Please discuss the history of advanced practice nursing and where you feel the role is going in the future. Explore how the role of APRNs in Texas will impact your clinical practice. Identify and apply a theory that you will structure your practice around. 3 sources with in text citations
The history of advanced practice nursing (APN) can be traced back to the mid-20th century in the United States. This time period was marked by a shortage of primary care physicians, which led to the emergence of nurses taking on expanded roles and responsibilities to meet the growing healthcare needs of the population. The role of APNs has evolved significantly over the years and continues to do so, driven by changes in healthcare policy, advancements in technology, and the recognition of the unique contributions that APNs can make to improve patient outcomes.
In the early years, APNs primarily focused on delivering primary care in underserved areas. They were known as nurse practitioners (NPs) and were trained to provide comprehensive healthcare services, including diagnosis, treatment, and management of common acute and chronic illnesses. The first NP program was established in 1965 at the University of Colorado, paving the way for the development of similar programs across the country (Lachman, 2012). Since then, APN roles have expanded to include other specialties such as nurse anesthetists, nurse-midwives, and clinical nurse specialists.
An important milestone in the history of advanced practice nursing was the establishment of certification boards to ensure the competency and quality of APN practice. The American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP) were among the first organizations to offer certification exams for NPs (Morris, 2010). These certifications have become a standard requirement for APNs, demonstrating their advanced knowledge and skills in their respective specialties.
Over the years, APNs have gained more autonomy and authority to practice independently. This has been facilitated by changes in legislation at the state level, with many states granting APNs the ability to diagnose and prescribe medications without physician oversight (Laurant et al., 2013). This increased autonomy has allowed APNs to play a crucial role in addressing the primary care workforce shortage and improving access to healthcare, particularly in rural and underserved areas.
Looking towards the future, the role of APNs is expected to continue to expand and evolve. One of the key factors driving this expansion is the increasing complexity of healthcare delivery and the need for more specialized and advanced care providers. As the demand for primary care services continues to grow, APNs are well-positioned to fill this gap by providing quality, comprehensive care to patients across the lifespan.
Additionally, advancements in technology and telehealth are expected to further enhance the role of APNs in the future. Telehealth allows APNs to provide virtual care, consultation, and monitoring, reducing barriers to access and increasing convenience for patients. This technology-driven approach has the potential to revolutionize healthcare delivery and expand the reach of APNs beyond traditional clinic settings.
Texas is one state that has recognized the value of APNs in addressing the healthcare needs of its population. In 2013, the Texas legislature passed a landmark bill that removed the physician supervision requirement for NPs (Texas Medical Association, 2013). This change has allowed NPs in Texas to practice independently, diagnose and treat patients, and prescribe medications without physician oversight. The removal of this restriction has improved access to care for many Texans, particularly those in rural and underserved areas where physician shortages are common.
As an APN practicing in Texas, this change in legislation will have a significant impact on my clinical practice. It will allow me to fully utilize my advanced knowledge and skills to provide comprehensive care to patients in need. The removal of physician supervision requirement also means that I will have greater autonomy in decision-making and can more effectively meet the healthcare needs of my patients.
In terms of theory, one theoretical framework that can be applied to structure APN practice is the “Role Theory.” Role theory, developed by sociologist Robert K. Merton, examines the expectations, responsibilities, and behaviors associated with a particular role (Merton, 1957). Applying this theory to APN practice, it can help guide APNs in understanding their role, responsibilities, and interprofessional relationships within the healthcare team. By understanding the expectations and responsibilities associated with their role, APNs can effectively collaborate with other healthcare professionals, deliver quality care, and advocate for the needs of their patients.
In conclusion, the history of advanced practice nursing dates back to the mid-20th century and has evolved significantly over the years. APNs have gained more autonomy and responsibility in providing healthcare services, and their roles are expected to further expand in the future. The removal of physician supervision requirements in Texas has improved access to care and enhanced the role of APNs in providing comprehensive care to patients. Applying a theoretical framework such as Role Theory can help structure APN practice and ensure the delivery of quality, patient-centered care.