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Role Synthesis Paper:Doctorate of Nurse Practice in Family Nurse Practice with Subspecialty in Nurse EducationTelana N. FairchildUniversity of Massachusetts- WorcesterGraduate School of NursingIdeal JobI have recently graduated from the University of Massachusetts- Worcester, Graduate School of Nursing (UMASSW GSN) with a Doctorate of Nursing Practice (DNP) in Family Nurse Practitioner (FNP) and have a subspecialty in Nurse Education. With this degree my ideal career is to work in a rural clinic as a FNP as well as be part of nursing boards and affiliations to promote change for Advanced Practice Registered Nurses (APRN). Later, I would agree to be a clinical preceptor for nursing students, having the intent to eventually educate in a class room also as a part time position while I continue to practice in the clinic. Prior to receiving my degree I worked as a Registered Nurse (RN) for seven years as a bedside nurse in critical care. Over the seven years, I realized the importance of primary care, holistic patient-centered care, and education of those in the profession of patient care. My career path is multifocal with the intent to improve patient outcomes, change the role of NP, and educate the profession of nursing.Scope of Practice MATo achieve this opportunity, I would acquire and maintain my credentials, certifications, and license to practice. First, I have graduated from UMASSW GSN, an accredited establishment that required passing their courses in BSN to DNP program with a focus in FNP population and a subspecialty in Nurse Education. Then, I have passed a certification exam established by a national accrediting body proving I have the knowledge of the national core competencies of an Advanced Practice Registered Nurse (APRN) focused in the FNP population. Successful completion of the courses and passing of the exam provides me with license as an independent practitioner for practice as a DNP with a focus in FNP (NONPF, 2008). After receiving my licensure, I have obtained my National Provider Identifier (NPI) from the federal government for the purpose of electronic transmission of health information in compliance with the Health Insurance Portability and Accountability Act of 1996 (DeNisco &Barker, 2013). As well, I have acquired my Massachusetts Controlled Substance Registration MCSR and my United States Drug Enforcement Administration license number (DEA#) in order to prescribe. Throughout my career, in accordance with 244 CMR 4.00: MASSACHUSETTS REGULATIONS GOVERNING THE PRACTICE OF NURSING IN THE EXPANDED ROLE (244 CMR 4.00) I will keep my license, NPI, MCSR, and DEA# accurate and up to date by following the continuing education and application. Also, as I practice and prescribe I will follow the federal and state guidelines as stated by the APRN, 244 CMR 4.00, and any other governing body or institution standards ensuring to practice within my scope as an FNP (DHHS, 2012).Unique QualificationsI will contribute to the health care system at an individual level starting with care for patients and expand to the organizational level by changing practice standards, policies and regulations. My first unique qualification is I am a nurse, a trusted profession among the public. As a nurse, I take a holistic approach advocating for patient centered care to improve patient outcomes and society overall. Next, I have recently achieved my FNP education which expanded my professional career as a nurse to a licensed independent practitioner who can provided autonomous care (DeNisco & Barker, 2013, p. 5-7). During my education, I learned how there are many determinants of health, medical and non-medical, and about the importance of nursing models in practice to achieve patient centered care. As I practice I will not neglect the non-medical determinants such as, general socio-economic, cultural, and environmental statuses of each patient. Keeping in mind all health determinants will allow me to provide an agreeable treatment plan, individualized for each patient (DeNisco & Barker, 2013, p. 138-42). There are many nursing models discussed in my education, but the one I like to focus on is the trans-theoretical model better known as the 5A’s. Using the 5A’s model, I will guide the patients through an individual process to modify health behaviors and improve their overall outcome. In order to use the 5A’s model I also have the understanding of Motivational Interview (MI). MI is important in this process because it allows the patient to establish change on their terms and has been proven successful in causing change in behaviors (Coleman & Pasternak, 2012). Another important uniqueness is the realization many current providers do not understand the importance of improving health literacy. Health literacy means the patient can make an informed health decision by being able to fully comprehend health-related information (Speros, 2011). I believe in patient education and thus health literacy to allow patients to understand and be involved in their care. Beyond leading as an example in patient care, I will also apply these unique qualifications, in addition to my DNP, and change the health care system. Using Healthy People 2020, as a goal standard, I will work towards research and practice change to improve society’s overall health. Furthermore, I will work to improve access to primary preventive care by having more Primary Care facilities with more Primary Care Providers (PCP) for patients in rural areas. Additionally, I emphasize the importance of disease prevention using community outreaches and awareness programs for the public. Thus, I will help control cost of health care by decreasing the number of acute complications and hospital admissions or emergency room visits. I