Family Nurse Practitioner in California

Introduction

The main purpose of this essay is to explore the roles and scopes of nurse practitioners (NPS). It looks at scopes and roles found in a Master of Nursing careers such as Nurse Educators, Nurse Practitioner, Nurse Informatics, and Nurse Administrator.

Specifically, it focuses on a Family Nurse Practitioner in the State of California. The essay will review the scope, education, practices, regulatory and legal requirements, professional bodies, accreditation, leadership, and advocacy roles of a Family Nurse Practitioner in the State of California. NPS are registered nurses who provide primary health care services for patients based on their conditions and therefore ensure the health and well-being of patients. NPS must achieve the required minimum training and education to get accreditation and practice in the US.

Roles of the NPS

Nurse Practitioner

A nurse practitioner requires a minimum qualification of a master’s degree. Nurse practitioners normally get further training in diagnosing and treating various conditions, administering drugs, injuries and offering management support.

A nurse practitioner is a clinical professional who provides physical diagnosis, orders laboratory tests, and interprets results, medical prescriptions, and other roles. Nurse practitioners may specialize in specific areas based on age groups, family, women’s health, and orthopedics among others. Today, roles and scopes of nursing practice continue to broaden as the healthcare sector undergoes several reforms (Fairman, Rowe, Hassmiller, & Shalala, 2011).

Nurse Educator

A nurse educator’s major role is to teach nursing students who are pursuing careers in nursing at various levels such as diploma, associate degree, and baccalaureate. This role requires highly qualified individuals. Nurse educators also develop and provide continuing education courses for practicing nurses. At the same time, there are also nurse educators who provide nurse education on basic areas, whereas others specialize in certain areas, such as mental health, neonatal care, and geriatric care among others. In some instances, nurse educators take part-time roles in health care facilities to develop and maintain their clinical experiences and skills (Nurses for a Healthier Tomorrow, n.d).

Nurse Informaticist

A nurse informaticist has exceptionally high levels of qualification accompanied by solid years of work experience in practical nursing before changing career to nursing informatics. Nevertheless, the roles of nurse informatics continue to evolve as new healthcare technologies emerge (Orlovsky, 2005).

Roles may differ from one healthcare facility to another one, but the most common duties for nurse informaticists involve system deployment. This duty requires nurse informaticists to work with nursing and information technology specialists to link communication systems in a healthcare facility. Nurse informaticists provide training and technical assistance to healthcare workers in using health care information systems. Training programs are designed to mitigate negative outcomes on patients and technology implementation and usage. Nurse informaticists also promote safety and quality care outcomes through the adoption of health care information systems. They train nurses on how to use the system, enter and retrieve information as required efficiently.

Nurse Administrator

Nurse administrators need additional specialized training and qualifications in administration and leadership to handle various tasks associated with management, workflow, budgeting, and people management (Ferguson-Paré, 2003). While nurse administrators must know about nursing, they do not participate in nursing practices and patient care.

Family Nurse Practitioner

Roles and Scope of Responsibilities

The roles and scopes of family nurse practitioners have changed with those of physicians. In the State of California, nurse practitioners do not work alone, but alongside physicians (California HealthCare Foundation, 2008). Family nurse practitioners offer nursing care based on collaborative and family-centered care strategies.

A family nurse practitioner can examine, recommend medication and provide care for patients. However, these responsibilities differ from one state to another based on legislative requirements (California HealthCare Foundation, 2008). Hence, a nurse practitioner’s role may also include the prescription of all medications, including other highly regulated ones. Therefore, a lack of consistency can affect the roles of NPs and service delivery to patients.

State of California: Regulatory and Legal Requirements for Family Nurse Practitioner

Law and legal requirements for family nurse practitioners are the same for all registered nurse practitioners. For instance, the State of California notes that nurses must be registered and certified to serve the public (Board of Registered Nursing, 2013).

Under the State of California law, nurse practitioners must be registered and have the required professional qualifications to practice. During practice, nurse practitioners must observe legal issues that may arise because of their interaction with patients and other third parties in the provision of health care services.

