Nurse Practitioners are health care professionals trained and trained to provide health promotion and care through the diagnosis and treatment of acute diseases and chronic conditions. According to the International Council of Nurses, an enrolled nurse in practice (APRN) is "a registered nurse who has obtained an expert knowledge base, complex decision-making skills and clinical competence for expanded exercises, characteristics shaped by the context, and/or the country in which he is trusted to practice.The master degree is recommended for entry level. "
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Nurse practitioners (NPs) manage acute and chronic medical conditions, both physically and mentally, through history and physical examination and ordering diagnostic tests and medical care. NP is eligible to diagnose medical problems, order treatments, perform multiple procedures, prescribe medications, and make referrals for a variety of acute and chronic medical conditions within the scope of their practice determined depending on the country. Nurse Practitioners have become an integral part of medical and health care systems, because of the combination of experience and expertise they bring. Work experience as nurses gives them a special approach in providing patient care, while their advanced study provides the skills and abilities to perform tasks assigned to administrators, as they take intensive courses on leadership, health care policy, and lobbying. NP works in hospitals, private offices, clinics, and nursing homes/long-term care facilities. Some nurse practitioners contract out their services for personal work and may also work for private agents who provide medical staff to a clinic or hospital called lokum tenens.
In the United States, depending on the country where they work, nurse practitioners may or may not need to practice under the supervision of a doctor. Taking into account the shortage of primary care physicians/internist doctors, an increasing number of countries eliminates the requirement of "cooperative practice" and provides independent practice of nursing practitioners in primary care. The US National Institute of Medicine, the State Nursing Council, the Association of Nursing Practitioners of America and the Robert Wood Johnson Foundation have proposed a national model of full autonomy in professional practice to provide better accessibility to basic levels, to reduce costs and to increase the capacity of the US Health System.
NPs can serve as primary care providers of patients, and they can treat patients of all ages depending on their specialty. With equal education and experience, NP can specialize in areas such as cardiology, dermatology, oncology, pain management, surgical services, orthopedics, women's health, and other specializations. The core philosophy of the nurse practitioner's role is individual care that focuses on the patient's medical problems as well as the effects of illness on the lives of patients and their families. TN tends to concentrate on a holistic approach to patient care, and they emphasize health promotion, patient education/counseling, and disease prevention. The main classifications of nurse practitioners are: adult (ANP); acute care (ACNP); gerontological (GNP); family (FNP); pediatrics (PNP); neonatal (NNP); and mental health psychology (PMHNP). The adult-gerontology primary care practitioner (AGPCNP) is a classification that has recently evolved.
In addition to providing various health care services, nurse practitioners may conduct research or teaching, and they are often very active in lobbying the legislature to expand the scope of health care policy and development practices at local, state, and national levels.
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History
The role of advanced practice nursing began to form in the mid-20th century of the United States. Nurse anesthesiologist and midwife nurse was established in the 1940s, followed by psychiatric nursing in 1954. The current concept of APRN as a primary care provider was made in the mid-1960s, driven by a shortage of national medical doctors. The first formal graduate certificate program for nursing practitioners was created by Henry Silver, a doctor, and Loretta Ford, a nurse, in 1965, with a vision to help balance health care costs, increase the number of healthcare providers, and improve inefficient distribution. health resources. In 1971, US Secretary of Health, Education and Welfare, Elliot Richardson, made an official recommendation in expanding the scope of nursing practice and granting them qualifications to serve as primary care providers. During the mid-1970s to early 1980s, completion of a master's degree became necessary to become a certified nurse practitioner. In 2012, discussions have increased between the accreditation body, the national certification body, and the state nursing board on the possibility of making DNP a new minimum education for certification and NP licensing by 2015.
Scope of practice
United States
In the United States, because the profession is governed by the state, the care provided by NPs varies and is limited to their education and credentials. Many NPs attempt to work independently from other health professionals, while in some countries, supervisory agreements with physicians are required for training. The breadth of this collaborative agreement, and the roles, duties, responsibilities, nursing care, pharmacological recommendations, etc. It varies greatly between states of license/certification.
"Pearson report" provides state details for specific tasks that the NP can do in the state. The role of a nurse practitioner may include the following:
- Medical diagnosis, treatment, evaluation, and management of various acute and chronic diseases
- Obtain patient history and perform a physical exam
- Request diagnostic imaging
- Conduct diagnostic studies (e.g., lab tests and ECG)
- Request physical therapy, occupational therapy, and other rehabilitation treatments
- Prescribe drugs for acute and chronic illness (prescriptive authority levels vary according to state regulations)
- Provide pregnancy and family planning services
- Provide good childcare, including screening and immunization
- Provide primary and special care services, adult health care, including annual physical
- Provide care for patients in acute and critical care settings and long care facilities
- Conducting or assisting in minor operations and procedures (eg, biopsy/dermatological procedures, suturing, casting, etc.)
