Personal Philosophy and Framework
Personal research demonstrates that Family Nurse Practitioners (FNP) are trained and specialized healthcare workers who focus on providing basic healthcare facilities to patients of all ages. Contemporary spiritual care needs of the patients explore the reduction of pain, physical healing, and personal growth (Rachel et al., 2019). Therefore, the FNP should also focus on providing patient-centric healthcare and improving overall healthcare while ensuring spiritual care is provided to the patients. As per my understanding, patient-centric care is based on certain principles that result in positive outcomes, and these principles mainly focus on providing awareness to the patients, educating them about their medical condition, multiple aspects of care, respecting the preference and privacy of the patients and most of all providing emotional support to the patients through spirituality. In this stance, Family Nurse Practitioners are spiritually responsible for diagnosing the patient, evaluating their overall health condition, and making efforts to help the patients prevent the diseases.
Furthermore, I have considered Jean Watson’s theory of human caring as the foundation for this philosophy. It completely aligns with my philosophy and framework for practice. The theory revolves around the concept that humans cannot be treated as objects when providing healthcare; it is mandatory to have an effective relationship between the caregiver and recipient to get positive outcomes and provide patient-centric care (Jardien-Baboo et al., 2021). The theory focuses on providing emotional support to the patient and their families to ease their suffering and promote the overall process of the patient’s healing. The theory ensures the need for nurses to contemplate the spiritual dimension while treating patients affected by life-threatening diseases (Evangelista et al., 2021).
As advanced practice registered nurses (APRN) is one of the well-paid professions in the USA, these nurses are trained in advanced nursing courses. They can work with healthcare professionals for effective diagnosis and treatment plans for the patients (Winter et al., 2021). To be an APRN professional in California, the individual must have a bachelor’s degree in nursing, a state license, a graduate degree with a specialization, and finally, a certification. In California, the individual can fulfill the professional requirements for APRN by simply getting a bachelor’s degree in nursing, which makes the individual eligible to register for licensure. For this, the California candidates must register and clear National Council Licensure Examination (NCLEX) to get APRN professional certification. Other than this, the individual must opt for relevant courses to help them get the APRN Practitioner certification. These courses include communication skills, pathophysiology, psychosocial assessments, advanced health assessments, nutrition, and emergency treatments. Moreover, in California for an individual to be certified as an advanced nurse, they must have the license of a registered nurse; for this, the individual can apply to the California Board of Registered Nursing to get the certification.
Application form Respective Authorities
The overall cost for the certification examination in the state of California is approximately $150 needs to be paid to the Board of California as a fee to process their respective application, and $200 is to be paid to Pearson, which is the fee for NCLEX-PN licensing test, all these amounts are non-refundable. If the individual fails the exam, the candidate will have to retake the exam after 45 days and will again have to submit the payment. Furthermore, the candidates must clear the certification exam within 5 years after completion of the graduation degree. It takes approximately 10-12 weeks for the candidate to get a permanent license from the California Board of Registered Nursing. As far as issues of APRNs in California are concerned, there is a lack of support from Practitioners and a lack of public awareness about health-related matters.
APRN Roles and Impact on Client Safety
Studies revealed that APRN practitioners are individuals who have done certification in advanced nursing practices and can diagnose, assess and prescribe effective treatment to patients. There are four primary roles of APRN practitioners, which include Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Midwife (CNM), and Certified Nurse Practitioner (CNP).
Clinical Nurse Specialists (CNS) are the nurses who work within the clinical setting and focus on applying evidence-based practices to provide effective patient healthcare (Saunders, 2021). CNS also focuses on administrative and leadership roles in clinical settings requiring a high level of RN clinical expertise. State license certification, relevant experience, and master’s degrees are all prerequisites for individuals working as CNS.
Certified Registered Nurse Anesthetist (CRNA): under this role, the RN is responsible for effectively administering anesthesia to patients undergoing surgery. One of the main focuses of RN here is to keep patient safety under consideration. CRNA works with dentists, surgeons, anesthesiologists, and other healthcare professionals, ensuring that patients are stable during the procedure and facilitating the patients by effective pain management. Postoperative recovery of patients is yet another role of CRNA.
Certified Nurse Midwives (CNM) are responsible for the reproductive health of women and children during the process of giving birth (Monterrey et al., 2021). It even focuses on guiding the women during the pregnancy process. Lastly, Certified Nurse Practitioners (CNP) are responsible for working effectively with the physician to assist and provide patient treatment (Gonzalez & Gigli, 2021). They are even responsible for examining the patient, making diagnoses, and prescribing medication to the patients.
