The work for this paper entails interviewing TWO different categories of advanced practice nurses (APNs). One APN has to be a primary care nurse practitioner (e.g., family NP, adult NP, pediatric NP); that is, the NP cannot be one who is an acute care NP. Furthermore, the NP must work in a primary care setting such as a “doctor’s office” or community health center—that is, in a setting the buzz-word for which is now medical home. An NP who works in a retail clinic or free-standing urgent care center would also be acceptable (but NOT an emergency department). Yes, there are many APNs who are prepared as FNPs or adult NPs who take jobs in non-primary care settings (e.g., as hospitalists and as providers in nursing homes). But a common premise with health care reform and the Affordable Care Act is that there already is and will be a huge need for primary care providers, thus paving the way for even greater opportunities for NPs in this area. It is important that you get a firm grasp of how NPs are prepared for primary care, and thus why NP organizations assert an important solution to the primary care provider shortage is educating more NPs which is why every state should allow full independent practice authority for APNs, especially NPs.
The other APN may be your choice of one of the following: a certified nurse midwife (CNM) or a certified nurse anesthetist (CRNA) or a clinical nurse specialist (CNS). There is no limitation regarding the types of settings these APNs might work. Be sure to indicate the state(s) where the APNs practice.
Although the information gathered from these APNs will be acquired via an interview, the paper should be written in summary format (i.e., it should not look like a dialogue between you and the APN). Information on both interviews should be in a single document. It is not necessary to provide the APNs’ full names. Most elements of APA format should be used, including a title page and abstract. Most students’ papers that address all of these questions for both APN are about five double-spaced pages, without counting the title page or abstract (be sure to read your APA manual regarding what an abstract should look like!). An exception to the APA format requirement is that a reference list is not required, since all of the information will be derived from two sources (the APNs whom you interviewed). Although you have free range to discuss other topics about advanced practice nursing, you must address the following issues with each APN (please follow the order of list below):
1. Reason for their choosing their specific APN specialty.
2. Descriptions of: (a) the type of setting where they work (e.g., community hospital, major medical center, private primary care practice, clinic for the underserved, etc.), and (b) a “typical” day as they render care.
3. Level of satisfaction with their role in general, and specifically within the system where they are currently employed.
4. The type of APN certification that they hold, including identifying the accurate name of the certifying body with which they are certified (Note: Review your textbooks for the correct names of these certifying bodies. Also note there are several different certifying bodies for NPs).
5. Whether they have prescriptive authority and whether they prescribe controlled substances. If they do prescribe controlled substances, you must indicate from which schedules of controlled substances they are allowed prescribe.
6. Whether they must practice according to an agreement with a physician. If so, is the relationship supervisory or collaborative?
7. Are they credentialed and privileged by a hospital or health system? If the answer is “yes,” ask them to explain what the credentialing and privileging process entails at their organization (e.g., are the documents reviewed by only the human resources department, the nursing department, or the medical staff office, a combination of all three, etc.).
8. Whether they belong to a professional organization(s) that specifically addresses APN issues. If so, which one (s)? If not, why not?
9. Their understanding about the DNP degree (i.e., have them actually explain what they know about the degree) and whether they have this degree already or intend to pursue it. Be sure to probe to see if they have positive or negative feelings about the DNP—and why.
10. Final grading criterion: Paper’s adherence to APA format (with the exception that references are not required for this particular paper), including grammar, spelling, punctuation, sentence structure, etc.
Total points for this assignment is 100; each question above is worth 10 points.
- Interview questions for Advanced Practice Nursing.
First of all, I would like to express my thanks for being willing to participate in this process as I work towards becoming a Nurse Practitioner. Your feedback is a valuable part of my education, and I would like to thank you for your assistance on this part of my journey.
Please feel free to add additional comments, discuss other topics in addition to your responses to the required elements below.
Thank you again!
Zelda
- What is the reason that you chose your specific APN specialty?