- Counseling and educating patients on health behaviors, self-care skills, and treatment options in coordination with occupational therapists and other health care providers.
Nurse practitioners can examine patients legally, diagnose illness, prescribe medications, and provide care. Nearly half of the country allows NP authorities to practice on their own. In fact, 22 countries (plus D.C.) provide full practice authority to the TN. Thirty-eight countries require the NP to have a written agreement with the doctor to provide care. Even with formal agreements between doctors and NPs, their practice is limited to at least one domain (eg, prescribing, medication). The twelve states limit the NP even more. In order for NPs to provide care to patients, they should be supervised or delegated by a doctor. The states in the Pacific Northwest, the Mountain states, and in upper New England generally allow more freedom for TN. Many states in the South are the most restrictive countries.
Canada
In Canada, NP is a registered nurse with a nursing degree. Canada recognizes them in the following specializations: Primary health care (PHCNP) and acute care NP (ACNP). TN diagnose the disease, prescribe drugs, order and interpret diagnostic tests, and perform procedures within the scope of their practice. PHCNPs work in places like community health centers, primary health care settings and long-term care institutions. PHCNPs main focus includes health promotion, preventive care, treatment and diagnosis of acute illness and injury, as well as monitoring and managing chronic diseases. ANCNPs are special NPs that serve specific patient populations. They provide care to individuals who are acute, critical or chronically ill. ANCNP generally works in inpatient facilities that include neonatology, nephrology and cardiology units.
Board education, licensing and certification
United States
The way to become a nursing practitioner in the United States begins with obtaining a Bachelor of Science in Nursing (BSN) degree or another degree, and requires a license as a registered nurse (RN) and experience in the role of the RN generalist. Then, a person must graduate from an accredited (MSN) or doctoral (DNP) graduate program. A typical curriculum for nurse practitioners programs including epidemiology courses; health promotion; pathophysiology; physical assessment and diagnostic reasoning; pharmacology; laboratory/radiographic diagnostics; statistics and research methods; health policy; role and leadership development; management of acute and chronic minor diseases (eg, adults, children, women's health, geriatrics, etc.); and clinical rotation, which vary greatly depending on the program and population focus. The Doctor of Nursing Practice (DNP) program includes additional basic biostatistics; research methods; size of clinical outcome; general care for special populations; organizational management; informatics; and health and economic policies. The DNP program also requires the completion of a research project. Some nurse practitioners, as well as other APRN roles, may choose to pursue Doctor of Philosophy (PhD) as terminal titles. The PhD in nursing focuses on nursing research and nursing education, whereas DNP focuses more on clinical practice.
There is an initiative to require the DNP as an entry level level for all APRN roles, including nurse practitioners, anesthesiologists, clinical nurse specialists, and nurse midwives. Those who have MSN but are currently practicing in the APRN role will be overrun this change without having extra education. Many universities have begun to stop MSN programs in lieu of these expected changes and have designed the BSN-DNP program. TN may choose to complete a graduate residency or fellowship.
Upon completion of the required education, the NP must pass the national board certification exam in a particular population focus: acute care, family practice, women's health, pediatrics, adult-gerontology, neonatal or mental mental health, coinciding with the type of program from which he graduated. After obtaining board certification, nurse practitioners must apply for additional credentials (eg APRN license, prescriptive authority, DEA registration number, etc.) at the state and federal level. Nurse practitioners must achieve a number of continuing medical education credits (CME) and hours of clinical practice to maintain certification and licensing. NP is licensed through state nursing boards.
Australia
In Australia, the NP must be registered by the Australian Health Practitioner's Regulatory Body. The Australian professional organization is the Australian College of Nurse Practitioners (ACNP).
Canada
In Canada, the standard of education is a bachelor's degree in nursing. The Canadian Nursing Association (CNA) notes that advanced practice nurses should have a combination of postgraduate level education and clinical experience that prepares them for advanced practice. Their own education does not give them the ability to practice at an advanced level. Two national frameworks have been developed to provide further guidance for course development and educational requirements, research concepts, and government position statements on APRN: The CNA's Advanced Nursing Practice: A National Framework and Framework Core Competition of Canadian Nurse Practitioners. All education programs for TNs must obtain official approval from provincial and territorial nurses due to the fact that TN is considered a prominent role in Canada. Thus, it is common to see the difference between an approved education program between the region and the province. In particular, inconsistencies can be found in core graduate courses, clinical experience, and duration of the program. Canada does not have a national curriculum or a consistent standard of advanced nursing practice so that all APRNs must meet the individual requirements established by the competent provincial or territorial authorities in which they are practicing. In conclusion, completion of postgraduate education, passing exams through the CNA Nurses Practice Nursing Program, and successful enrollment in the appropriate region or province is required to practice as a nursing practitioner in Canada.