Major issues for NPs include patient safety, rights, and confidentiality. For instance, the Health Insurance Portability and Accountability Act (HIPPA) of 2006 affects all healthcare practitioners in the US. Hence, family nurse practitioners in the State of California must observe HIPPA conditions and maintain procedures for the privacy of their patient’s health data. Moreover, NPs must adhere to the code of conduct as provided in their respective facilities. They must also observe various regulations and changes as communicated by the Board of Registered Nursing, State of California.

Professional Organizations for Family Nurse Practitioners

The Board of Registered Nursing

The Board of Registered Nursing regulates “the practice of registered nursing and certified advanced practice nurses to protect the public” (Board of Registered Nursing, 2013). Hence, all NPs must be registered and certified by the Board. The Board helps in clarifying conflicting federal and state laws for NPs.

It also has the regulatory role of ensuring that all nurses practicing in the State of California have attained the necessary qualifications to ensure patient safety during practices. Therefore, the Board notes that only qualified and certified individuals may use the title ‘nurse practitioner’ in the State of California (Board of Registered Nursing, 2013).

California Nurses Association/National Nurses United

The National Nurses United has nearly 185,000 members in every state of the US. It promotes the interests of direct care nurses and patients, negotiates their contracts, and influences other stakeholders such as the healthcare industry, governments, and employers. In addition, the NNU also promotes healthcare advocacy and influences healthcare policies (National Nurses United, 2014).

American Nurses Association – ANA

The ANA is a full-service professional body that represents over 3.1 million registered nurses in the United States (American Nurses Association, 2014). It has several constituents and affiliated bodies, which promote the nursing profession through advocacy and lobbying to all stakeholders.

American Association of Nurse Practitioners – AANP

The AANP claims that it is the ‘Voice of the Nurse Practitioner’ (American Association of Nurse Practitioners, 2014). Its duties include advocacy, education, and professional advancement for all its registered members.

The National Organization of Nurse Practitioner Faculties – NONPF

The NONPF notes that it is a leader in quality nurse practitioner education at both the local and global levels (National Organization of Nurse Practitioner Faculties, 2014). The organization develops its curriculum guidelines for nurse practitioners to enhance excellence in nursing education and practices.

Required Core Competencies for Family Nurse Practitioner

NPS must develop relationship management competencies. A family nurse practitioner must therefore show competencies in personal, mutual respect, and collaborative strategies in healthcare service provision for improved healthcare outcomes.

A family nurse practitioner requires competencies in health promotion, protection, disease prevention, and treatment (NONPF & AACN, 2002). NPs provide direct healthcare services to patients. A nurse practitioner needs to assess both theoretical and evidence-based studies to manage patients’ conditions effectively.

A family nurse practitioner needs competencies in teaching and coaching.

NPS should be able to educate their patients about their conditions and best practices. Moreover, coaching activities allow the nurse practitioner to infer and personalize treatment for patients through advocacy and training.

NPS needs competencies in professional roles. For instance, a nurse practitioner should demonstrate a commitment to ensure, preserve and enhance positive changes in professional duties. These competencies also require a family nurse practitioner to promote critical thinking, teamwork, and multifaceted approaches to healthcare issues for quality outcomes.

Given the evolving nature of the healthcare sector, NPS requires competencies in managing healthcare provision strategies. A family nurse practitioner must demonstrate abilities to control healthcare processes and deliveries effectively to enhance healthcare outcomes for all stakeholders by managing and controlling service provision approaches in an integrated healthcare model.

NPS must also possess competencies in supervising and providing quality healthcare to patients (NONPF & AACN, 2002). A family nurse practitioner, therefore, should ensure quality healthcare outcomes for patients through continued discourses, qualifications, education and training, partnership, mentoring, and process evaluation. NPS must also observe their practice and collaborate with peers to ensure the best care for patients.

The US population has become more diverse over the years as the number of immigrants continues to increase. Consequently, cultural awareness and competencies are necessary for a family nurse practitioner. The NP should show cultural awareness and cultural competencies based on the belief systems of patients. Moreover, a family nurse practitioner must facilitate healthcare provision and limit healthcare discrepancies for patients from various cultural orientations.

Certification for a family nurse practitioner

There are three critical requirements for certification in the State of California. A family nurse practitioner must have an active California registered nurse (RN) license for eligibility, an Application for California RN Licensure by Endorsement must also be submitted, and NPS must either renew or reactivate the California RN license when he or she has a permanent California RN license (Board of Registered Nursing, 2014).

