This research examines the issue of advanced nursing practice with a goal of identifying the implications of this trend in practice for both professional nursing and health care delivery. The prospects for significant health care reform in the United States, the growth of the managed care concept, and changing composition of both patient and nursing populations are driving the trend in relation to advanced practice nursing (Donley, 1995, p. 84).
Advanced Practice Nursing As A Conceptual Approach to Professional Nursing Practice
One of the major goals of health care reform is the reduction of costs associated with the delivery of care while simultaneously maintaining standards of care quality (Siccardi & Winland, 1995, p. 9). Enhanced use of qualified professional nurses is one means of attaining these twin goals (Soehren & Schumann, 1994, pp. 123-127). For nurses to be effective in such a role, professional qualifications must be developed beyond the levels required for registered nurses. Registered nurses acquire the specialized skills for advanced nursing practice through both practice and education (Hamric, 1995, p. 547). A master's degree is required for certification as either a clinical nurse specialist (CNS) or a nurse practitioner. In the relatively recent past, nurse practitioners were not required to hold master's degrees; however, to be considered to be advanced practice nurses, master's degree certification is required (Watson, 1995, p. 78; Jackson, 1995, p. 43).
Applications of the Advanced Practice Nursing Concept, and Implications for Professional Nursing and Health Care Delivery
Traditional acts of medical care in the contemporary period increasingly are overlapping with the functions of CNSs, nurse practitioners, nurse anesthetists, and nurse midwives (Hohman & vander Woude, 1993, p. 617). This overlapping of functions is changing the ways in which health care is delivered.
The role of the nurse p...