Scope of Practice for Advanced Practice Nurses


Compare the Scope of Practice for Advanced Practice Nurses across the Country.

Over the last several years, the responsibilities of advanced practicing nurses (APNs) have been continually evolving. This is because there is a shortage of qualified nurses inside the health care sector from rising demand. In many rural and inner city locations, these professionals are in greater demand. According to a study conducted by the Bureau of Labor Statistics, these numbers are expected to continually increase in the next decade and beyond. This is illustrating how the rising demand for them will require shifting duties and responsibilities in the process.

To fully understand what is taking place requires carefully examining the scope and practice for APNs across the country. This will be accomplished by exploring their role as an advocate, comparing / contrasting the ways APNs can engage in research, outlining clinical expertise with patient management skills, summarizing complimentary therapies / their duties in treatment options, discussing ways to deal with cultural / linguistic challenges and utilizing conflict resolution skills. Together, these elements will highlight how their duties are changing and the impact it is having on the way health care solutions are delivered to patients. (Hughes, 2008)

Part 1

The changes that are evolving inside the field means, APNs will have shifting responsibilities and how they deal with various challenges. This is leading to greater responsibilities for these individuals. That is focused on utilizing their experience and expertise to improve the quality of care which is provided to patients.

Explore the Role of the APN as an Advocate

The APN has a unique role they must play as an advocate for the patient. This is when they are diagnosing and developing treatment plans for helping them to maximize functional abilities, manage health problems, promoting health maintenance and preventing / minimizing disabilities. At the same time, they must work with other professionals to improve the quality of care they are receiving and seek out solutions while helping patients. This is accomplished through effective communication, leadership and encouraging collaboration in enhancing the overall health care environment for everyone. (Fitzpatrick, 2003) (Naylor, 2010)

These factors are showing how the APN is someone who must use their knowledge, expertise and guidance to create a shift in attitudes about how to deal with a variety of challenges. This means that they are advocates for different stakeholders, who are focused on offering better solutions for addressing a number of challenges. When this happens, they can create an environment that is supportive of these individuals and introduce lasting transformations that will improve quality / professionalism. (Fitzpatrick, 2003)

Compare and Contrast ways that an APN can engage in Research and the Link between Evidence-Based Practice and Research.

The APN serves a unique role where they must engage in different areas of research. This occurs when they are using patient records and other information as a part of the clinical decision making process. Under this approach, they will look at what information is available (such as: the progression of the disease, signs / symptoms and treatment options) in order to recommend the most appropriate course of action. They are also involved in utilizing data to evaluate patient outcomes and manage care in different practical settings. These evaluations are focused not only on the needs of the patients they are working with, but entire populations who are experiencing similar kinds of challenges. This is showing how APNs can engage in research and evidence-based practices through using their understanding of an entire group of patients. That is dealing with similar challenges from larger segments of the population. This helps APNs to have better knowledge of the symptoms, causes and most effective strategies for treating them. (Strommel, 2004) (Naylor, 2010)

The way that this is accomplished is through engaging in quantitative research from other health care professionals. This is when they will look at different studies and determine the impact of utilizing specific techniques on larger groups of patients. They can then apply these ideas in their own evidence-based practices to improve quality. This is showing how there is a direct link between the research and the ability of APNs to troubleshoot problems using the latest techniques. When this happens, they can offer better solutions for dealing with a host of challenges impacting patients and possible complications associated with their conditions. (Strommel, 2004) (Naylor, 2010)

At the same time, the APN can use research to understand the best techniques for dealing with the issues impacting patients and how to improve the quality of the health care environment. This occurs with them learning about new ideas and the way they are transforming the professionalism of staff members / their ability to troubleshoot issues. When this happens, they can apply the best practices that will create an atmosphere which is supportive of different stakeholders in the process. This helps evidence-based practices by making them more responsive to everyone’s needs. (Strommel, 2004) (Naylor, 2010)

In this aspect, the research is conducted through engaging in qualitative and quantitative analysis. During this process, they are studying numerous techniques and the impact of these strategies on different segment of people they are working with. In some cases, this could involve them seeing the results of what is happening through looking at actual figures and examining the impact it is having on patients. While at other times, they could be focused on understanding more general concepts to improve how they are working with various health care professionals. (Strommel, 2004)

This is illustrating how there is a link between research and evidence-based practices by taking specific figures and incorporating them inside a health care environment. At the same time, it is showing how more general strategies are used to improve their ability to work with other professionals and to be more supportive of them. It is at this point when they can utilize these ideas to create changes in the way treatment options are applied and its lasting impact on others through various ideas that were uncovered in their research. Then, begin applying them at precise moments inside their evidence-based practices. (Strommel, 2004)