In addition, the NPS must have other preparation and skills in certain areas such as “physical diagnosis, psychosocial assessment, and management of health and illness needs in primary healthcare” (Board of Registered Nursing, 2014). Still, the Board requires all NPs to report cases of prior convictions or disciplines for all methods. That is, the nurse practitioner must meet all the eligibility conditions to become a family nurse practitioner in the State of California.

It is imperative to note “Effective July 1, 2012, the Board of Registered Nursing is required to deny an application for licensure and to suspend the license/certificate/registration of any applicant or licensee who has outstanding tax obligation ….” (Board of Registered Nursing, 2014, p. 1).

Predicted Healthcare Organization

Cedars-Sinai

Cedars-Sinai is known for providing the highest quality patient care (Cedars-Sinai, 2014). The hospital has ensured excellence, compassion, and innovation. In addition, it promotes leadership, education, and training of physicians and other healthcare professionals, expands medical knowledge through biomedical research, and strives to improve the health status of the community (Cedars-Sinai, 2014).

With over “2,000 physicians in every clinical specialty, 10,000 employees, 2,000 volunteers and 15,000 fundraising support group members” (Cedars-Sinai, 2014), Cedars-Sinai has the more diversified workforce to provide world-class care to patients from various parts of the world.

Given its strategies and a focus on community health based on basic and clinical research to bring medical advancements to patients, Cedars-Sinai is the best facility for an aspiring family nurse practitioner.

Leadership Attributes

Collaborative Leadership Style

The leadership style would enhance decision-making and information sharing among healthcare workers. A family nurse practitioner, therefore, should understand task prioritization, teamwork and demonstrate to the team that he or she trusts their roles in promoting leadership.

A family nurse practitioner may lack interest in teamwork with other team members and inability to complete tasks successfully when working independently. In addition, the leader may fail to define roles and provide guidance to the team. The nurse practitioner also demonstrates poor skills in decision-making and an inability to inspire others.

Acquiring and Evaluating Missing Values

A family nurse practitioner can take the following strategies to attain and evaluate the missing leadership values. NPS should take initiatives to improve leadership skills in specific areas, such as decision-making, teamwork, and role definition through reading leadership assignments. According to Sorensen, Iedema, and Severinsson (2008), a nurse practitioner must move beyond a reliance on professional clinical models to become skilled multidisciplinary team members. NPS will have to develop leadership competency-related tasks in professional, management, and interpersonal relations by working with mentors and completing mentoring assignments.

A family nurse practitioner should acquire decision-making skills by understanding role definition and using certain criteria to guide decision-making processes. Finally, NPS should develop collaboration and negotiation skills and accommodate different opinions and contributions from other team members.

Health Policy and the Advanced Practice Role

The US public health system aims to provide the best public health with the ultimate goal of reducing cases of preventable chronic diseases such as cancer, diabetes, heart conditions, and obesity among others.

The main causes of death in the US are mainly preventable diseases associated with risky behaviors (Wilcox, 2013). Individuals engage in unhealthy behavior choices such as smoking, lack of physical activities, and poor diets, which increase the chances of developing chronic diseases. The current Public Health and Prevention Policy has failed to promote healthy eating habits, access to healthy affordable foods, public space for physical activities, and clean air.

The US lacks an effective method of evaluating the performances of public health agencies. As a result, States cannot understand or share best practices and policies in public health and resource management.

Therefore, there is a need to develop a consistent and coordinated public health system that ensures constant changes and improvements in current practices. This strategy would promote public health efforts and ensure that all communities, including the underserved and uninsured, receive public health interventions. Hence, the public should get quality healthcare when reforms occur.

The Process Required for Making the Change with Key Players and Parties of Interest

The US public healthcare system must determine new ways of managing chronic diseases. This process requires healthcare stakeholders to develop a change process that involves major stakeholders to prevent diseases and reduce costs of healthcare services. It must be an interactive process as noted by Abood (2007). According to Abood (2007), there are three processes in change strategy, which include the “policy formulation phase, the implementation phase, and the evaluation phase” (p. Manuscript 2). These processes involve collecting inputs, opinions, and ideas from the public and conducting research at different sources to evaluate change. This would result in a well-formulated policy with a clear outline, purpose, and desired public health outcomes (Abood, 2007).