I chose to become a CRNA because I saw it as the most advanced nursing practice that I could see myself doing. I wanted to do clinical work and not management. I enjoy the bedside aspect of ICU nursing and anesthesia encompasses that as well as more independence.
- Please provide a description of: a) the type of setting where you work (i.e. community hospital, major medical center, private primary care practice, clinic for the underserved, etc.), and (b) a “typical” day as you render care.
I work in a 500 bed pediatric and adult level 1 trauma center. I care for patients in both the adult hospital as well as the children’s hospital. I care for patients getting all types of surgery except cardiac and liver transplant. I do both inpatient and outpatient OR settings. My typical day begins the day before doing chart reviews of my cases for the next day and writing preop notes. I also develop my anesthesia plan for the patient based on the case and the patient.
The next day I come in and set up my anesthesia work area, discuss the anesthesia plan with my staff anesthesiologist and do a preop assessment for my patient. In these few moments before going to the OR with the patient my job is to put them at ease and get them to trust me with their life in the OR. The OR RN and I take the patient back to the OR, I determine if any pre medication for anxiety or pain is needed and administer it if so. After the OR timeout typically the MD anesthesiologist pushes induction drugs. I mask ventilate the patient, place any airway device needed for the case, assess its positioning and secure the device. From this point generally I administer medications as needed for pain, nausea, muscle relaxation and reversal. I am responsible for monitoring and maintaining the patients vital signs. At the end of the case, the MD is required (for billing) to be present for emergence from anesthesia and extubation. Typically I am responsible for actually stopping the anesthesia, removing the airway device and assessing airway patency after removal. The surgery resident and I then transport the patient to the PACU and give bedside report to the PACU RN.
- What is your level of satisfaction with your role in general, and specifically within the system where you are currently employed?
As a CRNA, when we graduate most of us must decide whether we want to practice independently, do our own regional anesthesia but not care for very sick patients on a regular basis or practice at a large center where we likely will not do our own regional anesthesia and be medically directed but then care for sicker patients. The smaller facilities generally come with higher pay, but more call. The larger centers, especially those with residents come with a more restrictive practice, usually less pay but a much more favorable schedule and far less call.
When I finished school I was older than most new CRNA’s, I have children and my choice was to have a better schedule. I would love to practice independently but at this point in my life the schedule is more important. I also have a love for pediatric anesthesia and while you may care for some healthy kids getting basic procedures in smaller places, you will not care for the types of patients that I do at a large children’s hospital. The children’s hospital keeps my satisfied with my current position. The perfect CRNA position currently does not exist where I could do my current job with independent practice.
- What type of APN certification do you hold? Identify the accurate name of the certifying body with which you are certified.
I am a CRNA. We are certified by the NBCRNA (National Board of Certification and Recertification of Nurse Anesthetists)
- Do you have prescriptive authority and do you prescribe controlled substances? If you do prescribe controlled substances, from which schedules of controlled substances are you allowed to prescribe?
I do have prescriptive authority. In my current position I do not prescribe outside the OR. Legally I can prescribe controlled substances schedule 2 and all other legal schedules.
- Must you practice according to an agreement with a physician? If so, is the relationship supervisory or collaborative?(Please share as much information re: this as you are able.)
In my current position I am required to practice with an agreement with an MD. This is a supervisory relationship as our OR cases are billed as medically directed. This is the most restrictive type of anesthesia billing and practice for a CRNA. It is typical of all large medical centers throughout the country.
In the state of WI however, APRN’s are not required by the practice acts to have practice agreements. APRN’s can practice indecently and because we are a medicare opt out state we can also bill independently.
- Are you credentialed and privileged by a hospital or health system? If your answer is “Yes”, please explain what the credentialing and privileging process entails in your organization (i.e., are the documents reviewed by only the human resources department, the nursing department, or the medical staff office, or perhaps all of these, etc.).
