Introduction
The advanced practice registered nurse (APRN) position is increasingly becoming important across the United States. This is partly due to their role as a link between the physicians and the general population. However, to become an advanced practice nurse, one must complete an extensive, accredited postgraduate course in their specialty.
Therefore, this paper aims to describe the future role of the nurse practitioner, specifically the Acute Care Nurse Practitioner (ACNP), and their scope, regulatory framework, and accreditation. Similarly, the discussion will focus on the nursing professional organizations ACNPs can join, then conclude with a controversial matter related to ACNP practice. In essence, ACNPs have received extensive education and training to expand their scope, combined with the availability of evidence-based resources that help advanced registered nurses to provide high-quality care.
The Scope of Future Role as an Advanced Registered Nurse
Future Responsibilities
The future role of ACNPs centers on performing invasive procedures and administering critical therapies. They include “intubation, chest tube insertion, arterial line placement, central line placement, endoscopic gastric (PEG) tube placement, and percutaneous tracheostomy (Kleinpell et al., 2018, p. 140). Therefore, ACNPs are advanced registered nurses working across different healthcare settings to care for patients with chronic conditions (Kleinpell et al., 2018). The responsibilities above describe the scope of the future role of ACNPs due to the extensive education and training they receive. More specifically, the future of ACNPs looks promising, and their specific roles, as evidenced above, are likely to expand as the profession is regulated at the state level.
Regulation
The regulation of ACNPs is undertaken at the state level through standards of practice, but the framework used differs from one state to another. According to Cimiotti et al. (2019), the regulatory authority for any advanced practice nurse is exercised by the Board of Nursing at the state level, with each state adopting different regulatory frameworks for ACNPs. Some states in the USA support full practice authority, while others have either reduced or restricted practice. For clarity, full practice authority allows nurse practitioners to perform their duties without supervision, while reduced practice authority requires ACNPs to operate under a collaborative agreement. Certification is also critical to becoming an effective ACNP.
Certification Steps
The certification process for ACNP can be simplified into four common steps, with the first requiring one to become a registered nurse (RN). According to Hoyt et al. (2022), becoming an acute care nurse practitioner starts with completing an approved nursing program, such as a Bachelor of Science in Nursing (BSN), and becoming an RN. However, one must also pass the NCLEX-RN exam to obtain RN licensure; other graduate programs may require some RN experience.
The second step is for nurses to undertake and complete a graduate nursing program, such as a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP), with a particular focus on acute care. Thirdly, one must obtain certification as an ACNP through different certifying organizations, such as the American Association of Critical-Care Nurses (AACN) (Hoyt et al., 2022). Lastly, a certified nurse practitioner can apply for a state license to operate as an advanced practice registered nurse (APRN) within their state. As noted above, the license can be for full practice authority, reduced practice authority, or restricted practice.
Three Influential Professional Nursing Organizations
Professional nursing organizations are essential in helping APRNs and other nurses expand their scope of practice through networking. Similarly, professional nursing organizations provide significant opportunities for continuous personal and professional development through conferences and participation in issues that affect their practice (Cherry et al., 2019). Such bodies offer them a unified and collective voice, allowing them to address their issues. Therefore, the three influential professional nursing organizations that ACNP specialists may join are the American Nursing Association (ANA), the American Association of Nurse Practitioners (AANP), and the American Psychiatric Nurses Association (APNA).
American Nursing Association
Firstly, as a professional body, ANA serves the needs of all nurses across the US, regardless of specialty. This organization’s primary role is to advocate on behalf of all nurses. Most importantly, as Cherry et al. (2019) explained, its membership is open to all. ANA was founded in 1896 and has members in all the states and US territories, such as Puerto Rico.
American Association of Nurse Practitioners
Secondly, APNA was introduced to promote education, support nurses, and advance treatment for mental health-related conditions. As observed by Cherry et al. (2019), it “fosters knowledge dissemination and professional support for its members” (p. 517). For example, as of 2016, the professional body had introduced an online course intended to help address some notable knowledge gaps. The American Psychiatric Nurses Association Transitions in Practice (ATP) course focuses on providing its students with best practices and evidence-based nursing knowledge.