Nurses’ roles and responsibilities directly impact the overall health and safety of the patients. Nurses are responsible for monitoring the patients, reporting any clinical deterioration, and identifying any errors or education issues that might affect the overall patient’s safety. Effective communication between APRN practitioners and patients is mandatory to ensure better and improved patient safety. It even facilitates reducing the overall risk and error chances in healthcare and ensuring the provision of quality healthcare, which is the patients’ fundamental right.
Prescriptive Authority, Credentialing, and Clinical Privileges
The basic concept of credentialing focuses on verifying and scrutinizing the individual’s professional education, training, and experience. This information or data collection regarding the candidate enables the healthcare institution to make effective decisions ensuring improved healthcare and increased patient safety. The healthcare organization uses the following credentials: certification, rewards, post-graduate work, license, and re-license. Many healthcare organizations also conduct extensive background checks of candidates to verify their information. On the other hand, clinical privileges focus on giving or authorizing the healthcare professional to emphasize specific patient care services. A particular patient care area is given to the individual after assessing their qualification, experience, and overall performance.
At the same time, prescriptive authority focuses on the healthcare provider’s ability to prescribe specific medications and controlled substances. It gives more power and authority to the healthcare individual, enabling them to provide better and improved healthcare. Prescriptive authority, credentialing, and clinical privileges play a significant role in ensuring the overall patient’s safety, as it ensures that the healthcare provider is well qualified and experienced to provide better and improved healthcare to the patients, also reducing the chances of medication error increasing the overall patient’s safety.
Role of APRNs from a Global Perspective
The shortage of nurses and, at the same time, increased demand for skilled nurses who can handle complicated and diverse healthcare cases effectively. Countries around the globe are focused on improving APRN practitioners by incorporating advanced development nursing programs into educational programs. It will not only allow health care professionals to overcome the shortage of nurses but also enable the world to overcome the shortage of skilled nurses (Newland, 2018). The role of APRN practitioners is mainly focused on providing individualized healthcare to the patients, acting as an advance for the patients, and most importantly, educating the patient and creating awareness among the patients regarding multiple health issues and disease prevention. While performing their roles effectively, the nurses should remember not to discriminate among the patients based on their cultural background, color, geographic location, religion, or other factors. Their main focus should be on being empathetic towards the patient, treating them with respect, and, most importantly, providing them with quality healthcare. These perspectives enable the APRN practitioners to perform their roles and responsibilities effectively both in global and local settings. A global view of APRNs empowers them and allows them to provide improved quality healthcare to patients (Newland, 2018). Therefore, whether the nurse is providing healthcare in a local or international setting, effective communication and empathy towards the patients are mandatory and crucial to providing quality healthcare.
Evangelista, C. B., Lopes, M. E. L., Costa, S. F. G. da, Batista, P. S. de S., Duarte, M. C. S., Morais, G. S. da N., França, J. R. F. de S., & Gomes, B. da M. R. (2021). Nurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring. Revista Brasileira de Enfermagem, 75(1), e20210029. https://doi.org/10.1590/0034-7167-2021-0029
Gonzalez, J., & Gigli, K. (2021). Navigating Population Foci and Implications for Nurse Practitioner Scope of Practice. Journal for Nurse Practitioners, 17(7), 846–850. https://doi.org/10.1016/j.nurpra.2021.04.008
Jardien-Baboo, S., van Rooyen, D., Ricks, E. J., Jordan, P. J., & ten Ham-Baloyi, W. (2021). Integrative literature review of evidence-based patient-centered care guidelines. Journal of Advanced Nursing, 77(5), 2155–2165. https://doi.org/10.1111/jan.14716
Monterrey, T. De, Chen, J., Mcmichael, B. J., Brannin, L., Biscone, E., Snapp, C., Wertman, S., Gutterman, Z., Woeber, K., Jacobwitz, J., & Kohl, A. (2021). Pr ep rin ot pe er r ev we d Pr ep rin t n er we. July.
Newland, J. A. (2018). Global Perspectives: A new look at international nursing. Nurse Practitioner, 43(12), 6. https://doi.org/10.1097/01.NPR.0000547555.79012.7d
Saunders, M. M. (2021). Informing and Supporting the New Clinical Nurse Specialist Prescriber. AACN Advanced Critical Care, 32(4), 404–412. https://doi.org/10.4037/AACNACC2021869
Winter, S., Chapman, S. A., Chan, G. K., Duderstadt, K., & Spetz, J. (2021). Nurse Practitioner Role and Practice Environment in Primary and in Nonprimary Care in California. Medical Care Research and Review, 78(6), 780–788. https://doi.org/10.1177/1077558720942706
Rachel, H., Chiara, C., Robert, K., & Francesco, S. (2019). Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses. Acta Bio Medica: Atenei Parmensis, 90(Suppl 4), 44.