I am credentialed by a hospital. The credentialing process is actually fairly easy and efficient. We have to be credentialed every 3 years. I am sent a packet of forms to fill out about 2 months ahead of time and just have to fill it out and turn in to our HR contact. The finalized credentials are reviewed by the hospital credentialing committee and the hospital medical staff affairs office.
- Do you specifically belong to a professional organization (s) that specifically addresses APN issues? If so, which one (s)? If not, why not?
I am a member of the AANA (American Association of Nurse Anesthetists). This is our voice for legislative actions. Currently they are addressing a few things, first the AANA recently approved “nurse anesthesiologist” as a descriptor for us. The American Society of Anesthesiologists (ASA) is currently fighting this with bills in several states to stop this. They also are constantly lobbying for our ability to practice independently in all states. Another large practice issue for us to try to prevent licensure of anesthesiologist’s assistants (AA) from getting practice authority in any more states. The ASA is consistently fighting to try to make our CRNA practice level the same as the AA level of practice. AA’s can not practice independently ever and this is what the ASA would like for us as well. Many of our issues are the same as any other APN, sadly the AANA and other APN organizations do not work together very well. If they would all work together we may have more success.
- What is your understanding about the DNP degree (Please explain what you know about the degree itself), and whether you have this degree already or intend to pursue it? Can you please also tell me your feelings ( Positive or negative) about the DNP and why you feel this way.
The DNP is a clinical doctorate degree. It is 1 of 2 end degrees for an APN (PHD being the other). The DNP is more focused on clinical practice than research. I plan to get my DNP (or DNAP) at some point. I think that requiring a more advanced degree to practice is not a bad thing. If we are going to make the case that we are as good as an MD, adding more education can not hurt that argument.
- Please feel free to add any additional information re: your specific field that you may feel may be beneficial for my learning process.
CRNA’s as a group had a falling out with other APN’s and RN’s in the past. This is why many CRNA programs are not housed in schools of nursing. Consequently many CRNA’s do not have a traditional MSN or DNP. Many of us have Masters or doctorate of nurse anesthesia practice, some even have a masters in biology or just anesthesia. Some nursing schools do house CRNA programs but most do not.
If at all possible, please return the responses to me by sometime Saturday, Feb,8,2020.
Sorry, I know its a little late, I was on call this weekend 🙁
Many thanks!
Zelda Skaife MSN/RN
1.) What is the reason that you chose your specific APN specialty?
The love of this side of medicine and the lack of empathy from others. These patients support and understanding.
2.) Please provide a description of: a) the type of setting where you work (i.e. community hospital, major medical center, private primary care practice, clinic for the underserved, etc.), and (b) a “typical” day as you render care.
I currently work in a hospital clinic in 2 different locations. A typical day for me is seen patients starting at 8:00 in the morning and 8 AM at 5 PM. I see anywhere between 10 and 22 patients per day
3.) What is your level of satisfaction with your role in general, and specifically within the system where you are currently employed?
I love what I do. I attempt to stay out of the weeds and politics.
4.) What type of APN certification do you hold? Identify the accurate name of the certifying body with which you are certified.
I am an adult psychiatric nurse practitioner board-certified and gain this certification through the ANCC.
5.) Do you have prescriptive authority and do you prescribe controlled substances? If you do prescribe controlled substances, from which schedules of controlled substances are you allowed to prescribe?
I do have prescriptive authority and prescribed controlled substances. I do not prescribe class I.
6.) Must you practice according to an agreement with a physician? If so, is the relationship supervisory or collaborative?(Please share as much information re: this as you are able.)
In the state of New Mexico I do not have to work under a physician. However, due to regulations as well as hospital bylaws I do work under a physician. I do not have to report to this physician each and every patient.
7.) Are you credentialed and privileged by a hospital or health system? If your answer is “Yes”, please explain what the credentialing and privileging process entails in your organization (i.e., are the documents reviewed by only the human resources department, the nursing department, or the medical staff office, or perhaps all of these, etc.).
I am credentialed and have privileges at my local hospital. However, the hospital has not begun allowing nurse practitioners to admit under their own names. We still have to admit under an MD.
