With the evolution of healthcare delivery, the roles of nurse practitioners (NP) have become increasingly vital. NPs are advanced practice registered nurses (APRNs) who provide a range of primary, acute, and specialty care services to patients across the lifespan. State regulatory agencies define the scope of practice for NPs, and it varies by state (Boehning & Haddad, 2023). The NP roles include specific competencies essential for providing effective and safe care. Leadership is also an integral part of the NP roles, as NPs often work in collaborative teams and are responsible for managing patient care.
This paper aims to explore the foundational concepts and advanced practice roles of the nurse practitioner. This paper discusses the scope of practice, competencies, and leadership roles of NPs. Understanding these essential components of the NP roles enables healthcare organizations to optimize the utilization of NPs to provide high-quality, patient-centered care.
Advanced Practice Nurse Scope of Practice
In Ohio, Advanced Practice Nurses (APNs) are authorized to practice as Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Certified Nurse-Midwives (CNMs), and Certified Registered Nurse Anesthetists (CRNAs). APNs must have a Master’s degree or higher in nursing, national certification in their specialty area, and a current license as a registered nurse. They must also complete continuing education requirements to maintain their certification and licensure.
Educational Requirements
Ohio’s Nurse Practice Act requires APNs to hold a Master’s degree or higher in nursing from an accredited nursing program. The degree must include clinical experience in their chosen specialty area, and they must have certification from a national certifying organization. APNs must also maintain continuing education requirements to keep their certification and licensure current (Wheeler et al., 2022). Ohio’s educational requirements for APNs align with the standards set by the National Organization of Nurse Practitioner Faculties.
License Requirements
In Ohio, individuals must first obtain a registered nurse license to practice nursing. Obtaining an RN license in Ohio costs $75, and the renewal fee is $65 every two years. Obtaining an APN license costs $135, and the renewal fee is $65 every two years. APNs must maintain their RN license and national certification in their specialty area to keep their APN license current and up-to-date.
Regulatory Requirements
APNs in Ohio are regulated by the Ohio Board of Nursing (OBN). Individuals must have national certification in their specialty area from an accredited certifying organization to practice. The OBN requires APNs to complete 24 contact hours of continuing education every two years to maintain their license. APNs must also maintain their certification in their specialty area and provide proof of current certification to the OBN (Starting a Nurse Practitioner Private Practice, 2019). According to the OBN, there are multiple certifying organizations for each specialty area, and the certification cost varies by organization.
Practice Authority
APNs have full practice authority, meaning they have the authority to diagnose, treat, and prescribe medications for patients. APNs can work collaboratively with physicians or other healthcare providers or independently depending on the individual’s work setting or specialty area. According to the Ohio Association of Advanced Practice Nurses, Ohio is one of the states and the District of Columbia that allow full practice authority for APNs (Ohio, 2021).
Prescriptive Authority
APNs in Ohio have prescriptive authority and can prescribe medications by Ohio law and their specialty area. They must have a current Drug Enforcement Administration (DEA) number and a Certificate of Authority to prescribe controlled substances. APNs must also maintain their national certification in their specialty area and complete continuing education requirements related to prescribing and pharmacology. There are no licenses or additional fees for APNs to maintain their prescriptive authority in the state.
Nurse Practitioner Core Competencies
The National Organization of Nurse Practitioner Faculties (NONPF) Core Competencies provides a framework for Nurse Practitioners (NPs) to develop the knowledge and skills needed to provide high-quality healthcare. An NP must reflect on the areas for growth and personal strengths for professional development.
Personally Strong competency Areas
In the “Scientific Foundation Competency,” I feel confident in integrating scientific knowledge into clinical practice. I have a strong foundation in the basic sciences and understand common diseases’ pathophysiology and pharmacology. I am also comfortable conducting and interpreting diagnostic tests and applying evidence-based practice to patient care. This competency is essential for NPs, as it helps provide safe and effective patient care.
Regarding the “Clinical Management Competency,” I believe I am skilled in managing patients’ health conditions. I also have experience developing patient-centered care plans, counseling patients on lifestyle changes, and prescribing medications appropriately. I am confident in communicating effectively with patients and other healthcare professionals to ensure coordinated care. This competency is crucial for NPs as it enables them to manage complex patients’ health conditions and improve patient outcomes.
