Chapter 3 A Definition of Advanced Practice NursingAnn B. HamricThis chapter considers two central questions that provide the foundation for this text:•Why is it important to define carefully and clearly what is meant by the term advanced practice nursing?•What distinguishes the practices of advanced practice nurses (APNs) from those of other nurses and other health care providers?Advanced practice nursing is considered here as a concept, not a role, a set of skills, or a substitution for physicians. Rather, it is a powerful idea, the origins of which date back more than a century. Such a conceptual definition provides a stable core understanding for all APN roles (see Chapter 2), it promotes consistency in practice that can aid others in understanding what this level of nursing entails, and it promotes the achievement of value-added patient outcomes and improvement in health care delivery processes. Advanced practice nursing is a relatively new concept in nursing's evolution (see Chapter 1). Although debates and dissention are necessary and even healthy in forging consensus, ultimately the profession must agree on the key issues of definition, education, credentialing, and practice. This agreement is critically important to the survival, much less the growth, of advanced practice nursing. In this chapter, advanced practice nursing is defined and the scope of practice of APNs is discussed. Various APN roles are differentiated and key factors influencing advanced practice in health care environments are identified. The importance of a common and unified understanding of the distinguishing characteristics of advanced practice nursing is emphasized.The advanced practice of nursing builds on the foundation and core values of the nursing discipline. APN roles do not stand apart from nursing; they do not represent a separate profession, although references to “the nurse practitioner (NP) profession,” for example, are seen in the literature. It is the nursing core that contributes to the distinctiveness seen in APN practices. According to the American Nurses Association (ANA, 2010), contemporary nursing practice has seven essential features:… provision of a caring relationship that facilitates health and healing; attention to the range of human experiences and responses to health and illness within the physical and social environments; integration of assessment data with knowledge gained from an appreciation of the patient or the group; application of scientific knowledge to the processes of diagnosis and treatment through the use of judgment and critical thinking; advancement of professional nursing knowledge through scholarly inquiry; influence on social and public policy to promote social justice; and, assurance of safe, quality, and evidence-based practice (p. 9).
These characteristics are equally essential for advanced practice nursing. Core values that guide nurses in practice include advocating for patients, respecting
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- Winter '17
- Nursing, advanced practice nursing