3 RESOURCES PLEASE– Please use Tracy & Ogrady resource EXAMPLE below — NP and APN Roles Comparison
Compare and contrast the primary care NP role with other nursing advanced practice roles and the role of physician assistants. What are the similarities among the roles and what are the differences? What are some growing areas of nursing specialization in nursing, and how do you see this continuing to evolve in the future? For example, informatics and disaster nursing are a growing area of nursing specialization that grow from specific needs in healthcare. What do you envision when you consider the roles of nursing advanced practice in the future?
NP and APN Roles Comparison
Advanced practice nurses (APNs) are RNs with advanced degrees at the master’s level or above and who are trained in specialized areas of nursing. Most states in the United States recognizes only four APNs, these include (1). NPs, these work in primary care to provide care to patients across the life span. (2). Certified Nurse-Midwives (CNM), they provide women’s health from prenatal care, delivering of babies to provision of post-natal care. (3). Clinical Nurse Specialists (CNS) work in different work settings and provide care according to their specialties. Their roles may differ, they may include administration, program development or research. (4). Certified Registered Nurse Anesthetists (CRNA), they work alongside anesthesiologist to provide anesthetics during surgery or special procedures. APNs provide care in different clinical setting, mostly in primary care and other specialized settings depending on their specialty. They are regulated and licensed by individual states of their practice (Tracy & O’Grady, 2018).
Growing Areas of Nursing Specialization
Due to the growing trends in disease etiology and prognosis, as well as the growth in epidemics and pandemics, the demand in primary care is also increasingly. NPs and other APNs are also in high demand. Therefore, inorder to meet the demands of the industry, the healthcare sector is changing the way care is being provided. Consequently, warranting for the development of new treatments and development of new medications/vaccines inorder to combat different disease variants. Apart from NPs we have also seen the growth of other nursing specialization such as nurse educators, nurse administrators/managers, nurse informatics, public health nurses etc. Apart from nurse educators, who maybe required to have a DNP, many may require nurses to be educated at the bachelor’s level and above, though many old nurses with diplomas/associate degrees may have vast experience, it is worth pointing out that many of them are retiring from the profession. Therefore, I envision future nursing roles to be highly competitive, as more and more nurses are attaining higher education, which is MSN and above, or acquiring more specialization.
NPs and PAs Roles Comparison
Similar to NPs, physician assistants work in collaboration with the physician, surgeons, and other healthcare providers to provide care in clinical settings. They are also trained at a master’s level and require license to practice in their state. Equally to NPs, they also do assess, examine, diagnose, evaluate, and treat patients. They can order and interpret labs and diagnostics tests. The extent to which they can be supervised varies per State of practice (BLS, 2021). The only differences is that one does not need to be an RN to be a PA. Conversely, in other states, NP can practice autonomously and operate their own practice in States that allow full authority. Meanwhile, PAs are only allowed to practice interdependently or under physician supervision (Nurse. Org, 2019; BLS, 2014; Tracy & O’Grady, 2018)
Nurse.org (2019). Nurse Practitioner or Physician Assistant: Difference in Salary and Benefits. Retrieved from https://nurse.org/articles/rise-of-non-physician-roles-in-medicine/
U.S Bureau of Labor Statistics (BLS) (2014) Physician Assistants. Occupational Outlook Handbook. Retrieved on 4/26/2021 from https://www.bls.gov/ooh/healthcare/physician-assistants.htm#tab-2.
Tracy, M.F., and O’Grady, E.T., (2018). Advanced Practice Nursing: An Integrative Approach (6th ed). St. Louis. Elsevier.
EXAMPLE 2 —
Primary Care Nurse Practitioners versus Other APRN Roles
Primary care nurse practitioners are providers responsible for comprehensive care, longitudinal care, coordination of various healthcare services, and are the ones who usually have the first contact of care of their patients (Tracy & O’Grady, 2018). Primary care strives to eliminate social discrepancies, organizes health services, integrates health into public forums, and pursues collaboration (Tracy & O’Grady, 2018). Unlike other APRN roles, primary care nurse practitioners see a wide variety of patients ranging from various stages of life and demographics. Other APRN roles tend to have a more specific patient population such as adults or women’s health. Primary care nurse practitioners tend to be more of the “jack of all trades”.
Nurse Practitioners versus Physician Assistants
Physician assistants are similar to primary care nurse practitioners in the fact that they can practice in a wide variety of practice settings but differ in the sense that they operate under more of a medical model and have less autonomy than nurse practitioners (Burrows, et al. 2020) (Van Erp, et al. 2020). The schooling process is different for both professions as well yet both end up with a Master’s degree. Most physician assistant’s scope of practice is decided at the practice level and can change based on the setting or specialty.
Evolving Nurse Practitioner Roles
The nurse practitioner role is something that is ever changing and evolving to meet the current standard of practice. Being able to have more nurse practitioners in practice would help to decrease the expensive costs of healthcare not in a primary care setting, such as utilizing an emergency department (Van Erp, et al. 2020). Changes with the prevalence of chronic diseases, increase in aging population, and an increase in the amount of patients seen in outpatient settings all call for an increase in primary care nurse practitioner positions (Hinch, et al. 2005). As I move into a nurse practitioner role, I envision that there will be constant changes that will better improve patient-centered care and I need to be ready to embrace those changes. I think that down the line, nurse practitioners might have to expand their scope of practice or take on more responsibility as a provider. I also envision infection control/prevention being a role that continues to grow.
