Introduction
The term of the scope of practice is frequently associated with certified nurse practitioners. It refers to actions, procedures, and processes that are legally permitted for advanced practice registered nurses by their professional license. The scope of practice is regulated by the Nurse Practice Acts, and every state of the country has its own act and NP prescriptive authority. NP competencies are requirements applied for all advanced practice nurses regardless of their population focus and specialty for effective practice as licensed practitioners. And it goes without saying that for this practice, NPs should develop essential leadership skills.
The purpose of this paper is to review the Florida Nurse Practice Act (the state of practice after graduation) and Nurse Practitioner (NONPF) Core Competencies to get a personal insight into NP scope of practice, education, regulatory, and licensure requirements, essential competencies, and leadership skills. In addition, this work helps to evaluate what personal qualities required for further nursing practice need improvement.
APN Scope of Practice
All essential components of competent and safe nursing practice are displayed in nurse practice acts that regulate the work of registered nurses in all states across the country. According to Florida Statutes, Chapter 464 that includes the Nurse Practice Act (2019), the advanced nursing practice may be executed by clinical nurse specialists, certified nurse anesthetists, certified nurse midwives, and certified nurse practitioners. It should be based on professional knowledge and skills that are acquired through advanced nursing education, certification, training, and accumulated experience.
APN scope of practice includes advanced nursing patient diagnosis and health assessment. Advanced registered nurses are occupied with the ordering and performing of therapeutic and diagnostic tests and procedures with health care equipment, and the interpretation of obtained results. Advanced practice nurses are responsible for the ordering of treatments and appropriate medical devices, and the implementation of corrective, therapeutic, and nursing medical measures to improve the patients’ health statuses and treat diseases. They are in charge of delegating certain activities to other licensed nursing professionals. APNs provide end-of-life and palliative care, health education, advanced patient counseling, and patient advocacy as well.
APN licensure that allows advanced practice registered professionals to execute their practice requires specific education requirements, and a completed application should be submitted according to the establishment of the Department. Clinical practice is permitted for applicants who successfully completed all necessary requirements and maintained national certification as a clinical nurse specialist, certified registered nurse anesthetist, nurse practitioner, or certified nurse midwife from a national certifying body.
Moreover, for advanced clinical practice, an appropriate graduate degree (a master’s degree in nursing) or the graduation from accredited and approved pre-licensure programs is required for the certification in advanced nursing specialty (Florida Statutes: Chapter 464, 2019). A nurse my obtain licensure either by the examination from the Department or endorsement (Florida Statutes: Chapter 464, 2019). In addition, all applicants should submit the check of criminal history records, electronic fingerprinting, and the verification of current licensure status as is statutorily required.
All applicants who do not pass the examination within six months after graduation or fail it three consecutive times should complete obligatory board-approved remedial or preparatory courses. The APN license’s expiration date and further renewal period are established by rule. A license holder may pay the prescribed fee and renew this document one month in advance before the expiration date. If licensees change their residence or move to another state, they are responsible for informing the Board of Nursing about the change of an address in written form (Florida Statutes: Chapter 464, 2019). An expired license may be restored by making an application, verifying qualifications according to rule, and paying the required license restoration fee.
The Florida Nurse Practice Act pays specific attention to the description of various types of registered nurses’ violations, such as unprofessional, sexual misconduct and minor violations that result in certain disciplinary actions. Punishment may vary from a fine to the denial, revocation, or suspension of a license. Moreover, every advanced practice registered nurse should register the place of his or her practice in the system of the Board of Nursing (Florida Statutes: Chapter 464, 2019). However, there is a wide range of available places such as hospitals, rehabilitation facilities, acute care facilities, clinics, home health care agencies, long-term care facilities, physician’s offices, educational institutions, mental health facilities, and insurance companies.
The focus on strict control over licensees in the Nurse Practice Act demonstrates that Florida allows restricted NP practice. Nurse practitioners may diagnose, educate, and prescribe medicines and treat patients, however, they need constant physician oversight. Despite the fact that full practice status was recommended by the National Council for State Boards of Nursing and the Institute of Medicine in 2010, however, a9 states across the country continue to mandate restricted or limited NP practice regulations (“Where can nurse practitioners work without physician supervision?” n.d.). However, in recent years, the situation began to change as a substantial number of health care leaders from the fields of nursing agreed that advanced practice registered nurses need more independence in their practice in all states.
