Paper Example on Nurse Practitioners: A Growing Need for Quality Healthcare

Introduction

The changing needs of the country's healthcare system are increasingly calling for the nurses to play a more significant role in the provision of quality healthcare as well as the management of the healthcare services (Flaherty & Bartels, 2019). In light of this, the demand for nurse practitioners (NPs) is on the rise (Forsberg, Swartwout, Murphy, Danko, & Delaney, 2015). Moreover, the shortage of physicians in the family practice field, as well as the rising need for preventive care, has increased the demand for Family Nurse Practitioners (FNP). It was, therefore, with great pleasure that I sat down with Genesis Salgado, an FNP, to get his thoughts, experiences, as well as recommendations for nurses who would like to get into this specialty. The interview took place on the 12th of July 2019 at 5 pm at a local restaurant. Though it was initially meant to take 30 minutes, it went on for close to an hour as I sought to gain more insight from the FNP. After a brief review of his professional background, the interview focused on his experience and perception of NP, particularly FNP.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Salgado has been a nurse for the past 11 years. He has an NP degree from Chamberlain University. At the moment, he serves as an FNP at an ambulatory clinic in Texas. The facility offers standard medical services with three observation rooms, full lab capabilities as well as imaging modalities. Point of care testing (POCT) is also provided. The facility has three providers. The total number of patients seen daily range from 25 to 30 and are of all ages. Below is a summary of the responses given by Salgado during the interview, which have offered me great insight into what to expect as an NP.

1. Discuss how you became interested in becoming a nurse practitioner (or CNM) and what university did you attend?

I became interested in nursing from an early age, mainly because my mother was a nurse and the fact that I like helping those in pain. However, it is after working for five years as a general nurse that I realized that NP would offer the much-needed challenge. The inspiration from an excellent NP that I worked with also propelled me towards this direction. I applied for a BSN program at the Chamberlain University, after which I did an FNP program. I graduated in 2018. The decision greatly enhanced my abilities, expanded my scope, and increased my autonomy.

2. In keeping up to date with current information regarding guidelines, political issues, etc. what conferences do you attend and which professional organizations have you joined?

This field is highly dynamic. New laws and regulations are always being made, and new treatment methods are ever emerging. To keep up with these changes, one should be involved in various activities held by different professional bodies. I am a member of the Texas Nurse Practitioners Association as well as the American Association of Nurse Practitioners (AANP). Though I have not attended any conference held by these bodies yet, I plan to attend one soon to be in touch with what is happening in the profession and also form professional networks with other APRNs.

3. At your practice site, what are your most common reference sources used for daily decision making? What resources would you recommend a new APRN utilize in the practice setting?

Other than attending conferences, various reference sources can give credible information regarding the best practices in various areas of care. As a member of AANP, I enjoy free access to the Journal for Nurse Practitioners (JNP) and the Journal of the American Association of Nurse Practitioners (JAANP). These peer-reviewed publications offer original and up-to-date information on clinical practice, health policy, practice management, among other relevant issues. The association also provides various digital reference tools such as DynaMed Plus and UpToDate that give me access to current evidence and medical findings as well as practical recommendations to support me in diagnosis and patient care (AANP, 2019). For new NPs, I would recommend that they should have a journal within their specialty. For instance, those in the Obstetrics and Gynecology should use THE American College of Obstetricians and Gynecologists (ACOG) journal. Epocrates and Medscape are useful tools in the calculation of dosages.

4. Identify and describe your personal scope of practice as compared to your professional scope of practice. What are the differences? For example, some FNPs perform joint injections, toenail removal, etc. which is within the professional scope of practice, but other FNPs do not perform these procedures.

The scope of practice of NPs varies depending on the jurisdiction. In Texas, the BON outlines what an NP should do depending on their level of training. Patients present at the facility with both acute and minor injuries and complaints. Therefore, at times, I have to play the role traditionally played by physicians. However, some procedures included in the scope of practice such as incision and drainage on abscesses as well as joint injections require high levels of competence and experience, that a new NP may lack (Texas Board of Nursing, 2013). This is an instance where the personal scope of practice differs from the professional scope of practice. For example, though I have performed most of the procedures learned in school, I am yet to carry out a joint injection, yet it falls within my professional and personal scope of practice. In such circumstances, collaboration with a physician is necessary. This, however, should not be seen as an infringement on the autonomy of the NP. Removal of foreign bodies, wound sutures, as well as treatment of conditions such as flu, ear infections, streptococcus infections, among others, are some of the procedures I have performed recently. Moreover, with the training of a physician, I have been able to carry out procedures that I formerly thought were beyond my personal scope of practice, such as applying casts.

