Advanced registered nursing graduates are entering the profession at dynamic time when roles and scope of practice are shifting based on developments in legislation and policy in response to the evolving needs of the health care system. Professional nursing organizations play an important role in making sure the perspectives of advanced registered nurses are heard, and in supporting nurse specialties in their efforts to expand their scope of practice and their full participation throughout the health care system.
For this assignment, you will conduct research on the current scope of practice for your specialty and efforts that are being made to expand that scope and the role of the advanced nurse in positively influencing the health care system. Write a 1,250-1,500-word paper that includes the following:
- A discussion of the scope of your future role as an advanced registered nurse, including any regulatory, certification, or accreditation agencies that define that scope.
- A discussion of three professional nursing organizations that you think are most influential in advancing the scope and influence of advanced nursing. Of these organizations, evaluate the one that you would most like to join. How do its goals and mission fit in with your worldview and philosophy of care? How might membership in this organization improve your practice?
- A discussion of a controversial or evolving issue that is most likely to affect your scope of practice or role in the next few years. How do you think this issue could influence the profession and other stakeholders, and why does it matters to the advanced registered nurse?
- You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
- Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Clinical Nurse Specialist Benchmark – Future Scope, Role, and Professional Obligations Sample Paper
The scope of your future role as an advanced registered nurse (Clinical Nurse Specialist). My future role as an advanced registered nurse is that of a clinical nurse specialist (CNS). CNS was the initial designated advanced practice nurses category in the United States. The CNS is believed to have been established by Hildegard Peplau in the 1956. Hildegard also established the initial master degree program in nursing, which exclusively centered on clinical practice. The program graduates were regarded as clinical specialists (Mayo et al., 2017). CNS competencies and education are founded on levels of education attained by registered nurses (RNs). CNSs are thus licensed registered nurses, who have advanced their education to incorporate doctoral, master, or degree graduate-level preparation in nursing.
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All programs of CNS prepare RNs to take care of patient population that is complex and unique. The CNS core curriculum includes advanced physical assessment, advance pharmacology and advanced physiology. Extra course work assists in preparing the CNS with advanced and unique level competencies, and to offer expert field care. This comprises of advanced roles in management, diagnosis, and assessment; leadership focused on guaranteeing the utilization of best evidence-based care and practice to attain cost effective, high quality patient outcome in the healthcare environment; and proficiency in supporting nurses taking care of patients at the bedside (Brassard, 2014). The CNS integrates unique care across continuum, via three influence spheres that include the nurses, patient and the extensive healthcare system. Each of these influence spheres contains unique focus, though CNS care intersects and overlaps with the primary objectives of progressive enhancement of general nursing care and patient outcomes. Preparation in an advanced specialty practice that include psychiatric health, oncology, diabetes, stroke and gerontology guarantees that the CNS is ready to handle significant care results that include hospital readmissions, and preventing avoidable complications (Tian et al., 2014).
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The CNSs need to obtain national certification through the American Association of Critical Care Nurses (AACN) or the American Nurses Credentialing Center (ANCC). ANCC offers a certification for Adult-Gerontology Clinical Nurse Specialist. Nurses are only able to sit for this certification exam after they are done with their post-graduate, doctoral or master degree, with a specialization in adult-gerontology clinical nursing. The program needs to include at least 500 supervised hours of clinical practicum in the specialist role of adult-gerontology clinical nursing, and content on advanced pathophysiology and physiology, different methods of disease management and diagnosis, advanced health assessment, health promotion and advanced pharmacology (Foster & Flanders, 2014). ANCC also provides four more CNS certifications that include Adult Psychiatric-Mental Health CNS, Pediatric CNS, Child/Adolescent Psychiatric-Mental Health CNS, and Adult Health CNS. According to ANCC any person holding any of the certificates can renew them if they keep on adhering to practice requirement and professional development (Proehl, 2016).
