The document discusses the critical role of Advanced Practice Nurses (APNs) in the U.S. healthcare system, emphasizing their diverse roles, including nurse practitioners, educators, administrators, and informaticists. It highlights the evolving scope of APNs, legislative challenges they face in Florida, and advocates for increased autonomy and recognition to improve healthcare access. Furthermore, it outlines the author's aspirations to become a Family Nurse Practitioner and address the pressing need for primary care providers while navigating the restrictive regulations in Florida.

1. Running head: FINAL
1
FINAL
12
Final Project
Yoanka Rodriguez
South University
July 2017
Final Project
Advanced practice nurses (APNs) have become an essential part
of contemporary health care system in the United States. These

2. specialists have the key role in the provision of quality, safe,
and cost-effective health care to broad populations. They make
an invaluable contribution to the transformation of the health
care system to provide better customer experience in health care
institutions. The changes in the American society including
demographic changes, technologic progress, and the progress in
the area of policy-making to provide access to the health care
services to all suggests that the roles of the ANPs will continue
to evolve and gain more significance in society. Effective
functioning of health care system in contemporary conditions is
impossible without the contribution made by nurse
practitioners, nurse informaticists, nurse educators, and nurse
administrators. This final paper aims to summarize the
information learned during this course concerning the
significance of advanced practice nursing roles, legislative
regulations that control their scope of practice, and their
contribution in the area of policy-making related to health care.
Advanced Practice Roles in Nursing
Advanced nursing practice is a growing specialty in the nursing
profession with the broad scope of practice. APNs work in a
variety of fields and settings, including both clinical and non-
clinical ones (Sun et al., 2015). These specialists engage in
both direct and indirect patient care, and can become essential
members of managerial teams or start their own business in
family practice.
There are multiple roles in the advanced nursing practice
including nurse practitioners, nurse educators, nurse
administrators, and nurse informaticists. The advanced practice
registered nurses (APRNs) employed in clinical practice are the
certified nurse-midwife (CNM), clinical nurse specialist (CNS),
certified registered nurse anesthetist (CRNA), and nurse
practitioner (NP) (Melnyk, Gallagher‐Ford, Long, &
Fineout‐Overholt, 2014). All these clinical specialists are
focused on patient care quality improvement and patient
outcomes facilitation (Melnyk et al., 2014). As for the

3. difference between APN and ANP, from the information above,
it can be seen that the APN is a broader concept meaning the
whole specialty of advanced practice nursing, and the ANP is a
more specific concept describing the specialty of nurse
practitioners employed in the clinical field.
Family Nurse Practitioners
Family nurse practitioners (FNPs) are employed in primary
care. Their main goal is to provide disease prevention and
health care promotion services to community populations (Sun
et al., 2015). These specialists have specific proficiencies,
skills, and competencies to perform their daily tasks in clinical
settings. FNPs serve various populations including children,
women, gerontology patients, mentally ill patients, and acute
care patients (Sun et al., 2015).
FNP is the very role this writer aspires for herself. Being an
experienced nurse and a person with the goal to help others, this
writer has seen many opportunities for herself in the field of
primary care. Therefore, she decided to become an FNP. This
writer’s personal philosophy is to seek for opportunities to
make a difference and positive change in other people’s lives
through helping them to improve their health and quality of life
as a result.
Nurse Educators
Nurse educators are employed in education. These specialists
focus on teaching and training nurse students to help them
become qualified specialists serving broad populations. Nurse
educators train the nursing workforce for a diverse, ever-
changing health care environment (Sun et al., 2015). The role
of nurse educators is highly important because they are the key
stakeholders in the preparation of the nursing workforce able to
transform the health care system and improve health outcomes
for the nation.
Nurse Administrators

4. Nurse administrators work in nursing administration and
managerial practice to facilitate effective workflow. These
specialists collaborate with various members of the health care
process and ensure coordinated efforts of all these professionals
(Sun et al., 2015). Nurse administrators are patient advocates,
policy-makers, and specialists in the use of the evidence-based
practice in transforming models of care and facilitating patient
outcomes (Yee, Boukus, Cross, & Samuel, 2013).
Nurse Informaticists
Nurse informaticists are the rapidly developing role in nursing,
and it has been recognized as an independent profession in the
recent period (Sun et al., 2015). Nurse informaticists work with
information technologies and systems based on these
technologies. Their goal is to help other health care
professionals facilitate their working process and data
processing with the use of information technologies. These
specialists also work to help patients be engaged in the
technological development helping to transform the health care
and introduce telemedicine and other technologies in the
process of care and interaction between clients and providers
(Sun et al., 2015).
Selected Advanced Practice Role
Legal Regulations
This writer’s selected advanced practice role is a family nurse
practitioner. Florida's Nurse Practitioner Supervision Laws
regulate the scope of practice of FNPs in the state of Florida,
where this writer intends to be employed after graduation from
the program. To practice in Florida as a family nurse
practitioner, the main criteria include graduate education in
nursing, certification for the role, and practice focused on the
patient (American Association of Nurse Practitioners, 2013).
To be eligible for certification for the specialty, the candidate
must complete a graduate nursing program and acquire the
necessary body of knowledge, skills, and competencies
(American Association of Nurse Practitioners, 2013).
Many specialists qualify Florida's Nurse Practitioner

