Discussion Advanced Practice Registered Nurses Certification
Discussion Advanced Practice Registered Nurses Certification
Advanced Practice Registered Nurses-APRNs are a type of nurses who have undergone advanced training and education as well as clinical practice. Licensing nurses has numerous advantages for practicing nurses. APRN nurses have obtained at least a master’s degree and further specializations within the sphere of APRN. The advanced education by APRN nurses makes them have high skills and specialization in a specific patient population.
At the very least, APRN nurses must have an RN- Registered Nurse license, clinical experience, and a master’s degree in nursing. The APRN being interviewed has been practicing for 3 years as an oncologist in the adult section. For better performance APRN nurses need higher qualifications than other nurses (Ares, 2018). These nurses are highly specialized and skilled in their area of expertise. (For ease of identification the nurse being interviewed will be referred to as nurse X). Discussion Advanced Practice Registered Nurses Certification
Nurse X obtained his/her post-basic RN training as an APRN at UT Arlington. As a recent graduate, nurse X said that she felt she was quite unprepared to deal with patients with acute and critical conditions. This is because as a recent graduate, she did not have a lot of experience dealing with emergency and critical care patients. In terms of incompetency, nurse X admits feeling incompetent dealing with matters relating to NONPF core and population competencies. Advanced Practice Registered Nurses Certification
Having such qualifications enable APRN nurses to perform competitively (Quirt et al., 2018 Discussion: Advanced Practice Registered Nurses Certification). The nurse wishes that had she studied adult acute care, she would be competent enough to deal with NONPF core and population competencies. Discussion Advanced Practice Registered Nurses Certification
Credentials and responsibilities
According to the American Nursing Association ANA, it is not enough for nurses to get certified and sit back. Nurses must get recertified to ensure that they remain competent for their entire professional life. Nurse X is a certified nurse who has worked as an AANP for 5 years and ONC for 4 years. For identification purposes, nurse X documents her name as follows: Jane Doe ARNP. Currently, nurse X works for St. Luke’s Hospital.
In her work setting, the nurse does not see patients in a multiple-practice setting. Nurse X works in the adult oncology section where she attends to adult oncology patients who have plasma cell disease including multiple myeloma, smoldering multiple myeloma, MGUS, AL amyloidosis, and Waldenstrom macroglobulinemia. The nurse supports three attendings only each day and sees them through all the stages of their disease, that is, newly diagnosed, relapsed, post stem cell transplant, and end of life. Discussion Advanced Practice Registered Nurses Certification
Responsibility for Making Practice Decisions
The scheduling nurse creates the day-to-day activities for all nurses in the oncology section. However, nurse X makes her own decisions but works collaboratively with other members of the team. Other team members in the section include the clinical nurse and the rest of the oncology team. Every week, the team meets at least once to discuss what happened during the week and how to deal with arising problems. Most of the time, nurse X works individually when attending to her oncology patients at St. Luke’s. However, there is a collaborative effort between her and the scheduler, the clinical nurse, and the rest of the staff at the oncology section. Discussion Advanced Practice Registered Nurses Certification
Nurse X has a specific job description as the head nurse in charge of the oncology department. With this job description come specific responsibilities and duties about her skill set, qualification, and position. One of her major responsibilities is providing care to cancer patients at St. Luke’s. Another critical responsibility of nurse X is prescription. The nurse prescribes medicine to her cancer patient according to their needs and condition. Through the Prescriptive Authority Agreement, nurse X is both qualified and mandated to diagnose and to give prescriptions. Advanced Practice Registered Nurses Certification
Other responsibilities of nurses offering critical care include diagnosis, treatment, and providing end-of-life care. As an oncology nurse, nurse X assumes numerous roles when dealing with cancer patients. Some critical roles played by nurse x include offering education to cancer patients and their families, and taking care of the needs of cancer patients. Discussion Advanced Practice Registered Nurses Certification
As a qualified APRN nurse, nurse X has the power to prescribe medication to patients in all 50 states in America. This power includes the power to prescribe narcotic medicines, antibiotics, opioids, and all other schedules II drugs for example Adderall. Being an oncologist, nurse X works with some of the most addictive drugs and substances that have a high potential for abuse. These drugs are commonly used to help cancer patients ease their pain (Ward, 2018). Examples of highly addictive schedule II drugs that nurse X is authorized to prescribe to her patients include; hydromorphone, methadone, meperidine/Demerol, and oxycodone among others. Further, nurse X has authority to prescribe (IV/SQ/PO chemotherapy, drugs–no restriction including controlled substances, procedures, consults, DME.
Compliance with Substance Laws
As an authorized person to prescribe medicine in the United States, nurse x adheres to all the national and regional prescription laws and regulations before prescribing schedules 2, 2N, 3, 3N, 4, 5. She also educates patients and their families about the risk and side effects of the drugs if they are opioid naïve. Nurse X does a reassessment of a patient’s continued need for controlled substances and makes appropriate changes including taper and weaning off.
