NUR 510 Week 2 discussion – Leadership and Role of the Advanced Practice Nurse
NUR 510 Week 2 discussion – Leadership and Role of the Advanced Practice Nurse
NUR 510 Week 2 discussion – Leadership and Role of the Advanced Practice Nurse
This is a graded discussion: 100 points possible
due Nov 10, 2019
Week 2: Advanced Practice Nursing (Orig Post due Wednesday, Responses due Sunday)
1616 unread replies.8282 replies.
Purpose
The purpose of this discussion assignment is to research all four APN roles in one’s current state of residence. Students will understand the practice parameters for each including work environment, level of accountability, patient population, salary, and scope of practice for each of the APN roles. NUR 510 Week 2 discussion – Leadership and Role of the Advanced Practice Nurse
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
Analyze the development of advanced practice nursing roles from a historical perspective including the impact of advanced practice nursing on the healthcare delivery system from the perspective of selected current reports (i.e., LACE, IOM, etc.) (CO1)
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Due Date: Wednesday of week 2 by 11:59PM MST
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday of week 2 by 11:59PM MST, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points Possible: 100
Requirements:
In week one, you discussed your scope of practice in your current state as a nurse practitioner. Now, explore the four APN roles in your state (CNP, CNS, CRNA & CNM).
Discuss work environment, level of accountability, patient population, salary, and scope of practice for each of the APN roles.
Provide your personal Pro and Con list for each role and provide appropriate citations.
Describe your rationale for choosing the CNP advanced practice role versus any of the other three.
What are your plans for clinical practice after graduation?
Has your idea of NP practice changed after researching this for your state?
Students must reply to each graded discussion topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week.
A minimum of three posts in each graded discussion must be made on three separate days.
Respond to at least one peer in the threaded discussion
Responses to peer/faculty are substantive (adds importance, depth, and meaningfulness to the discussion)
Responds to all direct questions from faculty (if no question asked directly, student responded to questions posed to the entire class)
Summarizes what was learned from the lesson, readings, and other student posts for the week. The summary could be included in one of the three minimum posts.
DISCUSSION CONTENT
Category
Points
%
Description
Discuss work environment, level of accountability, patient population, salary, and scope of practice for each of the APN roles. Provide your personal Pro and Con list for each role and provide appropriate citations.
45
45%
Students will research all four APN roles in their state including work environment, level of accountability, patient population, salary, and scope of practice for each of the APN roles.
Next, they will develop a pros and cons list based upon the criterium as it pertains to their future goals as an APN.
Describe your rationale for choosing the CNP advanced practice role versus any of the other three. What are your plans for clinical practice after graduation? Has your idea of NP practice changed after researching this for your state?
30
30%
Based upon the research, students will evaluate their current choice of APN role as an NP and whether there has been a potential change of their current role.
Next, students will discuss their plans for practice after graduation as an NP.
Interactive Dialogue
20
20%
4 Required Elements:
· Responds to at least two peers in the threaded discussion;
· Responses to peer/faculty are substantive (adds importance, depth, and meaningfulness to the discussion)
· Responds to all direct questions from faculty (if no question asked directly, student responded to questions posed to the entire class)
· Summarizes what was learned from the lesson, readings, and other student posts for the week. The summary could be included in one of the three minimum posts.
95
95%
Total CONTENT Points= 95 pts
DISCUSSION FORMAT
Category
Points
%
Description
Grammar, Syntax, Spelling, & Punctuation
5
5%
Grammar, syntax, spelling, and punctuation are accurate.
5
5%
Total FORMAT Points= 5 pts
100
100%
DISCUSSION TOTAL=100 points
**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.
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ReplyReply to Week 2: Advanced Practice Nursing (Orig Post due Wednesday, Responses due Sunday)
Collapse SubdiscussionKarina Takinan
Karina Takinan
Nov 4, 2019Nov 4, 2019 at 9:23pm
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Hi everyone,
Sorry I had to make a table for this presentation, I though of simplifying it and simply adding up the last pieces of my thoughts outside of the table.
APN Role in New Jersey
Work Environment
Level of Accountability
Patient Population
Salary range (New Jersey)
Scope of Practice
Clinical Nurse Specialist (CNS) – CNS are advanced practice nurses that provide care utilizing evidence-based practices that promote healthcare outcomes in collaboration with other interdisciplinary staff (Darmody, 2019).
-Regulated by the NJ Board of Nursing.