8.) Do you specifically belong to a professional organization (s) that specifically addresses APN issues? If so, which one (s)? If not, why not?
I belong to ANCC and APNA
9.) What is your understanding about the DNP degree (Please explain what you know about the degree itself), and whether you have this degree already or intend to pursue it? Can you please also tell me your feelings ( Positive or negative) about the DNP and why you feel this way.
DNP programs are meant for people who are wanting more knowledge and the research area as well as a social area. I am not sure if this is something I want to obtain/pursue at this time. This is mainly due to no increase in pay or standing within the medical community. I believe that a DNP is worth while, but not at this time due to financial gains.
Please feel free to add any additional information re: your specific field that you may feel may be beneficial for my learning process.
When you are completed with your program it is important that you work with others who are willing to continue your learning in a collaborative manner. Do not feel you have to take the first job or decrease in pay since you’re a new provider.
ANSWER
- Advanced Nursing Practice Role
Name
Institution
Date
Abstract
An advanced registered nurse practitioner has primary responsibility for patient care as they can practice independently or work collaboratively with other physicians and other healthcare providers. The CNM role is primarily and directly related to the provision of healthcare services for women. Often, CNMs act as primary care providers for women providing care for relatively healthy women whose conditions are considered uncomplicated or less risk. For those with high-risk pregnancies and health, the CNMs may work collaboratively with other physicians to ensure the quality of care and safety of the patients.
- What is a typical shift like for a CRNA?
A: “Every day is different. CRNAs work in various parts of the hospital and participate in various parts of surgery. You can expect to participate in preoperative interviews, set up/check all equipment you will utilize in the OR and you will help transport patients to the PACU after surgery.”
- How much collaboration is there between the CRNA and other members of the surgical team?
A: “Complete collaboration. All members of the surgical team including the CRNA must be on the same page during each case.”
- If desired, how quickly are staff promoted?
A: “That depends on each person and their willingness to move forward. There is always room for advancement.”
- What do you believe is the ideal candidate for the CRNA position?
A: “Someone who is able to collaborate with others. Able to multi-task. Someone who can display confidence in their abilities. An ideal candidate must be able to adapt to different personalities because they will be working with various different co-workers in various different environments.”
- Can you enlighten me on your vision for the surgical units?
A: “My vision is for the unit to perform their duties safely and successfully.”
- How would you describe your supervisory style?
A: “Democratic/participative. The staff is encouraged to make decisions and participate in desired outcomes.”
- Can you tell me about any challenges I may face initially in this position?
A: “CRNAs are faced with tremendous responsibility and a great deal of accountability. Adjusting to the heaviness of the job responsibilities may be a challenge initially.”
- What have other CRNAs done to succeed in the position?
A: “Attention to detail and compassion are some of the same qualities observed of successful CRNAs. Nurse Anesthetists can significantly impact the health of their patients. They must be able to notice subtle changes in their patient’s condition.”
- What should a CRNA have accomplished within the first three months of employment?
A: “There aren’t required tasks that a CRNA must have accomplished, but successful completion of the orientation process and the ability to display adequate understanding of the necessary characteristics related to the position is amongst the few tasks that would be ideal to have accomplished in the first three months.”
- What reservations do you have about my qualifications for this position?
A: “At this moment, there are no concerns. I will be sure to make you aware if any concerns may arise.”
I interviewed fellow classmate Tabby Cintron, RN. The interview went pretty well actually. I gave Tabby a heads up on the topic that I wanted to interview her on. She answered the questions to the best of her knowledge and I feel that they were a descent representation of the job description. I wanted to make sure that I asked questions about the daily duties of a CRNA and what I needed to do to be successful in my chosen career. I definitely feel that I have made a great career choice. My talent inventory summary suggested the CRNA career which has solidified my choice even more.
