Introduction
Advanced nursing practice is a professional stage essential for healthcare organizations’ effective functioning; thus, obtaining a degree and certification in this field is a key to a successful career. In the primary care setting, family nurse practitioners (FNP) are the employees who positively influence patient outcomes and assist physicians in treatments (Torrens et al., 2020). This paper aims to discuss the FNP role, philosophy, ethical and legal regulations for the profession in New Jersey, certification requirements, leadership approaches, policies, and the importance of practitioners in primary care.
Difference between Advanced Nursing Practice and The Advanced Practice Nurse
Professionalism and dedication to work are equally expected from practitioners, while the educational background requirements depend on the selected specialization and range of responsibilities. Indeed, Advanced Nursing Practice (ANP) is a level that demands an expanded scope of work options where the knowledge and skills beyond the general job description are necessary (Torrens et al., 2020). For instance, ANP includes competencies sufficient for differentiation diagnosis and medication prescription, enabling the practitioners to obtain additional licenses and be involved in continuing education. An advanced Practice Nurse (APN) is a healthcare specialist with approved certification and at least a master’s degree that allows them to build a career in the selected specialization (Jokiniemi et al., 2020). The key distinction between ANP and APN is that the latter refers to a professional, and the former describes the field of expertise. Healthcare providers can perform advanced practice occasionally and thus be involved in the ANP, yet they cannot become an APN or, for example, an FNP without their competencies’ confirmation.
Roles in Advanced Practice Nursing
Advanced nursing expands the capabilities and responsibilities of practitioners, increasing their influence on patient outcomes. As certified professionals, APNs are allowed to analyze symptoms, identify diagnoses, prescribe medication, suggest further treatment, and refer to a relevant physician. Consequently, their role in advanced practice nursing is to make evidence-based decisions and participate in healthcare as a medium between patients and specialists. In the clinical setting, such practitioners participate in most interactions with clients and their families, helping them maximize the effectiveness of services and timely addressing challenges (Torrens et al., 2020). APNs have a crucial role in primary care because their expertise is sufficient to provide a patient with the basic assessment and subsequent treatment.
Moreover, advanced practitioners influence educational standards by obtaining experiences, analyzing what knowledge they lack for success, and reporting the feedback to Boards and Universities. APNs’ role includes a certain degree of leadership and authority; therefore, their role in administration provides an opportunity to initiate and execute interventions and assist their subordinates in maximizing their efficiency (Heinen et al., 2019). Advanced practitioners actively participate in health information development and distribution by holding membership in related local boards and associations.
Family Nurse Practitioner Role Description
Advanced nursing allows practitioners to specialize in diverse segments, depending on their organization, skills, and philosophy. For instance, family-centered service is prevalent in the primary care setting and is an appropriate field for professionals with expertise in assisting patients of all ages (McNelis et al., 2021). FNPs’ role includes developing prevention recommendations, proper monitoring conditions, and working with physicians to enhance treatment efficiency (Andrews et al., 2021). The experiences in primary care during the COVID-19 outbreak became motivators to select the family-based field of advanced practice. Indeed, infectious disease spread prevention was an essential aspect of healthcare during the pandemic, and addressing the family members’ needs based on their age and conditions proved to maximize positive outcomes. FNPs have a unique position that allows them to expand their expertise in pediatric, elderly, and palliative care, identify tendencies and commonalities in treatment efficacy, and improve well-being in local communities.
Family Nurse Practitioner Nursing Philosophy
Nursing philosophy outlines the key values and aims that move practitioners in selecting their careers and expanding their expertise in different specializations. Furthermore, it addresses the fundamental aspects of the profession, such as empathy, striving to care, and improving the world through healing (Andrews et al., 2021). The personal nursing philosophy of an aspiring FNP is based on moral postulates of beneficence and non-maleficence and on the willingness to improve evidence-based practices continuously. Family is the central value in various cultures, and its well-being defines the development of entire nations. Consequently, the nursing ideology is to participate in the world’s improvement by caring for people of diverse ages and their most valuable relatives. The middle-range model applies to the described philosophy because it includes theoretical and practical mechanisms of action and decision-making (Bender, 2018). An FNP’s work is also dedicated to providing complex patient care, which includes holistically addressing mental and physical issues rather than only applying the diseases’ treatment approaches.
Legislation for Advanced Practitioners: New Jersey
The region of planned FNP work in New Jersey with relatively strict regulatory and legal requirements for advanced nursing practice. The state’s Board of Nursing established rules for obtaining prescription rights, setting obligatory practice hours, and working with a senior physician. New Jersey Administrative Code’s chapter 37 (n. d.) states that “an APRN has prescriptive authority and is required to have a joint protocol with a collaborating physician prior to prescribing any medication or medical device.” An FNP must also comply with the regulations established for certification renewal, continuing education, and diverse types of treatment such as telemedicine. In New Jersey, licenses must be updated biennially, with the Board’s review and approval; healthcare organizations should receive funding for continuing education of their advanced nursing employees (New Jersey Administrative Code, n. d.). The Board of Nursing can adjust legislative requirements for FNPs, and practitioners have a right to influence their decisions by identifying the problem, collecting evidence, and offering an alternative to current regulations.