These different areas are showing how there are contrasting approaches an APN will us to engage in research. In some cases, they will focus on specific figures from larger segments of the population to understand what is affecting them and the most effective ways to provide treatment (utilizing quantitative analysis). While at other times, they will focus on using quantitative and qualitative analysis to comprehend how to create changes inside the health care environment (utilizing a mixture of both methods). This will introduce alternative strategies for understanding what is happening and allow them to implement new ideas for treating patients or working with other stakeholders. That is negatively impacted by these conditions. It is at this point when they can provide shifts for creating lasting changes among the various segments of patients. (Strommel, 2004)

Outline the Clinical Expertise and Patient Management Skills that an APN could use as a Foundation for Case Management.

The clinical expertise and patient management skills are something an APN will gain through their research and experiences. This helps them to effectively troubleshoot challenges and create innovative solutions for improving the treatment options provided to patients. Some examples of this include: preventive care, treatment, advanced therapeutic programs, patient / family education, initiating referrals to other health care professionals (such as: specialists), managing chronic conditions using advanced skills / diagnostic reasoning, conducting interventions / treatment and prescribing pharmacology / non-pharmacology protocols (which are in compliance with state law). (Mezey, 2003) (Naylor, 2010)

These skills can be used as a foundation for case management by providing the APN with the tools they need for interacting with a variety of patients and their families. This helps them to more effectively understand their condition, the best treatment options and how they will be able to assist them over the long-term. At the same time, these skills are allowing them to prevent various diseases from becoming worse or developing in patients. When this happens, they can work with them to troubleshoot the challenges they are facing and to comprehend the best techniques for addressing them. (Mezey, 2003)

Moreover, the different relationships they have established with various experts; will help them to offer referrals to other health care professionals. This occurs during events when the individual does not respond to their treatment options. These factors are illustrating how patient management skills and clinical expertise are essential for APNs to know what is happening and quickly respond to distinctive situations. It at this point, when they can make a difference in the quality of care they are receiving. (Mezey, 2003)

Part 2

APNs are a unique part of any health care team. This is because they can provide specific insights which are discussing how they can improve treatment and to effectively deal with a host of issues. These factors help doctors, patients and other professionals to have a reliable partner they can count on in the process.

Summarize Complementary Therapies and the APNs Role in guiding their Inclusion in Treatment Plans.

Complimentary therapies are a part of the practices which are utilized to help patients to improve their underlying state of health and reduce the need for long periods of hospitalization. In most cases, this allows them to receive continuous treatment on an outpatient basis. Some of the most notable include: chemotherapy, kinesiology, nutrition / diet, focusing on the mind / body connection and psychological treatment options. These different areas are important, as they will help patients to understand other tools they can utilize in dealing with their condition. This is giving them a sense of empowerment by comprehending what is occurring and the best approaches for addressing these challenges over the long-term. (Mezey, 2003) (Naylor, 2010)

The APNs role is to suggest other therapies they can use during the process and help to supervise the patient. This means that they will introduce them to these alternatives and educate patients / families about how this can reduce pain and suffering. At the same time, they are offering them with tools to provide greater amounts of control over their treatment. When this happens, they can work with patients to manage events that are occurring in their lives more effectively. It is at this point that all encompassing solutions can be utilized to achieve the primary objectives in the treatment plan. (Mezey, 2003) (Naylor, 2010)

APNs are central part of this process, through helping patients to see how they can improve their underlying levels of health and educating them about procedures they can use in their daily lives. This decreases the chances of someone needing to spend added amounts of time in the hospital. It is also giving them a sense of empowerment. As a result, these areas are important in assisting everyone in effectively dealing with these issues over the longer term. This is when they can use complimentary therapies to enhance their overall levels of health through utilizing a number of solutions. APNs assist patients and their families to understand the most effective techniques and the way this can boost the treatment options they are receiving. (Mezey, 2003) (Naylor, 2010)

Create a teaching plan that an APN could use.

One of the most important roles that an APN will play is as an educator. This means that they will help stakeholders to understand effective techniques through their experiences, skills, leadership and insights. As they have a responsibility of teaching patients and their families about the condition along with the best approaches for treating it. To achieve these various objectives, any kind of techniques that are utilized must follow a predetermined plan. (Jansen, 2010) (Naylor, 2010)

This requires creating a strategy that is tailored to the audience or individuals they are reaching out to. This means following precise steps that will assist them in accomplishing these goals. The most notable include:

Analyze the overall resources that are available: This is when the APN will carefully look at what tools are available and determine when they should be utilized in the process. (Jansen, 2010) (Naylor, 2010)

