3. Evolution of the APN role (Specialty and subspecialties) Patterns in the Evolution of Specialty to Advanced Practice Nursing a. Before discussing the evolution of specialty nursing practice into advanced practice nursing, it is important to make a distinction between the two, as well as to clarify the use of the term subspecialty in this chapter. Specialization involves focusing on practice in a specific area derived from the field of professional nursing. Specialties can be further characterized as nursing practice that intersects with another body of knowledge, has a direct impact on nursing practice, and is supportive of the direct care provided to patients by other registered nurses (American Nurses Association [ANA], 2010a). Example: Oncology Nursing Society [ONS], traces its origin to the first National Cancer Nursing Research Conference, supported by the ANA and American Cancer Society, in 1973. (Hamric 112-113) Sub-specialization further delineates the focus of practice. In subspecialty practice, knowledge and skill in a delimited clinical area is expanded further. With this expanded knowledge and skill, there is potentially further advancement of theoretical, evidence-based, and practical knowledge in caring for a specific patient population base. Examples of subspecialty practices within the specialty of adult health nursing include diabetes, transplant, and palliative care nursing (Hamric 113) 1. The initial stage of the evolution from specialty practice to advanced practice is characterized by the development of a specialty focus.. Examples from our history include the specialty of enterostomal therapy (ET) nursing, now known as wound, ostomy, and continence (WOC) nursing, and forensic nursing, which has historically encompassed care provision in correctional facilities, psychiatric settings, and emergency Page 4 of 2 NSG 6006 Pre-Specialty Evaluation ©2017 South University
The Role of the Advanced Practice Nurse NSG 6006 Week 2 departments as nurse examiners care for sexual assault and child abuse victims (Burgess, Berger, & Boersma, 2004; Doyle, 2001; Hutson, 2002; Maeve & Vaughn, 2001; McCrone & Shelton, 2001). 2. Several evolving roles in nursing are characterized as being innovative. Some of these roles do not reflect the core competencies of advanced practice nursing and the role components differ significantly, in some cases, from those of an APN. For example, if the focus of practice in forensic nursing had remained on the gathering of legal evidence, not sustained clinical practice using advanced practice core competency elements. The trend of educating forensic nurses in certificate programs is changing as graduate nursing programs are established; thus, forensic nursing is a specialty in transition. Similar to previous efforts to move wound, ostomy, and continence (WOC) nursing into graduate nursing education programs (Gray et al., 2000), forensic nursing has been taught at the graduate level in a few institutions for several years. Although certificate programs are sometimes the route to preparation, there are
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