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This article present a gap in research regarding advocacy at the APRN level, despite the large amount of evidence surrounding advocacy at the RN level. The article calls for more research regarding if and how advocacy may differ at the APRN level and how exactly institutions are preparing APRN students for the advocacy role.

This link shows all the certifying bodies available and has links to those websites The American Association of Nurse Practitioners (AANP) is the largest and only full-service national professional membership organization for nurse practitioners (NPs) of all specialties.

In this article, author Lugo discusses the findings of her study relating limits on full practice authority for APRNs to issues of gender equality. She investigated the link between state support of the Equal Rights Amendment (ERA) and laws in these states allowing APRNs full scope of practice and prescribing rights. Her study showed that states that have historically and currently supported the ERA in fact allow greater APRN scope of practice, and thus she draws conclusions about attitudes towards women's equality and the regulation of advanced practice nursing, which remains to be a woman-dominated profession.

In this May 2016 article published in the Online Journal of Issues in Nursing, Dr. Nancy Rudner Lugo argues that advanced practicing nursing viewed through a gendered perspective due to nursing's history as a predominantly female profession; because of this, APRNS in states that are less accepting of women's equality have a more narrow scope of practice. There is not currently a national-level evidence based method used to determine APRN scope, and is instead decided at the state level. The author seeks to explain the cause of the discrepancy between differing APRN scopes of practice in different states by comparing the APRN scope of practice between states that did and did not vote to pass the Equal Right Amendment, positing that states with cultural attitudes that are more equitable between genders reflect this at the legislative level, thus explaining the wider or full practice authority given to APRNs in these states. In conclusion, Lugo advocates for increasing the number of women in legislative positions, forming relationships between women's equality organizations and groups working towards expanded health care access, and emphasizing the skills and competency of APRNs in achieving positive patient health outcomes.

This article touches on a topic of particular interest to me, specifically how APRN's can help fill a critical shortage of primary care providers in HIV medicine. The article validates that APRN's (NP's) are more than capable of providing high quality care to those living with HIV. Moreover, we are well positioned to fill the provider shortage that is only expected to grow over the next decade and beyond.

As NPs, many of us who have not practiced as nurses, it might be difficult to get your foot in the door of that first job. This is a personal strategy that I came up with to try and help mitigate that for myself, I'm obviously hoping that it works! For those of us who know where we want to work, for me that's in HIV medicine, I think it's important to develop the competencies that your employer will be looking for when you walk in the door. This article does a nice job of laying those out for entry level NPs looking to get into HIV medicine. What I'm trying to do is add as many of these skills to my resume while I'm attending school. My hope is that will give me an edge over NPs that I'm competing with who may not have been in the specialty specific time. If you can identify your desired areas of practice then its just a matter of looking for opportunities to add to your skillset. Look for faculty that have a shared interest, see if you can work on a research project with them. Look for nursing organizations in that specialty. There are two HIV specific organizations for APRNs looking to get into HIV medicine (ANAC and AAHIV). Join them and start networking. Take as much CNE as you can in your specialty topic - much of its free and can be done online at your own pace.

This article describes the Consensus Model developed in 2008 for the APRN role for licensure, accreditation and certification across the United States. Though the intended goal for adoption was in 2015 (still has not happened yet), there is still much work that needs to be done at the state and national level to get this to approved.

BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges

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 reflects on the progressive changes in the redesign of healthcare and how the role of the APRN will simultaneously evolve to allow practitioners to practice to the expected level of their capabilities.

An interesting article that opines about the DNP. Here's a fairly provocative quote: "When viewed together, doctorally prepared nurses do not spend the majority of their time in direct patient care, but rather in research (11%), education (32%), and administration (30%). With these demanding roles, they cannot be expected to maintain expert levels of clinical competence required for teaching APN students. While research and practice are critical components of nursing, each requires a different skill set and education."

The author figures out the challenges in interdisciplinary teamwork among healthcare providers. These challenges are worth attention if we hope to do well in interdisciplinary teamwork.

This article discusses how interdisciplinary teamwork is experienced at three levels: healthcare professionals, patients, and healthcare organizations.

The points made by the author - reaching decisions collectively, making sure everyone is committed to the same purpose and goal, full participation, understanding the work of other disciplines - can be applied in any type of teamwork setting for successful outcomes. However, with healthcare the author points out that effective teamwork can lead to decreasing health care costs, improved patient safety, and decreasing workload through shared responsibilities. All areas that can allow for better patient care and more efficient use of time and financial resources.

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