Term Paper on "From RN to Nurse Practitioner"

Term Paper 10 pages (3164 words) Sources: 10

[EXCERPT] . . . .

Nurse Practitioner R.N.

From R.N. To Nurse Practitioner

Summary of Research & Clinical Problem

Analysis of Literature on Nursing Practice - Use of Self-Report Tools

Nurse Practitioner vs. Registered Nurse

Reasons for Transfer

Gaps in Research

Strengths & Weaknesses of the Concept

Summary of Overall State of Knowledge of the Concept & Related Problem

Discussions & Summary Conclusions

This paper will research the process of transferring from a status of Registered Nurse to Nurse Practitioner. In doing so, the researcher will define and describe the duties, obligations and educational abilities of both positions. The primary questions addressed include: (1) what decisions factor into a nurses decision to transfer from one position to the next. (2) Does transferring from R.N. To Nurse Practitioner pose specific advantages or disadvantages to the nurse in question, (3) what gaps in literature currently exist regarding research in this area? The answers to these questions will assess whether further study of this phenomenon is necessary or prudent in assessing the career goals and motivations of nurses in the field of medicine. The researcher hypothesizes that as a continuing decline in the supply of practicing nurses becomes evidence, fewer R.N.s may decide to transfer to the role of Nurse Practitioner, partly because of elevated responsibilities, and partly due to lack of communication, proper training and support, as the researcher predicts evidence will show with the results of the literature review.

Problem

At present, there is a national crisis within the nursing industry. More and more, people are interested in becoming nurses. Nurses work in many capacities in clinics, community centers, hospitals and in private practice. However for some, there is no clear distinction between an R.N. And a Nurse Practitioner. Further, there is little data exploring the mechanisms through which a nurse may decide to pursue an advancing career, and what support if any he or she may receive in doing so. The purpose of this paper is to clarify the roles of these two positions, and assess which is most needed given the status of the nursing and healthcare industry in the United States today.

Rationale

By identifying the differences between, and the need for, both R.N. And Nurse Practitioners, and the ease with which one may transfer from one to another, those interested in pursuing the field of nursing are better prepared to make sound judgments about their careers and livelihood, and that of their community. A nurse's role in the community dramatically affects the quality of life of patients, the outcome patient's experience, as well as a nurse's role in organizational management. One's choice of profession may also have financial ramifications personally, and for the organization with which they work, and may affect productivity. This researcher will help clarify all of these concerns through a comprehensive review of the current literature available on the profession.

Theoretical Framework

The theoretical framework for this research is supplied through Hackman & Oldman's job characteristics theory (Blossom, et al., 2007; Fisher & Ashkanasy, 2000), who suggest the influence of job characteristics have multiple effects on job outcomes and choices among incumbents within positions. Using this theory, the characteristics of certain jobs and the demands they place on the incumbent can significantly influence a persons desire to move positions or transfer to another position, such as switching from a registered nurse to a nurse practitioner. In the next section we will review these concepts in more detail. Hackman & Oldman's study among other characteristics job satisfaction, motivation and its implication on one's odds of transferring from one position to another. This is useful for discerning one's reasons for moving from one job to another.

Literature Review - Summary of Research & Clinical Problem

Riley (2000) beings by confirming the theoretical framework provided for this analysis by stating multiple characteristics of a job, including communication chiefly, influence one's desire to transfer from one position in nursing to another. Riley suggests nurses make "intimate journeys with clients and families" throughout their career, and provide multiple tools for patients including education that may affect the patient's outcome and future (p.2). A nurse's role and title can affect their ability to communicate, and thus their ability to delivery healthcare quality (Riley, 2000). Thus, one must examine the role a nurse has and its implication on their ability to communicate efficiently, and build their communication skills as part of their purpose.

Nurse's actions vary according to their job responsibility. A nurse may promote, maintain or restore a patients health or well-being contingent on their role; for example, professional nurse practitioners may "bear primary responsibility for the nursing care clients and patients receive" (Riley, 2000:25; Congress for Nursing Practice, American Nurses Association, 1973). What this means is nurses in the nurse practitioner role have more responsibility and according to Riley (2000), more ability to communicate with patients in an empowered roll.

Analysis of Literature on Nursing Practice - Use of Self-Report Tools

When deciding whether to transfer from one profession in nursing to the next, Riley (2000) recommends the self-assessment tool, one that allows nurses to check "their skills, but also use the self-assessment as a tool to teach tenants of customer service" and communication (p. 439). Using this tool, nurses must answer 25 questions using a likert type scale from 1 (not skilled) to 4(very skilled), with questions assessing their ability to communicate, their ability to interact with clients, their ability to take responsibility for patient care, to encourage client feedback, to offer help, and to respect and honor confidentiality among other questions (p.440). Nurses with high scores, those ranking of 77-100 are more likely to have awareness of their ability and be cognizant of whether they want to transfer to a new role or remain satisfied in the role they currently hold within the nursing profession (Riley, 2000: 440).

Nurse Practitioner vs. Registered Nurse

To understand the reasons one might to transfer from one profession to the next, one must understand or distinguish between the levels of service a nurse practitioner offers compared with a registered nurse. There are many publications offering insight into these terms. There is much more status associated with the role of nurse practitioner than the role of a traditional RN (Sobralske & Naegele, 2001; Shi & Samuels, 1997). The practice environment for nurse practitioners is much like that of a physician's assistant, where the nurse is given authority to communicate directly with patients, assess patients and provide treatment recommendations in many of the same ways a PA or doctor would, with the oversight of the primary care physician (Sobralske & Naegele, 2001:544). For many, the environment, and the characteristics of employment for the nurse practitioner, using the theoretical framework suggested for this study, is idealized, because nurses working in this role are more empowered to make decisions and take charge of their employment and their role as part of the healthcare team (Shi & Samuels, 1997).

This does not devalue the role an RN ha however; an RN is a critical provider in any healthcare facility, but often must endure some of the more mundane tasks associated with nursing, and may be overburdened with job characteristics that they perceive to be less favorable, including less pay for more work, or greater requests for overtime assistance without regard for the time and commitment they give to their patients (Sekcenski et al., 1994).

Using the same theoretical framework, one may suggest that the lack of supply of adequate nurse practitioners contingent on practice environments and rules and regulations needed within states to promote one to the status of a nurse practitioner may be limiting. They may induce too much in the way of economic or personal hardship for RNs to seek out such accomplishment (Sekcenski, et al. 1995:1268).

Reasons for Transfer

When evaluating the motivations for an R.N. To transfer to the status of a registered nurse, one must look at multiple factors including an R.N.s desire for greater autonomy at work. The Registered Nurse is more likely to hold a position of authority and respect among peers, especially given much of the research leads to the conclusion that a registered nurse is often aligned with the title of a physician assistant, to which many patients hold in great esteem (Sekcensnki, et. al, 1995).

There is some evidence however that little support exists for nurses aspiring to the role of Nurse Practitioner, though the need for greater support in this area is evident by nursing shortages throughout the nation and world (Sekcenski, et al., 1995). However, with the possibility of nurses transferring to advanced practice, so too does the opportunity present itself that nurses may be in even more demand because fewer will practice the role of the traditional R.N.

Gaps in Research

Many gaps in research that may limit ones ability to assess whether the decision to transfer from one role to the next is easy or difficult exist. Evans (n.d.) notes that there are many problems associated with clinical teaching, especially in the field of clinical teaching and… READ MORE

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