Advanced Nursing Role
The world has been facing a global increase in demand for healthcare services on all levels placing a significant strain on healthcare systems. The escalating demand, as well as the shortages in numbers of nurses, has forced many institutions and healthcare systems to reevaluate the distribution of roles and responsibilities to different healthcare providers. The role of advanced nurse practitioners (ANP) can be divided into clinical or non-clinical (educator) role. According to APRM consensus model, APN roles are classified into four; Clinical Nurse Specialist (CNP), Certified Nurse Practitioner (CNP), Certified Registered Nurse Anesthetist (CRNA), and Certified Nurse-Midwife (CNM) (Iglehart, 2013). The APN role was developed to address the issue of increased demand for specialized care services. According to Hamric et al. (2014), advanced practice nursing is a concept and not a set of skills or a role of physicians essential for care provision.
An Advanced Practice Nurse, as defined by ANA (2017), is a nurse who has completed graduate-level education program which has the impact of preparing the nurse for the role of CNP, CNP, CRNA, and CNM. As an Advanced Registered Nurse Practitioner, one may assume the CRNA or CNM role. Based on this paper, the analysis will focus on the certified nurse-midwife role of an advanced registered nurse practitioner.
Role of the Nurse Practitioner: Certified Nurse-Midwife
As stated in the introduction, an advanced registered nurse practitioner (ARNP) can assume two important clinical roles; Certified Registered Nurse Anesthetist (CRNA), and Certified Nurse-Midwife (CNM). The role of the nurse practitioner is direct care clinical practice as he/she are directly involved in the provision of care to the women. One the nurse practitioners have been certified, Hamricet et al. (2013), points out that they can provide counseling, education, order lab tests, perform procedures, and order medications for their patients. In the United States, CNM is an APRN role of midwifery and caring for women across their lifespan including before and during pregnancy, postpartum period, and in issues of birth control. For a nurse practitioner to assume this role, he/she must possess a graduate degree, pass the American Midwifery Certification Board exams, pass NCLEX exams, and hold an active registered nurse license.
Besides being primary healthcare providers, Bartels (2005) indicate that CNMs may work as educators. Mainly, CNM role incorporates patient education with the ARNP engaging in health promotion practices such as sex education, disease prevention, counseling, and disease management practices. This aspect of the CNM role is considered direct clinical care as it requires that the nurse apply the teaching and learning competencies while educating his/her audience (AACN, 2016). Health education is an important primary intervention as it focuses on helping the patient identify their health issues or the risk factors for poor health and adopt new ways of preventing these issues or risk factors for poor health. Most women are unaware of the risk that surrounds them and their unborn babies, and there is a gap that the CNM role helps bridge.
Promotion of Patient Outcomes
As ARNP, the role of CNM allows the advanced nurse practitioners to address the health issues surrounding their patients fully. They can carry out research on nursing issues, educate their patients, and manage the health of their patients through many healthcare strategies. Advanced registered nurses are extensively trained and are capable of assessing and treating their patients in a variety of settings (Naylor & Kurtzman, 2010). Due to this extensive training, they can handle basic functions of the doctors, therefore, reducing the time of waiting for the patient. That way, they are known for reducing the time the patient is attended to thereby promoting patient outcomes.
In most cases, the safety of the patients is compromised due to medical errors related to lack of experience and enough training. It is without a doubt that the nursing practice has evolved to adapt to current patient needs as well as technology. According to Brassard (2013), the healthcare system is experiencing a shortage of nurses as well as other healthcare professionals, but with advanced nursing practice, there has been a distribution of roles across professionals with nurses with masters and doctorate degrees performing some roles that were initially meant for doctors. That way, the advanced nurse practitioners have cant impact had a significant impact on not only service provision but also access to healthcare services as they can work in clinics, hospitals, and at home.
Interview Questions
- How would you describe your role as an advanced nurse practitioner?
- Do you find any relationship between educational attainment and nurse performance and how does this affect patient outcome?
- What characteristics would you describe as essential to the success of a nurse?
- How many nurses do the organization you work for has?