5. What is your biggest challenge professionally as an NP?

From experience, I would say that a negative attitude towards NPs from the patients is the biggest challenge faced. I have encountered several instances where the patients would rather be attended to by a physician instead of an NP. This may be as a result of lack of enough knowledge on the capabilities of an NP. Though recent years have seen increased awareness on the role and scope of NP, more needs to be done to ensure that the patients do not underestimate NPs. This is particularly important in the face of a shrinking workforce, and increasing demand for healthcare services as baby boomers get into old age.

6. The National Organization of Nurse Practitioner Faculties has developed competencies for nurse practitioners as a whole, and they have developed population specific competencies, except for nurse-midwifery, neonatal nurse practitioner, and nurse anesthetists. Which three (3) of the competencies do you feel you best meet in your practice?

From the years I have practiced, I can authoritatively say that all the competencies outlined in NONPF are essential in FNP. Scientific Foundation Competencies ensure that an NP understands the evidence-based practice, clinical practice guidelines, translational research, as well as the treatment of various populations. I have appreciated the importance of these skills. For instance, new research evidence enhances my knowledge and improves the quality of care I give to my patients. Leadership competencies emphasize scholarship, professional accountability, and advocacy. This competency is essential, especially in the formation of liaisons with other professionals for the benefit of the patients. I am a natural leader and quickly forms partnerships and collaborations, and hence, this is among the competencies that I best meet. Quality care focuses on the consistency of health outcomes with professional standards and knowledge.

On the other hand, practice inquiry competencies seek to apply academic research in the clinical setting (DeCapua, 2019). The advanced training in nursing that I got has been helpful in the translation and application of research evidence into my practice since these fields are not exhaustively tackled in basic training. Therefore, I meet this competency quite well too.

The technology and information literacy competencies help me incorporate IT in my daily practice, which in turn improves patient outcomes. I am tech-savvy, and thus I meet this competency pretty well too. Policy competencies should also never be ignored. They help me understand the policies guiding the interdisciplinary approach to clinical practice, as well as the various ethical and legal requirements. The health delivery system competencies relate to the development, planning, and implementation of both community and public health programs (DeCapua, 2019). This competency is particularly vital to an FNP in that it encourages collaboration between different specialties, which in turn leads to the provision of cost-effective and high-quality care to the patients. Ethical competencies help all health practitioners negotiate ethical dilemmas that are part of the practice. Independent practice competencies are the last of the nine competencies developed by NONPF. It outlines the autonomy of NPs (DeCapua, 2019). Some of the roles that I can carry out without supervision include assessment, diagnosis, as well as treatment of patients. However, I am still accountable to the supervising physician. One perfects their knowledge of these competencies as they gain more experience in practice. A new NP should, therefore, not feel inadequate.

7. What type of theory or model do you utilize in promoting health-promoting behaviors such as diet, exercise, smoking cessation, etc.?

Preventive care is an essential element of ambulatory care. To achieve this, different nursing theories can be employed. Generally, the choice of the model is dictated by the situation as well as the expected response of the patient to the proposed treatment plan. Mostly, I use the Pender's Health Promotion Model as well as the Health Belief Model. Using these two models, I counsel the patient first and then assess their family history and social, economic status. Research has shown that these factors have a bearing on the health of individuals, and hence, this assessment helps me decide on the path of treatment to follow. By making known to them the diseases they are at a higher risk of contracting due to their lifestyle or family history, they get more receptive of the interventions that I propose such as lifestyle changes and regular screenings. To enhance adherence to these interventions, I employ the Kings Theory of Goal Attainment model, where we set goals with the patient. Along the journey, we may alter the plan to hit the target. Among the children, I employ the Jean Watson's Philosophy of Nursing and Caring. Annual checks to evaluate the growth and development of the children, their dietary habits, as well as head to toe examinations, are made. I also educate the parents on changes that they need to make to prevent their children from various health issues in the future.

8. What qualities do you believe are most important to the success of an NP?

I believe that compassion is the most important quality in a nurse. This quality enables the nurse to listen and understand the experience that the patient is going through. Other attributes that one must have to succeed in this field include confidence, consistency, and good communication and interpersonal skills. As the healthcare sector becomes more interdisciplinary, teamwork is also becoming an indispensable quality. Confidence enhances the trust that the patients and other staff have in...