The Role of Advanced Practice Nurses: Case Study in Florida

Introduction

Advanced Practice Registered Nurses (APRNs) play a key role in the future of healthcare (Holly & Salmond, 2011). The professionals include nurse practitioners, clinical specialists, and anesthetists. In Florida, they are the core healthcare providers. The reason is because they are at the frontline with regards to the provision of preventive care to members of the public. APRNs are nurses who hold a post-graduate nursing degree. To fully perform their duties as required, they are trained on all the things pertaining to the nursing field (Hamric, Hanson, Tracy & O’Grady, 2013). Their training touches on clinical education, knowledge, skills, and extent of practice. In Florida, the nurses are expected to put into practice the skills acquired at the post-graduate level. They do this during the assessment, planning, implementation, diagnosis, and evaluation of patients who need healthcare services.

Nurses with a post-graduate degree may be employed as specialists or generalists in Florida healthcare centers. In the field, the most vital aspect is the high level of knowledge and proficiency that determines the relationship between the nurse and the patient (Curley & Vitale, 2011). The element is what influences the outcomes of their interventions. The reason is because it allows for decisions to be made through critical analysis and problem solving approach. A good relationship fosters confidence and trust between the parties. As a result, the clients are free and comfortable with the practitioner when discussing their issues with the healthcare providers.

In this paper, the author will discuss about the various roles of nursing practitioners. The discussions will be provided in the context of a family nurse practitioner based in Florida. In addition, other aspects of nursing in general will be looked into. They include the leadership qualities of the nurse and a healthcare policy issue.

The Roles of Nurse Practitioners, Nurse Educators, Nurse Informaticists, and Nurse Administrators: A Comparative Analysis

There are various categories of APNs in Florida. Each category of experts has its specific roles in the healthcare sector. In this section, the author will compare and contrast the roles of nurse practitioners, educators, informaticists, and administrators. The analysis will be carried out in relation to their participation in clinical practice, primary care, education, administration, and research.

Nurse Practitioners

In relation to clinical practice and primary care, the nurse practitioner offers their services to various groups of people. Their clients include children, adults, and geriatric patients. They also deal with the mentally and acutely ill clients. With regards to their education, the nurses hold a master’s degree and have advanced academic and clinical experience (Hamric et al., 2013). Their roles involve working directly with the patients. In Florida, qualified nurse practitioners are mandated to carry out various duties. Such responsibilities include provision of curative and preventive care. In addition, they perform examinations on patients, order and interpret tests, and offer guidance and counseling services. Their work settings include hospitals, schools, clinics, and Health Maintenance Organizations (Hamric et al., 2013).

Nurse Educators

Nurse educators integrate their clinical expertise with their passion for teaching (Holly & Salmond, 2011). In Florida, they act as role models to peers and help in strengthening the field’s workforce. Like practitioners, they hold a master’s or doctorate degree in nursing. They work as members of faculty in a number of institutions. The educational settings include colleges, universities, and hospital-based schools of nursing. The educators’ roles include designing curriculum, developing courses, and evaluating learning (Hamric et al., 2013). In Florida, these nurses help students to identify their strengths and weaknesses.

Nurse Informaticists

Nurse informatics is a profession that deals with discovering ways of improving information management and communication in the field of nursing. It is aimed at enhancing efficiency, quality of care, and costs. The American Nurses Association (ANA) considers the career as a field made of nursing, computer, and information science (Curley & Vitale, 2011). The roles of nurse informatics include integrating data, information, and knowledge. They help patients, nurses, and other healthcare providers in Florida to make decisions. The key educational requirement in Florida is a Master of Science in Nursing (MSN) degree. However, unlike in nursing education and administration, one can still join the informatics field with an approved Bachelor of Science in Nursing (BSN).

To perform their duties, the informaticists use information technology, structures, and processes. The core aspect of the profession is documentation. To this end, it is noted that functional communication leads to improved healthcare services. They develop procedures to simplify and improve the documentation process of. As a result of expansions in this field, it is now easy to record notes using computers and handheld devices (Holly & Salmond, 2011). Writing notes manually is now a thing of the past in most healthcare centers based in Florida. Their work settings include consultancy agencies, hospitals, universities, and organizations responsible for designing healthcare data systems for the market.

Nurse Administrator

A Nurse Administrator is an advanced healthcare provider holding various positions. They range from managers, directors, to CEOs of health organizations. The professionals are equipped with the expertise and knowledge needed to become leaders. In Florida, nurse administrators can work in clinics, hospitals, and nursing homes. As individuals, they have visions for the healthcare facilities they manage. In addition, they guide the members of staff towards the realization of the organizational goals. The key role of the experts is to help manage finances and control organizational development (Hamric et al., 2013). In addition, they supervise the entire workforce of nurses in institutions where they are in charge. Another role entails addressing problems that revolve around ethical and legal issues in healthcare departments.