Other countries
There are nursing practitioners in over fifty countries around the world. Although credentials vary by country, most NPs have at least a master's degree worldwide.
In November 2013, TN is legally recognized in Israel. The law was passed on 21 November 2013. Although at an early stage, the Israeli Ministry of Health has passed two classes of NP - in palliative and geriatric care. The law was passed in response to a growing number of doctors in a particular field of health care, similar to worldwide trends.
Nurse practitioners of the title in the past were awarded to several advanced practicing nurses enrolled in the Netherlands. The title has now changed to Nursing Specialist . The idea is still the same: an independent licensed master degree nurse is able to set an indication for treatment that does not depend on MD.
Salary
A nurse's salary depends on areas of specialization, location, years of experience, level of education, and company size. In 2015, the American Association of Nurse Practitioners (AANP) conducts its fourth annual nurse salary survey. The results show the NP payroll range to between $ 98,760 to $ 108,643 reporting earnings among full-time NPs. According to the US Bureau of Labor Statistics, nurse practitioners in the top 10% earn an average salary of $ 135,800. The average salary is $ 98,190. According to a report published by Merritt Hawkins, the starting salary for NP increased dramatically between 2015 and 2016. The highest average starting salary totaled $ 197,000 in 2016. The main factor in the dramatic increase in early salary was skyrocketing demand for NPs, recognizing them as the 5 sought by high-level health professionals by 2016.
Increased requirements in the US
Registered nurse jobs and nurse practitioners are expected to increase tremendously within the next ten years through the law and the idea of ​​short-term savings. Much of the growth is expected to come as a result of legislation and proliferation of online schools, leading to better health care ideas and greater solutions to unproven health problems through proper research. Also, life expectancy is longer; therefore more patients live longer and live more actively. It is further anticipated that the need for NP will increase due to the passage of Patient Protection and the Affordable Care Act (PPACA).
Growth is also expected to be much faster in outpatient centers, where patients do not stay overnight. In addition, an increasing number of procedures were once only available in hospitals now in doctors' offices. The need for NP is estimated to be greatest in places where people have long-term illnesses such as dementia patients or head trauma who require extensive rehabilitation.
"Nurse practitioners really are a growing presence, especially in primary care," says David I. Auerbach, PhD, author and health economist at RAND Corp. In addition, the site says that nurse practitioners are expected to double by 2025. Auerbach also told American Medical News, "There are many experiments that occur in searching for different ways of working, and there is a lot of interest in collaborative team-based models.New treatment models, such as patient-centered patient care homes and responsible care organizations, are completely dependent on nurse practitioners and physician assistants. "
As a result of PPACA, hospitals and medical care facilities were forced to rethink demand for nurses and non-doctor providers. This is mainly because the new Act attracts millions of people a chance at medical attention who did not have it before, and because there are so many new people who need medical attention, the need for medical personnel is also increasing. With this combination of new laws, and the increasingly aging Baby Boomer population, there is expected to be a big increase in the need for medical staff, especially doctors. Unfortunately, the Act does not take into account the need for increased residency expansion of doctors thus creating a shortage of artificial doctors in an overloaded system. According to a study published in American Medical News (an online publication that no longer exists), the work of nurse practitioners is expected to grow by 130 percent from 86,000 in 2008 to 198,000 by 2025 through aggressive lobbying. Despite some skepticism over these big figures, they are backed by a wealth of research and the opinions of very famous medical professionals. As a result of extreme needs for TN, they are also expected to receive more autonomy through lobbying for legislation, meaning that nurse practitioners will be able to fill the traditional primary care role as doctors will though not necessarily train that way. For example, a nurse practitioner will be able to prescribe drugs without doctor supervision, which will be harmless without proper course and pharmacological examination. Many countries are issuing legislation enabling the practice of independent nurse practitioners because of aggressive nursing lobbying. "There are currently 12 countries with active legislation that use nurse practitioners at the top of their education to meet patient care needs," said Dr. Tayin Kopanos with the American Association of Nurse Practitioners. Many nurses and other leaders in healthcare advocate a law that requires doctors to check the work of the NP.
See also
- The Journal for Nurse Practitioners
- The American Nurse Doctors Association
- List of nursing credentials
- Clinical nursing specialist
- Nurse anesthesia
- Nurse midwife
References
External links
- Nurse Practitioner: American Journal of Primary Health Care
- AANP Standard for NP practice in retail based clinics CNS and NP Practice in Canada (PDF) , Archived from the original in 2012-03-13 Ã, CS1 maint: BOT: unknown original url status (link)
Source of the article : Wikipedia
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