The Role 1

What is the Role?

Christy Holshouser

University of Alabama at Birmingham

School of Nursing

NFH 601

Dr. Anne Williams

3-18-09

The Role 2

What is the Role?

Introduction

My journey to pursue the role of Nurse Practitioner (NP) had its inception approximately

two to three years ago when I was in Uganda, Africa traveling with Operation Renewed Hope

(ORH) and conducting medical clinics in local villages. I had worked in a pediatric intensive

care unit for eight years at this time and had traveled with ORH for two years primarily serving

as head nurse. On this particular trip, I was asked to work with the physicians and to care for the

children. This experience sparked a fire that pushed me to consider an advanced practice nursing

role. My expectations of this role are to increase my knowledge, assessment, and diagnostic

skills in the medical care of children and families to be able to function as a practitioner for the

children on these medical mission trips.

The role of a nurse practitioner is an advanced practice role as evidenced by meeting the

advanced practice criteria of expanded knowledge and specialization, certification, and a clinical

focus on patient care. The National Organization of Nurse Practitioner Faculties (NONPF)

indicates the NP competencies as follows: consultation, research skills, clinical and professional

leadership, collaboration, ethical decision-making skills, and expert coaching and guidance

(NONPF, 2002). Direct clinical practice is identified as the core competency of the advanced

practice nurse (APN). Hamric, Spross and Hanson state that “what distinguishes APN practice is

the expectation that these competencies are visible in the practice…” (Hamric, Spross & Hanson,

2005, p. 96)

Comparison Table

The following table lists a comparison of three professional roles. These roles include

Nurse Practitioner, Clinical Nurse Specialist, and Social Worker.

The Role 3

Role comparison table Comparisons Nurse Practitioner Clinical Nurse Specialist Social Worker

Specific functions 1. Direct clinical practice: a. Assessment b. Diagnosis c. Management of care d. Prescriptive treatments 2. Consultation 3. Research skills 4. Clinical and professional leadership 5. Collaboration 6. Ethical decision-making skills (NONPF, 2002)

1. Consultation 2. Professional expert 3. Case manager 4. Educator 5. Director of patient care 6. Research skills

1. Research skills 2. Advocacy 3. Case manager 4. Supervisor 5. Legislative practice 6. System design

Independent versus collaborative role

Collaborative role Collaborative role Collaborative role

Education Master’s degree Doctorate degree

Bachelor’s degree Master’s degree

Bachelor’s degree Master’s degree Doctorate degree

Licensure Licensure standards vary by state Licensure standards vary by state Licensure standards vary by state Certification 1. Examination required for

certification 2. Obtained through American Nurses Credentialing Center or American Academy of Nurse Practitioners

1. Examination required for certification 2. Certification in specialty areas are currently being developed 3. Obtained through American Nurses Credentialing Center and other specialty organizations

1. Dependent on at least Master’s degree level of education 2. Based on professional experience

The Role 4

Scope of practice Provide primary care to patients including: 1. Obtaining health history and performing physical assessment 2. Manage acute and chronic illness 3. Educate patients in health management and disease prevention 4. Manage prescriptive therapies 5. Identify patients in need of referral services

Work with patients, nursing personnel and organizational systems to provide expertise in education, consultation and research that will provide quality outcomes

Work with individuals, children and families to aid in coping with issues, relationships and activities of daily living including: 1. Finances 2. Domestic and marital dysfunction 3. Unemployment 4. Abuse and neglect

Other comparisons Initiated in response to a physician shortage

1. Not usually involved in direct patient care 2. Developed to improve the quality of nursing care 3. Work with a specific population

Work with a specific population

The Role 5

Summary

The comparison table above delineates the separate characteristics of each identified role

and helps to show the similarities and differences between each role. The three roles compared

focus on aspects of patient/client care although that care may or may not be direct care of the

person. All three roles require a higher level of education and licensure to practice, and they may

be complemented with certifications specific to patient populations. Consultation, research,

collaboration, and education are also key components to each of these roles. In summary, to be

able to effectively function in a desired role, a professional must first be able to differentiate that

role from the role of other professionals. Role development and definition is a dynamic function

that is crucial in providing quality care to the population being served.

The Role 6

References

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-

09 Edition, Social Workers, on the Internet at http://www.bls.gov/oco/ocos060.htm (visited

March 18, 2009).

Christian, S., Dower, C., & O'Neil, E. (2007). Overview of nurse practitioner scopes of practice

in the United States-discussion [Electronic version]. University of California, The Center

for the Health Professions..

Hamric, A. B., Spross, J. A., & Hanson, C. M. (2005). Advanced practice nursing: An

integrative approach. St. Louis, Missouri: Elsevier Saunders.

National Organization of Nurse Practitioner Faculties. (2002, April 1). Nurse practitioner

primary care competencies in specialty areas: adult, family, gerontological, pediatric,

and women's health. .

Teicher, S., Crawford, K., Williams, B., Nelson, B., & Andrews, C. (2001, August 1). Emerging

role of the pediatric nurse practitioner in acute care. Pediatric Nursing, 27(No. 4), 387.