Advanced Practice Roles in Nursing

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Comparison of the Roles of the NP, Nurse Educator, Nurse Informaticist, and Nurse Administrator

Being a family nurse practitioner means delivering family-focused care, working autonomously or collaborating with other healthcare professionals. It is crucial to be knowledgeable in the different advanced practice roles and scope of practice to bring the positive outcomes and understand the importance of healthcare employees. In addition, it is essential to know regulatory and legal requirements to fulfill the roles of Nurse Administrator, Nurse Informaticist, Nurse Educator, and Nurse Practitioner to the full extent. It is a must also to acquire the necessary leadership style to provide the qualitative healthcare. Consequently, this paper intends to study the advanced practice roles in nursing to understand the requirements for them, and their importance to healthcare. Along with that, this paper analyzes the current health policy, the necessary changes, and the effects of these changes on the health quality.

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A nurse practitioner (NP) is of pivotal importance in the healthcare. The roles of NP are related to the following tasks: providing preventative care to the public and being primary care providers. A nurse practitioner should have the expert knowledge base, clinical competencies, and complex decision-making skills. Nurse practitioners should have the necessary education preparation, practice, and be knowledgeable in regulatory mechanisms. Nurse practitioners can bring many benefits to the advanced practice nursing developing globally and improving the quality of healthcare (Bryant-Lukosius & DiCenso, 2004).

Nurse educators are responsible for providing the leadership skills, serving as role models, and strengthening the nursing workforce. The roles of nurse educators are as noble as nurse practitioners’ since they both benefit the growth and development of healthcare research, administration, education, primary care, and clinical practice. The difference between them refers to their tasks. Nurse educators are responsible for providing training and learning to healthcare specialists. They combine clinical expertise as well as teach how to improve healthcare quality. Nurse educators are also responsible for delivering continuing and education programs for clinical staff and nurses. At the same time, nurse educators should be leaders to provide the effective learning process.

Nurse informaticists have the following roles: working in informatics field, designing electronic medical record screens and choosing equipment. It means that nurse informaticists should be knowledgeable not only in nursing and healthcare but in the innovative technologies. The similarity between nurse practitioner, nurse educator, and nurse informaticist refers to their common objective to advance nursing and improve its quality. However, nurse informaticists are responsible for collecting, analyzing, and evaluating of medical information and applying it in a proper way.

Nurse administrators are head nurses. Consequently, management and leadership skills are the most crucial for them that are not much typical for nurse practitioner and nurse informaticist. Nurse administrators have the managerial role in advanced practice nursing. The key tasks of nurse administrators are to elaborate policy and budget, make decisions, represent employees, supervise employees, and ensure patients’ welfare (Bryant-Lukosius & DiCenso, 2004).Nurse administrators should be more educated not only in nursing but science and management comparing with other nursing roles. Nurse administrators as well as nurse educators have more limited interaction with patients similarly to practitioners. Consequently, their task is to manage and handle employees to improve healthcare quality.

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It is a must for a nurse administrator, nurse informaticist, nurse educator, and nurse practitioner to have the democratic or participative leadership style to bring the positive changes in health policy.

Selected Advanced Practice Role

Regulatory and Legal Requirements for Arizona

Nurse practice regulations and laws are specific to each state. On a personal level, I would like to practice in the state Arizona as it provides a full practice. It means that its regulatory and legal requirements allow initiating and managing treatment, evaluating patients, order and diagnose provided for all practitioners. Licensure requirements for the state Arizona are the following: national certification, graduate degree in NP role, and RN license. Board of Nursing is the regulatory agency in Arizona (Arizona State Board of Nursing, 2016). To become a nurse practitioner in this state, I should follow Nurse Practice Act. I do not need reduced or restricted practice as they will limit my opportunities for further development and growth while I do not want somebody to reduce my abilities. Consequently, Arizona is my choice for practice and self-development as a nursing practitioner.

The Professional Organizations Available For Membership Based on a Nurse Practitioner

Arizona Nurses Association is one of the professional organizations available for membership based on a nurse practitioner in Arizona. It is the oldest and largest nursing organization in this state. It means that it has much to teach and train for the nurse practitioners who are novices. The members of Arizona Nurses Association cover all segments of nursing practice from administration, advanced practice, education, and consulting to education (Arizona Nurses, n.d.). In addition, the purpose of this professional organization is to advance excellence in nursing, and it is suitable for me as a nurse practitioner. Leadership, involvement, and commitment are the key traits promoted by Arizona Nurses Association (Arizona Nurses, n.d.). Arizona Hospital and Healthcare Association is another healthcare organization that is available for a full practice. Arizona Hospital and Healthcare Association has a noble objective to build better healthcare and health for people, patients, and communities of Arizona (Arizona Department of Health Services, 2016).