CNS work in hospitals, physicians offices, laboratories, outpatient care centers, colleges and universities and other clinical locations.
CNS are usually employed by institutions like hospitals and community setting, their level of accountability is minimal compared to that of the physicians, similar to the Nurse Practitioners.
Pediatrics, Adult-gerontology, home care and psychiatric patients.
The average annual salary for CNS $101,276 with the highest paid CNS earning more than $120,000. (Salary.com, 2018)
CNS, work in collaboration with physicians and other health care practitioners. According to the National Association of Clinical Nurse Specialist (NACNS), CNS provide clinical expertise, leadership, education and help in innovations in hospital, community or outpatient settings.
Nurse Practitioner (NP) – A masters’ educated nurse who has been trained and educated on how to diagnose and treat and treat diseases. Often, they are referred to as a physician’s extension. Regulation of practice varies depending on the state. NJ’s nurse practitioners have limited practice, they work in collaboration with physicians.
Regulated by the Board of Nursing
Hospitals, private practices, ambulatory clinics and long-term care.
Since APN’s in NJ do not have full-practice authority and are usually employed by hospitals, physicians and other clinical institutions, the level of accountability is minimal. Between September 1990 & November 2012, only 1% of NJ’s APRN’s were reported for malpractice compared to the nearly 34% of NJ physicians (Torre & Drake, 2014).
Adult
Adult-Gerontology
Pediatric
Women and women’s health
Psychiatric patient population
The NP median salary as of 2017 according to the Bureau of Labor Statistics (BLS) is $103,880, although this amount may vary depending on the degree of specialty, the location and years of experience.
(BLS, 2017)
NP’s practice in collaboration with physicians. They also have prescriptive authority but has to be in a joint protocol with physicians especially with controlled substances (Phillips, 2019).
Certified Registered Nurse Anesthesiologist (CRNA) – CRNA’s are advanced practices nurses who administer anesthesia or other medications. They also monitor patients who are recovering from anesthesia administration. Regulated by the Board of Nursing
Hospitals, ambulatory care
NJ state legislations require CRNA’s to be supervised by a physician licensed to provide anesthesia or an anesthesiologist. Hence, the “captain of the ship” doctrine applies to the same. Similar to other APRN roles (Torre & Drake, 2014).
Patients from all walks of life who are undergoing procedures requiring anesthesia.
CRNA’s are the highest paid nurses. According to the BLS report in 2016, the average salary for CRNA in NJ is $177,120 (BLS, 2016).
As earlier mentioned, CRNA’s practice under the supervision of an anesthesiologist or a physician certified to provide anesthesia in sedation procedures.
Certified Nurse Midwife (CNM) – These are nurses who are educated to provide family health services as well as family and child-bearing care (DeNisco & Barker, 2015).
– Regulated by the Board of Midwifery
Hospitals, birth-centers, homes and offices.
In NJ, prior to practicing as a CMN, a consulting agreement must be entered into by the CNM and a licensed physician who holds hospital privileges in obstetrics and gynecology (NJAC, 2019).
Women & infant
According to salary.com, the average salary for NJ CNM’s is at $120,334 as of 2019.
CNM’s have prescriptive authorities in NJ. They can also perform simple diagnostic procedures like ultrasound and some gynecological examinations (NJAC, 2019).
Pros and Cons
Being a licensed APN is fulfilling, professionally, academically and financially. That would be a major pro in this category. However, one of the problems that may arise is the increase in liability in becoming an advanced practice nurse. Leadership skills will be put to test and the bigger mistakes we make may lead to bigger problems.
For CNS, the advantage will be the scope of practice and the financial fulfillment derived from it. CNS are also tasked to educate other nurses hence, the opportunity to develop plans and innovations. One major disadvantage however is the frustration that may arise from failure to implement plans and projects. Also, CNS are mostly overlooked in the hospital setting (Darmody, 2019).
For NP’s, as always, one major factor that attracts other nurses and myself towards this role is the financial reward. However, the liability becomes bigger as more patients and other professionals rely on your skill and expertise as a nurse practitioner. I personally witnessed how the NP’s at work can also suffer from exhaustion (Torre & Drake, 2014).
For CRNA’s, again, the financial gratification is a very good draw to this profession as it is also considered the highest paid nursing profession. It can also be fulfilling because the physical effort is lesser compared to that of the floor nurses and other roles. However, the level of accountability seems much higher and the education requirements seem more rigorous and time-consuming (Lamb, 2018).
