Advanced Practice Nurses, commonly abbreviated as APN, is a term applied when referring to registered nurses, who have acquired higher preparation for extended clinical practice after earning a master’s degree in the nursing field. The difference between these professionals and the other nurses is that APN receive specific training and advanced skills. Advanced Practice Nurses consist of other minor subgroups: clinical nurse specialists (CNSs), nurse practitioners, certified nurse-midwives (CNMs) and nurse anesthetists (CNMs). The APN possess proper knowledge, motivation and competence to plan total change and ensure their patients’ well being. They also get in a position to detect available opportunities and develop process, structure and outcome. This puts them in such a position that they are able to communicate with a variety of people. Bearing this in mind, APNs have to exhibit certain skills, competencies and knowledge to be effective in their sphere. This paper describes some situations when APN consultation might be necessary and later applies the model of APN consultation, as illustrated by Hamric, to a clinical situation.
Common APN Consultation Situations
There are many reasons as to why one would decide to receive APN’s consultation. The decision to see a consultant is not actually scientifically determined, but such a decision is commonly triggered by impulse, such as feelings of desperation or frustration (SlideShare Inc., 2011). People normally consult medical professionals when they are either physically or mentally agonized, or when they are afraid that they might become such. This implies that clients will mainly approach consultants when they are likely to get hurt. This makes their work periodical and, sometimes, though the consultant might enjoy serving the public, there is no one to serve, hence their services have to be withheld till the right time.
Another instance when a consultant might have to conduct his/her work is when there is quest to support an initial evaluation and a plan of action. For example, if there was an assessment carried out earlier, a person might seek a consultant to affirm that what he or she is about to implement is doable and that there is a clear perception of the potential consequences before executing the plan. Brain injury is another situation when people may seek for APN’s intervention. Normally, rehabilitation experts use medication to treat the agitated behavior. However, they do not address the sole cause of such agitation. APN play a very vital role in identifying causes of that excitation and recommend ways through which such disturbance can be controlled. This does not only assist the medical professionals in charge of the patient, but also helps in providing a somewhat permanent solution to the crux (Duraski, 2011).
Application of Hamric’s Model of Advanced Nursing Practice
In his model of advancing nursing practice, Hamric identifies various main competencies that APNs ought to possess to enable them handle their duties satisfactorily. First, one must have direct clinical practice, which means that he or she must have acquired proper training, as the normal registered nurses do, before pursuing education to attain the title of an APN (Cooke, Gemmill, & Grant, 2008). The emphasis is on physical practice rather that the theoretical study of concepts. Second, there exists expert coaching as well as guidance which encompasses knowledge expertise, capacity to shape evidence-based instructive involvements, based on specific patients and the family requirements, and ability to apply adult teaching principles. Thus, an APN is expected to demonstrate certain expertise in this area by taking total care of the issue at hand and providing necessary guidance on what ought to be done. For example, let us look at Peter’s case, who is excited to be discharged and go home to meet Paul, who he considers to be his coach. This would be beneficial to both him and his wife. It was at this time that I was working alongside Paul as his assistant. Paul flexed his schedule so that Peter’s wife would be with her husband after work. After they both arrived, Paul consulted them on the dangers of engaging in practice before Peter has fully recovered. This demonstrates Paul’s guidance skills towards Peter in his case.
Third, consultation should be demonstrated by applying knowledge, acquired from other disciplines such as social work, psychology, and physical therapy, in order to supplement and come up with a complete teaching intervention. This competence demands one to possess a broad scope of observing the issues and addressing them appropriately. In the case highlighted above, after Peter is dissuaded from engaging in rigorous actions, he believes he will recover quickly after coming home and receiving care from his own wife. Contrary to his expectations, his condition worsens and he is even unable to take care of himself. Paul continues to offer guidance concerning nutrition, hygiene, psychology and physiology.
Fourth, research skills should be demonstrated by the capacity to be an intervention nurse during a research study (Benner, Tanner, & Chesla, 2009). This entails being aware of the study’s aims and objectives, getting included in the research team, assisting in designing the content of the evidence-based intervention, delivering the content and preserving the bond with the patient, as dictated by the goals of the study, as well as applying evidence-based literature to create positive impact on the patient. It was not long after Peter’s stay at home when his health state continued to deteriorate that he remembered Paul’s advice to see a medical expert in case his condition did not improve. He requests his wife to make the call and they both rushed to the health center for a check up. This stage depicts Paul’s research role. He is executing the experimental condition in a study assessing the efficacy of an APN coach for the patient’s benefit.
Fifth, clinical and professional leadership is illustrated by constant interaction with the medical center’s staff, aimed at executing the study, serving as a good APN role model and providing feedback when required. This follows the obvious perception that there must exist communication between the APN nurses and the main medical professionals (Jansen, Mirr Jansen, & Zwygart-Stauffacher, 2009). The virtue of collaboration is demonstrated by partnering and utilizing facilities, knowledge and any other forms of assistance from diverse healthcare teams for the patient’s gain (Cooke, Gemmill, & Grant, 2008). Finally, skills for making ethical decisions are mandatory as they are required in designing accurate documents, identifying areas, which could be probable for ethical concerns pertaining to patient care in the course of study execution, and reporting to administration about the patient’s state.
When Peter returns home, he feels much better and he is optimistic that everything will be good despite Paul earlier mentioning that re-admissions were normal. In two days, thought, Peter’s pains return and he develops an acute fever that ruins his peace. He and his wife search for antibiotics after they remember that Paul had advised them to perform such measures in case such a situation occurred. Peter’s condition does not tend to improve and he is re-admitted. A new check-up states that he has to receive an implant of his right atrial catheter after gram positive bacteremia is identified. The patient is found to be suffering from acute leukemia. At this level, Paul invites other healthcare professionals, reviews a lot of literature and involves various healthcare teams to assist Peter recover completely.
Analyzing the Case Study
I would consider the above study to be a consultation because Paul manages a current matter which has a high prevalence and requires management for quite a considerate period of time, which is basically the principal reason as to why APNs are hired (Jansen, Mirr Jansen, & Zwygart-Stauffacher, 2009). The study applied a number of algorithm steps. To start with, the patient was asked easy questions in order to get an overview of what problem the patient could be suffering from. The second step included expanding the earlier asked questions in the secondary gray boxes. The numbers that accompany every item are later employed in expanding each item by the person involved (Feier, 2008). This research can be deemed informal as the interaction between both the patient and the APN were not formalized. They took place in an informal setting from the very first meeting.
Conclusion
Advanced Practice Nurses (APNs) are individuals expected to be responsible for all their actions as they are likely to be held accountable for certain accomplishments. Bearing in mind the fact that nurses deal with human lives, extra caution must be taken to ensure that the personnel handling patients are highly qualified and competent. Consultation competence involves application of various skills in the research study in a manner that produces feasible results as circumstances demand. Some of these skills include expert coaching and guidance, consultation, research skills and collaboration among other aspects discussed above.