Before an ordinary nurse can become an administrator in Florida, they must have worked for a number of years. The aim of such exposure is to gain the required experience. Majority of them begin as staff nurses before advancing the leadership positions. They are key participants and stakeholders in the bodies mandated with the duty of updating policies and procedures in the nursing field (Curley & Vitale, 2011). The minimum requirement for a nurse administrator in Florida is a Bachelor of Science in Nursing Degree. In addition, the expert should have a master’s degree in administration. Completion of the program takes a period of between 18 to 24 months.

Legal and Regulatory Requirements for a Family Nurse Practitioner in Florida

The legal and regulatory requirements for nurse practitioners vary between states. In Florida, family nurse practitioners can carry out their duties in three ways. They include full, reduced, and restricted practice. In full performance, the state and licensure laws allow the nurses to evaluate, diagnose, initiate and manage treatment of patients (Hamric et al., 2013). They do this under the exclusive licensure authority of the state’s board of nursing. The healthcare practice is defined by the relevant authorities. The agencies include the Institute of Medicine and National Council State Boards of Nursing (Hamric et al., 2013).

In reduced practice, the family practitioners can take part in at least one constituent of the profession. The state in which the expert is operating must have a synchronized mutual agreement with an outside discipline (Holly & Salmond, 2011). The agreement should be established before allowing the nurses to offer their services. The authorities regulate delegation and administration of tasks. The procedure is carried out by a specified external health expert (Holly & Salmond, 2011).

In Florida, there are strict regulatory and legal requirements for a family nurse practitioner. The APN works in partnership with physicians and other healthcare experts (Hamric et al., 2013). In Florida, the practice was licensed in 1975. The legal requirements are managed by the Board of Nursing under Part 1 of Chapter 464, F.S. However, the Florida laws acknowledge clinical nurse specialists differently. To be certified as an Advanced Family Nurse Practitioner, it is mandatory for the expert to have an up-to-date license of practice. In addition, one should prove to the Board of Nursing that all the requirements are met. The family nurse practitioner is required to have completed a formal post-basic educational program, graduate, or a master’s degree in their area of specialty (Curley & Vitale, 2011). The license should be from a nationally recognized certifying body.

Under Florida Laws, the Board of Nursing is required to implement all the rules and protocols permitting the nurses to perform their healthcare duties. The scope of practice as per the rules extends to the functions the ARNPs have been taught to carry out. In some instances, the family nurse practitioner may be allowed to prescribe medications, excluding controlled substances (Hamric et al., 2013). However, in Florida, the case is different. The professionals are not authorized to recommend drugs. The healthcare expert may perform the duties under supervision. The supervisor can be a medical or an osteopathic physician with high levels of expertise.

The Board of Nursing in Florida operates under Rule 64B9-4.003 F.A.C to ascertain principles of advanced nursing programs. The education curriculum must have a minimum length of one academic year (Curley & Vitale, 2011). In addition, it should include biological theories, nursing, and medical sciences related to the area of expertise. As a result, it is mandatory for the family nurse practitioner to have gone through the curriculum. In addition, the healthcare provider should have accumulated at least 500 hours of supervised clinical experience. The title cannot be assigned if all the requirements are not met. The certification to be a fully licensed practitioner should be authorized by Medicare and other insurers. The aim is to ensure third-party billing.

Membership to Professional Organizations

A legally certified family nurse practitioner can apply for membership in various professional organizations. Networking among healthcare experts is a vital element of their practice. The reason is because it creates a platform for continued learning and career advancement in the field. Generally, being a member of an organization enables a family nurse practitioner to have professional links with their peers in the specialty (Holly & Salmond, 2011). In addition, the expert becomes an active participant of the nursing community. Some of the of the groups available for membership include The American Association of Nurse Practitioners, Society of Nurses in Advanced Practice, NP Central, and NP Healthcare Foundation. The American Association of NPs, for example, is recommended for family nurse practitioners who wish to become more involved in their career and with healthcare experts from other fields.

Family Nurse Practitioner in Florida: Organizational Setting, Population, and Colleagues

I intend to work in an open heart ICU in my selected healthcare organization. It is a special care department in hospitals that offers intensive care medicine. The patients include those who have undergone surgery involving the opening of their thoracic cavity. Such surgical procedures expose the heart to the surgeons. The blood is circulated and oxygenated by the use of a heart-lung machine (Holly & Salmond, 2011). Monitoring and support of patients is very important in this section. The aim is to ensure the patient’s body and the operating machines function as expected. The Heart Open Intensive Care Unit is managed by highly qualified doctors and nurses, who specialize in the provision of critical care to patients (Curley & Vitale, 2011). The experts will be my colleagues. The ratio of patients to nurses in the department is expected to be 2:1. For those requiring very high levels of monitoring, the ratio reduces to 1:1.