For CNM’s, they are also highly paid just like all other APN roles. This is suitable for nurses who are really interested in child-birth and women’s health. However, nurses who cannot do so may not be happy being a CNM (NJAC, 2019).
Evaluation
I am currently taking the FNP program to be a nurse practitioner. I have chosen this track because it has been my dream to work in the primary care setting. Another drive was the physical exhaustion from being a bedside nurse, however, while moving further to this program, it has made me realize the great importance and the valuable contributions a nurse practitioner can give to the health care system itself. While researching and reading more about the different APN roles, I came to understand the different contributions each can give to the health care system. However, this did not change my mind from my focus on becoming a FNP.
Plan
After graduation, I plan to practice in the family practice within my community. I plan to keep learning more by keeping abreast to news and recent developments, legislative or otherwise, about the APN profession. In the long run, I would eventually love to introduce this concept to my home country where this practice is still unknown and where it is very badly needed.
Summary
These APN roles may differ in some of the roles and responsibilities but the goal is mainly for a better provision of health care to the population. In this presentation, I have discussed the different scopes, the level of accountability, the definition of each of the four APN roles, the salary, the work environment and the population each role specializes in.
References
Darmody, J. (2019). Becoming a clinical nurse specialist in the United States. Educator’s Corner 33(6), 284-286. doi: 10.1097/0000000000000480
Retrieved from: https://nacns.org/advocacy-policy/policies-affecting-cnss/scope-of-practice/ (Links to an external site.)
Retrieved from: https://www.salary.com/research/salary/benchmark/clinical-nurse-specialist-salary (Links to an external site.)
Phillips, S. (2019). 31stAnnual APRN legislative update: Improving state practice authority and access to care. The Nurse Practitioner 1 (44), 27-55. doi: 10.1097/01.NPR.0000550248.81655.30
Retrieved from: https://www.bls.gov/oes/current/oes291151.htm (Links to an external site.)
Retrieved from: https://www.bls.gov/oes/current/oes291171.htm (Links to an external site.)
Torre, C. & Drake, S. (2014). Maximizing access to healthcare in New Jersey: The care for APN’s. New Jersey Nurseretrieved from: https:pdfs.semanticscholar.org/84e7/f7e810d75b39bea0c6217f953698334ee.pdf
DeNisco, S.M., & Barker, A. M. (2015). Advanced practice nursing: Essential knowledge for the profession(3rd ed.). Retrieved from https://bookshelf.vitalsource.com
Certified Nurse Midwife Scope of Practice. Retrieved from: https://www.njconsumeraffairs.gov/regulations/Chapter-35-Subchapter-2A-Midwifery-Liaison-Committee;.pdf (Links to an external site.)
Lamb, K. (2018). Understanding motivations and barriers of CRNAs involved in global health: A qualitative descriptive study. AANA Journal, 86(5), 371–378. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=132213421&site=eds-live&scope=site
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Collapse SubdiscussionKatherine Storms
Katherine Storms
Nov 5, 2019Nov 5, 2019 at 4:52pm
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Karina, great post. So many patients are litigious these days. Do you think that some of these roles are more likely to have the risk of a lawsuit than others and if so, is the NP going to be responsible for responding to lawyers in the case or the supervising MD?
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Collapse SubdiscussionKarina Takinan
Karina Takinan
Nov 6, 2019Nov 6, 2019 at 12:56pm
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Professor Storms,
APN’s, whatever role they play, are at a similar risk of lawsuit with physicians (PR Newswire, 2018). In New Jersey however, due to the collaborative role that the physicians have together with the APN’s, the liability becomes more complicated. In cases where NP’s are actually employed by the physicians or a hospital institution, vicarious liability sets in and the physicians and/or the institution acquires the liability over the APN’s action (West, 2014). This can still be determined further in the court of law with the facts and other pieces of evidence which is beyond our scope in this discussion. Furthermore, in a collaborative relationship between APN’s and physicians which is not clearly defined can prove riskier for the physicians than the APN’s because of the doctrine of respondeat superior which, again, gives rise to the vicarious liability held by the physician employer or the institution (Drake & Torre, 2014). Hence, key to a harmonious relationship is a clear cut definition of roles between the APN’s and the physicians when entering into a collaborative contract or agreement.
So to answer the question on whether the APN is going to be responsible in answering the lawyers will depend on the employer-employee relationship the APN has with the physician and/or hospital.
Thank you.
