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01 wengstrom 1 01 wengstrom 1 Presentation Transcript

  •  
  •  
    • Evidence based practice
    • Political skill
    • Persistence
    • Commitment
    • Inspiration to others
    • Personal example
    • Organizational skill
    • Positive:
      • Nursing education and leadership
      • Hospital organization/management
      • Emphasis on environment of care
      • Research based practice
      • Nursing as a distinct profession
    • Negative:
      • Nurse as handmaiden of physician
      • Physician writes orders even for nursing care
    • Focus on supporting the healing process; health promotion
    • Focus on the whole person
    • Focus on the environment of care
    • Coordination of care
    • Continuity of care
    • Nursing ’ s knowledge base has continually expanded.
    • Nurses must have substantial medical knowledge as well, but are conditioned to hide it from the doctor.
    • Expanding population and increase in disparities in health care have driven development of the nurse practitioner role.
    • International Council of Nurses
      • Expert knowledge base
      • Complex decision-making skills
      • Clinical competency for advanced practice
      • Shaped by context/country of practice
      • MSN recommended
    • Integration of research, education, practice, management
    • Autonomy
    • Case management/own case load
    • Consultant services
    • Program planning, implementation, evaluation
    • First point of contact
    • Understanding of how the AP role has evolved so far can help us guide its future development
    • Curriculum development
    • Program accreditation
    • Licensure/certification/credentialing mechanisms standardized
    • Authority to: diagnose, prescribe medications and treatments, refer, admit
    • Title protection
    • National conference
    • Consensus gained among nursing leaders
    • Laws changed
    • Masters curriculum initiated
    • Obstacles: physician, nurse and public resistance
    • Many nurses reluctant to assume responsibility
    • Public perception: “ just a nurse ” : “ where ’ s the doctor? ”
    • MD perception: “ just a nurse ” ; threat
    • Nurses: “ not a nurse – a mini-doctor ” ; fear of change; fear of responsibility
    • Regulations/Laws
    • Bureaucratic inertia
    • Nurses ’ self-perception
    • Nurses ’ resistance
    • Change is not easy
    • Create demand among the public
    • Offer a concrete proposal
    • Provide a concrete cost/benefit analysis
    • Understand competing interest groups and address their concerns (eg, MD organanizations, nurses)
    • Direct patient care services without MD presence – nurse led clinics
    • Public relations: media, flyers, newsletters
    • Community-based activities
    • Personal example
    • News articles
    • Interdisciplinary activities with active APN participation
    • Shared training, research, practice
    • Confidence and assertiveness - without aggressiveness or arrogance
    • Recognize differences and articulate mutual strengths and interdependence
  •  
    • Being a nurse
    • It is the “ nurse ” in “ advanced practice nurse ” that is our greatest asset