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  • 1. Delmar LearningDelmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Nursing Leadership &Nursing Leadership & ManagementManagement Patricia Kelly-Heidenthal 0-7668-2508-6
  • 2. Delmar LearningDelmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 27Chapter 27 Emerging Opportunities
  • 3. Chapter 27 Copyright © 2003 Delmar Learning, a 3 ObjectivesObjectives  Upon completion of this chapter, the reader should be able to: • Discuss the many nursing opportunities available upon graduation. • Discuss advanced nursing practice and other nontraditional nursing roles. • Identify various opportunities for certification. • Review hospital and nonhospital based nursing practice. • Identify directions for the future.
  • 4. Chapter 27 Copyright © 2003 Delmar Learning, a 4 Nontraditional Emerging OpportunitiesNontraditional Emerging Opportunities  For nurses who remain in traditional settings, opportunities exist to receive certification in specialized areas.  Certification is the process by which a nongovernmental agency or association certifies that an individual licensed to practice a profession has met certain predetermined standards specified by that profession for practice.
  • 5. Chapter 27 Copyright © 2003 Delmar Learning, a 5 Sample List of Certifying OrganizationsSample List of Certifying Organizations  ANCC • American Nurses Association Credentialing Center  NAPNAP • National Association of Pediatric Nurse Associates and Practitioners  ACCN • Association of Critical Care Nurses  AWONN • Association of Women's Health Obstetrics and Neonatal Nurse
  • 6. Chapter 27 Copyright © 2003 Delmar Learning, a 6 Sample List of Certifying OrganizationsSample List of Certifying Organizations  NANN • National Association of Neonatal Nurses  WOCN • Wound, Ostomy, and Continence Nurses Society  AANA • American Association of Nurse Anesthetists
  • 7. Chapter 27 Copyright © 2003 Delmar Learning, a 7 Possible Areas of SpecializationPossible Areas of Specialization  Neonatal  Pediatric  Adult medical/surgical  Women's health  Obstetrics/gynecology  Psychiatry  Dermatology  Case management  Renal  Critical care  Emergency room  Clinical nurse specialist  Nurse practitioner  Nurse anesthetist  Nurse midwife  Nursing informatics
  • 8. Chapter 27 Copyright © 2003 Delmar Learning, a 8 Traveling NurseTraveling Nurse  Travels to various locations throughout the United States  Usually works in 3-month assignments on the same unit  May receive a similar or higher salary compared to salaries of fellow employees  Needs to be aware of differing nursing methodologies and licensure requirements from state to state
  • 9. Chapter 27 Copyright © 2003 Delmar Learning, a 9 Traveling NurseTraveling Nurse  Requires a license for each state in which he or she will practice  Should ensure that contract says exactly what the assignment will be regarding expectations of the institution and agency
  • 10. Chapter 27 Copyright © 2003 Delmar Learning, a 10 Representative for PharmaceuticalRepresentative for Pharmaceutical Company, Home Care, or Nursing AgencyCompany, Home Care, or Nursing Agency  Affords the nurse a perspective on corporate America and the workings of the business world  Often involves salary enhancements or perks  Allows for a certain level of independence  May present difficulties in meeting sales quotas, providing for customers, or surviving the ups and downs of the business world
  • 11. Chapter 27 Copyright © 2003 Delmar Learning, a 11 Case ManagerCase Manager  This new delivery of care method includes providing and coordinating care across the continuum of prevention, wellness, acute care, rehabilitation, long- term, hospice, and respite care.  The nurse case manager should have at least a baccalaureate degree and expert clinical skills; should possess knowledge of the health care system, health care finances, and legal issues; and should be an effective communicator.
  • 12. Chapter 27 Copyright © 2003 Delmar Learning, a 12 Nurse EntrepreneurNurse Entrepreneur  Many nurses are becoming entrepreneurs in a variety of consultative, educational, and technical areas.  Advantages: • Independence • Job satisfaction • Flexibility • Choice
  • 13. Chapter 27 Copyright © 2003 Delmar Learning, a 13 Nurse EntrepreneurNurse Entrepreneur  Disadvantages: • Competition • Volatility • Lack of provided benefits • Must learn to develop and follow a business plan
  • 14. Chapter 27 Copyright © 2003 Delmar Learning, a 14 Advanced Practice/Expanded RoleAdvanced Practice/Expanded Role Emerging OpportunitiesEmerging Opportunities  Advanced practice nursing builds on the foundation of professional nursing practice and responds to the developing health care needs of the United States.  In advanced practice nursing, the nurse may: • Assess patients, synthesize and analyze data, and understand and apply nursing principles at an advanced level • Provide expert guidance and teaching • Work effectively with patients, families, and other members of the health care team • Manage patient's physical and psychosocial health-illness status
  • 15. Chapter 27 Copyright © 2003 Delmar Learning, a 15 Advanced Practice/Expanded RoleAdvanced Practice/Expanded Role Emerging OpportunitiesEmerging Opportunities • Use research skills • Analyze multiple sources of data, identify alternative possibilities as to the nature of a health care problem, and select appropriate treatment • Make independent decisions in solving complex patient care problems • Perform acts of diagnosis and prescribe therapeutic measures consistent with the area of practice • Recognize limits of knowledge and experience, plan for situations beyond expertise, and consult with or refer patients to other health care providers as appropriate
  • 16. Chapter 27 Copyright © 2003 Delmar Learning, a 16 Advanced Practice Nursing: Types ofAdvanced Practice Nursing: Types of Expanded RolesExpanded Roles  Wound, ostomy, continence nurse specialist • Clinical expert in managing patients with ostomies, alterations in skin integrity, and wounds  Flight nurse • Provides care to infants, children, and adult patients while performing a variety of therapeutic interventions requiring independent decisions; also provides education to outlying communities and serves as a volunteer in emergency situations
  • 17. Chapter 27 Copyright © 2003 Delmar Learning, a 17 Advanced Practice Nursing: Types ofAdvanced Practice Nursing: Types of Expanded RolesExpanded Roles  Nurse anesthetist: certified registered nurse anesthetist (CRNA) • Takes care of the patient’s anesthesia needs before, during, and after surgery and other procedures, either alone or in conjunction with other health care professionals  Certified nurse midwife (CNM) • Delivers newborns; also provides health education, including teaching of self-care skills and preparation for childbirth and childrearing
  • 18. Chapter 27 Copyright © 2003 Delmar Learning, a 18 Advanced Practice Nursing: Types ofAdvanced Practice Nursing: Types of Expanded RolesExpanded Roles  Clinical nurse specialist (CNS) • A registered nurse with an advanced nursing degree, master’s degree, or doctorate who is an expert in a specialized area of clinical practice  Nurse practitioner (NP) • An advanced practice nurse who has education beyond the bachelor’s degree in a clinical specialty area strongly focused on primary care, though some subspecialties are hospital-based  Clinical nurse specialist/nurse practitioner (CNS/NP) • Combines qualities of both specialties