
When an individual is a clinical setting, some roles, like that of working in collaboration with patients or making innovative decisions in healthcare strategy differs from APNs working elsewhere, like in an academic setting where there is a greater importance placed on the leadership role to guide future nurses. The text suggests that the direct care of an APN is distinguished by six characteristics: "use of holistic perspective, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence to guide practice, and use of diverse approaches to health and illness management" (Hamric et al
A growing number of advanced practice nurses are actively involved in epidemiological investigations (Stanberry, 2006). In response to a rapidly aging population, increasing numbers of APNs are becoming actively involved in geriatric research (Acton, Yauk, Hopkins & Mayhew, 2007)
Changing sites for health care education and practice from acute care to community sites; and, 4. A need for standardizing APN practice and education across states (Beitz & Kost, 2006)
Advanced practice nurses have a fundamental responsibility to help train other nurses (Levin & Feldman, 2006). While all nurses are educated to and have assumed the role of teacher, the APN's role is often limited to patients (Flynn & Stack, 2006)
1). Not surprisingly, the expanded role of the advanced practice nurse has allowed these healthcare professionals to make significant contributions to a wider range of patents, including prescriptive authority in many states (Hales, 2002)
Surveillance; Prevention and control of illness, accident, poisoning, and domestic or community violence; Immunization; Promotion of healthy environment; Management of outbreak disease; Comprehensive health assessment of individual, family and community. Early detection and management of illness and risk behavior of individual, family and community (Hanucharurnkul, 2007)
Figure 1. Conceptual schematic of advanced practice nurse's position in the healthcare spectrum The selection of these primary components is congruent with a number of researchers who emphasize that the recipient of care, goals of are and the environment in which healthcare services are provided as common features of many advanced practice nurse positions today (Levin & Feldman, 2006)
13). In their capacity as researchers, advanced practice nurses have increasingly relied on innovations in telecommunications and telemedicine to gather relevant data (Marineau, 2007)
78-79). The titles assigned to the advanced practice nursing role also vary from jurisdiction to jurisdiction, but include general terms such as clinical nurse specialist and nurse practitioner, with specialty fields of practice including adult psychiatric clinical nurse specialist, family nurse practitioner, psychiatric mental health nurse practitioner and adult nurse practitioner (Mccabe & Burman, 2006)
48). These authors add an additional qualification that "The core competency of each role is direct clinical practice and that a nurse practitioner is therefore an advanced practice nurse" (McFarland & Eipperle, 2008, p
Irrespective of the educational setting, advanced practice nurses must possess excellent skills in communication, team building skills, evaluative skills, and clinical proficiency (Flynn & Stack, 2006). Researcher The role of advanced practice nurses in their capacity as researchers includes "examining and testing the clinical practice guides as part of the process of accepting, integrating, and evaluating continued use as standards of care" (Mezey, Fulmer & Abraham, 2006, p