Group items tagged

This article chronicles the history of nursing and how expanding the role of nurses was initially justified. It discusses how this expanded role eventually became the role of the nurse practitioner that we are familiar with today.

I found this article to be completely fascinating as I was almost completely unaware of the history of the APRN role. I have heard of Lillian Wald and Mary Breckenridge but didn't know the full extent of their backgrounds. I enjoyed the history provided in this article and feel that it was a perfect reading to begin my APRN transition. It provided some important information on how the role of the nurse changed and was diminished by ourselves (ANA) before being re-expanded in the 1960s with the role of the NP. I'd love to hear what others think and if you have other interesting historical articles on the background of the APRN role!

Recently published article in NEJM that pulls together some of the exciting things coming for NPs and RNs in continuing expanded roles to meet primary care needs in our health care system.

This article discusses the difficulties APRNs experience while attempting to expand their scope of practice. It explores arguments between nurse practitioners and physicians on how APRNs will contribute to the shortage of primary care providers.

Summary of key points and link to FTC paper (March 2014) addressing regulation of APRN scope of practice

The purpose of this hermeneutic phenomenology (van Manen, 1990) was to gain insight into the meaning and lived experience of nurse practitioners (NP) with at least one year of work experience regarding their initial transition from new graduate to hospital-based practitioner. This study provided information regarding NP hospital-based transition experience that had not been revealed in the nursing literature. The meaning of transitioning into hospital-based practice was discovered through analysis of nurse practitioner letters and interviews in this phenomenological study. Six themes emerged from this research including: Going from expert RN to novice NP; system integration; "Don't Give Up"; Learning "On the Fly"; They Don't Understand my NP Role; and Succeeding Through Collaboration.   Master's prepared, board-certified NPs in North Carolina (NC) with between one and three years of NP practice experience in a hospital setting comprised the population of interest for this study. Twelve participants were purposefully sampled from nine hospitals in NC. Individual, voice-recorded, in-depth, open-ended telephone interviews were conducted with each participant.   The majority of the participants indicated a timeframe that ranged from six to 18 months regarding how long it took them to feel more comfortable in their NP role, the lack of comfort was most intense during the first nine months of practice. Participants confronted multiple obstacles and challenges as new NPs. These challenges included navigating and negotiating a new health care provider role; becoming integrated into a hospital system in what was a new role for them and sometimes for the system; learning how to function effectively as a NP while simultaneously working to re-establish themselves as proficient clinicians with a newly expanded practice scope; building key relationships; and educating physicians, hospital leaders, clinical staff, patients, and families about the NP

The role of APRNs continues to expand when current gaps in patient care management and outcomes are identified. Central Arkansas Veteran Healthcare System created the role of Abnormal Radiology Findings APRN with the aim of improving patient outcomes by decreasing the length of time between abnormal radiology findings and decrease of care for our veterans. During the year of research since the advent of this position, the days until decision dropped on average from 38 to 7 demonstrating the efficacy of the role and the ways APRN are well placed within the health care system to provide patient-centered care.

This is an interesting article that conducted a lit review to see how expanding the scope of practice for APRNs would affect health care delivery and costs in Ohio. Although it is specific to Ohio, the lit review they did highlights many benefits to full practice authority that could be generalized to any state.

Discussion of progress and barriers to expanded SOP for NPs, including physician's arguments for mandatory physician oversight.

This is an excellent overview of NP history and practice changes written by Arlene W. Keeling PhD, RN, FAAN. It includes a historical narrative for the NP role that includes key figures (Lillian Wald, Mary Breckenridge, Loretta Ford) with seminal legislation, challenges to the practice, and future implications.

This article is about the scope of practice of midwives and childbirth outcomes. It discusses the relationship between autonomous practice and better birth outcomes. The article suggests there should be future policies to expand the access to midwifery services.

This article describes the similarities between Midwifery practice and palliative care. The authors state that historically Midwives have been involved in the "cradle to grave" process. They argue Midwives are well suited to provide palliative care.

This article describes entry-level competencies for NPs practicing in emergency care - it was the first to define these competencies which is key since the roles of APRNs have expanded. A Nurse Practitioner (NP) Validation Work Team was formed and a Delphi study was conducted to verify and gain consensus on professional and clinical competencies for NPs in emergency care.

This article discusses how the role of the Nurse Practitioner profession has expanded around the world. They outline the "developmental progress" of the role in the United States and compare the role development of the NP to that of Erickson's developmental stages in children. Interesting read!

This is a nice synopsis of key moments in history that have triggered the growth and development of the NP role in the US.