Karina
Reference
PR Newswire. (2018, March 13). Study shows nurse practitioners and physicians face similar liability risks. PR Newswire US. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=n5h&AN=201803130630PR.NEWS.USPR.LA36997&site=eds-live&scope=site (Links to an external site.)
West, J. C. (2014). Case law update. Journal Of Healthcare Risk Management: The Journal Of The American Society For Healthcare Risk Management, 34(1), 45–51. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1002/jhrm.21150 (Links to an external site.)
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Collapse SubdiscussionYouseline Thermitus-Hais
Youseline Thermitus-Hais
Nov 8, 2019Nov 8, 2019 at 12:22am
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Dr Storms,
If a physician is associated with an NP who is sued, the physician bears some risk of being sued as well. It is documented that a physician can be exposed to liability for malpractice when a patient is harmed by the actions or inactions of a NP, even if the physician was not directly involved in treating the patient (Paterick, Waterhouse, Paterick, & Sanbar, 2014). It is speculated that, there are several legal theories that may be applied to attach liability to a physician, either directly or vicariously, for a NP’s negligence. First, the physician may be directly responsible for negligent hiring of a NP. The screening process necessary to determine whether a NP is competent and capable of performing the specific functions that will be required includes a review of educational background, appropriate certification, prior work history and recommendations from previous employers or professors. Paterick et al, (2014) explain how the other legal ground for finding a physician directly liable for the actions of a NP is a failure to supervise properly. The starting place for determining the required level of supervision is the applicable state statute and regulations. It acknowledged that many statutes specify whether the supervising physician must be physically present in the facility where the NP is working, or can have some lesser degree of availability. The ratio of supervising physicians to NPs also may be spelled out in the statutes (Paterick, Waterhouse, Paterick, & Sanbar, 2014).
As documented by Bernard (2015), the responsibility for quality assurance, including review and cosigning of charts is also a common statutory provision. It is proven that, failure to perform any of these functions may in some instances be deemed negligence perse such that the supervising physician may be held liable even without proof of negligence by the NP. A physician may also be held vicariously liable for the acts of an NP on the grounds that the NP is acting as an agent of the physician. In some states, statutes create a conclusive presumption of agency so that a physician will always be responsible for the negligence of a NP (Paterick, Waterhouse, Paterick, & Sanbar, 2014).
In other states, liability will depend on whether the physician has a right to control the work done by the NP. However, given the typical requirements of supervision, it will be a rare circumstance when a NP will not be found to be an agent of the supervising physician. It is also important to be aware, to the extent possible, of the applicable standard of care for NPs. In some states, the NP is held to the standard of care of the supervising physician, on the theory that the NP is carrying out the function of the doctor and the patient is entitled to an equivalent level of treatment regardless of the provider (Bernard, 2015),
References
Bernard, C. D. (2015). Physician liability for the actions of midlevel providers. Medical Economics, 92(4), 43–45. Retrieved from https://search-ebscohost (Links to an external site.) com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=26299005&site=eds-live&scope=site
Paterick, B. B., Waterhouse, B. E., Paterick, T. E., & Sanbar, S. S. (2014). Liability of physicians supervising nonphysician clinicians. The Journal Of Medical Practice Management: MPM, 29(5), 309–313. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=24873129&site=eds-live&scope=site
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Collapse SubdiscussionChristian Parker
Christian Parker
Nov 8, 2019Nov 8, 2019 at 11:27am
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Dr. Storms
I have noticed over the past few years people are more likely to sue you than the previous norm. Is this because the millennial generation mentally of financial reward. “The consumer is the king. He has the right to know what he is receiving” (Karri, 2018). With becoming a provider this is very scary, though on the flip side it will help make sure I am doing everything right. It is very important that the consumer is aware of every detail, also that the documentation is excellent. We also need to respect our patients wishes for their care. If as a nurse practitioner we do not feel comfortable about anything we should consult the doctor before given any care.
Reference:
Karri, R. (2018). “PUT A SIGN HERE and PUT A SIGN THERE!” (obtaining informed consent is not so easy in this changed litigious world). Archives of Mental Health, 19(2), 52. doi: 10.4103/amh.amh_42_18
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Collapse SubdiscussionKimberly Logsdon
Kimberly Logsdon
Nov 8, 2019Nov 8, 2019 at 7:46pm
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Professor Storms,
Thank you for posing the question of if some of these roles are more likely to have the risk of a lawsuit than others. The answer is that it varies by state. If the litigation occurs in a state that requires nurse practitioners to work under a physician or collaborate with a physician, then the physician may be responsible for responding to the lawyers. If the litigation occurs in a state that grants nurse practitioners full independent practice authority, then only the NP is liable. In researching the answer to your question, I also learned about group medical malpractice insurance policies. Employers and unions inform NPs that they are covered, giving them a false sense of security. It’s what’s omitted that can be dangerous. Employers often carry “claims made” rather than “occurrence” policies. This means the nurse practitioner will not be covered for an incident that occurred while employed once he or she leaves that job. Occurrence policies cover the nurse practitioner up to the day he or she stops practicing (Gardenier, 2014).