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Required Competencies for a Nurse Practitioner

The following competencies are required to become a nurse practitioner: scientific foundation, leadership, quality, practice inquiry, technology and information literacy, policy, health delivery system, ethics, and independent practice. Certification requirements for a nurse practitioner are the following: a Bachelor of Science in Nursing, a minimum score on the Graduate Record Examination, a minimum amount of clinical experience, and a minimum score on the Miller Analogies Test Arizona (Arizona State Board of Nursing, 2016). The nurse practitioner core competencies can be guidelines for educational programs. It is a must for nurse practitioners to have skills, abilities, and knowledge that are crucial for independent clinical practice. Along with that, the graduates should pay more attention to independent and interprofessional practice, analytical skills, and advanced knowledge. A nurse practitioner should be also sociable to find the common language with patients and colleagues. Additionally, he/she should be knowledgeable in conflict management to avoid disagreeable situations and misunderstanding (Arizona State Board of Nursing, 2016).

The Organization, Setting, Population, and Colleagues

I would like to work at Arizona Hospital and Healthcare Association as it builds better healthcare and health for people, patients, and communities of Arizona. The setting of this organization is favorable as it suggests a full practice for nurse practitioners. Consequently, I would advance my professional skills. In regard to population of Arizona, it deals with many healthcare issues, and their solutions demand the involvement of more healthcare professionals. Heart diseases and cancer are the most widespread diseases in this state (Arizona Department of Health Services, 2016). I believe that I will find the common language with the colleagues in Arizona Hospital and Healthcare Association as I read that this organization is based only on qualitative and skillful staff. I think that Arizona Hospital and Healthcare Association is favorable place for my first practice, development, and professional growth. I realize that the setting of any healthcare organization is challenging for a novice. However, I am not afraid of difficulties.

Leadership Attributes of the Advanced Practice Role

Leadership Style

Every person has his/her leadership style that can be determined with the help of psychological tests. According to psychologist Kurt Lewin, there are three main leadership styles: authoritarian (autocratic), democratic (participative), and laissez-faire (delegative) (Health Psychology, 2016). The participative, or democratic, style is the most effective leadership style that suggests guidance to the group, cooperation, and collaboration. Authoritarian, or autocratic, leadership style is based on command and control. It presupposes the clear division between a leader and team members. Laisser-faire, or delegative, leadership is the least productive as it is based on a little guidance to the group. My leadership style is democratic, or participative, as I believe that a leader should not divide himself/herself from the team members and be a participant when it comes to the group work.

Leadership Attributes for Possession and Development

Currently, I possess many leadership attributes. They are the following: cooperation and cooperation skills, ability to encourage and motivate other group members, and suggesting the creative ideas (Health Psychology, 2016). However, it does not mean that I can become a good democratic leader for a group of people. Consequently, I need many skills to develop to become more authoritative and valuable. First, I should learn how to offer guidance to group members and interact with them in the most effective way. Second, I am always afraid to make serious decisions. As a result, I need to get to know more about the decision-making process and become more responsible. Third, if I want to become a good leader, I should provide the continuous learning and training to myself and team members.

How to Obtain and Evaluate Missing Leadership Attributes

The work in a group or any collective project will help evaluate missing leadership attributes. They will be evident after the received results. It is crucial to be ready to criticism, negative feedback, and recommendations to obtain these missing attributes. The team work will be effective in finding out the missing attributes. Consequently, it is necessary to develop skill-sets and competencies constantly. Another missing attribute is the reputation that influences the place and role of a leader in a team group. To have a positive reputation, it is crucial to create the personal image and be a role model for the team members. It is also recommended to create a personal advisory board to be committed to the continuous learning and improvement.

Health Policy and the Advanced Practice Role

Health policy is constantly changing and developing under the influence of the emerged health issues and increasing healthcare needs. One should say that the USA spends more to health care comparing with other countries. However, Americans are not satisfied with the healthcare level. It means that health policy should support advances in technology and science as well as information and computer science. In addition, health policy should respond to the changing nature of health problems and the growing disparities in the health. Health policy of the USA is theoretically valuable as it takes into consideration global health issues, and state and local problems. However, the key challenge is that the health status and the rate of diseases are increasing creating the new tasks for advanced nurse practitioners (Boufford & Lee, 2011).

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The role of advanced practice is crucial when it comes to improving health policy and health status. First, advanced nursing practice reduces pressures related to high patient acuity and clinical activity. It means that advanced nursing practice can contribute to the development of the profession and extend the traditional approaches to healthcare. Second, advanced nursing practice is a change agent that involves consultation with other healthcare providers and collaboration. It means that advanced nursing practice is an innovative and more progressive approach to health policy.

Health Policy Issues

The Current Policy and Necessary Changes

The current healthcare policy is based on the following aspects: child and family well-being, health coverage, health leadership and workforce, health system improvement, healthy communities, and healthy weight. The focus areas of the current policy are related to expanding the opportunities to pursue the best health possible both on the national and local level (Bryant-Lukosius & DiCenso, 2004). According to Robert Wood Johnson Foundation (2016), the current healthcare policy intends to improve the health and health care of all Americans and provide the high-deductible health plans to affect healthcare outcomes and access. At the same time, clinical research should be based on transparency and recent policy initiatives.