Burrows, K., Abelson, J., Miller, P., Levine, M., & Vanstone, M. (2020). Understanding health professional role integration in complex adaptive systems: a multiple-case study of physician assistants in Ontario, Canada. BMC Health Services Research, 20(365). https://doi.org/10.1186/s12913-020-05087-8
Hinch, B., Murphy, M., & Lauer, M. (2005). Preparing students for evolving nurse practitioner roles in health care. Medsurg Nursing, 14(4), 240-245.
Tracy, M., F., & O’Grady, E. (2018). Advanced Practice Nursing: An integrative approach. Edition: 6th (2018). Elsevier.
Van Erp, R., Van Doorn, A., Van Den Brink, G., Peters, J., Laurant, M., & Van Vught, A. (2020). Physician assistants and nurse practitioners in primary care plus: a systematic review. International Journal of Integrated Care, 21(1), 1-17. doi: 10.5334./ijic.5485.
NP and APN Roles
Differences of Roles
The primary care nurse practitioner (PCNP) works all throughout the community caring for patients across the entire lifespan. Clinical nurse specialists (CNS) provide direct patient care to those with complex conditions in specialty areas, and may also work in management departments. An adult-gerontology acute care nurse practitioner (AG-ACNP) works with adult patients to diagnose and manage their acute and/or chronic diseases. The certified nurse midwife (CNM) provides women-centered care during their lifespan, particularly during pregnancy and childbirth. Certified registered nurse anesthetists (CRNAs) provide anesthesia care alongside of anesthesiologists and other medical professionals (Tracy & O’Grady, 2019). Physician assistants (PA) are medical professionals that are licensed and educated on how to diagnose & treat medical conditions, and can also prescribe medications. They must work alongside a licensed physician (Liaison International, 2020).
Similarities of Roles
Each and every one of the roles mentioned above have something in common, they all provide some sort of healthcare to patients. Yes, each has their own certain specialty/area, but in the end, they all give evidence-based, patient-centered care to everyone they care for. For example, let’s say the patient’s name is Katie, she is 25-years-old, and is pregnant with her second baby. She has been seeing her PCNP her entire life, and that’s who she will be using for her baby’s primary care provider once he or she is born. Katie has type 1 diabetes mellitus so whenever she is admitted to the hospital she is seen by the diabetic CNS. She also sees an AG-ACNP that helps manager her diabetes. She is seeing a CNM whom does all of her prenatal visits and will be delivering her baby. This CNM works below an obstetrician that also has a physician assistant in her office that sometimes preforms Katie’s exams. She also is a repeat cesarean section, so the CRNA will be the one administering her anesthesia for the procedure. All of these roles are related in certain ways (Tracy & O’Grady, 2019).
Growing Areas of Nursing Specialization
In my personal opinion, I believe that the roles of the CRNA and CNM are actively growing. I work in labor and delivery so I see these two specialties all of the time. The CRNA’s do all of our epidurals, and 80% of our deliveries are done be a CNM. These two areas are very popular, don’t really require a whole lot of schooling (just a master’s degree), and come with very nice paychecks. I think that in the future, there will be more CRNA’s than anesthesiologists. They are able to do procedures as long as the anesthesiologist is in the building. This is such a fast-growing profession. I also think that CNM’s will begin completely replacing obstetrician’s in the childbirth department as birth centers become more and more popular. A vast majority of women would rather have an all-natural delivery and that’s mainly where the CNM comes into play. I’m guessing that one day in the future, CNM’s may be taught how to perform cesarean sections, as that’s really the only thing out of their scope of practice (Red Ventures Company, 2021).
APN Future Roles
When thinking about the future roles of advanced practice nursing, I see a lot of good change. I think that PCNP’s will start to become an oversaturated profession, and that is who almost everyone will start seeing for their primary healthcare. I also believe that eventually, PCNP’s will be really needed in hospital settings rather than just clinic settings. I don’t see PA’s being a very popular profession much longer, in my opinion. And like I mentioned above, CRNA’s and CNM’s will become very, very popular and begin to “take the spots”, or so to speak, of delivering obstetrician’s and most anesthesiologists. I see nothing but good in the future of an advanced practice nursing professional!
Liaison International. (2020, November 12). Physician Assistant. ExploreHealthCareers.org. https://explorehealthcareers.org/career/medicine/physician-assistant/.
Red Ventures Company. (2021, April 6). 5 Booming nursing specialties where the demand is high. NurseJournal. https://nursejournal.org/articles/nursing-specialties-where-demand-is-high/.
Tracy, M., & O’Grady, E. (2019). Advanced practice nursing: An integrative approach (6th ed.). St. Louis: Elsevier
For more information on Advanced Practice Nursing Roles read this:https://en.wikipedia.org/wiki/Advanced_practice_nurse
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