Kim Logsdon
References
Gardenier, D. (2014). Should nurse practitioners who are covered by large group malpractice plans also maintain their own malpractice coverage? The Journal For Nurse Practitioners. doi:https://doi.org/10.1016/j.nurpra.2014.07.024
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Collapse SubdiscussionNicole Truslow
Nicole Truslow
Nov 9, 2019Nov 9, 2019 at 8:34pm
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Professor Storms,
I believe any of these roles are at risk of lawsuits. People will sue for any reason without much cause behind it. I think the lawsuits that could hold the most detrimental reasons would be against nurse midwifes. When dealing with delivering babies, typically if something goes wrong it is a major problem. Not only are mothers at risk but so is the unborn baby. Even when advanced practices nurses are working under a physician’s license they themselves are still liable and at risk. Typically when a person sues they sue everyone that has been involved in the case. I hold a certification in nurse life care planning and work with attorney’s on different medical cases and find that in most cases everyone is dragged into it no matter who small a part they had in providing care. This is unfortunate for medical providers because in general there is not malicious intent to ever do harm to any patients and some people are just looking for a payout.
Nicole Truslow
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Collapse SubdiscussionChristian Parker
Christian Parker
Nov 7, 2019Nov 7, 2019 at 10:22am
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Karina
The interesting thing about New Jersey that I saw was the pay difference between New Jersey and North Carolina. I would think that New Jersey would pay more than North Carolina for nurse practitioners. “Compensation for nurses decreased 3.1% from 2015 to 2016, for an average salary of $61,875, according to survey information collected from nearly 20,000 health care workers and reported in the Health eCareers 2016 Salary Guide. NP compensation, however, increased 5.3%, for an average salary of $100,549″ (Zolot, 2016). I appreciate that NP compensation is rising, but the sad truth about Registered nurse salary is decreasing. Working as certified nursing assistant then a registered nurse, I have saw how important both jobs are. I also know during my career as a nurse practitioner when it comes to my patient, I need to trust the RN and their skills. Because majority of the time the RN notices changes/concerns for the patient before the provider.
Reference:
Zolot, J. (2016). Salaries for Nurses Decrease, While NP Salaries Rise. AJN, American Journal of Nursing, 116(11), 16. doi: 10.1097/01.naj.0000505573.04645.f5
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Collapse SubdiscussionNavdeep Kaur
Navdeep Kaur
Nov 4, 2019Nov 4, 2019 at 10:10pm
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Hello Professor and Class,
The four types of advanced practice nurses in California are Nurse Practitioners, Nurse midwives, Nurse anesthetists, and clinical nurse specialists. The nurse practitioners work environment is primary care. They cannot practice alone in the state of California and must follow policies and protocols set by a supervising physical. The patient population for a nurse practitioner is anyone cradle to grave needing acute or chronic care. According to salary.com the average salary for a NP in California is $105,920. The scope of practice is a registered nurse who has additional training through a program that conforms to board standards, who can treat chronic and acute illnesses (California Scope of Practice Policy, 2019). Work environment, level of accountability, patient population, salary and scope of practice. In the future I would like to work as a nurse practitioner and a pro to this is I get to work in a primary care setting taking care of all different types of patients. A con to this is in the state of California I cannot work as a solo practitioner and will have to work under a physician. The quality of care is the same when Nurse practitioners are delivering it as physicians if not better (Mark & Patel, 2019) so it does not make sense why they do not have independence.
The nurse midwife works in an OBGYN office, antepartum, intrapartum, postpartum, interconceptional periods and with family planning needs. Their level of accountability is the same as a nurse practitioner, they report to a supervisor or manager such as an MD. The patient population that a nurse midwife works with is women or transgenders that are in need of obstetric or gynecologic needs. The average salary according to salary.com is $122,300. The scope of practice is to provide necessary supervision, care, advice to women or transgenders during antepartum, intrapartum, postpartum, interconceptional periods and with family planning needs (2016). A pro to this line of work for me would be working with women of childbearing ages. I am used to that population group and it would be an easy transition for me. A con would be the hours of work, being on call all the time and as a nurse midwife the doctor you work for will probably have you on night call a lot.
