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Access The Future of Nursing: Leading Change, Advancing Health. Identify the two reco=endations for nursing education you believe will be most effective or radical in creating change within the industly. Provide rationale based on your experience in practice. Do you agree or disagree with how the Institute of Medicine (IOM) describes the advanced practice registered nurse role evolving. Why or why not?
Describe how the role of advanced registered nurse transformed over time. Consider shifts in scope and expectations in the 20th and 21st centuries. In what ways will the advanced registered nurse role and responsibilities continue to evolve and emerge as the American health care system changes?
As health care continues to change with the ever-evolving patient population, nursing education needs to be strengthened to better prepare the nurses of the future. “Nursing schools will need to ensure that nurses are prepared to understand and identify the different social determinants of health, have expanding learning experiences and cultural values, and have the competencies to care for an aging and diverse population” (Wakefield, Williams, Menestrel, & Flaubert, 2021). The National Advisory Council on Nurse Education and Practice (NACNEP) recommends population health concepts be incorporated into the nursing curriculum. They also suggest nursing programs should partner with HRSA, the VA, and the Indian Health Services to increase a student’s exposure to different environments and experiences.
I completely agree with this recommendation. My experience in nursing school was secluded to Banner Health facilities. The patient population seen was very predictable, especially on the med-surg floor. As the student, I did many head-to-toe assessments, and then proceed to pass out medication multiple times throughout the day. The population consisted of patients recovering from surgeries, broken bones, an exacerbation of COPD, or, etc. These clinicals felt very redundant and they changed my perspective of nursing until I started as a new grad in the emergency department. With the ability to visit a VA hospital, a student could be introduced to many different disease processes. War veterans have a combination of problems including PTSD, war amputations, drug addiction, mental instability, alcoholism, or other issues complicating their health. These complications allow a student to be exposed and educated on various disease processes. If the nursing school partnered with the Indian Health Services, a student would be introduced to a whole community they are unaware of or unexposed to. During nursing school, there was one patient I took care of who was from the Indian reservation. Having access to different patient populations, a student will be more accustomed to cultures, different age populations, plus rural and urban communities, allowing them to be more rounded as they graduate and enter real-world practice.
With the evolution of incorporating advanced practical registered nurses (APRN) into practice, there are many regulations that control a nurse’s scope of practice. There are private and public health systems restraining an APRN from practicing their full scope, limiting their expertise. Approximately 62% of rural areas have health shortages and would benefit from increased access to APRNs. With limited autonomy in urban areas, APRN can help patients and practice at their licensed ability (Wakefield, Williams, Menestrel, & Flaubert, 2021). I do agree with the report on the evolution of APRN. From personal experience, I was looking into becoming a certified registered nurse anesthetist (CRNA). I was speaking to a CRNA about the education route, and what licenses are needed before applying to CRNA school. She informed me it is very political depending on the state where practiced. Arizona is one of the states where CRNAs are welcome but a state like Colorado, prefer a doctor, and will not hire a CRNA. It amazes me how far nurses have become but there is still a limitation to their ability based on politics.
References:
Wakefield, M., Williams, D., Menestrel, S., & Flaubert, J. (2021). Chapter 7. In Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (pp. 189–201). essay, National Academies Press.
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