According to American Nurses Association (2010), registered nurses practicing within United State operate under the guidance of the code of ethics for nurses with interpretive statements, nursing social policy statement, and nursing scope, standards of practice. The nursing practice is individualized, coordinates care by establishing a partnership, involves caring, and focuses on the provision of quality healthcare and achieving optimal outcomes. Advanced practice nursing, similarly to nursing, relates to focusing on quality, safety, and evidence-based care to patients. This paper evaluates the advanced practice nursing certification as prescribing nurses.
Professional Components and Educational Requirements of Prescriptive Authority for APNs
To qualify as a prescriber, non-prescribers have to be experienced practitioners. After sufficient experience as a practitioner, the non-medical prescriber can pursue the required education program and become an independent or supplementary prescriber upon completion of an approved program. Traditionally, prescribing has been dominated in medicine. However, this procedure is currently extending into other health experts as part of National Health Service (NHS) modernization agenda. The latter aims at ensuring that patients receive not only accessible but also quality care.
In order for one to become a nursing practitioner in Illinois, it is crucial to be qualified in a specific nursing field (Stanley, 2011, p. 47). Specialization could be based on personal interests or job security and possibility of promotion. The areas of specializations include nursing practitioners in such areas as acute, adult, emergency, geriatric, family practice, oncology, neonatal, pediatric and women’s health among others (Ross, 2012). After completion of an undergraduate degree, one can go for a master’s of science in nursing or MSN degree from accredited university in advanced study with the aim of gaining comprehensive primary and specialty care (Stanley, 2011). This issue is followed by obtaining a registered nursing license from the American Nursing Association.
The Emerging Roles of the Registered Prescription Nurse
Advanced practice nurse with prescriptive authority can offer services in licensed hospitals, hospital affiliate, or ambulatory surgical treatment center (Stanley, 2011). The roles of the nurse prescriber include medication management, providing patient advocacy roles: for instance, eliciting patient preferences, running nurse-led initiatives and clinics, working as an independent nurse prescriber, and offering advice to medical colleagues. Other prescribing nursing duties include formalizing the existing prescribing activities, increasing autonomous working, offering more sensitive and appropriate patient care. In order to be effective in their roles, nurse practitioners require organizational skills, medication management skills, risk management, interpersonal skills, and specialist knowledge. The prescribing nurse is also expected to have good skills in care coordination, and undertaking assessment and decision-making skills.
Role Development from a Theoretical Perspective
To perform prescription tasks, nurses require advanced nursing training to gain sophisticated professional judgment for use in their provision of high-quality patient care (Lovatt, 2010). Additionally, receiving necessary prescriptive training is essential for nursing accountability and autonomy. According to Stanley (2011), engaging nurses in prescription authority in the US has been linked with numerous benefits, including minimized workloads and time-saving, low-cost and accessible care, patient enablement, and provision of quality care among others. These views have been shared globally, involving such countries as Australia, United Kingdom and Canada. The US is known to have pioneered nursing practitioner prescribing role in the 1970s after the nation experienced a shortage in primary physicians. In order to deal with the phenomenon, nursing practitioners, with their well-established advanced practice role, was the best option to fill in the gap.
With the authority to prescribe autonomously, nurses have been licensed to practice in 12 states and the District of Colombia (National Council for the Profesional Development of Nursing and Midwifery, 2005). In the other 38 states, the stance is that some formal physician supervision is necessary. Prescriptive authority of nurse practitioners is also limited in 40 states where it must be done under collaboration with a physician, while in 48 states, it involves controlled substances (Ross, 2012). These differences make it almost impossible for advanced practice registered nurses (APRNs) to move from one state to the other since they encounter divergent and new licensing requirements. Such variations will require addressing APRN education through an integrated APRN preparation with credentialing for practice and uniform consideration.
With distinctive endurance and firmness, APRN will go on making progress based on prescriptive authority and autonomy (Stanely, 2011). Unlike psychologists and pharmacists, APRN independent prescription authority is expected to take longer and significant social-political will before its goal and expectations are achieved. This is the case given existing barriers to practice, such as low level of clinical expertise, lack of primary care trust, inability to generate computer prescription, and organizational or national restrictions (Ross, 2012).
Role Development from a Global Perspective
The world’s health is affected by factors that are specific to widespread in given areas. Further, national resources and health standards allocation in one country impacts another state requiring that they divert resources to assist affected nations at the expense of their citizens. According to Stanley (2011), APRNs are to travel throughout the globe to share their skills and knowledge (p. 336). Additionally, APRNs are continually required by nations to fill in critical gaps within their healthcare system.
In Canada, NPs are continually gaining acceptance in replacing skilled clinicians where physicians are unavailable, for example, in rural environments (Forchuk & Kohr, 2009). Instead of being regarded as mere physicians’ replacements, NPs in Canada are increasingly playing a crucial role in healthcare delivery, which calls for changes in legislation to allow independent functioning through prescriptive authority. Unlike the US where the population is high, Forchuk and Kohr (2009) reveal that the low population of Canada hinders the country’s inability to exploit particular specialty areas within NP role.
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