5. Supervision Laws as the strictest supervision systems in the
United States (Sun et al., 2015). This law requires that the
family nurse practitioner’s activity is supervised by the medical
doctor of practice (American Association of Nurse
Practitioners, 2013). The MD must be present in practice for at
least two times a week, and all patients in practice are to be
informed about the hours of the doctor’s presence. The rest of
the time, the MD can supervise the FNP on the phone or via the
Internet connection (American Association of Nurse
Practitioners, 2013). FNPs are not allowed to sign death
certificates, but they can sign handicap parking permits
(American Association of Nurse Practitioners, 2013).
Florida's Nurse Practitioner Prescribing Laws is another
significant regulation that establishes the legal foundations for
the role of the family nurse practitioner in Florida (American
Association of Nurse Practitioners, 2013). This law makes the
provision that the FNP is allowed to prescribe medicines under
the supervision of the medical doctor and only according to the
skills and competencies acquired in the nursing school
(American Association of Nurse Practitioners, 2013). For
example, in Florida, FNPs can prescribe antibiotics, but they do
not have the authority to prescribe controlled substances
(American Association of Nurse Practitioners, 2013). Besides,
family nurse practitioners in Florida are not allowed to use
forms pre-signed by the physician and utilize of the DEA
number of the physician as provided in Florida's Nurse
Practitioner Prescribing Laws (American Association of Nurse
Practitioners, 2013).
The Professional Organizations Available for Membership
As for the professional organizations available for membership
for family nurse practitioners, the list is quite broad. FNPs can
join the American Association of Nurse Practitioners, the
National Organization of Nurse Practitioner Faculties, and
American College of Nurse Practitioners (Yee et al., 2013).
More options include basic nursing organizations in the United

6. States including the American Nurses Association and National
League for Nursing. NPs can also join American Association of
Critical-Care Nurses, American Nurses Credentialing Centre.
International Council of Nurses, National Council of State
Boards of Nursing, and the Joint Commission for Accreditation
(Yee et al., 2013). Since nursing organizations in the United
States are quite multiple, it is difficult to mention them all in
this project. So, only the most significant were listed.
Nevertheless, professional nursing organizations for nurse
practitioners are manifold and can have a narrowed focus of
interest to address the needs of specific patient populations and
specialties (Yee et al., 2013).
Required Competencies
The required competencies for FNPs address the clinical
domain, first of all, since these professionals work in direct
patient care. Excellence in direct clinical practice provides a
foundation necessary for these professionals to execute
competencies; consultation, guidance, coaching, and leadership
within organizations. Family nurse practitioners, therefore,
need substantial clinical experience and expertise in the field of
direct patient care including the competencies of health
assessment diagnostics, disease management, patient education,
and health promotion (Sun et al., 2015). Florida Board of
Nursing (2017) establishes that the FNP must possess the
advanced clinical knowledge, skills, and clinical experience,
advanced knowledge of pathophysiology and pharmacology,
health maintenance and promotion competencies, advanced
clinical research skills, policy making competencies, advanced
leadership competencies, business literacy, and managerial
skills.
The Organization and Setting, Population, and Colleagues with
Whom This Writer Plans to Work
This writer is a business oriented person. She loves working
with patients and understands that patients are also customers.
In the long run, she plans to open her own practice in her

