Primary Care NP Role vs. APN Roles
Compare the primary care NP role with other APN roles. What are the similarities among the roles, what are the differences, and how would you communicate the role to a healthcare provider and a consumer?
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M2 Discussion – Primary Care NP and other APN roles
There are approximately 290,000 nurse practitioners licensed in the United States (U.S.) (AANP, 2020). In the early 1900s, there was an accelerated growth of hospital nursing schools in the U.S. Some important dates in the history of nursing include 1931, 1955, 1965, and 1985 when the American Association of Nurse Anesthetists (AANA), the American College of Nurse-Midwife, the Pediatric Nurse Practitioner (PNP) certification program, and the American Association of Nurse Practitioners (AANP) were respectively created (Cockerham & Keeling, 2013). The four most common advanced practice registered nurse (APRN) or advanced practice nursing (APN) roles are – nurse practitioner (NP), certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), and certified nurse-midwife (CNM).
An APN is a registered nurse who has obtained a graduated degree from an accredited school (master’s or doctorate) and, upon completion of the program, passed a national certification exam to achieved certification in a specific specialty (NP, CRNA, CNS, or CNM). All APN programs should have practices focused on the patient and families and offer standard courses such as advanced health assessment, advanced pathophysiology, and advanced pharmacology before specifically advance the education in one of the four roles. For example, an NP program should include pediatric clinical practice rotation, while a CNS program may not require this rotation. Also, all APN programs require a minimum of clinical hours in order for a student to graduate.
The similarity between all APN roles includes direct clinical practice, evidence-based practice, leadership, collaboration, consultation, education, and ethical decision making (Hamric, 2013). Also, the scope of practice for all APN includes assessment, diagnosing, and autonomy to practice. However, the autonomy of practice may vary from states, where some states allow APN to practice without a physician overseeing.
Some difference between APN roles includes the population specialization that an APN focus such as neonatal, women’s health, adult health, community health or psychiatric health. It can also have a more specific practice, like diabetes, oncology, wound care, and transplant.
The primary care NP role was created in the 1960s as a primary care specialty and differs from the other APN roles due to emphasis on primary care. A primary care NP is an APN trained to promote health, assess, diagnose, interpret diagnostic tests and treat disease based on a holistic approach to direct patient care (Pohl & Kao, 2013) (Taylor et al., 2021).
An example of effective communication between APN, healthcare provider, and consumer is when a patient is first diagnosed with diabetes by his primary care provider (PCP). The patient has many questions about diabetes self-management, diet exercises, and medication; for this reason, the PCP asks a diabetes CNS for a consult. Then, the diabetes CNS in collaboration with the PCP, develops a specific care of plan for this patient resulting in a patient-focus care where the patient can actively participate on the planning and be more engaged and responsible for his or her health.
In conclusion, a primary care NP is the largest number of APN roles (AANP, 2021). All APN share similarities in competencies and core values and show some differences regarding the scope of practice. Although all NP and other healthcare workers have differentiation and strengthening of their own specialty, all providers should have a patient-centered care approach.
References
American Association of Nurse Practitioners (AANP). (2020, March 3). More Than 290,000 Nurse Practitioners Licensed in the United States. https://www.aanp.org/news-feed/290-000-nps-licensed-in-us.
American Association of Nurse Practitioners (AANP). (2021, May). NP fact sheet.
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