Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
Jessica, a baccalaureate prepared registered nurse, has been practicing for 8 years. Throughout her nursing career, she has worked in pediatric, surgical, and emergency departments. She worked as a floor nurse, a charge nurse, and she was recently offered a position in Nursing Administration. A stipulation for becoming a nurse administrator is that Jessica must attain a Master of Science in Nursing degree within 2 years of accepting the position. The offer prompted Jessica to contemplate her career. She is interested in returning to college, and wants to have greater impact on patient care but isn’t sure she will find that in an Administrative role, nor is she sure is ready for the responsibility of becoming a Nurse Practitioner. Jessica has decided to explore the advance practice roles available in nursing in order to determine the best MSN track for her. Jessica must choose one role (CNP, CRNA, CNS, CNM) and apply to a program, but she is unsure about the different roles and their individual scopes of practice. One colleague states, “You know, Jessica, working as an NP is great because you can diagnose and write prescriptions, and the accountability will fall on the physician you are working with.”

Discussion questions:

Is Jessica’s colleague right? Why or why not?
Explore the four APN roles, and compare and contrast the pros and cons of each role against each other in order to determine the best choice for Jessica. Consider issues such as work environment, level of accountability, patient population, salary, and scope of practice. Include each role of the APN on the list, and be certain to provide appropriate rationales and citations.

Solution:

DQ2: Historical Development of Advanced Practice Nursing and Evidence-Based Practice

Jessica’s colleague is wrong in stating that one can diagnose and write prescriptions and the accountability will fall on the physician. This is attributed to the fact that a nurse practitioner one is expected to deliver medical treatment as well as offering care to different patients and could be supervised by a physician at some instances but not all the time. Hurlock-Chorostecki, Forchuk, Orchard, van Soeren, and Reeves (2014) indicate that one should be accountable as an NP in the diagnosis and prescription of any medication.

The four APN roles are Certified Nurse practitioner (CNP), Certified Registered Nurses Anesthetists (CRNA), Clinical Nurse Specialist (CNS), and Certified Nurses Midwife (CNM). In relation to the working environment, the CNP work in diverse areas including the acute care, neonatal, women health, family practice, and Gerontology. On the other hand,..