7. community that badly lacks primary care providers due to the
increased needs of the local population Before this goal
realization, this writer would like to actualize her skills while
collaborating with experienced nurse practitioners and medical
doctors in one of the health care centers in her city. She is
interested to master the practical skills in the area of
administration, collaboration facilitation, budgeting policy
making, and health care systems operation. Afterward, this
author would like to open her own primary care office, where
she will serve families with diverse needs. The focus of this
center will be to help people improve their quality of life
through continuous health promotion.
Leadership Attributes of the Nurse Practitioner Role
Upon the offered test completion during this course, this writer
has learned that her leadership style is democratic leadership
(Cherry, 2016). This result was quite expected since this author
believes that democratic leadership provides the optimal
opportunities for excellent performance of team members. As a
democratic leader, this writer’s strong skills and competencies
include emotional intelligence, excellent relations building
skills, delegating skills, excellent communication skills,
decision-making skills, and teaching abilities.
Transformational leadership is another successful leadership
style. A row of specialists believes this style to be the best
leadership style in today’s conditions of the rapidly changing
health care landscape (Wong, Cummings, & Ducharme, 2013).
Defining transformational leadership, it can be said that this
leadership style is a leadership that changes and transforms
people (Wong et al., 2013). It is concerned with values,
emotions, ethics, standards, and long-term goals. It includes
assessing followers' motives, satisfying their needs, and treating
them as full human beings. Transformational leadership
involves an exceptional form of influence that moves followers
to accomplish more than what is usually expected of them
(Wong et al., 2013). As for this writer’s intended leadership

8. style she would like to embrace, transformational leadership
skills building in herself is her intent. Applying this leadership
style to the domain of FNPs practice, its effectiveness is high
because it allows to empower and motivate team members to
their highest capacity (Wong et al., 2013).
Health Policy and the Role of Nurse Practitioner
The information provided in the subheading “Legal Regulation”
provides multiple details proving the fact that the scope of
practice of NPs in Florida is being restricted. The state of
affairs with the scope of NPs in Florida is unfortunate for the
residents because the need for the primary care providers in this
state is the biggest among all locations in the country, but the
scope of FNPs’ practice is the most restricted (American
Association of Nurse Practitioners, 2013). This unfortunate
situation is a paradox of the health care system in Florida.
While patients in Florida badly need quality, safe, and cost-
effective health care provided by nurse practitioners, the policy-
makers and legislators seem to be blind to the citizens’ basic
needs.
The topic of interest here is full prescriptive authority for nurse
practitioners in Florida and possible resulting changes to access
to health care when NPs have more autonomy. NPs who work
in primary care show patient outcomes equal to or better than
physicians (Aiken et al., 2016). More than 40 years of studies
show that NPs perform safely in practice (Aiken et al., 2016).
The outcome related to full prescriptive authority for NPs is
increased access to health care in Florida. This author believes
that having proponents fighting for prescriptive authority for
NPs is an important area that needs further support. Be it
through studies or arguing the topic in legislative hearings, the
NPs in Florida are not being used to their fullest capability.
With the shift in healthcare policy towards more cost-effective
care, it is fundamental that the decision-makers need to
investigate ways to improve care while implementing cost-
saving techniques.
A study would need to be performed over at least two years

9. depicting the percentage change in access to healthcare when
NPs are afforded full practice authority. To evaluate the study
descriptive statistics and inferential statistics may be used.
Descriptive statistics describe the population studied and the
instruments used in the study. Scores or percentages may be
compared using measures of central tendency.
This writer could lead the effort to make the change in policy
by providing the results of the above-mentioned study to policy-
makers in Florida. This could be done by means of involving
interest groups such as the American Association of Nurse
Practitioners in order to have a stronger voice in society.
Continuous communication and cooperation with the policy-
makers in the state will be necessary in order to lobby for the
interests of NPs. This writer also plans to use the resource of
the social pressure by the wide public. This source is powerful
when it comes to affecting the decision-making process in
politics. Since the wide public’s interest to improve the
citizens’ health and NPs’ interests to have a broader scope of
practice coincide, this author believes in success of the above-
described efforts.
Conclusion
In conclusion, it should be pointed out that advanced practice
nurses have become essential specialists in contemporary reality
of the health care system in the United States. It is imperative
that APNs be recognized as a vital source for bridging the gap
in health care and be allowed to accommodate full patient care.
These specialists have important roles in direct patient care,
advocacy for patients’ interests, customer experience
facilitation, optimization of management, and policy-making to
help the vulnerable populations. This writer has shared her
plans regarding her further career development as a family
nurse practitioner. With an increasing shortage of primary care
physicians, the role of the FNP will become more vital in
meeting the demands of the cost-saving health care. Currently,
the need for nurse practitioners in the state of Florida where she
plans to be employed is significant, but their scope of practice

10. and the policy regulating it is an immense concern because it
appears that the law intended to benefit the population actually
harms it by limiting their access to the quality primary care
provided by NPs. This writer believes that NPs in Florida need
to continue to unite their interests using interest groups to
achieve the positive change in the legislative field in order to
broaden their scope of practice and acquire an opportunity to
serve diverse patient population to promote their wellbeing and
improve the quality of life.
References
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