According to Robert Wood Johnson Foundation (2016), there is the necessity for policies for action to build a culture of health. The key objective is to develop research generating actionable evidence and guiding legislators and other policymakers. It is also necessary to improve the system of insurance fostering competition among health insurance plans making healthcare of higher quality more accessible and more affordable. Another change that is a must is transparency in clinical research. The lack of transparency in clinical research can bring the negative effects to health systems, providers, and patients more generally. It is obligatory to strengthen the government’s capacity to improve healthcare policy and implement the necessary changes. In addition, Robert Wood Johnson Foundation (2016) suggests incentives for partnership between communities and government to improve health policy and health status.

According to Boufford, J. & Lee (2011:3), health policy should have three goals: ‘to create conditions that lead to longer, healthier lives for all Americans, to eliminate health disparities, and to protect communities from avoidable health hazards and help them to address their own health problems’. It means that the solutions to the health issues are simple. The main thing is to unite the communities, organizations, and government with the objective of improving healthcare.

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The Process Required Making the Change with Key Players and Parties of Interest

The process of making the change in health policy presupposes finding the solutions to healthcare and management challenges. The key players and parties of interest here are healthcare organizations and government that should address state and local problems, and coordinate healthcare programs. Another step in the process of making the change is the implementation of effective federal actions that are based on authority for health policy, inadequate management, divided responsibilities, and inadequate data (Arabi, Rafii, Cheraqhi, & Ghiyasvandian, 2014). The key players and parties of interest here are healthcare organizations and federal government that should change the focus on health policy and determine the following areas to focus on: strengthening the capacity of government, offering incentives for partnerships, increasing access to healthcare information, making sustainable investments, and improving the financial policy (Bryant-Lukosius & DiCenso, 2004). Another step in the process of making the change is the implementation of health policy adapting to the innovative technologies and necessities of the new century. This change is obligatory to address the threat of bioterrorism, spreading infectious diseases and epidemics such as AIDS/HIV. The key players and parties of interest here are healthcare organizations, government, and communities that are responsible for this initiative (Boufford & Lee, 2011).

How to Make or Influence the Change in Policy

It is evident that nurse practitioners can make or influence the change of health policy. The main task is to be initiative, persistent, and hard-working. First, nurse practitioners can organize together involving community groups and public opinions to make the government implement the innovations. The first attribute of policy influence is advocacy. It means that nurse practitioners should be patient advocates and involve in policies. They should understand that their roles are to collaborate with patients, recognize conflicts, and manage them effectively. ‘Nurses need to be aware of policy agendas, policy makers, and political backgrounds. They are advocates for the improvement of the quality of care (Arabi et al., 2014, p. 315).

The second attribute of policy influence is the power that helps achieve goals. However, to influence with power nurses should be leaders. In addition, nurses should use power with others (colleagues and patients). Consequently, nurses’ power should be the attribute for changing healthcare organizations and protecting the quality of care. Policy acumen is not less important attribute to influence the change in policy. It means that nurse practitioners should be able to analyze healthcare policies and programs and determine the strengths and weaknesses. Policy competence is also essential for any nurse practitioner to influence the change in policy. As a result, to make or influence the change in policy, a nurse practitioner should possess the following qualities: policy, competence, policy acumen, policy influence, and advocacy (Arabi et al., 2014).

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The Effect on Healthcare Quality if the Change in Policy is Implemented

If the change in policy is implemented, the effect on healthcare quality will be positive and effective. First, the change will help establish the new priorities for the 21st-century health policy. It will strengthen the capacity of the cooperation between the government, healthcare organizations, and communities to manage the protection and promotion of health and improve collaboration and coordination across government. Second, this change will help better finance personal health services and determine the priorities for patient safety and disease prevention. It is evident that the changes in health policy will demand the investments in the public health infrastructure. Third, the necessary changes in health policy will increase access to health information and create the necessary conditions for partnerships between the government and communities to improve health (Arabi et al., 2014).

It is evident that the qualitative healthcare is a continuous process that demands constant changes and improvements. Consequently, the described initiatives cannot be final for achieving the set of objectives. Along with that, the changes should touch the most vulnerable population that is unable to access the qualitative healthcare. It is evident that the changes are necessary not only in health policy but the social one as income and health are related.


It is necessary to say that a nurse practitioner plays an essential role in regard to the improvement in nursing and health policy. The roles of nurse practitioner, nurse administrator, nurse educator, and nurse informaticist are diverse, but they are united with the common goal to contribute to the healthcare quality and health policy. All these healthcare professionals can change and influence clinical practice, primary care, education, administration, and research. A nurse practitioner can influence or change health policy if he/she follows legal and regulatory requirements, knows his/her competencies and the organizations where he/she wants to practice. A nurse practitioner should be knowledgeable not only in healthcare but be ready to face challenges related to the relationships with colleagues, population, and setting. Leadership style is another requirement for a nurse practitioner. The most favorable leadership style is democratic, or participative, as it presupposes collaboration and cooperation that is necessary for the healthcare setting. In addition, a nurse practitioner should improve his/her attributes of leadership constantly to be able to manage the teamwork in a proper way. Consequently, a nurse practitioner plays a vital role with respect to health policymaking. First, he/she is able to change the current policy, influence key players and parties of interest, and predict the effect on health quality.

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