disadvantages includes barriers to practice in most states because of regulations still requires doctors involvement in a collaborative way ( Hamric, Hanson, Tracy & O' Grady, 2014).Certified Nurse-Midwife (CNM) plays an important role in all cultures. CNM practice isthe independent management of women's health focusing on primary common issues, family planning, and gynecologic needs of women, pregnancy, childbirth, postpartum and care of new born. Advantages includes; practicing within a healthcare system that provides for consultation collaboration and referrals, independent in using knowledge, skills , judgment, and authority in providing service to women while maintaining accountability for management of healthcare. CNM promote, advocate for, and strive to protect, health and well being of women, families and community ( Hamric, Hanson, Tracy & O' Grady, 2014). CNM has reduce disparities amongdisadvantaged groups and have documentation of fewer episiotomies, lacerations, inductions, useof epidural, and has higher rates of breastfeeding (Hamric, Hanson, Tracy & O' Grady, 2014). In
this study by Hampton & Hampton, (2009), a disadvantage to the CNM is from most organization who tend not to reward participation in professional associations. They do not reward continuous education and activities geared to keep up with the latest development in this specialty. Certified Registered Nurse Anesthetist(CRNA). CRNA is the oldest APN specialty which provides anesthesia duties with qualified healthcare providers. This is done in any setting in which anesthesia is delivered for acute or chronic pain management. They perform and document preanesthetic assessment and evaluation of the patient , requesting consultations and diagnostic studies. Also, they develop and implement an anesthetic plan , initiating which technique to use , manage patient's airway, and facilitates emergence and recovery from anesthesia(Hamric, Hanson, Tracy & O' Grady, 2014). CRNA advantages includes; independent responsibility and accountability for individual professional practice, freedom to exercise independent judgment within the scope of their practice, documentation from peer literature of safety and cost effective care provided by CRNA, and better pay rates. Disadvantages includes reimbursement challenge as healthcare system evolve. There is a 29.5% decrease in Medicare payments(American Association of Nurse Anesthetists(AANA), (2012h).ReferencesAmerican Association of Nurse Anesthetists (AANA), (2012h). Impact of proposed Medicare cut. Retrieved January, 6 2015 from DeNisco, S. M. , & Barker, A. M.(2013). Advanced practice nursing: Evolving roles for the transformation of the profession (2nd ed.). Burlington, MA: Jones & Bartlett.Hampton, D. L., & Hampton, G. M. (2009). Professionalism and the nurse-midwife practitioner: an exploratory study. Journal Of The American Academy Of Nurse Practitioners, 12(6), 218-225.
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