Nursing is a profession that is continually redefining its objectives and its spectrum of action. In the case of the Advanced Practice Nurse (APN), the challenge is to demonstrate the level of experience and training necessary to fulfill this role. Moreover, it requires establishing where the general nurse’s practice ends and where the APN practice begins.
It is challenging to evaluate it in the international spectrum due to differences in curricular and professional development. The path from novice nurse to expert nurse is neither linear nor universally understood. For people outside the profession, the different professional levels in Nursing, their functions with physicians, and the amalgam of titles and specialties are difficult to understand.
Furthermore, nurses have a severe problem of professional abandonment with more clinical experience in many countries. Chronic diseases constitute the most significant current challenge for health services. We have nurses as the leading providers due to an evident failure of conventional care models to face the current challenge.
CHANGING NEEDS AND CHANGING PERCEPTIONS
Like the population and its health need change over time, so do nurses’ roles and contributions. As a society, we need to include health and well-being as critical factors in developing health policies. We must recognize that the factors that contribute to and allow health and well-being go beyond health structure. The challenge of having an aging population forces us to promote lifestyles that achieve active aging and control chronic pathologies with current advances in drugs.
What kind of education, skills, and training is the most effective? How many nurses dedicated to advanced practice do we need? There are several options available for experienced nurses. In today’s environment, many nurses are considering an online BSN-DNP program for their career progress. Knowing all these things is essential. Any discussion of the importance of the APN should take this complexity into account from the outset. If we are not aware of this, there is a risk of focusing only on nurses’ perceptions. Eventually, we will forget how these functions make a difference in patients’ and relatives’ quality of care and health.
THE ADVANCED PRACTICE NURSE (APN)
In all countries, the APN is a minority occupation. The International Council of Nursing defines its function as follows. The APN is that nurse who acquires expert knowledge, skills for making complex decisions, and clinical competencies for expanded practice. ICN recommends a master’s degree as an initial level.
There is no consensus on what we should call this feature. A review identified thirteen different degrees that described the work of an APN. Nurse Practitioner and APN were the most common titles. Issues such as access to health services, improving the quality of care, cost control. The attempt to retain a more experienced and skilled workforce are all factors that influence the creation and development of the APN’s role.
APN’S ROLES
The most persuasive argument for the development and support of APN’s functions is that they add value to patient health outcomes. Evidence in the literature shows that licensed nurses with specific training achieve better health outcomes in their patients than those without this qualification. In contrast, there is less evidence that has compared the effectiveness of APNs with general nurses.
Patient outcomes need different perspectives: the patient and their caregivers, the caring institution or organization, and the professionals. A study concluded that users with a history of receiving care from health services correctly differentiated between nurses with technical skills and experts in managing complex chronic diseases and coordinating complex care.
In this study, the case manager nurse combined clinical experience with roles as an intermediary with other services, being a source of support and resources (including time). The APN ensured continuity of care in a confusing health system. It enhanced the patient’s self-care ability and a feeling that the hospital addressed the priorities. The patient does not necessarily know what the nurse did for him – it is an invisible performance. Nonetheless, they appreciated a qualitative difference (compared to other nurses) and an improvement for both patient and his family caregiver:
FUTURE NEEDS
Recruiting, retaining, and listening to advanced nurses‘ growing demands is a matter of concern to governments worldwide. The redesign of jobs, reorganization of functions, and problem-solving will continue to influence the work of the APN. A recent study on nursing prescription concluded that this role has been highly variable.
CONCLUSION
This article has argued that to address the provision of care with today’s increasing complexity. We need to invest in postgraduate nurses with a high level of training and skill in leadership and clinical care. We used the example of chronic diseases to discuss the development and modeling of APN and their functions. We need more details about the care process and how it impacts patient outcomes. From a strategic perspective, the nursing profession must make differences in professional training visible. We must also work on regulations that provide nurses with an infrastructure that promotes the independent practice.