will use education of nurses, other professions, and patients as my tool to advocate for health promotion in order to change the health care system. The old standard of caring for people in acute situations is driving cost up and not promoting overall well-being and it’s time for a change. My unique qualifications set me apart from all other applicants and contribute to the overall health promotion of society and improve the health care system.Interprofessional EnvironmentTo have this influence on the health care system I will work with other professionals as part of an interprofessional team (DeNisco & Barker, 2013, p. 633-5). Patient health involves complex multiple systems afflictions and allowing each member of an interprofessional team to use their expertise will improve patient outcomes. Including the patient as part of the interprofessional team is one value I would bring because as a nurse I’m patient focused. Also, the leadership skills I’ve learned in my DNP program will allow me to lead the team and give them direction and cohesion. Unique to my education at UMASSW GSN is we had the opportunity to be part of interprofessional experience. I participated in the following opportunities, working with institutions educating staff about new practice standards, assisting first year medical students to understand the flow of patient care in hospital setting, and collaborating with third year medical students on how to work within an interprofessional team and including patients. My interprofessional skills would be a value added to this institution as well as the health care system.Role ContributionsThe following evidence will further prove my role contributes to health and well-being of patients in this health care system. To begin, a study for expanding NP’s role to function as attending providers for injured workers in Washington State found an increases access to care, especially in rural areas, and system efficiency, which leads to improve workers’ outcomes and system costs. This study prompted legislation to allow NP to be attending providers in Washington State for the worker compensation system (Sears, Wickizer, Franklin, Cheadle, & Berkowitz, (2008). A qualitative study reveals that NP educating family medical residents about smoking cessation was well receptive and appreciated information gained (Mitchell, Brown, & Smith, 2009). This next article gives evidence for change needed in the health care system. The researchers explored why NP practicing as independent PCP is still an issues. They found physicians still believe NP’s are under qualified and state legislation limits our independent practice licensure restricting NP’s insurance reimbursements (Weiland, 2008). Receiving my DNP allows me the opportunity to facilitate legislation changes in complex health care system to achieve healthier outcomes for all of society (DeNisco & Barker, 2013, p. 67-71). Another article found literature does support NPs can provide equal care, compared to physicians. However, they suggest novice NP’s need mentoring programs to help them transition to the role of PCP (Harrington, 2011). This highlights a reason for becoming not only a DNP but also earning my subspecialty in nurse education. I will challenge and inspire the new NP’s to strive to give the best patient care and improve the health care system for the underserved. ConclusionOverall, as a DNP in FNP with a subspecialty in nurse education I have unique qualifications that would add value to any health network. As outlined, my career choice is to work with the underserved population in a rural setting to increase access to health care. In addition, I would be a part of nursing boards and health care organizations taking part in defining regulations and legislation changes pertaining to NP’s roles in practice. Plus, my desire to be an educator for patients, nurses and other professionals will impact health literacy, nurse practice and interprofessionalism. It is obvious my career goals previously detailed will definitely impact health care.References:Coleman, M.T., & Pasternak, R.H. (2012). Effective strategies for behavior change. Primary Care: Clinics in Office Practice, 39 (2). DeNisco, S.M., & Barker, A.M. (Eds.). (2013). Advances practice nursing: Evolving roles for the transformation of the profession. Burlington, MA: Jones & Bartlett Learning.Department of Health and Human Services (DHHS), Commonwealth of Massachusetts. (2012). Nursing licensing: Includes statutes, rules, regulations and policies. Retrieved from , S. (2011). Mentoring new nurse practitioners to accelerate their development as primary care providers: A literature review. Journal of the American Academy of Nurse Practitioners, 23 (4), 168-174. doi:?10.1111/j.1745-7599.2011.00601.x.Mitchelll, J., Brown, J.B., & Smith, C. (2009). Interprofessional education: A nurse practitioner impacts family medicine residents’ smoking cessation counseling experiences. Journal of Interprofessional Care, 23 (4), 401-409.National Organization of Nurse Practitioner Faculties (NONPF). (2008). Consensus model for APRN regulation: licensure, accreditation, certification & education. , J. M., Wickizer, T. M., Franklin, G. M., Cheadle, A. D. & Berkowitz, B. (2008). Expanding the role of nurse practitioners: Effects on rural access to care for injured workers. The Journal of Rural Health, 24:?171–178. doi:?10.1111/j.1748-0361.2008.00154.x.Speros, C.I. (2011). Promoting health literacy: A nursing imperative. The Nursing Clinical of North America, 46 (3), 321-333.Weiland, S.A. (2008). Reflections on independence in nurse practitioner practice. Journal of the American Academy of Nurse Practitioners, 20 (7), 345-352. doi 10.1111/j.1745-7599.2008.00330.x. ................
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