- How many of the nurses are advanced nurse practitioners?
- What role differential do you see between general nurses and advanced nurse practitioners?
- On average, how many patients do you tend to on a normal day?
- Are you allowed to work autonomously or are you expected to work under the supervision of a doctor or other physician?
- What is your thought about the role of nurses in the ever-changing healthcare system characterized by different patient needs?
- How would you describe your position as an advanced nurse practitioner?
Advanced Practice Nursing Role in the 22nd Century
The transformation of global healthcare is advancing at a bewildering rate that has never been experienced before. According to the US Institute of Medicine Report (2011), nurses should be at the frontline in advancing change and reform in the healthcare sector in a health system that is increasingly complex. By the 22nd century, nurses advanced practice registered nurses (APRNs) should have the requisite knowledge and skill set to perform the full extent of their training and education. Additionally, multiple systematic healthcare changes will occur subordinate to the US 2010 Patient Protection and Affordable Care Act (PPACA) (Islam, 2015), which will result in APRNs and family nurse practitioners (FNPS) exceptionally exploiting their full potential. Therefore, this research paper explores the future of the APRN role about legal, social, economic factors, as well as and faith-based and Christian worldview with a focus on primary care as well as the global, cultural and national issues and how APRNs and FNPs will offer services in the dynamic healthcare environments.
Factors Shaping APRN Role in Future (Innovative Practices)
Legal
In the 22nd century, nursing practice in the United States and other parts of the world will be characterized by strong regulation and policy initiatives including the Patient Protection and Affordable Care Act (PPACA), Doctor of Nursing Practice (DNP) Movement, the Consensus Model for APRN Regulation. Also, in this century, the primary consuming regulation mission for APRNs in the United States will be the Consensus Model for APRN Regulation which will entail licensure, certification, accreditation, and education (consensus Model). The process will be attributable to the efforts of more than 70 healthcare and nursing organizations which will culminate in the individual state having the mandate to deal with issues of licensure, education, certification, and accreditation consistently. Therefore, in the 22nd century, APRNs will operate in the era of regulatory consistency, thus eliminating significant hindrances to patient care and practice.
Additionally, 22nd century APRNs will have the following features. Firstly, APRN will be the practice and licensing title for those nurses educating and performing roles as Clinical nurse specialists (CNS), certified nurse-midwife (CNM), Certified registered nurse anesthetist (CRNA), and certified nurse practitioner (CNP). Secondly, it will be a requirement for all APRNs to complete a postgraduate or degree-granting accredited graduate program. Lastly, all APRNs will be required to be prepared to take full responsibilities from a pharmacologic and non-pharmacologic perspective including promoting, maintaining, and assessing health, as well as diagnosing and managing patient problems.
When the above recommendations are implemented and recognized by the DNP movement, APRNs and other related professionals will progress tremendously and achieve regulatory consistency in terms of licensing, education, credentialing, and accreditation. Also, the US healthcare system will have undergone massive changes, and APRNs will play a crucial role in such developments thought their knowledge and adequate preparation. APRNs will be invaluable in dealing with the lack of coordination for illnesses that are christened chronic. They will also be instrumental in the reduction of the overall cost of healthcare. Through active participation, APRNs will be able to contribute towards the elimination of scope-of-practice barrier, development of nurse residency programs, engaging in life-long learning, increasing the number of nurses with doctoral degrees by two-fold, as well as becoming change agents for an improved healthcare system. By so doing, they will be contributing towards the increment towards quality and access care.
Moreover, through policy revisions, APRNs will play crucial roles in improving and controlling the cost of health. First, NPs will affect the prevention and treatment of diseases, through successful prevention of diseases, APRNs will significantly lower the cost of healthcare. Moreover, through active participation in the policy-making making process, APRNs will affect the economics of good health by preventing injuries and diseases through the improvement in social determinants of good health including safe housing and balanced nutrition.
