With the Affordable Care Act now in effect, the important role of the advanced practice nurse has become even more essential. Health care has been in a state of flux for more than twenty years due to rapidly evolving technology, escalating costs, an aging population, and an increasing number of people with chronic diseases. All of these conditions have placed a heavy burden upon a health care system that has been unable to meet the increasing demands for providing high quality and opportune care at an affordable cost. As a result, a major restructuring of the health care delivery system has taken place, a restructuring that has resulted in a more effective utilization of the services of all health care professionals, specifically those of the advanced practice nurse. A closer look at the role of the advanced practice nurse will reveal the reasons why this profession is pivotal to the future of health care.

What is an Advanced Practice Nurse?

An advance practice nurse (APN or APRN) is a registered nurse who has completed accredited post-graduate education at a master’s or doctoral level and who is board certified for nursing practice. There are different types of APNs, the difference being distinguished by their education and clinical training.
Advanced practice nurses include:

  • Certified Nurse Practitioners (CNP)
  • Clinical Nurse Specialists (CNS)
  • Certified Nurse Midwives (CNM)
  • Certified Registered Nurse Anesthetists (CRNA)

The Consensus Model for APRN Regulation proposed by the American Nurses Association further defines the scope and practice of the advanced practice registered nurse. The Consensus Model may be reviewed at the association’s website. www.nursingworld.org.

Responsibilities of the Advanced Practice Nurse

The specific health services advanced practice nurses can provide will depend on the area of specialty and the health care setting in which they are employed. Advanced practice nursing can include performing physical exams, diagnosing and treating acute and chronic health problems, ordering diagnostic tests, and prescribing medications and treatments. Many of the responsibilities of the advanced practice nurse have historically been delivered by licensed medical doctors.
Advanced practice nurses work in hospitals, clinics, offices and a variety of outpatient settings. An advanced practice registered nurse may be the primary practitioner in a satellite clinic, a community health center or a skilled nursing facility.

The Impact of the Advanced Practice Nurse on Health Care

The expansion of the role of the APN to allow for the delivery of health care services previously assumed by doctors has helped to reduce the costs of healthcare, decrease the length of hospital stays and prevent hospital readmissions. Acting as educators and change-agents for the patients, advanced practice nurses facilitate behavioral changes necessary to improve health and prevent disease.

Surveys of patients who have received health care services from an advanced practice nurse indicate a preference for APNs because the nurse takes the time to listen to their concerns and answer questions. Patients feel that APNs have a better understanding of their health problems and offer choices in the available treatments.

The failure of modern health care to meet consumer demand has forced an examination of the patient care delivery model. As a result, the role of the registered nurse has been expanded to allow increased levels of autonomy, decision-making, and skill. This role expansion resulting in the creation of the profession of the advanced practice nurse has permitted more efficient utilization of the nursing profession to address the concerns and issues faced by the health care industry today.

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