Posted: September 5th, 2022

History and Evolution of the Advanced Practice Role, Advanced Practitioner

History and Evolution of the Advanced Practice Role, Advanced Practitioner Registered Nurse roles, challenges, and triumphs
The evolution of advanced practice roles can be traced back to the introduction of the specialist nurse in the late 19th century in the US. The specialist nurse became popular in the 1930s and 1940s. In the 1960s, the clinical nurse specialist became part of the nursing profession. The emergence of the specialist nurse was prompted by Mrs. Bedford Fenwick, together with her colleagues. They relentlessly pushed for an education, which will produce professional and dependable nurses. That led to the emergence of new roles, knowledge, and skills.
In 1965, Ford and Silver introduced the nurse practitioner concept, which led to the rise of a pediatric role in the US. According to Marchione and Garland, social problems, such as inadequate pediatricians, prompted the need of a nurse practitioner. The development of the nurse practitioner concept affected the relationship between nurses and other health providers. In the 1990s, several regulations and standards were put in place to regulate nurse practitioner education.
The journey to the establishment of advanced practice had both pitfalls and triumphs. One of the major successes is it led to improved healthcare leading to patient satisfaction. For instance, specialized care contributes to lower mortality rates of mothers and infants. The scarcity of nurses is one of the challenges that face advanced practice. Fewer students are joining the workforce and more nurses retiring.
Advanced practice registered nurses hold different roles; nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist, and clinical nurse specialist. A certified nurse-midwife is responsible for assisting women during delivery; they deal with reproductive health. A certified nurse anesthetist is in charge of pain management, and they give patients anesthesia during surgery. A clinical nurse specialist handles a specific area in medicine, such as pediatrics. A nurse practitioner provides advanced care to patients, for example, a psychiatric nurse practitioner.
The advanced nurses are responsible for; offering treatment to patients and tracking progress to change care and treatment when necessary, providing counseling services to patients and families, and ensuring patient’s privacy. They also keep records to make it easy to track the patient’s medical history. Advanced registered nurse practitioners play a significant role in the diagnosis and management of chronic diseases. They also engage in preventive and reproductive care.
The advanced nursing role faced several challenges as it evolved. There were so many misconceptions and complexities. There was also a lack of standards and regulations. The development of this advanced role also altered relationships between nurses and other medical professionals. It made advanced nurse practitioners more autonomous.
References
Sherry Greenberg, M. S. N., ed. Nurse practitioners: The evolution and future of the advanced practice. Springer Publishing Company, 2010.
Stanley, Joan M., Kathryn E. Werner, and Kathy Apple. “Positioning advanced practice registered nurses for health care reform: Consensus on APRN regulation.” Journal of Professional Nursing 25.6 (2009): 340-348.
Hinchliff, Sue, and Rosemary Rogers, eds. Competencies for advanced nursing practice. CRC Press, 2008.

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Tags: Advanced Practitioner, History and Evolution of the Advanced Practice Role