Roles of Advanced Practice Nurses and Nurse Practicioners in Paediatric Nursing

Roles of Advanced Practice Nurses and Nurse Practicioners in Paediatric Nursing
Community nursing is the nursing that develops and implements an integrated manner within the framework of public health care to the individual, family and community in the health-illness continuum. The community nurse was specifically created to help individuals, families and communities to acquire skills, habits and behaviors that promote self-care, in the context of promotion of health and healthy lifestyle.

The term community health nursing was established recently and it is considered a scholarly discipline of service, which purpose is to contribute individually and collectively to promote optimal functional level of the user or customer through education and caregiving.

Its action falls within the framework of primary health care, being a key primary care team. According to Nursing in general practice, NP’s are the advanced practice nurses, who have licence to practice and who completed either a Master’s or a Doctoral Degree.

As a rule, a Nurse Practitioner is a registered nurse who, as a rule, has enough knowledge, proper decision-making skills and the competency to do the practice, as stated in Advanced Nursing Practice. Its characteristics are usually shaped by the context or country where the nurse practitioner does to practice. As a fact, a master level degree in this sphere is recommended for entry level. NP/APN settings differ in purpose, type and sponsorship. NP’s responsibilities are teaching families and kids about the healthy lifestyle, answering questions about health problems, to perform some tests and procedures, to order medical tests, to document health history, to perform a physical exam, to treat common childhood illnesses and to provide referrals to community groups (Mayhen, 2006). The sites of the practice include hospitals, mobile clinics, work sites, schools, etc. Specific condition for the advanced practive care include: breast care, stoma care, diabetic care, cardiology, and oncology. Client group includes children, elderly, refugees, homeless, ill and immigrants. The specific area of work: Intensive care, Coronary care, Neonatal Unit, Nurse Managed Services, Orthopedic unit, etc. The practice is usually associated with Primary Health Care, home care and community care. Expansion of APN roles in institutions or hospitals is usually under the supervision of physicians. As a fact, APN services can also include care at the secondary and tertiary level.

The advanced nurse practitioner movement in Australia is new and, as a result, it has developed because of changing expectations of the Australian community. There have also been made some changes in the delivery of the health care, and consequently the role of the nurse expanded. The role of an advanced nurse has been introduced in Australia in the last ten years. And, as a fact, nurse practitioners are registered nurses with skills in their area of specialty and with more knowledge gained with the help of educational programs, which are certified by the Board of Nursing, as stated in General Practice and Policy - Review. As a fact, “nurse practitioner” is protected in legislation in the Nurse Practice Act, as described in Nurse Practitioner Legislation would have reduced barriers to care. Advanced nurse practitioners provide different services that are reflected in many models of health care delivery. The role and importance of the nurse practitioner is growing and it will continue to change in the future. Nowadays, different states and territories in Australia are working independently and have different rules considering the roles of the Nurse Practitioners.

Nurses that were registered for that care, usually assess patient health problems and needs. They also develop and implement nursing care plans and consequently maintain the medical records. Nurses administer nursing care to ill, injured, convalescent, or disabled patients. Nurses also can give the patients advises on health maintenance and disease prevention, and as well, to provide case management, as stated in For many, a nurse practitioner is The doctor. As a fact, there are advance practice nurses such as nurse practitioners, clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists. As a rule, advanced practice nursing is practiced by RNs who have specialized formal, post-basic education and who function in highly autonomous and specialized roles.

A nurse practitioner is a registered nurse, who is properly educated and authorised to to do the practice autonomously. He is also authorized to cooperate collaboratively in an extended and advanced clinical role. The majority of the Nurse Practitioner courses take 1.5 – 2 years of additional study, and also require applicants to: to have a degree qualification, to be registered, to have a current practising certificate, to have minimum 3 years of post-registration experience, as well, to be recognised as an advanced practice nurse in the current area of practice and also to show the true commitment to this sphere, as stated in Nursing in general practice. The nurse practitioner role requires the proper profession’s values, up-to-date knowledge and relevant practice. The detailed job description and permission in the practice of a nurse practitioner is defined in the context, which describes how a person is authorised to practise.

The knowledge and the expertise characterize the APN practice. Also, one of the most important points is the clinical judgment, along with the skilled and self-initiated care. Advanced nursing practice promotes the development of all aspects of advanced practice. In response to the global development of NP/APN roles, professional organizations along with professionals started to explore options for the development of an international resource. As a result, in 1998 in Melbourne, Australia, there were formal discussions considering the further development of an international network. As a matter of fact, the ICN INP/APN Network was launched in October 2000 at the 8th International Nurse Practitioner Conference in San Diego, California.

The international resource for nurse practitioners and advanced practice nurses provides the relevant and timely information about practice, health policy and regulatory changes; possibility of a forum for sharing and exchange of experience and research; support to nurses who are in the process of introducing NP and APN roles; an accessto the international resources and internet links.