Leading the Effort to Make or Influence the Change in Policy

The major issue for NPs is how to influence key decision-makers in public healthcare, including lawmakers to change the current Public Health and Prevention Policy. A family nurse practitioner acts as an advocate and therefore must review how the policymaking process takes place by concentrating on how lawmakers formulate and implement public health policies. Hence, the nurse advocate would understand important decision-makers who need to be influenced in the process of changing the current Public Health and Prevention Policy. A family nurse advocate will have to identify principal decision-makers, policies they formulate, enact the stages of consultation, responsibilities, and responsiveness. The nurse advocate must understand policy formulation and implementation processes.

As processes change, the NP should apply persuasive strategies by relying on facts available on healthcare disparities and their negative impacts on target populations. A family nurse advocate should gain direct access to principal decision-makers on public health issues. If no positive message is received, the nurse advocate may engage in other strategies such as disruption and litigation to influence lawmakers and other policymakers to take the required action to change the public health policy.

The Potential Effects on Healthcare Quality if the Change in Policy is Implemented

A family nurse practitioner expects positive healthcare outcomes when there is a change in the current Public Health and Prevention Policy. There would be a better way of tracking the performances of public health agencies across different States. Moreover, the public would understand how healthcare agencies use available resources to enhance public health. The new policy will promote healthcare provision to the public.

It shall enhance the use of available data to drive decision-making in allocating available resources for efficiency. At the same time, the policy shall promote public awareness, education, and campaigns on healthy lifestyles. On this note, the policy should also address the quality of data used in assessing chronic diseases as researchers have shown that it faces many issues (Wallace & Salive, 2013). As a result, it has been difficult to understand “disease occurrence, risk factors, prevention, treatment and outcomes” (Wallace & Salive, 2013, p. E59).

Conclusion

The essay has covered fundamental aspects of NPs. It shows that NPS must acquire the required qualifications and certifications to provide professional healthcare services. The essay has shown that various states have different laws and regulations on NPS. The State of California requires a family nurse practitioner to work alongside physicians. Overall, it shows that the roles and scopes of NPs have continued to evolve because of the ongoing reforms in the US healthcare sector. Hence, NPs must act as care providers, teachers, information officers, leaders, and advocates for their patients.

References

Abood, S. (2007). Influencing Health Care in the Legislative Arena. OJIN: The Online Journal of Issues in Nursing, 12(1). Web.

American Nurses Association. (2014).. Web.

Board of Registered Nursing. (2013). . Web.

Board of Registered Nursing. (2014). General Instructions and Application Requirements for Nurse Practitioner (NP) Certification. Web.

California HealthCare Foundation. (2008). Scope of Practice Laws in Health Care: Rethinking the Role of Nurse Practitioners. Web.

Cedars-Sinai. (2014). About Us. Web.

Fairman, J., Rowe, J., Hassmiller, S., & Shalala, D. (2011). Broadening the Scope of Nursing Practice. The New England Journal of Medicine, 364, 193-196. Web.

Ferguson-Paré, M. (2003). Administration: What Is Leadership in Nursing Administration? Nursing Leadership, 16(1), 35-37. Web.

National Nurses United. (2014). About National Nurses United. Web.

National Organization of Nurse Practitioner Faculties. (2014). History and Goals. Web.

NONPF & AACN. (2002). Nurse Practitioner Primary Care Competencies in Specialty Areas: Adult, Family, Gerontological, Pediatric, and Women’s Health. Web.

Nurses for a Healthier Tomorrow. (n.d). Nurse Educator. Web.

Orlovsky, C. (2005). The Emerging Role of the Nurse Informaticist. Web.

Sorensen, R., Iedema, R., & Severinsson, E. (2008). Beyond profession: nursing leadership in contemporary healthcare. Journal of Nursing Management, 16(5), 535-44. Web.

Wallace, R., & Salive, M. (2013). The Dimensions of Multiple Chronic Conditions: Where Do We Go From Here? A Commentary on the Special Issue of Preventing Chronic Disease. Preventing Chronic Disease, 10, E59. Web.

Wilcox, L. (2013). Ten Years of Preventing Chronic Disease. Preventing Chronic Disease, 10, 120245. Web.

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