APRN Role Ambiguity

With the adoption of the Consensus Model and the recognized need of the advance practice registered nurse, came the concerns with the ambiguity of the roles of APRNs amongst the healthcare team. These concerns have affected the integration and effective utilization of the APRN role in the practice setting. Joel (2018) writes that “there is a movement towards the educational preparation of APRNs to be more aligned with the medical model of cure rather than the advance practice nursing model of caring and healing.” Unfortunately for the APRNs profession, this movement has caused confusion of the role not only on the individual level, but on the community and peer level as well. According to Joel (2018), some APRNs believe that the movement towards regulation of practice has caused shifts in educational requirements leading to the loss of nursing theory. In order for the APRN to ensure that their role is distinguished from other nursing roles and physician counterparts, they must ensure that this core element to nursing practice not be substituted or eliminated.
There are two ways that APRN’s can assist with development, clarification and implementation of their roles in the clinical practice setting. One concept would be the absolute utilization of nursing theory in the ARPN approach to practice, regardless of the changes to curricula. The concepts of nursing theory in advance practice and research stem from the foundational instruction of nursing and are essential for APRN’s to be recognized as professional independent practitioners (Bond et al., 2010). Along with the knowledge and skills obtained through advanced education, the nursing theory background helps the APRNs approach to care to remain patient-centered while providing the tools and education to promote self-care. Another possibility for role identification of the APRN, lies with the recruiting process of organizations and ensuring that there is a system in place that is specific to on-boarding APRN’s. Key to successful adaption to the APRN role is by ensuring that the focus areas of recruiting and integration support the specific needs of the APRN and are not just a modified version of the process for physicians. This requires leadership, human resources, credentialing, competencies, billing and measurement of effectiveness to be overseen by masters prepared nurse leaders or executives so that the requirements are clear and achievable.
Without clarification of their role and inability to show their effectiveness as a clincian, the APRN will feel undervalued which could potentially lead to decreased job satisfaction, increased stress levels, increased turn-over rates, and potential errors in the management of patient care (Dubree et al., 2015). Regardless of which role the APRNs assumes; nurse practitioner, clinical nurse midwife, clinical nurse specialist, or clinical nurse anesthetists, their foundation is in nursing not medicine.
References
Joel, L.A., (2018). Advanced practice nursing: Essentials for role development. F.A Davis Company.
Bond,E., Farid, N., Bani-Khaled, M., Hamad, A., Habashneh, S., Kataua, H., al-Jarrak, I., Abu Kamal, A., Hamdan, F., Maabreh, R. (2011). Who uses nursing theory? A univariate descriptive analysis of five years’ research articles . Scandinavian Journal of Caring Sciences, 25(2), 404-409.
Dubree, M., Jones, P., Kapu, A., Parmley, C. (2015) APRN Practice: Challenges, Empowerment, and Outcomes. Nurse Leader, 12(2), 43-49.

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