Besides, the nurse checks the PMP regularly and refill patients’ prescriptions to ensure that there are no multiple prescribers and the patient is getting appropriate numbers of refill. Lastly, nurse X refers her patients to a pain clinic when they have uncontrolled pain and they’re above the 120mg MED dosing threshold which she may not be authorized to prescribe. Discussion Advanced Practice Registered Nurses Certification
Reimbursement of APRN Nurse’s
Services by APRN nurses are reimbursed through payments from the diagnosis-related group. Reimbursement of nurses follows certain principles of Medicare rules. One of the critical principles for reimbursement is that a nurse must meet the credentialing details by the payer. Most importantly, billing must be done using the provider number belonging to the APRN. Advanced Practice Registered Nurses Certification
Top of the benefits list that made these methods the best fit for use by APRNs is the fact that the APRNs are regulated by a code of ethics that attracts punishment if violated. The researcher got the opportunity to immerse themselves in the world of the women being interviewed and was able to observe both the subject as well as the environment within which the respondents operated from.
The observation was particularly pivotal for this research because it allowed the researcher to observe what was going on rather than just relying on what one has been told by the respondents which may be biased in opinion (Reboussin et al., 2018 Discussion: Advanced Practice Registered Nurses Certification).
These sources also allowed the researcher to be able to narrow down the research to be more specific which in turn helped the researcher to decide the direction of the research and be able to make amendments as necessary before final data could be gathered for analysis. Additionally, these methods were chosen over other methods because they come with a high degree of reliability. They are deemed reliable because the researcher relies on what he has observed and recorded. Discussion Advanced Practice Registered Nurses Certification
Philosophy of Care
According to nurse X, her philosophy of care is ‘Collaborative and holistic patient and family-centered care. Using this philosophy, the nurse uses the time to educate patients about their disease and always assures her patients and their family that there is hope in working as a team and that they should be active participants in their medical care. Collaborative care produces the best patient outcomes (Brook, & Rajagopalan, 2018). Nurse X asserted that she is sensitive to the values and beliefs of her patients and does not impose her wishes, values, or beliefs on her patients. Discussion Advanced Practice Registered Nurses Certification
Tools and Standards of Practice
The nurses are required to use the best tools and technology in collaborating with Evidence-based practice Clinical guidelines. Apart from the nursing guidelines, nurse X uses subscribes to other standards and tools to assess her competence concerning the patient population. For example, in a part form using her institution’s guidelines, nurse X also uses the NCCN and other peer-reviewed guidelines to help her remain competent. As part of improving patient outcomes, nurse X and her colleagues also review and include research studies treatments relevant to our patient population. As an APRN, nurse X is required to get credentialed to see patients on clinical studies through our organization.
To maintain her competence, nurse X reads different journal to review updates and new treatments relevant to her area of practice including Clinical Advances in Hematology & Oncology, The Nurse Practitioner Journal, Journal of the Advanced Practitioner in Oncology (JADPRO), and individual articles and journals related to my area of practice. These tools can maintain a nurse’s level of knowledge in his/her career (Wheton, 2018 Discussion Advanced Practice Registered Nurses Certification) Besides, nurse X also uses NCCN, UpToDate, Micromedics, Epocrates, Medscape, USPSTF for guidelines. Advanced Practice Registered Nurses Certification
Discussion: Advanced Practice Registered Nurses Certification References
Ares, T. L. (2018). Role transition after clinical nurse specialist education. Clinical Nurse Specialist, 32(2), 71-80.
Brook, R., & Rajagopalan, S. (2018). ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal Of The American Society Of Hypertension, 12(3), 238. doi: 10.1016/j.jash.2018.01.004. Advanced Practice Registered Nurses Certification
Reboussin, D., Allen, N., Griswold, M., Guallar, E., Hong, Y., & Lackland, D. et al. (2018). Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Journal Of The American College Of Cardiology, 71(19), 2176-2198. doi: 10.1016/j.jacc.2017.11.004
Cynthia Ward, D. N. P. (2018). Clinical nurse specialist: the unknown APRN. Medsurg Nursing, 27(6), 347.
Quirt, J., Hildebrand, K., Mazza, J., Noya, F., & Kim, H. (2018). High blood pressure. Allergy, High blood pressure & Clinical Immunology, 14(S2). doi: 10.1186/s13223-018-0279-0. Advanced Practice Registered Nurses Certification
Whelton, P., Carey, R., & Aronow, W. (2018). ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association. Task Force on Clinical Practi. KIDNEYS, 7(1), 68-74. doi: 10.22141/2307-12184.108.40.2068.122220