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1Running head: ROLES IN ADVANCED PRACTICE NURSINGRoles in Advanced Practice NursingChamberlain College of NursingNR500: Foundational Concepts and Advanced Practice RolesSeptember 2019
APN2Roles in Advanced Practice NursingThe development of advanced practice nursing (APN) roles began when Nurse Loretta Ford and physician Henry Silver proposed an expansion in the role of nursing as a solution to theprimary care shortage in the1960’s. To address the healthcare needs of children in the community, Ford and Silver founded the first nurse practitioner role in pediatrics which paved the way for the various APN roles we have today. Healthcare is an evolving field and the technology, medicine, and needs of patients in the 21stcentury is continuously changing. To address these changes, the role of nurses has expanded into four major APN roles. The transition from a registered nurse (RN) to the role of APN is a significant one involving advanced educational preparation and expanded work environment required for advanced practice licensing. This paper will examine the roles, education, work environment and transition into to the four APN roles.Four APN RolesThe APRN is a master’s prepared nurse that provides primary or specialty clinical care (DeNisco & Barker, 2015). The four APN roles defined by the APRN consensus model include certified nurse practitioner (CNP), clinical nurse specialist (CNS), certified nurse-midwife (CNM) and the certified registered nurse anesthetists (CRNA) (NCSBN, 2008). The APN can further specialize in one of six population foci which include, family/individual across the lifespan, adult-gerontology, neonatal, pediatrics, women's health/gender-related and psychiatric-mental health. All APN roles require graduate-level education with masters or doctorate in nursing and hold both an RN and APRN license. The APN credentials prepare them with specialized education and training required to be competent in various healthcare settings.
APN3The CNP provides direct or acute care in a variety of work environments. The CNP’s work environments include, hospitals, private practice, ambulatory clinics, outpatient and long-term facilities. The CNP’s practice area is defined by patient population and involves direct patient care ranging in duration from acute to long-term. The CNP can practice in one of three environments including, full, reduced or restricted, depending on the laws and regulations of the state they are practicing in. Currently, 22 states and district of Columbia permit CNP to engage infull practice, 17 states have reduced practice and 12 states allow for a restricted practice environment (AANP, 2018). The role of the CNP with full practice authority defined by the American Association of Nurse Practitioners (AANP) is "to evaluate patients, diagnose order andinterpret diagnostic tests, initiate and manage treatments including prescribing medications underthe exclusive licensure authority of the state board of nursing" (Peterson, 2017). Reduced