Advanced Practice Nurse Professional Development Plan

An Advanced Practice Nurse Professional Development Plan

As the demand for Advanced practice nurses (APN) increase across the country, so does the need for guidelines and standards. Establishing guidelines and standards sets the tone for our professional practice. As an APN the bar has been set higher than ever before. Transitioning into the APN requires the creation of a professional development plan (MacLellan, Levett‐Jones, & Higgins, 2015). 

As an APN, one must truly challenge themselves in all realms of practice. An APN expands their clinical practice, they teach, are culturally competent, and treat and care holistically. APN’s are known to be role models and shine professionally. Accomplishing all of these skills is only a small part of the responsibility; they must also perform this safely and in favor of their patient.            

In order to practice safely and effectively as an APN, several different organizations were formed over the years to create standards of practice. These standards of practice are a set of guidelines to aid in our practice and are the cornerstone of APN professional development. The foundations of professional practice for a nurse practitioner include: the APN scope of practice, core competencies, and leadership skills (Kells, Dunn, Melchiono, & Burke, 2015). 

Advanced Practice Nurse Scope of Practice

Knowing what the scope of practice is for an APN is important to know before you begin your career. The scope of practice defines your legal capabilities and limitations within your state of practice. The scope of practice is also known as “The nurse practice act”. One can find their state’s nurse practice act on the state board of nursing website (Online Sunshine, 2019).

While researching your state board of nursing, one can find a plethora of pertinent information regarding nursing practice. In researching the Florida Board for example, a direct link was listed to the current state statutes. These state statutes included information such as: the purpose of the scope of practice, who created it, licensure requirements, fees, and controlled substance prescribing (Online Sunshine, 2019).

According to Online Sunshine (2019), “The sole legislative purpose in enacting this part is to ensure that every nurse practicing in this state meets minimum requirements for safe practice. It is the legislative intent that nurses who fall below minimum competency or who otherwise present a danger to the public shall be prohibited from practicing in this state.“ (Purpose, para. 464.002). This statement proves that the state creates regulations and guidelines to protect the public and to hold APN’s accountable to practicing at a higher standard.

The qualifications of obtaining licensure as an APN, include already possessing a current nursing license, certification by the appropriate specialty board, and to have earned a master’s or doctoral degree in the area of specialty (Online Sunshine, 2019).

For Florida, the APN may practice to the fullest extent. This includes ordering diagnostic tests and initiating therapies. The only exception to this is if the APN works in a multi-supervision physician group; they must then enter a supervisory protocol (Online Sunshine, 2019). The APN may prescribe, dispense, order, and administer any drug including controlled substances if the APN has graduated from a master’s or doctoral program in the clinical nurse specialty trained in the skill of a specialized practitioner (Online Sunshine, 2019). 

Nurse Practitioner (NONPF) Core Competencies

The National Organization of Nurse Practitioner Faculties (NONPF) was developed to establish specific curriculum guidelines for the education of nurse practitioners (National Organization of Nurse Practitioner Faculties, 2017). The NONPF created core competencies to serve to as the foundation of NP practice.  Some of NONPF core competencies include: scientific foundation, leadership, quality, practice inquiry, technology and information literacy. These competencies are an integral part of the NP curriculum (National Organization of Nurse Practitioner Faculties, 2017).

As we gain experience in our practice, our skills become refined. We become more confident in our practice. APN’s can evaluate and recognize their own strengths and weaknesses. This self-reflection enables us to identify our needs to continue to grow professionally.

Pondering about the NONPF core competencies, I recognized my own strengths and weaknesses currently within my nursing practice. My current strengths I believe are technology/IT and leadership. I believe my current weaknesses are in policy and health delivery systems.

The operating room (OR) is one of the most technologically advanced places in a hospital. As an operating room circulator in a level I trauma center, I have a lot of experience with the equipment used in surgical cases. I believe for this very reason that my strengths lie within the technology world. I am responsible for setting up and troubleshooting most of the equipment used. 

My number one goal is to maintain my patient’s safety while surgical equipment is being used. I am able to confidently accomplish this thanks to the guidelines provided by the Association of periOperative Registered Nurses (AORN). This organization, just like other specialties provide the guidelines we as operating room nurses use, based on evidence based practice. This ensures that our practice is safe and effective (Association of periOperative Nurses, 2019).

My second-best strength I believe is leadership. I am the evening shift charge nurse of twenty-five operating rooms in the regions only level I trauma center. I am responsible for coordinating and keeping the OR running smoothly. I lead my team and coordinate with other interdisciplinary teams to accomplish a common goal.

For the difficult part; weaknesses. It is not easy for most people to admit defeat in certain areas of their career. Good leadership teaches that it is okay and normal to have weaknesses. This allows for growth and development in skill, professionalism and character.

I believe my weaknesses lie within policy and health care delivery systems. My weaknesses lie more within not having much interest in being involved with administrators establishing or making changes to the policy. On the broad spectrum, I also am not much into politics. I have little knowledge on healthcare legislation. I know as an APN I will have to improve on this as policy effects how I practice.

Healthcare delivery systems are a current hot topic. The lack of payment from Medicare and insurance companies cause stress among healthcare providers and companies. The people in our country continuously argue about the Affordable Care Act, and immigration. I personally have not done much research about these topics and therefore my lack of knowledge is my weakness.

In order to improve on my weaknesses, I have brainstormed some ideas that would aid in my practice. As an APN I would like to change the practice and or views on a couple of social issues effecting how we care for others. Ethical and global issues are hard to combat, but are necessary in our changing world.

Current ethical stigmas on treating patients with histories of drug abuse and sexual orientation are hot topics. Many healthcare professionals are still treating these patients unfairly based on their own biases. I would like to try and change this culture by doing an evidence-based practice project on the ethics in caring for these populations. With the information found, I would like to educate those who serve these populations.

