Question

1. Analyze the differences between Advanced Nursing Practice and Advanced Practice Nursing.

Answer 1

Ans) The premise of differentiating advanced practice nursing from advanced nursing practice came about to identify the activities and contributions of all graduate-level nurses. For example, and advanced practice nurse (APN) is considered a nurse practitioner prepared to deliver patient care services in a clinical role, such as family nurse practitioner, adult nurse practitioner, gerontologic nurse practitioner, pediatric nurse practitioner, certified nurse midwife, and certified registered nurse anesthetist.

- Most agree that a clinical nurse specialist is a part of this APN classification of nursing function.

- The LACE Consensus Model (Licensure, Accreditation, Certification, and Education) was formed through the work of the APRN Consensus Work Group and the National Council of State Boards of Nursing to clarify and bring about agreement on titles of advanced practice nurses.

- Organizations and stakeholders in advanced practice nursing are coordinating their efforts to identify and enhance the roles of APNs by recognizing and enhancing educational needs, certification and accreditation potential, and ultimately a uniform licensure.

- When the DNP degree was developed, it was directed toward the APN as described above as the intent was for all APNs to earn this degree by 2015 to reflect a standard of advanced practice nursing. This left other non-APN nurses questioning their position in the scheme of developing a practice doctorate degree. The verbiage in the "eight essentials" document was augmented to include population based care that could reflect the efforts of colleagues in nursing administration.

- Still others in our discipline pressed for inclusion and the description of advanced nursing practice was promulgated to include all nurses that worked above an entry-level role. So now, the general idea is that anyone with a master’s degree who is a nurse is in some form of advanced nursing practice, but is not necessarily an advanced practice nurse.

- I know many across the country are doing the same and have seen discussion about the dilution of the degree and the bastardization of the doctor of nursing practice degree as a result. I’ve heard it said that if you meet one DNP, you’ve met one DNP, as not all are created equally even though the AACN’s eight essentials are the foundations of these programs.

- Nursing is indeed a practice discipline. All will no doubt agree with that statement. The question that is still being explored is whether or not roles within our discipline are considered advanced practice nursing. For example, a nurse executive is an essential role, as is a nurse educator, as is a nurse researcher.

- Trying to identify two groups of nurses – advanced nursing practice and advanced practice nursing – may strengthen the discipline of nursing, but I believe that it has clouded the clarity of our practice driven professional focus. An engineer that is in an administrative role is considered an administrator. An accountant in an educational role is considered an educator. A pharmacist that is engaged in research is considered a researcher. All have backgrounds in their respective disciplines, but their roles reflect their activities, not the practice of their professions. They are not “practicing” their respective disciplines when engaged in these roles. Their respective degrees identify their professions but do not necessarily solidify an understanding or success at implementing these roles. This seems to be an immature and defensive stance to be inclusive at the risk of misidentifying our actions. We should be proud of the nurse educator, administrator, informatician, geneticist, researcher and legislator. However they are practicing their respective contributions and roles and are not advanced practice nurses or advanced nursing practice. Rather, they are nursing professionals performing distinct and necessary roles with a foundation in the discipline.