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NUR-513 Topic 1 DQ 1 how the role of advanced registered nurse transformed over time

how the role of advanced registered nurse transformed over time

Describe how the role of advanced registered nurse transformed over time. Consider shifts in scope and expectations in the 20th and 21st centuries. In what ways will the advanced registered nurse role and responsibilities continue to evolve and emerge as the American health care system changes?

3 posts
Re: Topic 1 DQ 1
Advanced practice registered nurse tittle, according to DeNisco & Barker (2016) is for masters prepared nurses who are responsible for providing clinical care to individuals. Historically, the role of an advanced practice nurse has commonly be associated to clinical roles and they include “clinical nurse specialist,

how the role of advanced registered nurse transformed over time

Assignment Describe how the role of advance registered nurse transformed over time

nurse practitioner, certified nurse-midwife, and certified registered nurse anesthetist” (DeNisco & Barker, 2016).

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In the 1970’s, there was a great shortage of primary care physicians in the United States. To resolve this, federal funding was given toward establishing more advanced registered nurses to occupy the positions for diagnosing and treatment in both urban and rural areas and prevent shortages (DeNisco & Barker, 2016). Nurse Practitioners are the largest in number of advance practice nurses in the United States. Overtime, the roles of advanced practice registered nurses expanded but not limited to nurse practitioners, nurse anesthetists, clinical specialists, and midwives, and all these field play a vital role in the current health care system (DeNisco & Barker, 2016).

Due to the shift in scope of nursing and focus on higher expectations and reliability in the 20th and 21st centuries, advanced education is required of nurses to work at the forefront of providing direct and preventative care. Hiring advanced practice registered nurses is seen as being cost effective to overcome physician’s shortages and other problems facing the health care system (Barton, Bevan, & Mooney, 2012). how the role of advanced registered nurse transformed over time

Advanced education in nursing has caused an increase in advanced nursing roles and responsibilities with broader scope of health care in areas including but not limited to primary, acute, and specialty health care across the lifespan through assessment, diagnosis, treatment of illnesses/injuries, and pain management (Tiffin, 2015). “Consequently, nurse administrators, public health nurses, and policymakers are considered advanced practice nurses albeit they do not provide direct care or obtain advanced practice licensure per the state they practice in” (DeNisco & Barker, 2016).

Advanced practice registered nursing is an avenue to focus on continuous management of individuals under the care and support of nursing experts. Advanced level of nursing education improves or changes the standard of practice of organizations using evidence-based practice.

Advanced practice registered nurses are trained to be prepared for changes in the nursing world and the application of learned skills, knowledge, and technology (DeNisco & Barker, 2016).In the future, advanced registered nurse are expected to make positive impacts on the health care system of the United States.

References: how the role of advanced registered nurse transformed over time

Barton, T. D., Bevan, L., & Mooney, G. (2012, June 8). Advanced nursing 1: the development of advanced nursing roles. Retrieved from Nursing Times: https://www.nursingtimes.net/clinical-archive/the-development-of-advanced-nursing-roles-08-06-2012/

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential

knowledge for the profession. Third edition. Burlington, MA: Jones & Bartlett


Tiffin, C. (2015, January 15). The Changing Role of Todays Nurses. Retrieved from The Journal of advanced Practice Nursing: https://www.asrn.org/journal-advanced-practice-nursing/1259-the-changing-role-of-todays-nurses.html

3 posts
Re: Topic 1 DQ 1
Nursing has always been a noble profession that demands hard work, dedication, skills and expertise. As described in the book, nursing and advanced nursing has always focused on treating the ailments of patients. However, over the years, the role of Advanced Registered Nurse has evolved and will continue to change as more policies and procedures are being implemented towards the advancement and achievement of quality Nursing care. As a result, advanced nursing has come to focus more on preventative care and measures through the modernization of equipment and treatment as well as the advancement in education and research associated with the roles and functions of ARNs. The broad medical scope of Nursing practice continues to become more defined, more goal-oriented, more holistic and more collaborative. As a result, NPs have been given full autonomy to function independently and thrive in a more challenging and competitive health care system. The increasing demand for Advanced RN ’s in the health care setting is becoming more popular and will continue to grow in the 21st century. In conclusion, there have been many changes in the health care system that can create a great impact on health care delivery and focus of care. Promotion of health and preventative care approach to nursing practice is what I can expect in the 21st century. It’s like going back to what Florence Nightingale stated, “Nursing focuses on illness and suffering with the goals of easing suffering and promoting disease prevention (Nightingale, 1859/2009).”Denisco, S. M., & Barker, A. M. (2016). ADVANCED PRACTICE NURSING Essential Knowledge for the Profession (3rd ed.). Jones & Bartlett Learning.

Re: Topic 1 DQ 1
The transformation of the roles of advanced practice nurses has been directly influenced by patient population throughout history (DeNisco & Barker, 2016). Advanced registered nurses are those nurses who possess a Master’s degree or higher and typically are classified under the following four subcategories, Nurse Practitioner (NP), Certified Nurse Midwife, Certified Nurse Anesthetist and Clinical Nurse Specialist (DeNisco & Barker, 2016). In the 1960’s The Clinical Nurse specialist role came about due to the need for nurses who could provide more complex care for Psychiatric patients and the NLN and ANA have largely supported this diverse role (DeNisco & Barker, 2016). While the Clinical nurse specialist’s role started based on a need for psychiatric care the abundant usefulness was identified and now these nurses are educated in all specialties (DeNisco & Barker, 2016).

