Introduction
The United States and other countries review the roles of advanced practice nurses in a bid to improve health care services delivered to the patients. The United States believes that developing more advanced roles for its nurses could be one of the most effective strategies to improve health care delivery in the country, especially now that the health care sector faces a limited supply of doctors. The major advanced practice nurses include nurse practitioners, clinical nurse specialists, nurse informaticists, nurse educators, nurse anesthetists, and nurse administrators (Barker & DeNisco, 2013). The main importance of advanced practice nurses is that they take up responsibilities that are similar to those discharged by doctors, which constitute several minor and major health care services (Jansen & Zwgart-Stauffacher, 2010). To explain the various characteristics of advanced practice nursing, this paper describes the roles of a family nurse practitioner and other aspects concerning the profession.
This paper is divided into different sections to cover all the main aspects relating to advanced practice roles in nursing, especially among family nurse practitioners. Firstly, the paper describes various advanced practice roles in nursing; in this regard, it compares and contrasts the roles of various advanced practice nurses. Secondly, the paper explains the duties of a family nurse practitioner. Thirdly, the paper outlines the leadership attributes expected of such nurses. Lastly, the paper describes the health policies that can affect family nurse practitioners when they undertake their roles as medical professionals.
Advanced Practice Roles in Nursing
Advanced practice nurses refer to nursing professionals who are licensed and registered by the Medical Practitioners Board after successfully acquiring a degree either as nurse practitioners, nurse informaticists, nurse educators, or nurse administrators. There are similarities and differences in the way these advanced practice nurses undertake their roles in clinical practice, education, primary care, research, and administration (Barker & DeNisco, 2013).
An advanced nurse practitioner is allowed to perform most roles and duties of a physician in primary care. An advanced practice nurse is authorized to conduct physical examinations, and diagnose, treat and manage minor and acute illnesses (Jansen & Zwgart-Stauffacher, 2010). In most cases, a family nurse practitioner is required to have attained a master’s degree in nursing, with a major focus on family medical care, in addition to other basics on advanced pharmacology, physiology, and anatomy. A family nurse practitioner is expected to conduct research on how to prevent diseases, mostly through patient education and counseling, to help patients adopt healthy lifestyles. Although the roles and responsibilities of family nurse practitioners are broad, they rarely take part in administrative duties in hospitals (Barker & DeNisco, 2013).
Unlike nurse practitioners who have broad roles and responsibilities, nurse educators are mostly tasked with education-related duties. Firstly, nurse educators are expected to design, teach, and evaluate the effectiveness of nursing courses in relation to the regulations and requirements of the state in which they operate. Secondly, nurse educators coach and mentor nursing students to help them become what society expects of them when they begin working. Nurse educators, like other advanced practice nurses, may also conduct research on various medical issues and present their findings at the various nursing conferences organized in the states in which they operate. Lastly, nurse educators may also take part in administrative duties, like in the case of nurse administrators. Responsibilities of nurse educators in administration include developing budgets, hiring and supervising employees, and ensuring that nursing programs are well funded (Barker & DeNisco, 2013).
Nurse informaticists are the only advanced practice nurses with a narrow line of duties. Unlike other advanced practice nurses, nurse informaticists concentrate only on finding strategies for improving communication and information management in nursing to improve the efficiency of hospitals; they do this by enhancing the quality of health care delivery while cutting down the related costs. Consequently, the main responsibility of nurse informaticists is to design strategies for simplifying and enhancing documentation through the use of advanced information technologies. The strategies developed by nurse informaticists should enhance documentation accuracy and data analysis and ease their work. Nurse informaticists’ main responsibility is research, as they rarely take part in primary care delivery, administration, or education (Jansen & Zwgart-Stauffacher, 2010).
Nurse administrators, like nurse practitioners and nurse educators, take part in primary health care delivery, clinical practice, and administration. Firstly, nurse administrators promote the welfare of patients and their families by ensuring that they are accorded the best health care services by the hospital’s nursing personnel. Secondly, nurse administrators are expected to supervise the employees who work in all the hospitals assigned to them. Nurse administrators take part in the recruitment, scheduling, training, evaluation, hiring, and firing of new nurses. For that reason, nurse administrators work side by side with the human resource department to ensure proper supervision of the hospital’s employees. Lastly, nurse administrators also participate in policymaking in health institutions. The nurses develop, implement and interpret the policies used to guide the work of the other types of nurses in the various health organizations (Barker & DeNisco, 2013).