Professional Nursing Organizations
The three professional nursing organizations that I think are most influential in advancing the scope and influence of advanced nursing include American Nurses Association (ANA), American Nurses Credentialing Center (ANCC), and National Association of Clinical Nurse Specialists (NACNS). ANCC refers to American Nurses Association subsidiary, which centers on enhancing healthcare and nursing excellence globally, by offering credential to programs. The program recognizes and certifies nurses in their areas of specialization. ANCC acknowledges healthcare organizations which enhance quality patient outcomes and nursing excellence while offering positive, safe work environment. It also accredits healthcare organizations, which approve and provide accredits transition and progressive nursing education to prepare nurses for novel roles of practice and practice programs (ANCC, 2019).
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ANA is regarded as a premier organization standing for the interest of four million registered nurses in the country. ANA is in the frontline in enhancing healthcare quality for all. It was established in 1896 and it has members in almost all states in the country and hence, serving as the strongest nursing professional voice. The organization lives to enhance nursing career by nurturing high nursing practice standards, promoting an ethical and safe work environment, bolstering the wellness and health of nurses and finally, advocating on issues of healthcare that impact the public and nurses (ANA, 2019).
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NACNS focuses on advancing the unique value and expertise the clinical nurse specialist adds to healthcare. The organization main goal is to promote the full practice scope of the clinical nurses specialist, at as the national CNS education leader, enhance benefits brought by CNS to patient safety, evidence-based quality, savings cost in healthcare delivery and finally, to enhance research which assesses the value and efficacy of CNS practice and interventions. The organization is also committed into offering education, mentoring and networking chances for the continuing CNS professional development. It also enhances impact of CNS visibility on access to nursing care quality and cost of healthcare systems. NACNS also enhances CNS unification in their roles of advance practice regarding influence spheres competencies, education preparations and professional standards among other things (NACNS, 2019).
Among the three, the organization that I am likely to join is the NACNS. This is because this organization is specialized on CNS needs in their daily career practice and in their professional growth in CNS specialization. Its mission of advancing the unique value and expertise the clinical nurse specialist adds to healthcare fits in my worldview and career philosophies of enhancing my proficiency level to be able to offer high quality of specialized care with intention of enhancing patients’ quality of life and regaining their ability to live independently. My membership in this organization will ensure that I build advance professional network that will help me to improve my knowledge in my specialty and get to know more evidence-based practices to address different patients’ conditions in this area. The organization will also keep me posted on changes taking place in the specialty, and helps me to always focus on my professional growth and building competency.
Controversial or Evolving Issue that is most likely to Affect Your Scope of Practice or Role in the Next Few Years
The controversial issue that is likely to impact my scope of practice is healthcare cost. CNS involves handling special health problems, especially those that are likely to affect aging population. America is currently facing the challenge of handling baby boomers healthcare cost as majority become eligible to Medicare. The cost of healthcare is already 2.5 times that of average countries with higher income (Salmond & Echevarria, 2017). The country population has been increasing to a level that state and federal budgets, patients, and employers are unable or unwilling to handle the bill. Republican government has been trying to do away with Obama care, which is accused of overburdening the economy of the country (Salmond & Echevarria, 2017).
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The issue of cost is likely to influence my scope of practice especially in a situation where a patient fails to afford advanced care. The situation can get worse in an event where those depending on government healthcare plan get to lose their eligibility due to policy change. In such situation, majority of patient will be required to pay for their services using private covers or out-of-pocket. This may mean that despite having the required skills, CNSs nurses may be unable to help their patients due to inability to meet the cost. This issue is likely to influence professionalism by always putting nurses in an ethical dilemma on what to prioritize on between saving life and ensuring the organization meets its financial goals, which facilitate its existence. The issue of cost is likely to limit patients’ access to healthcare, and affect the general health of people in the country. This issue matters to advanced registered nurses because nurses’ main goal is to save life and to improve patients’ quality of life (Woo, Lee & Tam, 2017). This may be impossible if patients will not be able to afford the nursing care, meaning registered nurses will not be able to live their dream of saving life.