Family Nurse Practitioner Competencies and Certification Requirements
The scope of practice required for FNPs also includes competencies necessary for providing patients with advanced care across their lifespan. The essential domains are interacting with clients, healthcare quality and delivery monitoring, leadership and teamwork, and evidence-based practice (Jokiniemi et al., 2020). Moreover, a practitioner’s willingness for continuous personal and professional improvement is beneficial for a prosperous career and clients’ positive experience in a healthcare organization. The required domains identify that such qualities as communication, critical thinking, teamwork, and stress resistance are necessary for FNPs in primary care. Furthermore, addressing challenges and developing work-life balance became another crucial competency for advanced practitioners after the COVID-19 pandemic demonstrated how overworking leads to burnouts and damages productivity (McNelis et al., 2021). Based on the experience in the FNP role, the most important domains are patient-centered care, communication, and quality of service monitoring, because they define the outcomes and image of an organization.
Certification is crucial for FNPs because it proves their professionalism and confirms their expertise in the selected role. The regulations for obtaining the documents depend on the states’ rules, and in New Jersey, advanced practitioners receive it from the local Board of Nursing and update it every five years (New Jersey Administrative Code, n. d.). The exam’s tests include checking for various competencies via questions, tasks, and case studies, enabling an FNP to use their skills, knowledge, and experience to get high scores. Becoming a certified advanced practice specialist is a milestone that includes an opportunity to re-evaluate the competencies and identify the aspects for further improvement.
Family Nurse Practitioner’s Transformational Leadership
Leadership is an essential competency for APNs of all specializations because their role includes project execution, process development, and monitoring. Furthermore, FNPs frequently have managed assistants and opportunities to make quality improvement interventions. The transformational leadership style is widely implemented in healthcare organizations due to its high motivational and stimulative aspects that move teams toward positive change in practice (Poghosyan & Bernhardt 2018). The most significant qualities of successful commanders are the ability to encourage the team to take action, a clear vision of the necessary steps, and evidence-based decision-making (Poghosyan & Bernhardt 2018). The future FNP needs to develop and possess these three attributes to implement transformational leadership into their work.
Aside from transformational leadership, which enables the teams to continuously seek and maintain positive change, other styles exist to increase healthcare providers’ efficiency and improve patient outcomes. For example, the transactional approach, where the goals are achieved by synchronized teamwork and a strict execution structure, is beneficial for FNPs who work with subordinate assistants (Heinen et al., 2019). This leadership style is appropriate for APNs in primary care due to its focus on daily operations, clear rewards and objectives, and an option to build systems for optimizing the team’s effectiveness. Transactional strategies lack the inspirational aspect of transformational leadership; however, they increase employees’ motivation through visible results, such as positive feedback from patients and their families.
Policies and Regulatory Trends for Family Nurse Practitioners in Primary Care
FNPs in primary care must consider several policies in their day-to-day operations, communication with patients, and evidence-based decision-making. The APN’s role in New Jersey’s clinics is limited by the prescription rights and demand for their collaborative physician’s approval (New Jersey Administrative Code, n. d.). Another essential aspect of regulations is the Code of Ethics developed by the American Nurses Association to identify priorities and resolve challenging situations that are inevitable in FNP’s work in primary care (American Nurses Association, 2022). Most policies relate to the responsibilities and activities advanced practitioners perform with patients: physical assessment, diagnosis, and prescription. Thus, clients have a right to report on a healthcare provider, and the law protects the latter from false statements.
The policies are built on solid ethical postulates; however, the current regulations can be adjusted if legislators and Boards of Nursing identify the need for change. For example, many states have strict prescription control, limiting advanced practitioners’ opportunities and slowing the treatment for patients even in emergency cases (Scope of Practice Policy, 2022). Campaigns for expanding the practice independence in many regions are the trend that might soon result in policy changes and influence FNPs’ work (Scope of Practice Policy, 2022). Although restricted rights protect healthcare providers from high-risk decisions, they frequently worsen primary care clients’ experiences.
Conclusion
FNPs are highly-valued in primary care settings because the practitioners’ specification allows them to timely perform an assessment, diagnosis, prescription, and treatment activities, positively influencing patient outcomes. The selected role inspires to improve populations’ well-being by assisting the families’ representatives throughout their lifespan. Current legislation and policies vary in states, and in New Jersey, FNPs are limited in the practice of independence yet protected by laws from their rights’ violation.
References
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