develop the practical wisdom essential to effective nursing practice. Graduate APN students who do not have nursing experience prior to graduate school are encouraged to reflect and expand on this model, considering how their life and professional experiences account for their experience of transformation and their mastery of advanced practice nursing. Shuler's Model of Nurse Practitioner Practice This model is complex and the review for this edition found no additional reports using this model. Because of its historical importance as an early NP model, the Shuler model ( Shuler &
Davis, 1993a ) is briefly discussed. Readers should refer to the original article to see the full model. Shuler's experience integrating nursing and medical knowledge skills into the NP role led to the development of a conceptual model that would make apparent the unique contributions of NPs, purposefully addressing the FIG 2-9 Oberle and Allen's conceptualization of advanced practice. (From Oberle, K., & Allen, M. . The nature of advanced practice nursing. Nursing Outlook, 49, 148—153.)
need for a model that reflects the acquisition of expertise by the NP in two health care disciplines, nursing and medicine. Shuler's Nurse Practitioner Practice Model is a complex systems model that is holistic and wellness-oriented. It is definitive and detailed in terms of how the NP-patient interaction, patient assessment, intervention, and evaluation should occur ( Shuler & Davis, 1993a ). It is complex and its value for understanding NP practice may not become clear until one is in practice. Table 2-2 outlines key model constructs and related theories, many of which should be familiar to students. Knowing that these familiar concepts are embedded in this comprehensive model may help readers appreciate its potential usefulness. Shuler's model is intended “to impact the NP domain at four levels: theoretical, clinical, educational, and research” ( Shuler & Davis, 1993a ). A close review of the model indicates that it addresses important components of a model of advanced practice nursing, such as the following: (1) nursing's metaparadigm (person, health, nursing, and environment); (2) the nursing process; (3) assumptions about patients and nurse practitioners; and (4) theoretical concepts relevant to practice. The model could be characterized as a network or system of frameworks. Box 2-4 Elements of Oberle and Allen's Conceptualization of Advanced Practice Nursing Patient-client presenting concern —problem or potential problem for which an individual needs nursing care General and particular knowledge —nurses move back and forth between global knowledge (e.g., the features of an illness or the nursing care that usually works for a particular problem) and specific knowledge (specifics about the individual patient or situation). General Knowledge • Theory—know what and know why.
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- Winter '17
- Nursing, advanced practice nursing