In addition to policy revision, aging populations have an overwhelming effect on the healthcare system due to the surge in risks factors such as smoking and obesity which have a profound impact on the rise in chronic diseases (Garza, 2016). Due to the resource-intensive nature of treating such chronic problems, nurses and NPs will be instrumental in managing them because of their cheaper costs, proximity to patients, and proven records in handling such cases. As a result, future APRNs will become fully-fledged healthcare providers in the management of global non-communicable illnesses. Therefore, the next century will be characterized by aggressive APRNs working with the government to craft policies that address the healthcare as mentioned above issues and contribute towards a comprehensive healthcare system that benefits all people.
Economic
In the 22nd century, it is anticipated that the demand for primary care service surge beyond the supply for the same services. The increased demand will be attributable to the continually growing population with the baby boomers qualifying for Medicare. Additionally, ambulatory care visits will have increased by over 30% due to the increment in the number of older adults, with over one-fifth of the American population being over 65 years of age (Schütte,2018). Moreover, this period will be marked by an increase in the percentage of people with chronic illnesses and conditions. Even in the face of increasing primary care demand, it is appalling that primary care physician is decreasing in number either due to retirement, or abandoning primary care (Petterson et al., 2016). Also, the number of school graduates pursuing family practice residencies or general internal medicine is on the decline. A projection of the status of the number of primary care physicians shows that in the next century, a significant amount of primary care physicians will have vacated the industry due to various reasons, thus creating insurmountable shortages in terms of hundreds of thousands. Such decrement is in contrast to the increasing number of NPs and APRNs who continue to join and graduate from primary care nursing practitioner programs.
In addition to the decreasing number of primary care physicians, the US is renowned for topping the global healthcare list for the most expensive healthcare systems. It spends the most funds in terms of per capita on healthcare compared to other developed nations (Davis et al., 2008). Also, worth noting is that it’s spending on healthcare is increasing far much faster compared to other countries with more or similar financial muscle. Nevertheless, such high costs do not translate to better results compared to those countries. On quality, access, morbidity, equity, mortality, and efficiency the US underperforms relative to comparable countries (Schütte,2018).
Due to the above challenges, APRNs in the future will play a significant role in providing quality and cost-effective healthcare. Research has shown that APRNs are capable of providing quality healthcare to patients similar to that provided by physicians or even better in terms of patient satisfaction, asthma control, readmission rates, mortality rates, perception on health, lipid control, among others at cost-effective prices (Center et al., 2014) Consequently, the future will entail the expansion of APRN-led clinics, patient-centered medical homes, as well as convenient-care clinics.
Social
The responsibilities for APRNs continue to broaden as communities become diverse and the world mobile. The enhancement of active NP development will be achieved through the organization and participation in medical brigades across the globe. Also, the APRNs will be instrumental in their social responsibility of assisting the UN to achieve the Millennium Development Goals. Moreover, the building of new nursing curriculums will continue to increase in a bid to educate and addresses health literacy and cultural issues. Such trends will continue to expand and accelerate in the 22nd century, thus requiring APRNs to be more prepared and collaborative to attain optimum results. As the engagement in international collaboration by NPs heighten, other stakeholders will also contribute to the process commensurately.
Faith-based and Christian Worldview
APRNs in the 22nd Century will continually, merge their practice with their faith and Christian beliefs. They will form unions with more advanced roles that will not only involve giving primary and acute care but also sharing their Christian faith with patients. They will also discuss a multitude of social and bioethical issues impacting them and how they address them using their Christian faith. Lastly, Christian APRNs will continue to increase and ultimately set up clinics based on the tenets of a good Christian.
Conclusion
The future of APRNs in terms of the legal, social, economic, and Christian perspective is broad. The role of APRNs will continue to advance in terms of healthcare provision, and we are likely to witness fully-fledged responsibilities of NP in healthcare provision as the number of primary care physicians decreases. The achievement of such roles will depend on research, role advocacy, collaborations, system coordination, and educational preparation. The leveraging of such factors will mean a bright future with more advanced roles for APRNs.
References
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