Family Nurse Practitioners
Every state in the United States has its own regulatory and legal requirements for family nurse practitioners (FNPs) who wish to work in those states. The New York State, where I plan to work as a family nurse practitioner, has its own regulatory and legal requirements that guide the operations of nurse practitioners. Generally, the New York State (NYS) requires FNPs to have attained education and professional nurse registration requirements before they are issued with a certificate that allows them to operate in the state. A family nurse practitioner in New York State is expected to practice in only one specialty area: family health (Bahouth, Blum, & Simone, 2013). The education requirements that FNPs in the New York State are required to satisfy include either a certification from national certifying organizations, such as the American Academy of Nurse Practitioners and National Certification Corporation, or completion of a program for nurse practitioner education, which is registered by the New York State Education Department, and approvals with regard to pharmacotherapeutic requirements, such as completion of pharmacotherapeutics examinations recognized by the NYS Education Department. FNPs in NYS is also expected to meet the collaborative agreement and practice protocol set by the state. The nurses are supposed to set up and maintain a collaborative agreement with a physician before they begin to practice nursing. In addition to the collaborative agreement, the nurses are also expected to establish a protocol text that they use as their official practice code, which also outlines their areas of specialty (Leik, 2007).
The only available professional organization in New York State that a family nurse practitioner may register with as a member is the Nurse Practitioner Association (NPA). The NPA was founded in 1980, exclusively as a not-for-profit organization. Since its establishment, the organization has developed programmatically and financially and has also managed to enhance the credibility and visibility of FNPs at all levels of government within the NYS. The NPA operations are based on its mission of promoting health care delivery throughout the state by empowering FNPs who practice in the state. The vision and values of the organization relate to enhancing health care delivery throughout the NYS by empowering the FNPs who practice in the state (Leik, 2007).
FNPs are expected to go through adequate competencies and certification procedures before they begin practicing. The certification examinations are issued and marked by the American Academy of Nurse Practitioners (AANP) through its certification program. FNPs are supposed to pass the AANP competency examinations in order to be pronounced competent to discharge their duties as advanced practice nurses. Most states, including New York, expect FNPs to have a national certification before they begin practicing. The national certification is normally awarded based on a master’s degree in a nursing practitioner program acquired from institutions recognized by the American Board of Nursing and the National Commission for Certifying Agencies (Leik, 2007).
I would like to work at Coler-Goldwater Hospital and its nursing facility when I complete my master’s degree in the family nursing practitioner. Coler Hospital is one of the most credited health organizations situated in New York State. The hospital admits more than 2,000 patients monthly. It has about 2016 beds, meaning that it can accommodate more than 2000 in-patients on an annual basis. The hospital offers family support services, such as patient support groups, pastoral care services, and patient representative support among other services. The FNPs in the hospital work together with physicians to ensure that their patients get the best health care services (Bahouth, Blum, & Simone, 2013).
Leadership Attributes of Family Nurse Practitioners
The family nurse practice is an advanced nursing profession that requires one to be objective and, at the same time, empathetic and compassionate. In addition to these three traits, there are other personal attributes that an individual is required to possess to succeed in the profession. Firstly, a family nurse practitioner is expected to serve as a mentor, while discharging his/her duties as a nurse. As a mentor, a family nurse practitioner needs to act and serve as a role model to colleagues at work (Bahouth, Blum, & Simone, 2013). Secondly, an FPN is supposed to offer necessary support to the staff members in the various circumstances and issues he/she may encounter at work. A family nurse practitioner should help his/her staff members solve various issues facing them, which may hinder them from delivering quality health care to patients. Thirdly, a family nurse practitioner is supposed to lay down strategies for motivating and encouraging staff members to enhance their performance and productivity. Lastly, a family nurse practitioner is supposed to lay down strategies for evaluating the performance of each staff member to determine the areas that require improvement and to ensure that the patients who visit the health organization receive the best health care services (Leik, 2007).
At the moment, I possess two of the main leadership qualities required for a family nurse practitioner. Firstly, I am good at mentoring after working at an organization that deals with abandoned children and victims of rape and other forms of abuse. I served as an officer in charge of mentoring the children in the organization. As for the second attribute, the ability to conduct job and performance evaluation, I acquired it after undergoing a short training on human resource management. Although I have some of the basic leadership qualities required for one to be a family nurse practitioner, I need to get other skills, such as the ability to offer support to staff members and encourage or motivate my colleagues.
There are a number of ways through which I can acquire the leadership qualities that I currently lack. Firstly, I believe in behavioral theories, which state that leaders are simply made and not born. Consistent with the various behavioral theories, I believe that I can acquire the qualities I do not have. The first method, I intend to rely on, is reading various literature that talks about leadership qualities for advanced nurse practitioners and how to acquire them. It is possible to adopt the qualities by reading such literature as they normally offer insights that are self-explanatory and easy to understand. The second strategy involves attending training sessions and seminars that teach trainees how they can acquire leadership qualities. Such training sessions and seminars are effective as they are organized and taught by experts with long-time experience in leadership.