One of the largest issues we have across the United States is the lack of access to healthcare. As rich as our country is, too many people still do not receive proper healthcare. A portion of this involves immigrants. I would like to study these statistics and find a way to be involved in developing ways to provide healthcare to those populations. Working in the communities and developing relationships is key to reaching this population. 

Leadership Skills

Part of the developing role of the APN is learning to lead others. Leadership is an expected skill as an APN. As leaders, we are leading a group to work together in order to accomplish a common goal or outcome. Leadership requires training, character building and integrity. Becoming a great leader requires mastering certain skills (Kells et al., 2015).  

Emotional intelligence is the skill of having awareness of emotions and the role they play within relationships (Culha & Acaroglu, 2019). As healthcare professionals, we need to practice awareness of ourselves in order to effectively and fairly communicate with others. Modeling self-composure in high stress situations creates a sense of self control and trust for those in which you lead.

Conquering your emotional intelligence takes practice. A great way to practice emotional intelligence is to take a moment in every situation and calmly analyze your thoughts. After you have collected your own thoughts, analyze again the situation and/or emotions of the other person to make a sound decision as to how to handle the situation (Culha & Acaroglu, 2019).

Effective Communication skills are extremely important as interactions include some form of communication. In collaborating with others to accomplish a common goal, we communicate via sending and receiving messages. How the communication is delivered can affect how the message is received. Communication is made up of verbal and nonverbal messages (Kourkouta & “Papathanasiou IV”, 2014). Awareness of nonverbal communication is key to the delivery of the message. Nonverbal cues include: body language, tone of voice, space, gestures, and facial expressions (Kourkouta & “Papathanasiou IV”, 2014).

Strategies to ensure that your communication is clear and concise is to be aware of your body language. Position yourself in a way that does not seem aggressive, demeaning or uninterested (Kourkouta & “Papathanasiou IV”, 2014). For example, while having a face to face conversation be sure to sit down in a relaxed posture if the other person is sitting or standing. Towering over someone feels authoritative and aggressive.

While verbally communicating be aware of facial expressions. Lastly practice listening. Listening is the hardest communication skill one can conquer. Active listening shows that you as the receiver truly are open and caring in understanding the sender’s thoughts (Kourkouta & “Papathanasiou IV”, 2014).

Conflict resolution is common and difficult to master. You cannot practice this skill the same way for every situation. As an APN you must be flexible in how you resolve conflict as every situation and person is a unique combination. Disagreements are inevitable as we are all humans and all have our own thoughts and feelings.  As expressed by Özkan Tuncay, Yaşar, and Sevimligül (2018) “In conflict management, not only being aware of the nature of the conflict but also the recognition of the factors that shape the conflict behavior is important” (p. 951).

Strategies to resolve conflict start within yourself. You must go back to your emotional intelligence. Taking control of your emotions is key in making decisions or making judgment. Second, use effective communication. Avoid using aggressive tones, being passive aggressive or using avoidance. Be assertive and direct (Özkan Tuncay et al., 2018). Finally, be sure that the situation ends on a positive note. 

Conclusion

In conclusion, becoming an APN involves more than just learning advanced clinical skills. You must understand what your scope of practice is. Practicing and understanding the limitations of those skills safely, effectively and legally lead to a long and fulfilling career. Development of the APN role include core competencies such as leadership and learning technology. 

The sole purpose of collaborating with an interprofessional team is to accomplish the goal of effectively and safely caring for the patient. The development of communication skills and emotional intelligence allows for interpersonal relationships to unify and accomplish that goal.

All will experience conflict. Resolving this conflict includes practicing your leadership skills while maintaining professionalism. Continuous practice of the skills within ones development plan will be beneficial in being successful. Professionalism as an APN is not a choice, it is a necessity and an obligation. We as Advanced Practice Nurses are obligated to represent and practice our profession at the fullest extent.

 References

• Association of periOperative Nurses. (2019). Guidelines for perioperative practice. Retrieved from https://www.aorn.org/guidelines/about-aorn-guidelines
• Culha, Y., & Acaroglu, R. (2019). The relationship amongst student nurses’ values, emotional intelligence and individualised care perceptions. Nursing Ethics, 26, 2373–2383. http://dx.doi.org/.chamberlainuniversity.idm.oclc.org/10.1177/0969733018796682
• Kells, M., Dunn, K., Melchiono, M., & Burke, P. (2015). Advance practice nurse fellowships: Creating awareness, creating opportunities. Journal of Pediatric Healthcare, 29, 297–301. http://dx.doi.org/.chamberlainuniversity.idm.oclc.org/10.1016/j.pedhc.2014.10.003
• Kourkouta, L., & “Papathanasiou IV”. (2014). Communication in nursing practice. Mater Sociomed, 26, 65–67. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990376/
• MacLellan, L., Levett‐Jones, T., & Higgins, I. (2015). Nurse practitioner role transition: A concept analysis. Journal of the American Association of Nurse Practitioners, 27, 389–397. http://dx.doi.org/10.1002/2327-6924.12165
• National Organization of Nurse Practitioner Faculties. (2017). Nurse practitioner core competencies content. Retrieved from https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf
• Online Sunshine. (2019). The 2019 Florida statutes-title XXXII
  REGULATION OF PROFESSIONS AND OCCUPATIONS
  Chapter 464
  NURSING. Retrieved from http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0464/0464.html
• Özkan Tuncay, F., Yaşar, Ö., & Sevimligül, G. (2018). Conflict management styles of nurse managers working in inpatient institutions: The case of Turkey. Journal of Nursing Management, 26, 945–952. http://dx.doi.org/10.1111/jonm.12609