Nurse Practitioner (NONPF) Core Competencies
The nurse practitioner’s core competencies were elaborated on the basis of existing fundamental competencies of a master’s and a doctorate degree in nursing. They are regarded as guidelines for the majority of educational programs that prepare NPs “to implement the full scope of practice as a licensed independent practitioner” (Nurse Practitioner Core Competencies, 2011, p.1). There are several competency areas, and, from a personal perspective, policy competencies are my personal strengths.
As a competent nurse practitioner, I understand that advanced nursing practice and policy are interdependent. I considerably support ethical policies that promote health care access, quality, and equity. I understand the significance of the personal contribution to the development of policy and the analysis of legal, social, and ethical factors that influence this development. Moreover, competent nurse practitioners should evaluate policy implications and the effect of globalization of health care regulations as well. I always consider law and regulations as the most significant elements of effective operation in any sphere of life and people’s general welfare.
Another competency area where I feel confident is ethical competencies, as I believe that a specialist should follow the norms of ethics in any scope of activity. Any advanced nursing professional should integrate ethical principles in his or her decision-making and evaluate its consequences. I believe that the respectful attitude towards systems of care, colleagues, and patients will guide me through my practice in all its aspects.
However, I see certain areas of competence, where I currently have opportunities to grow. A competent nurse should recognize the cultural peculiarities of patients and provide highly professional person-centered care with respect to people’s values, beliefs, traditions, personal characteristics, cultures, and spiritual preferences. I think that the relationship between people is an immeasurably questionable area, and I need to reach a substantively high level of empathy to provide emotional support and comfort to patients. I suppose that communication with people of various nationalities and cultures during the master’s program will be beneficial for my personal development of compassion and acceptance.
Another competency area where I want to progress is scientific foundation competencies as they are connected with researches that require logical conclusions. Advanced registered nurses are able to collect and analyze data critically for the improvement of nursing practice. As a competent certified nurse practitioner, I should know how to integrate received knowledge into my practice to improve its processes and outcomes and develop new approaches on the basis of previous theoretical researches. I should practice in making my own critical reviews of various scholarly articles to learn all steps of the research process.
Leadership Skills
There are several skills that are essential for any certified advanced nurse practitioner who attempts to be a leader in his or her field of work. First of all, nurse professionals should have excellent communication skills. Although professional competency and knowledge are highly essential for effective medical practice, communication skills help nursing leaders to establish a trust-based and strong relationship with patients and their families (“9 essential qualities of nurse leadership,” n.d.). Positive health outcomes and the delivery of person-centered health care that is characterized by the cooperation between a nurse practitioner and a patient substantially depend on the communication between them.
Another essential leadership skill for NPs is critical thinking. This ability helps advanced practice nurse practitioners make quick and right decisions on the basis of a substantial number of various factors. Critical thinking is essential both for autonomous advanced nursing practice and collaboration with colleagues and physicians as well. And it goes without saying that nurse leaders should be respectful to preferences, values, and cultural beliefs of their patients, ethical norms of nursing practice, and other certified nurse practitioners and health care specialists. Respect is a fundamental element of effective operation in any area of activities.
From a personal perspective, leadership appears and becomes beneficial only in cooperation with other people. That is why I think that communication with various people during my education program will encourage the development of my leadership skills. The understanding of people’s peculiarities will promote my respect to patients and positively influence the quality of my health care delivery. Moreover, intensive study and reading of literature related to my profession, psychology, and management will enhance my professional and leadership skills as well.
Conclusion
All essential components of competent and safe nursing practice are displayed in nurse practice acts that regulate the work of registered nurses in all states across the country. According to the Florida Nurse Practice Act, NPs have a wide range of responsibilities, however, their practice in this state is restricted and required physician oversight. Concerning the essential competencies for nurse practitioners, the competency areas of scientific foundation and person-centered care need improvement. The development of leadership skills that are essential in nursing practice, such as critical thinking, communication skills, and respect to ethical standards, health care providers, and patients, require consideration as well.
References
Online Sunshine. (2017). Florida Statutes: Chapter 464. Web.
Regis College. (n.d.). 9 essential qualities of nurse leadership. Web.
Simmons University. (n.d.). Where can nurse practitioners work without physician supervision? Web.
The National Organization of Nurse Practitioner Faculties. (2011). Nurse Practitioner Core Competencies [PDF file]. Web.