Advanced Practice Nurse Role in Leading and Creating Change


Advanced practice nursing is a nursing aspect that utilizes expanded skills to asses, plan, implement, diagnose and measure the level of care required in medical condition that is beyond the traditional nursing practises.Most of the nurses practicing the APN are either generalist or specialist and are globally registered under the APRN (Advanced Practice Registered Nurse) (Ruth and Anna,2004 ).This kind of medical care requires high degree of knowledge, experience, skills and critical thinking so as to ensure optimum results while still maintaining high levels of patient nurse relationship. This paper carefully examines the role played by the advanced practice nurse in leading and creating change within the society (Matano, 1991).

Provision of sufficient care

One of the main roles of Advanced practice nursing is to provide patients with quality medical and therapeutic attention. According to Maxine (2000), it is through the help of advanced practicing nurse, that referral times to appointments have been minimized. This in turns leads to an improved medical care since the nurse closely works in conjunction with patients’ specialists and physicians so as to plan and provide the necessary care. Sometimes they spend more time with patient than the patients’ physician while they answer questions concerning patients’ illnesses thus averting the occurrences of similar diseases in future.

Alcohol abuse group therapy

The second significant role of APN as a leader is to give therapy to alcohol abusers especially in the developed countries. According to studies done by Puskar and McClure (2004), it is noted that APN use a lot of compassion and empathy which are coupled with education. This makes the alcoholics to fully understand the dangers that the drug posses on their lives. Ultimately the alcohol abusers recovers fully and this is done in conjunction with the American Nurses Association Psychiatric Mental Health Scope.

Development of medical program

In addition, Advanced practice nursing helps in development of programs emulated by nurses. According to Peplau (1991), nurses are nowadays partnering with other medical representatives in their areas of operations.This is made possible by the fact that the APN are more educated and experienced which also enables them to participate in programs like research and other quality improvement in the health sector in conjunction with their colleagues in the medical field such as Doctors.

This has enabled the clinical and hospital staffs to deal with the patients as their interpersonal skills and mutual respect between the patient and the nurse is improved (Puskar and McClure, 2004). Through the research programs the APN has greatly improved on how to deal with patients on group therapists such as drug abusers by equipping them with all the necessary knowledge on the impact of continuous drug abuse to their health in long run after the therapy (Jarman, 2000).

Implementation and evaluation of APRN Board Policies

The third role of Advanced practice nursing is the implementation and evaluation of policies developed by the advanced practice registered nurse (APRN) board in the various countries. Mattson (2003), advocates that APN should ensure that the policies discussed by the board are executed on the ground by the staffs in hospitals and clinics. This ultimately ensures smooth running of the entire medical firm as medical policies are harmonized across all the medical centers.

The nurses act as the representatives to the APRN board. In this way, they ensure the policies discussed during the APRN board meetings reach the ground in the shortest time possible. Most of these changes have positive effects to the society thus making APN to be an important pillar to the development of any country which is all in line with the millennium development goals (Peplau, 1998).

Concept advancement

Likewise, APN assists in the concept advancement within the nursing career. According to Maxine (2000), nurses provide care to patients suffering from complex and unpredictable health needs that require extended skills and knowledge which is beyond the traditional scope of nursing practice. Most of the complex diseases require to be dealt by a person who is able to integrate theoretical, research, and practical knowledge, a virtue which is not readily available in the normal nursing practice. In many situations the APN is forced to critically analyze a situation when applying the depth of knowledge which lacks during the normal nursing practice (Kreger, 1991).

Therefore, extending health provision beyond the traditional boundaries of the nursing practice but aimed primarily to provision of clinical care is the main responsibility of the advanced practicing nurses. This task is vital since it provides the necessary medical care to patients when the traditional ones fails thus making APN a necessary part of society (Roberts, 2003).

Conflicts of roles between APN and other nursing practitioners

Despite the positive impacts discussed above, APN have posed a negative effect to the society based on the fact that their roles highly clash with those of the clinical and the hospital members of staff. According to Maxine (2000), one of the main reason as to why this happens is due to lack of a clear distinction of the roles each type of nurse is supposed to play in the medical field. Consequently, patients are left confused as they end up not knowing who to seek medical advice from during times of illness. All this is caused by the lack of clearly defined roles of APN, their goal expectations and the underutilization of evidence based approach to aid the introduction of APN.

In his studies Jarman (1997), argues that nurses acting in different capacities should be clearly distinguished so as to ensure efficient service provision to the patients especially in the positions of the Advanced practice nurse and that of Advanced clinical practice. In some countries such as the United States, the roles of clinical nurse specialists, nurse midwives, nurse practitioner and nurse anaesthetist are clearly depicted thus there is no difficulty in distinguishing APN roles. However in the countries like India where some titles such as nurse specialist are applied for different roles such as nurse practitioner it becomes difficult for the Advanced Practicing Nurses to execute the mandates given to them by the APRN Board (Roth, 1996).


As discussed above, the roles played by the APN are vital tools towards provision of good medical care to the patients and it is important that countries come up with clearly defined roles of APN so as to enable them to have a much bigger impact to the societies which the serve in.


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