Health Policy and Family Nurse Practitioners
According to Robert Wood Johnson Foundation (2013), one of the health policies that are bound to experience new changes is the Supplemental Nutrition Assistance Program (SNAP). SNAP is a health policy that provides nutrition aid to several Americans, especially families and individuals with low-income earning jobs. The policy ensures proper nutrition for these participants and offers several economic and social benefits to needy communities. SNAP is considered the largest and the most effective domestic hunger safety net and works in conjunction with faith-based organizations, nutrition educators, and state agencies to ensure that those who require nutrition assistance do not miss out on the program. Family nurse practitioners also take part in the SNAP program to ensure that no eligible persons are barred from receiving the assistance they need (Robert Wood Johnson Foundation, 2013).
The SNAP program has different participants who consume different proportions of the available food. The participants of the program mostly include children and a few adults from poor families. Studies show that the participants of the program stick to diets that do not meet the requirements of the Dietary Guidelines for Americans, while non-SNAP members enjoy healthy lifestyles. Health risks, such as for overweight and obesity, are common occurrences among children and women who participate in the SNAP as they obtain most of their daily calories from added sugars, solid fats, and alcohol. SNAP participants are at a higher risk of developing metabolic risk factors than low-income families who do not participate in the program (Robert Wood Johnson Foundation, 2013).
Although the SNAP program was intended to improve the health of its participants, current studies show that most of the beneficiaries are extremely obese. As a result, some changes have been proposed to be made to the policy to ensure that the obesity health risk they face is avoided. The main players that have offered some changes to be made to the SNAP program are the members of the House and Senate. The proposed changes mainly affect eligibility requirements and the levels of benefits that participants are likely to obtain from the program. The House and Senate members want the eligibility of participants raised and the benefits they get from the program reduced. The proposed changes are currently under Congress’ consideration that is expected to make a ruling after debating over the proposed changes (Robert Wood Johnson Foundation, 2013).
It is possible that the changes may help to reduce the problems of obesity and overweight currently affecting SNAP’s participants; however, the changes are likely to come with more severe consequences. Firstly, close to 5 million people, including about 1.4 million children, are likely to be locked out of the program. Secondly, about 1.2 million school-going children are likely to lose SNAP eligibility and consequently face the risk of being locked out of free school meals. Thirdly, if the proposed changes are introduced into the program, they are likely to cause acute food insecurity in the country as there are many individuals who are not able to obtain basic meals consistently (Robert Wood Johnson Foundation, 2013).
There are better changes that could be made to the SNAP program to enable the members to have the best quality nutrition and reduce the risks of developing unwanted conditions, such as obesity and overweight. Firstly, the participants should be provided with a discount from the EBT card to enable them to buy more nutritious food items, such as vegetables and fruits, which are rich in vitamins and minerals. Secondly, the government should enact changes in the marketplace to allow SNAP participants to buy more nutritious foods at discounted prices from various food retailers. Thirdly, the government should bar SNAP participants from purchasing foods with less nutritious through the program or at any other marketplace. Some of the foods that participants should be discouraged from purchasing include sweet baked foods, soft drinks, and candies. Fourthly, the government should increase the benefits of the program by availing more money that could be used to purchase more nutritious foods. Lastly, the government should enhance SNAP-Ed, which is the component of the program concerned with educating the participants on the benefits of taking nutritious foods.
The proposed changes are likely to improve the functionality of the SNAP program and help reduce the risks of developing obesity among the participants. Firstly, the changes will ensure that the program offers more nutritious food items to its participants without necessarily increasing eligibility requirements. Secondly, the later changes will ensure that the participants become more educated and informed on the most nutritious foods and improve the eating habits that can help them avoid developing disorders, such as obesity. Lastly, the changes will help the country prevent the problem of food insecurity, especially among its poor citizens.
Conclusion
This paper discusses the roles of family nurse practitioners and other advanced practice nurses in the United States. Firstly, the paper outlines the similarities and differences of the four major advanced practice nurses, who include family nurse practitioners, nurse administrators, nurse informaticists, and nurse educators. The main similarity among the four nurses is that all of them participate in research to improve health care delivery to their patients. The paper also discusses the family nurse practitioners’ profession in detail, including the regulatory and legal requirements and leadership attributes needed for one to become a family nurse practitioner. Lastly, the paper addresses the Supplemental Nutrition Assistance Program (SNAP) and the changes being proposed to make the program better; it also talks about the effects of the changes on the program’s beneficiaries.
References
Bahouth, M. N., Blum, K., & Simone, S. (2013). Transitioning into hospital-based practice: A guide for nurse practitioners and administrators. New York, NY: Singer Pub.
Barker, A. M., & DeNisco, S. (2013). Advanced practice nursing: Evolving roles for the transformation of the profession (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Jansen, M. P. W., & Zwgart-Stauffacher, M. (2010). Advanced practice nursing: Core concepts for professional role development (4th ed.). New York, NY: Springer.
Leik, M. T. C. (2007). Family nurse practitioner certification: Intensive review. New York, NY: Springer Pub.
Robert Wood Johnson Foundation. (2013). Health impact assessment of proposed changes to the supplemental nutrition assistance program. Web.