Much like clinical nurse specialties Nurse Practitioners have been providing care for patients since the 1960’s and the role was established based on a shortage of physicians able to provide care for pediatric patients (DeNisco & Barker, 2016). Programs started as short 3-12-month training courses and by the 1990’s masters degrees where the baseline requirement for all NP’s. Np’s currently are the largest group of APRN and are licensed to practice with prescriptive authority in all 50 states and DC.

Certified Nurse midwives where first established based on the overwhelming maternal and child death rates in rural Kentucky (DeNisco & Barker, 2016). These initial midwives received education that allowed them to provide family care and ultimate patient outcomes in this area where better than the rest of the US thus proving the inherent worth of Midwives. All education for midwives is now in educational institutions and those who graduate and become licensed are granted privileges and prescriptive authority in all states (DeNisco & Barker, 2016).

The role of Nurse Anesthetic (CRNA) is documented as far back as 150 years ago during the Civil war (DeNisco & Barker, 2016). This unique APRN role is seen predominately in rural America with some underserved areas being covered solely by the CRNA. CRNA are licensed individual practitioner and are able to have autonomy for their care.

Healthcare is ever changing and is constantly being reformed. On key aspect that has led the change was the 2010 Institute of Medicine (IOM) report (IOM Future of Nursing Report, n.d.). The 2010 IOM Report emphasized the need for nurses to be able to practice to the full scope of their license and this was a direct reflection of a need identified due to the changing healthcare system (IOM Future of Nursing Report, n.d.). Baby boomers are aging and increasing the strain for HCP there are many nurses that are a part of that group that are retiring and thus increasing the nursing shortage. The report also addresses that fact that nurses should be in partnership with physicians to lead change and help addresses the new needs of a changing healthcare system (IOM Future of Nursing Report, n.d.).

DeNisco, S. M., & Barker, A. M. (2016). ADVANCED PRACTICE NURSING Essential Knowledge for the Profession(3rd ed.). Jones & Bartlett Learning.

IOM Future of Nursing Report. (n.d.). Retrieved February 27, 2021, from https://www.nursingworld.org/practice-policy/iom-future-of-nursing-report/

Re: Topic 1 DQ 1
The role of the advance practice nurse (APN) has changed considerably in the past century. The role of the nurse practitioner (NP), for example, was born out of the shortage of primary care physicians able to serve pediatric populations (DeNisco & Baker, 2016). However, during this time, nurse practitioners were restricted from diagnosing and prescribing by the American Nurse’s Association (Keeling, 2015). This meant that NPs were much more limited in the autonomy within their practice. Since it is widely believed that NPs provide high quality care that is more cost efficient than that of their physician counterparts, it would lead one to infer that this was done to keep NPs within the bounds of nursing rather than encroaching on the role of a physician. Nowadays, the responsibilities and education requirements for NPs have grown. In fact, The Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) call for nurses to “practice to the full extent of their education and training” and for nurses to achieve higher levels of education and training though an improved education system (DeNisco & Baker, 2016). More than 192,000 NPs are now licensed and practicing with some level of authority in all 50 states and the District of Colombia (DeNisco & Baker, 2016). The role of the APN will continue to evolve and emerge as the nation pushes to improve access to quality health care while reducing costs (DeNisco & Baker, 2016). This, in turn, will further expand the demand for APNs and nurses in general to broaden the scope of their responsibilities.ReferencesDeNisco, S. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 978-1284072570Keeling, A. W. (2015, May). Historical perspectives on an expanded role for nursing. RetrievedFebruary 25, 2021, from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/Historical-Perspectives-Expanded-Role-Nursing.html

Traditionally, advanced practice nursing referred to one of four positions: certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM), clinical nurse specialist (CNS), or certified nurse practitioner (CNP) (CNP). Advanced practice nursing was defined by the American Association of Colleges of Nursing (AACN) in 2004 as “any form of nursing intervention that influences health care outcomes for individuals or populations, including direct patient care, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy” (Denisco & Barker, 2016).

Many other nursing jobs, such as nurse administrators and public health nurses, have been considered advanced practice nursing roles since this definition was published. Advanced practice nursing used to be mostly used in clinical settings, but it is currently expanding into non-clinical areas. With the ever-expanding role of nurses, as well as the desire to increase access to and lower the cost of health care, numerous new nursing roles are anticipated to emerge. Even if they are not in clinical areas, these professions will necessitate advanced degrees, therefore they should be considered advanced practice nursing.

S.M. Denisco and A.M. Barker (2016).
Advanced Practice Nursing: Essential Knowledge for the Profession is a book that teaches you everything you need to know about advanced practice nursing.
Jones and Bartlett Learning is a company that specializes in education.
https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing essential-knowledge-for-the-profession 3e.php

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