As a fact, nowadays practice nurses are employed in nearly sixty percent of general practices in Australia. There are different opinions on the quality of the roles undertaken by the advanced practice nurses. Nurse practitioners in general Pediatric area in Australia have different capabilities and their own opinion and the ways to do the practice. Some consider them not so preferable, including the methodics that are being used. As well, in addition, financial support is provided for general practices to employ practice nurses. Unfortunately there are certain issues in the policy in implementing the practice and in its development. There have been raised the issues, which affect the sustainability of the practice-nurse workforce. It is especially visible if these issues are not addressed systematically. As a fact, there is not enough information about the Australian practice-nurse workforce, as well about funding models to support their work and the outcomes, as described in Categories of Nurses in Australia. As a result, Australian practice nursing lacks a career structure and an education framework. But, as the demand shows, the advance nurses’ skills and knowledge can be implemented in the process much more effectively. As a fact, a more systematic approach is needed in this sphere to reach achieve results and to provide better care and a strong policy to support effective outcomes.

As described, Australian studies of the practice-nurse workforce are sometimes exploratory and descriptive, also with little evidence about models of practice or further outcomes. As a fact, the nursing profession in Australia also has the two approaches for the development in practice nursing. That is why, according to the circumstances, nursing is now established as a field of practice in the primary-care sector. And, perhaps, these politics have began to make a progress on workforce data collection, in funding models, educational opportunities and career pathways. These points are also well developed for other health professions. The policy should be strengthened for a better practice nursing in Australia, so it could support the quality outcomes. And also, these methods will help to provide a proper understanding of the important practice for nurses to the health system. As a fact, Australia has well established comprehensive sources of information for the medical workforce. It needs proper and constant development of effective policy and planning in the pediatric nursing.

As a result, correct and proper planning of the activities in the area of pediatric nursing can accurately make necessary contributions in the area by different professionals. The better innovative model of practice for nurses has not been found yet. That is why advantages and disadvantages of different models are often limited, as either the substitution or collaborative model are not well understood. This view is implicit in the Australian Government’s Nursing in General Practice Initiative, which aims to “relieve workforce pressure in general practice”, as stated in Nurse practitioners. But, at the same time, a collaborative practice model states the fact, that the practice nurse is an autonomous provider. And also she is considered an independent professional with the ability to effectively manage the process of the care of patients. As a fact, the professional autonomous models are supported as well by the competency standards for nurse practitioners in general practice. In this case, nurses take their own responsibility for their competence and fulfillment of their practice. That is why it is extremely important to have high standards, proper planning and new approaches in the pediatric nursing.

Obviously, there are suggestions for the considerable variation in practice of nurses. These changes can be from traditional delegation of tasks and assistance to doctors, with the help of advanced or independent practice in different areas. These areas include preventive care, disease management and care coordination. The factors that determine current models of practice include the professional characteristics of the nurse, the business orientation of the practice, and the needs of the local population. As well, nowadays, systematic investigation is required to provide evidence with the help of which models the work becomes the most effective and has a positive impact for the health outcomes. And, as well, it is important to take into consideration the satisfaction for the work the nurse practitioners do, as it will reflect their relation to their work and its essectiveness.

As well, other professional issues still remain unresolved in the further development of the work that nurse practitioners do. These issues include education and training, funding arrangements, supervision, professional indemnity, and also the lack of a systematic approach to the further policy development and its evaluation. There is also a problem considering the professional isolation which the nurse practitioners face, which creates a vulnerability to pressure to fulfill different creative tasks of practice.

It has also been found out, that education for the nurse practitioners does not always meet the demands of their current roles and future perspectives, because of the lack of the clear boundaries for the nurce practitioners’ education. Although the Australian Government has offered scholarships for education in some clinical areas through the Nursing in General Practice Training and Support Initiative, these scholarships have not been properly organized and tied to a quality audit of the programs of study, as stated in Australian Government Department of Health and Ageing. As statistic states, seventy-three per cent of nurses work in general practice in Australia. Their age is over 40 years, which means that they have little training or experience in primary care. This is the problem, which can cause many misunderstandings and lead to big disadvantages in the pediatric nursing. A strategy urgently has to provide education and training programs to support nurses to gain levels of education and knowledge. And unfortunately, the current policy initiatives have failed to implement mechanisms for better monitoring and evaluation.

All in all, the roles of advanced practice nurses and nurse practitioners in pediatric nursing in Australia have certain perspectives. They can be realized with the help of new changes, improved delivery different aspects of care and new approach. As a fact, there are still many challenges in establishing a perspective, innovative and sustainable practice-nurse workforce. The practice nurses with their practice and work they do, which state the quality of care they provide, and its outcomes. Of course the importance of the work that advanced practice nurses and nurse practitioners do should be carefully supervised and the possibilities for people working in this sphere should be increased. Obviously, practice nurses need a quality education and clear career perspectives and goals, which will attract those people who are looking for an alternative to hospital careers.


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Roles of Advanced Practice Nurses and Nurse Practicioners in Paediatric Nursing 8.1 of 10 on the basis of 1766 Review.