01 wengstrom 1

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01 wengstrom 1

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

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