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Nurse practitioners (NP) are at the frontline of the provision of care to patients. The recent empowerment of these healthcare professionals facilitates the development of the American healthcare system as nurses are engaged in various aspects of clinical practice, as well as administrative and scholarly incentives. Nurse practitioners in Missouri still have certain boundaries to overcome, but they also need to master numerous competencies to provide care within the scope of their practice (Missouri State Board of Nursing, 2017).
The major national nurse practitioner organizations, as well as smaller ones (state institutions), have created detailed guidelines that can be followed at different levels to ensure the delivery of patient-centered care. This professional development plan includes a brief description of the scope of practice of nurses in Missouri, as well as some competencies nurses should have to provide high-quality care.
APN Scope of Practice
The state of Missouri allows restricted NP practice, which implies the supervision of a nurse’s practice by another healthcare professional. Without such supervision, nurse practitioners in Missouri cannot diagnose, interpret tests, develop treatments, or prescribe medications (American Association of Nurse Practitioners [AANP], 2018). In this state, nurses receive Registered Nurse (RN) license and can be recognized as Advanced Practice Registered Nurses (APRN) if they have the corresponding educational background (Missouri State Board of Nursing, 2017).
The recognized APRNs obtain a Document of Recognition that authorizes these professionals to work in Missouri healthcare facilities. APRN education is grounded on national certification requirements and should include at least 500 hours of clinical practice conducted under the supervision of a health provider. The recognition process of APRN is implemented by nationally approved certification organizations that specialize in specific areas such as midwifery or critical care. APRNs, who had a pharmacology course and have at least 300 hours of preceptorship, need to collaborate with a physician. When an APRN has, at least, 1,000 hours of experience, this healthcare practitioner can apply for prescriptive authority.
Nurse Practitioner (NONPF) Core Competencies
The National Organization of Nurse Practitioner Faculties (NONPF) listed a number of competencies enabling nurses to perform the necessary tasks successfully and achieve continuing growth in their clinical practice. One of the competencies I see as my strength is a scientific foundation competency. I always try to translate “research and other forms of knowledge to improve practice processes and outcomes” (National Organization of Nurse Practitioner Faculties [NONPF], 2014, p. 2).
I believe that the use of the most recent strategies and techniques in nurses’ daily activities can contribute to the development of nursing practice. I tend to review the most recent peer-reviewed articles, and other reputable sources, on the aspects that interest me, and I manage to apply my new knowledge, which makes me a more effective caregiver. I also advocate for the use of some methods by discussing them with my peers and suggesting the corresponding projects to nurse leaders and administrators.
Another competency I consider to be one of my strengths is related to quality. I anticipate “variations in practice,” and I am “proactive in implementing interventions to ensure quality” (NONPF, 2014, p. 5). As mentioned above, I address nurse leaders and administrators when I find a technique or strategy that can be instrumental in achieving a higher quality of care. I am also willing to participate in projects and initiatives involving the introduction of novel practices or norms. I am open to new solutions and approaches, which makes me ready to address the challenges that may arise on a daily basis.
Clearly, certain competencies remain the areas for my personal growth, such as leadership competencies. I take up a leading role in some processes, especially when it comes to interacting with people who are less knowledgeable or less willing to lead. However, I feel I do not fully or successfully assume “complex and advanced leadership roles to initiate and guide change” (NONPF, 2014, p. 3). I think the lack of confidence is one of the primary obstacles to mastering this competency.
My educational achievements and experience will make me more confident and more prepared for leading roles. I also intend to implement a study in terms of my master’s program that will equip me with the necessary skills and knowledge to become a more effective leader. This endeavor will help me in my daily practice, as well as the development of the organization I will work for at that period.
Another area for my personal growth is linked to an independent practice competency. According to NONPF (2014), an effective nurse “[p]rovides patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision making” (p. 12). I try to provide patient-centered care and respect patients’ autonomy by paying attention to their cultural backgrounds. Nevertheless, I often need help in negotiating the optimal treatment plan with patients and their caregivers. I sometimes find it difficult to prevent my bias from intervening with the delivery of high-quality care.
Again, one of the reasons for such behavior, in my opinion, is the lack of knowledge and skills. Apart from conducting a review of the academic (and other) sources concerning cultural diversity and methods to avoid bias, I will try to participate in conferences and workshops on the matter. Sharing information is one of the major ways to improve the healthcare system and the performance of each healthcare professional. I will also try to initiate knowledge sharing within the boundaries of my healthcare facility, our community, and our state.
In order to provide high-quality patient-centered care, nurses should be ready to take up leading roles and become nurse leaders. One of the leadership skills necessary to achieve this goal is facilitating autonomy and independence in patients, their relatives, as well as other healthcare professionals (Lamb, Martin-Misener, Bryant-Lukosius, & Latimer, 2018). Nurse leaders should inspire people to become more confident and knowledgeable about numerous health-related aspects.
In order to master this skill, I will need to learn more regarding transformational leadership techniques. I will need to practice using these skills when interacting with my patients, my colleagues, as well as my family or friends. Nurses train patients and raise their awareness of various subjects related to their health and wellbeing. The ability to make patients responsible, empowered, and able to undertake autonomous steps, as well as live independently addressing their current or upcoming health conditions, is critical for a nurse practitioner. This approach creates an environment where people behave responsibly and try to maintain their health for a long period.
Apart from the skill mentioned above, a nurse leader should be able to discuss numerous issues, including uncomfortable topics. Initiating “meaningful communication” is another leadership skill nurse leaders need to have (Lamb et al., 2018, p. 405). For instance, patients often find it easier to discuss some sexuality issues with nurses rather than other healthcare providers or family members (Lamb et al., 2018).
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Different aspects of care also seem challenging for many people, but these issues need to be discussed in order to make patient-centered care possible. Reviewing scholarly sources related to communication, spirituality, and ethics, among other topics, will be instrumental in gaining these skills. I will search for other sources of information as well because I believe practitioners’ experience is as valuable as scholarly knowledge. Hence, I will participate in conferences or look for diverse platforms for sharing professional knowledge.
To sum up, APRN in Missouri have to operate within a restricted scope of practice. However, they can obtain more autonomy by gaining knowledge (completing a master’s degree) and experience. Nurse practitioners are still reluctant to take up leading roles in the process of the transformation of the current system of care delivery. However, the empowerment of nurses will eventually lead to significant progress in nursing practice. The described competencies nurses should master serve as guidance for practitioners who strive to gaining the necessary skills. Leadership skills are central to achieving the highest standards of nursing practice.
Life-long learning should be one of the principles to follow because nurses should constantly gain new knowledge and skills. The involvement in the academic sphere is another essential priority for nurse leaders who need to accumulate and disseminate knowledge, enriching nursing practice. The development of a professional development plan is one of the ways to ensure professional growth as a nurse leader. This plan will become an effective guide for nurses who will remain focused on their goals.
American Association of Nurse Practitioners. (2018). State practice environment. Web.
Lamb, A., Martin-Misener, R., Bryant-Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open, 5(3), 400-413. Web.
Missouri State Board of Nursing. (2017). Nursing practice act and rules. Web.
National Organization of Nurse Practitioner Faculties. (2014). Nurse practitioner core competencies content. Web.