Nurse anesthetists work in hospitals, surgical centers and offices. They are independent practitioners who are legally responsible for their own actions and due to this their salary is higher than the other advanced practice nurses (2009). They are highly trained specialists who make on average $204,547 annually. Their scope of practice includes assessing, implementing plans and performing general, regional and local anesthesia. A pro for this line of work would be the amount of independence and money you make. But the amount of independence and legal obligation can be a con as well.
A clinical nurse specialist depending on specialty can work with certain populations, in certain settings such as ER, disease or medical subspecialty, type of care such as rehabilitation or psychiatric or type of problem such as pain or wound (2018). Level of accountability is the same as a np and nurse midwife. Patient population can be direct or indirect patient care activities. The average salary according to salary.com is $117,574. The scope of practice includes patients, nursing personnel and organization systems, providing research, education, consultation, clinical practice and clinical leadership. A pro to this job is having flexibility and being able to do a variety of different tasks. A con may be figuring out where you want to work and what you want to do with this advanced practice degree, it seems so broad that I may have a hard time figuring out what I want to do.
I currently would like to become a family nurse practitioner. And as a FNP I have the flexibility to work with a variety of different populations. I moved from Virginia to California so there are more restrictions for me in this state but that is ok because I still see myself as a FNP and not pursuing any other advanced practice degree. My plans have changed a little bit since moving to California. I originally had planned to work with one of the doctors I work with after I graduate but things change so here I am. I would like to get a job in a family practice near my current home. My idea has not changed after doing some extra research but I’m glad this discussion got me thinking about next steps and what I will be able to do in my current state.
Reference
Advanced Practice and PHN Certification. (2018, March 29). Retrieved from https://www.rn.ca.gov/applicants/ad-pract.shtml (Links to an external site.).
California association of Nurse anesthetists CRNA scope of practice guidelines. (2009, September 21). Retrieved from http://canainc.org/compendium/pdfs/CRNA Scope of Practice.pdf.
Certified Nurse-Midwife practice explanation of standardized procedure for CNM. (2016, November 16). Retrieved from https://www.rn.ca.gov/pdfs/regulations/npr-b-32.pdf (Links to an external site.).
Mark, B., & Patel, E. (2019). Nurse practitioner scope of practice: What do we know and where do we go? Western Journal of Nursing Research, 41(4), 483-487. doi:10.1177/0193945918820338
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Collapse SubdiscussionKatherine Storms
Katherine Storms
Nov 5, 2019Nov 5, 2019 at 4:53pm
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Nav, something I find interesting is the reimbursement rates across the roles. For example, CNMs get reimbursed 100% for services billed whereas NPs only get 80%. How do you feel about this?
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Collapse SubdiscussionNavdeep Kaur
Navdeep Kaur
Nov 6, 2019Nov 6, 2019 at 7:20pm
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Hello Dr. Storms,
Wow I actually did not realize that was the case. So I did some research and according to the American College of Nurse-Midwives the reimbursement rate increased from 65% to 100% in 2010 due to a law that President Barack Obama signed. The article states that CNM’s wrote called and emailed their members of Congress to support this reimbursement. It is definitely well earned due to the amount of hours that they work and the hard shifts. I have seen my friends miss out on so many events such as birthdays, holidays and so many other events. As a future nurse practitioner I too am going to follow in The CNM’s direction and write to my congress to see if they can support us. I could be bitter and say why aren’t we getting the same reimbursement, but it seems like a lot of work went into this and we should follow in their direction.
Reference
Equitable medicare reimbursement. (2011). Retrieved from https://www.midwife.org/Equitable-Reimbursement
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Collapse SubdiscussionKarina Takinan
Karina Takinan
Nov 7, 2019Nov 7, 2019 at 11:06am
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Hi Navdeep and Professor Storms,
Indeed, there still seems to be an inequality regarding the reimbursement rates between NP’s and physicians in primary care despite the similarity of the care being provided. Across the US, NP’s CRNA’s and CNS have 85% reimbursement rates while Oregon is the only state that requires private insurers to reimburse NP’s and PA’s in primary and behavioral healthcare at 100% rate (Gill, 2019). There is now a call statewide for NP’s to take action regarding this matter to ensure that reimbursement methods be f
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