Understanding the limitations and disabilities of the person: This requires examining what areas could hinder the ability of the APN to offer support to the patient or family members. (Jansen, 2010) (Naylor, 2010)

Laying out the plan for reaching out to the individual: This will occur when they are able to create a strategy that will help the patient to understand the main ideas. To achieve these objectives, there must be a focus on making the concepts simple, using common terms, establishing short / long-term goals, planning a series of incremental learning activities, helping the person to apply the various concepts on their own, using positive reinforcement and evaluating the outcomes. These elements are important, as they will provide a foundation for allowing them to overcome the challenges they are facing and ensuring that everyone has a better understanding of what is taking place. (Jansen, 2010) (Naylor, 2010)

Follow up: This will occur with the APN analyzing how the patient responds to the new ideas through monitoring the way they are able to interact with stakeholders. It is at this point when they can provide insights that will help the patient to see how they are improving and if there are any changes that need to be made during the process. (Jansen, 2010) (Naylor, 2010)

If this kind of teaching plan is used, it will ensure that everyone has effective follow up for what is happening and can reach out to them. When this takes place, the patients will understand the importance of the ideas that are being presented. This is the point when they are more willing to follow these practices and guidelines over the long-term. (Jansen, 2010) (Naylor, 2010)

Outline ways to deal with Cultural and Linguistic Challenges.

The best way to deal with cultural and linguistic challenges is for the APN to work with other professionals on the staff. These individuals can provide them with research about the overall culture and background of the different patients they are serving. This will help them to determine what ethnic groups are utilizing the facility and the most common issues impacting other APNs. (Lenninger, 2001) (Cronenwett, 2009)

Once this takes place, is when the APN must conduct their own form of self-study. During this process, they will learn about the best approaches for interacting with the various segments of the population who utilize the facility. This will require understanding what customs and practices are most important to them. At the same time, they must begin learning various phrases and keywords that are important to reaching out to these individuals. This means they will have to study the language and slowly become accustomed with it. The basic idea is for the APN to become an expert on the cultural practices, customs and linguistics that are most important to different segments. (Lenninger, 2001) (Cronenwett, 2009)

When they are interacting with patients, is the point they can utilize these ideas to reduce any kind of communication barriers and help them to understand the importance of the information. This will take place, with them embracing those practices which are of significance to them and drawing a direct correlation to these ideas to modern medical concepts. It is at this point where they can be able to eliminate any kind of communication barriers in the process. (Lenninger, 2001) (Cronenwett, 2009)

Utilize Conflict Resolution Skills

To prevent misunderstandings requires that all APNs must use conflict resolution skills. This means that they need to listen to everything the patient has to say. Then, respond to them in manner that is sympathetic with their views. Yet, is it is not supporting their thinking or taking sides. Instead, they are serving as an objective party who they can relate to and feel comfortable with in explaining their issues. This will reduce the intensity and emotions they are feeling about specific issues. (Jansen, 2010) (Cronenwett, 2009)

Next, the APN must seek out neutral solutions that will solve these challenges for the patient. However, they must also ensure that they are giving in on some points, in order to feel completely satisfied with the process. This requires the individuals remaining unemotional and always working to support a friendly atmosphere. When this occurs, they can serve as liaison between the different sides and have an understanding what issues are impacting these parties. It is at this point where they can create win — win solutions. That will make everyone feel satisfied with the outcome. (Jansen, 2010) (Cronenwett, 2009)


Clearly the role of APNs across the country is continually evolving. This is because they have become an important member of any health care team. That has the responsibility for providing leadership, working with patients and resolving conflicts. This means they must utilize flexibility to evolve with these challenges and understand the needs of stakeholders in the process. The impact they are having is to offer everyone with assistance from a person who can educate them about various conditions, offer complementary therapies and encourage them to follow these practices. This reduces any complications and it creates a foundation for ensuring that patients are working with health care professionals they can trust.


Cronenwett, L. (2009). Quality and Safety Education. Nursing Outlook, 57 (6), 338 — 348.

Fitzpatrick, J. (2003). Managing Your Practice. New York, NY: Springer.

Hughes, R. (2008). Patient Safety and Quality. Rockville, MD: Agency for Research and Health Care Quality.

Jansen, M. (2010). Advanced Practice Nursing. New York, NY: Springer.

Lenninger, M. (2001). Cultural Care Diversity and Universality. Boston, MA: Jones and Bartlett.

Mezey, M. (2003). Nurse Practitioners. New York, NY: Springer.

Naylor, M. (2010). The Role of Nurse Practitioners in Reinventing Primary Care. Health Affairs, 29(5), 893-9.

Strommel, M. (2004). Clinical Research. Philadelphia, PA: Lippencott, Williams and Wilkins.

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