American Psychiatric Nurses Association
Lastly, regardless of specialty, AANP is considered the most prominent professional nursing organization for all nurse practitioners. It was formed in 2013 following a merger between the American Academy of Nurse Practitioners (AANP) and the American College of Nurse Practitioners (ACNP)(Brennan, 2020). The main aim of this merger was to ensure nurse practitioners receive a unified platform to voice their issues and build strong networks.
Most Appealing Professional Organization
The most appealing professional organization is AANP because it strives to provide professional support to its members by conferring Fellowship status to those individuals with outstanding performance in their scope of practice. My decision to join AANP is informed by the fact that the body aims to represent the interests of nurse practitioners licensed to practice in the United States. It aims to advocate for their needs at the local, state, and federal levels.
Most importantly, the mission and goals of AANP fit in with my worldview and philosophy of providing patients with high-quality patient-centered care. AANP’s mission is to empower all NPs “to advance accessible, person-centered, equitable, high-quality health care for diverse communities through practice, education, advocacy, research, and leadership” (Brennan, 2020, p. 83). As elucidated further by Brennan (2020), the care strategy for acute care success is to deliver more value and better patient outcomes. In general, membership in AANP ensures the care provider gains access to evidence-based resources needed to provide high-quality and safe patient care.
Evolving Issue Impacting Scope of Practice
An evolving issue is that some states in the USA support full practice while others offer restricted or reduced authority. By the year 2020, about 50 percent of the states in the United States had put in place measures to ensure ACNPs work independently (DePriest et al., 2020). The other 50 percent either have reduced or restricted practice where ACNPs must sign a collaborative agreement (DePriest et al., 2020). This issue could have a significant influence on how ACNPs work because it, to some extent, limits their scope of practice despite them being competent to do the same authoritatively.
In line with the above, the stakeholders may fail to invest in the practice because the profession may fail to help transform primary care. According to DePriest et al. (2020), stakeholders think the lack of full practice authority hinders advanced registered nurses’ ability to provide efficient, cost-effective, and high-quality patient care. Overall, this issue remains controversial because ACNPs have what it takes to work independently – the process requires completing an advanced nursing degree, direct experience as a nurse, and certification.
Conclusion
Advanced practice registered nurses are emerging as one of the most highly recognized professions in the US. APRNs, such as ACNPs, are essential in providing safe care to patients suffering from exacerbated chronic conditions and ensuring the health care system achieves its objective of providing high-quality care. In fact, ACNP is one of the most impactful and fulfilling specialties that one can pursue – one has to complete the certification process and later obtain state licensure for practice. As evidenced above, one can join several professional nursing organizations. For instance, the American Association of Nurse Practitioners exists to help ACNPs improve their scope of practice by ensuring they can access evidence-based resources for optimum care. However, free practice authority remains one of the most controversial issues affecting the specialty, as it limits their scope of practice despite them being highly competent.
References
Brennan, C. (2020). Tracing the history of the nurse practitioner profession in 2020, the year of the Nurse. Journal of Pediatric Health Care, 34(2), 83-84.
Cherry, B., Caramanica, L., Everett, L. Q., Fennimore, L., & Scott, E. (2019). Leveraging the power of board leadership in professional nursing organizations. The Journal of Nursing Administration, 49(11), 517-519.
Cimiotti, J. P., Li, Y., Sloane, D. M., Barnes, H., Brom, H. M., & Aiken, L. H. (2019). Regulation of the nurse practitioner workforce: Implications for care across settings. Journal of Nursing Regulation, 10(2), 31-37.
DePriest, K., D’Aoust, R., Samuel, L., Commodore-Mensah, Y., Hanson, G., & Slade, E. P. (2020). Nurse practitioners’ workforce outcomes under implementation of full practice authority. Nursing Outlook, 68(4), 459-467.
Hoyt, A., O’Reilly-Jacob, M., & Souris-Kraemer, M. (2022). Certification alignment of nurse practitioners in acute care. Nursing Outlook, 70(3), 417-428.
Kleinpell, R., Cook, M. L., & Padden, D. L. (2018). American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 30(3), 140-149.