Question: Comparison of APN Practice

Interviews of Two APNs

The work for this paper entails interviewing in person (not by telephone or e-mail), TWO different categories of advanced practice nurses (APNs). One APN has to be a primary care nurse practitioner (e.g., family NP, adult NP, pediatric NP); that is, the NP cannot be one who is an acute care NP. Furthermore, the NP must work in a primary care setting such as a "doctor's office" or community health center-that is, in a setting the buzz-word for which is now medical home. An NP who works in a retail clinic or free-standing urgent care center would also be acceptable (but NOT an emergency department). Yes, there are many APNs who are prepared as FNPs or adult NPs who take jobs in non-primary care settings (e.g., as hospitalists and as providers in nursing homes). But a common premise with health care reform and the Affordable Care Act is that there already is and will be a huge need for primary care providers, thus paving the way for even greater opportunities for NPs in this area. It is important that you get a firm grasp of how NPs are prepared for primary care, and thus why NP organizations assert an important solution to the primary care provider shortage is educating more NPs which is why every state should allow full independent practice authority for APNs, especially NPs.

The other APN may be your choice of one of the following: a certified nurse midwife (CNM) or a certified nurse anesthetist (CRNA) or a clinical nurse specialist (CNS). There is no limitation regarding the types of settings these APNs might work. Be sure to indicate the state(s) where the APNs practice.

Although the information gathered from these APNs will be acquired via an interview, the paper should be written in summary format (i.e., it should not look like a dialogue between you and the APN). Information on both interviews should be in a single document. It is not necessary to provide the APNs' full names. Most elements of APA format should be used, including a title page and abstract. Most students' papers that address all of these questions for both APN are about five double-spaced pages, without counting the title page or abstract (be sure to read your APA manual regarding what an abstract should look like!). An exception to the APA format requirement is that a reference list is not required, since all of the information will be derived from two sources (the APNs whom you interviewed). Although you have free range to discuss other topics about advanced practice nursing, you must address the following issues with each APN (please follow the order of list below):

1. Reason for their choosing their specific APN specialty.

2. Descriptions of: (a) the type of setting where they work (e.g., community hospital, major medical center, private primary care practice, clinic for the underserved, etc.), and (b) a "typical" day as they render care.

3. Level of satisfaction with their role in general, and specifically within the system where they are currently employed.

4. The type of APN certification that they hold, including identifying the accurate name of the certifying body with which they are certified (Note: Review your textbooks for the correct names of these certifying bodies. Also note there are several different certifying bodies for NPs).

5. Whether they have prescriptive authority and whether they prescribe controlled substances. If they do prescribe controlled substances, you must indicate from which schedules of controlled substances they are allowed prescribe.

6. Whether they must practice according to an agreement with a physician. If so, is the relationship supervisory or collaborative?

7. Are they credentialed and privileged by a hospital or health system? If the answer is "yes," ask them to explain what the credentialing and privileging process entails at their organization (e.g., are the documents reviewed by only the human resources department, the nursing department, or the medical staff office, a combination of all three, etc.).

8. Whether they belong to a professional organization(s) that specifically addresses APN issues. If so, which one (s)? If not, why not?

9. Their understanding about the DNP degree (i.e., have them actually explain what they know about the degree) and whether they have this degree already or intend to pursue it. Be sure to probe to see if they have positive or negative feelings about the DNP-and why.

10. Final grading criterion: Paper's adherence to APA format (with the exception that references are not required for this particular paper), including grammar, spelling, punctuation, sentence structure, etc.