I need the peer response for this discussion
As the nursing profession continues to adapt to meet the demands of a rapidly changing healthcare system, the need for advance practice nurses became more evident. “Advanced nursing practice is an umbrella term used to described various roles that incorporates highly developed knowledge and skills relevant to a particular field.” (Wall, 2006). However, with the emerging of these advance nursing specialty roles came questions as to which roles qualified for the title of advanced practice. Per the Consensus Model in 2008, many nurses with advanced graduate nursing preparation practice in roles and specialties such as., informatics, public health, education, or administration, are essential to advancing the health of the public but do not focus on direct care to the individual. The Clinical Nurse Specialist, Nurse Practitioner, Nurse Midwife and Nurse Anesthetist are the more commonly known advance practice roles because of the advanced education and skills requirred to perform their roles in direct patient care. However, what about what about the Nurse Educator and Nurse Leader roles? These roles also require education at the Master’s level or higher and require a different, but just as equal, set of skills as well as expertise in their field of practice. The dilemma with the advanced practice registered nurse role is that the definition is self-limiting and the speciality roles are the only ones currently accepted by other healthcare professional organizations and state regulatory agencies.
Nurse educators play an important part in the development of not only new nurses and in the education and preparation of other APRN’s in any role, but also as patient educators to specific disease processes. With the challenges of nursing faculty shortages and the salary limitations, the importance of this role must be recognized and elevated in status. Similar to the specialty APRN roles, nurse educators are graduate level educated nurses and strive to prepare future nurses and APRN’s to provide basic and advanced scope of services to a specific patient population. Nurse educators have to possess the clinical expertise to be able to teach their students to train them effectively, as well as their patients so that their medical conditions do not worsen. For example, they focus on training and educating nurses from basic skills, such as intravenous insertion, to more advanced, such as central line, placement based on the clinical work environment. They also can become specialty educators for the public, such as for pediatric diabetes. The assist the parents and patient to understanding the disease process and dietary management to prevent going into DKA or having multiple hypoglycemia episodes. One identified barrier to being considered an advance practice registered nurses is that the nurse educator is not required to pass a national certification examination that measures APRN, role and population-focused competencies. Another barrier for APRN specialty role consideration, is that nurse educator does not have many hours of direct patient care in that the population they serve are advance practice nurses, nurses and nursing students.
The clinical nurse leader role has advanced a little more towards meeting the Consensus Models definition of an APRN than the nurse educator role. Clinical nurse leaders oversee the care coordination for patients, assess risks, develop quality improvement strategies, facilitate team communication, and implement evidence-based solutions at the unit level (AACN,2021) . The CNL role is not one of just administration or management but by definition is a leader in healthcare delivery across all settings, not just in acute care (AACN, 2021). Clinical nurse leaders have a high level of clinical competence and knowledge and serve as resources to any healthcare team, administrative or clinical. The role of the CNL has gained such recognition that the AACN has approved for certification to validate the knowledge and skill of the CNL. Certified CNL’s have increased professional trust from their peers as well as autonomy in the workplace. Similar to the nurse educator role, the only obvious barrier to being considered as an APRN is that the Clinical Nurse leader is that they also have minimal direct patient care hours. However, the advanced nursing practice would benefit as whole to include another clinically certified role to their repertoire.
Besides the barriers identified above for the nurse educator and clinical nurse leader, another barrier is the definition of the APRN role per the Consensus Model (2008). According to the Consensus Model (2008), a nurse is recognized as an APRN when they have obtained a license to practice as one of the four identified APRN roles: certified registered nurse anesthetist, certified nurse-midwife, clinical nurse specialist, or certified nurse practitioner. Since the roles and practice of an nurse educator and clinical nurse leader do not require regulatory recognition beyond the registered nurse license granted by state boards of nursing (Consensus Model, 2008), they will continue tostruggle to be accepted as APRN’s.
Overcoming the barriers or cons to APRN practice and including clinical leaders and educators in today’s healthcare environment will lead to improvements in the healthcare provided by all APRN’s. APRN’s not only provide direct patient care but they also play important roles in education, administration, and research in regards to furthering the advance practice roles in healthcare. Although there has been some debate as to which roles qualify as APN’s, you must have advanced practice educators to teach the advance practice nurses, and an advanced practice clinical leader to assist with policy and regulatory changes to the internal and external oppositions related to providing optimal patient care. As a future certified clinical nurse leader, I hope that the defined roles for APRN’s include that of the leader and educator, the success of our profession relies on their critical positions and contributions to they provide to the role.
American Association of the Colleges of Nursing. (2021). Certified Nurse Leader.https://www.aacnnursing.org/CNL.
The APRN Consensus Work Group and the APRN Joint Dialogue Group. (2008). Consensus Model for APRN Regulation: Licensure, Accreditation, Certification