The Leadership Attributes of the Family Nurse Practitioner Operating in Florida

Leadership involves the strategies used to offer direction, execute plans, and motivate people. My leadership style is characterized by delegative and participative attributes. A delegative leader permits the employees to make independent choices on certain issues (Lencioni, 2002). In spite of this freedom, the manager is held responsible for the outcomes of the decisions made. The mode is applied in cases where the workers are capable of examining the situation and determining the right steps to take. For a family nurse practitioner to use this style of leadership, they must have total confidence in their employees and peers (Lencioni, 2002). The approach is not used to put blame on others when things turn out differently.

Participative leadership is where a leader involves others in the decision making process. However, they retain the authority of determining the final resolution. The style is considered as a sign of strength and not weakness. It is employed when the leader and the employees have different views regarding a given issue (Lencioni, 2002). Different perspectives towards a subject enhance creativity. As a result, the leader and the employees arrive at functional choices and approaches.

A family nurse practitioner needs to have authoritarian leadership attributes. As such, I need to address the gap between what I have and what is needed. Authoritarian leaders leave little room for suggestions. However, this approach facilitates timely making of decisions. The reason is that the choices are made by only one individual. I can attain the missing attributes by associating myself with leaders who possess these qualities. In addition, I should evaluate my strengths and weaknesses as a leader.

Health Policy Issue and the Roles of Family Nurse Practitioner in Florida

A Review of the Family Gap in Affordable Care Acts

One of the health policy issues identified in the Robert Wood Johnson Foundation’s database is the family ‘glitch’ in the Affordable Care Act. Many low and medium income families in Florida are unable to purchase healthcare cover. The situation is brought about by developments in the new health insurance marketplaces (Hamric et al., 2013). Eligibility is determined by income and the ability to access affordable insurance provided by the employer. The Affordable Care Acts were implemented to ensure all citizens have access to quality healthcare (Curley & Vitale, 2011). However, some families in Florida still find themselves in the ‘glitch’. They do not benefit from the premium tax credits intended to reduce the cost of a marketplace plan. In addition, they do not qualify for the cost-sharing reductions. As such, their burden of out-of-pocket payments for healthcare services is heavy.

Most children from the families suffering from the glitch are eligible for health coverage. They can access the arrangement through the Children’s Health Insurance Program (CHIP). However, if the problem is not addressed, some spouses and children may never benefit from the affordable insurance plans. The current funding of CHIP will expire in 2015 (Hamric et al., 2013).

Changing the Policy

To address the problem of family glitch in Florida, various measures need to be put in place. For example, all working families should be made eligible for affordable health insurance (Curley & Vitale, 2011). The qualifications should be determined by the cost of family-based cover with respect to the employee’s family members. The healthcare benefits should also be distributed fairly across all the eligible workers in Florida. The low and middle income families who cannot afford the package should be exempted from some taxes. In addition, they should be made eligible for the cost-sharing reductions initiative (Holly & Salmond, 2011). In addition to the children, the cover should be extended to parents and spouses. The productivity of insured adults is enhanced. As a result, they are able to support and care for their families.

Leading the Change

As a family nurse practitioner, I will be part of the campaign to make changes in the policy. I will do this by ensuring that the right channels are followed and key lawmakers and nurse administrators are brought on board. Government officials in the health department will also be consulted. I will encourage them to raise the motion in parliament. In addition, I will clearly point out the defects of the existing policy and benefits expected after the amendment. If the leaders in the healthcare sector are convinced that the issues are valid, they will support the initiative. As a result, there will be more support and influence to drive the cause towards the expected direction (Hamric et al., 2013).

Effects of the Change

If the policy is modified, more families in Florida will be able to enjoy the benefits of the affordable healthcare plan. More spouses and children will also be covered. Generally, the quality of healthcare will improve.

Conclusion

Nurses play a critical role of providing care to members of the public. Advanced skills are needed to perform in the field. All the legal requirements should be met for one to operate as a family nurse practitioner. The state of Florida has strict legislations informing the conduct of nurses. Policies in the healthcare sector should be reviewed regularly to ensure they are beneficial to all the stakeholders.

References

Curley, A., & Vitale, P. (2011). Population-based nursing: Concepts and competencies for advanced practice. New York, N.Y.: Springer Publishing Company.

Hamric, A., Hanson, C., Tracy, M., & O’Grady, E. (2013). Advanced practice nursing: An integrative approach (5th ed.). St. Louis, Mo.: Saunders/Elsevier.

Holly, C., & Salmond, S. (2011). Comprehensive systematic review for advanced nursing practice. New York: Springer Publishing Company.

Lencioni, P. (2002). The five dysfunctions of a team: A leadership fable. New York: Jossey-Bass.