Competency Areas Where There is Room for Growth
I need to improve in Health Promotion and Disease Prevention competency. I recognize the importance of prevention in healthcare, but I need to enhance my skills in developing and implementing patient health promotion strategies. Attending conferences and workshops to learn about health promotion and disease prevention will enable me to grow and improve in this area. Participating in research studies on this topic and collaborating with healthcare professionals to design effective prevention programs will also enhance my understanding and promote overall growth.
Policy and Advocacy Competency is another area that requires personal improvement and growth. As an NP, it is critical to be knowledgeable about healthcare policy and advocate for changes that benefit patients and the healthcare system. However, I need to improve my skills in interpreting healthcare policies, analyzing their impact on patients, and advocating for policy changes. I plan to join nursing organizations focusing on policy and advocacy to improve this area. I will also participate in community-based activities that promote healthcare access and equity and network with other healthcare professionals knowledgeable about policy and advocacy.
Scholarly Activities to Help Achieve NP Competencies
Attending conferences and workshops related to health promotion, policy, and advocacy to learn from experts in these fields will enable me to improve adequately. Writing research articles on these topics and participating in research studies to gain a deeper understanding of the issues will also give me insight into the growth opportunities. I also plan to join nursing organizations that focus on policy and advocacy and network with healthcare professionals knowledgeable about healthcare policies.
Leadership skills
Leadership skills are essential for nurse practitioners (NPs) who work in complex healthcare systems. In such systems, NPs must be able to lead interprofessional teams, communicate effectively with diverse stakeholders, and make decisions based on a comprehensive understanding of the healthcare landscape. Such complex systems require essential leadership skills like collaboration, strategic thinking, and adaptability.
Three Leadership Skills Required to Lead in Complex Systems
Strategic thinking is the ability to analyze complex problems, identify opportunities for improvement, and develop strategies to achieve organizational goals. This skill is essential for NPs who must navigate complex healthcare systems and work with diverse stakeholders to provide high-quality care. In addition, strategic thinking allows NPs to anticipate challenges and develop proactive solutions. Collaboration is another essential leadership skill for NPs. Effective collaboration requires strong interpersonal skills, including communicating, listening actively, and building relationships based on trust and respect. Collaboration enables NPs to work effectively with interprofessional teams and other stakeholders to achieve shared goals. Another critical leadership skill for NPs is adaptability. It involves the ability to respond to changing circumstances, adjust priorities, and make decisions in the face of uncertainty. This skill is vital in healthcare, where the patient needs, regulations, and technology changes are constant.
Two Strategies to Help Develop NP Leadership Skills
One approach is to engage in formal leadership training programs such as those offered by professional organizations or academic institutions. These programs can provide NPs with a structured curriculum that covers essential leadership skills and opportunities to practice these skills in real-world settings. Another strategy is to seek mentorship or coaching from experienced leaders, either within or outside of healthcare. Mentors can provide NPs with personalized guidance and feedback on their leadership skills and opportunities to network with other professionals in their field. NPs can also seek out opportunities to lead projects or initiatives within their organization, which can help them develop their leadership skills in a practical context.
Conclusion
The nurse practitioner (NP) role is becoming increasingly important in healthcare delivery systems, as they provide a range of primary, acute, and specialty care services to patients across the lifespan. This paper explored the foundational concepts and advanced practice roles of the nurse practitioner, explicitly focusing on the scope of practice, competencies, and leadership roles of NPs. State regulatory agencies define the scope of practice for NPs in Ohio and include full practice authority and prescriptive authority. NPs must meet educational and regulatory requirements, including maintaining certification and licensure and completing continuing education. The National Organization of Nurse Practitioner Faculties (NONPF) Core Competencies provides a framework for NPs to develop the knowledge and skills needed to provide high-quality healthcare. Leadership is also an integral part of the NP role, as NPs often work in collaborative teams and are responsible for managing patient care.
References
Boehning, A. P., & Haddad, L. M. (2023). Nursing practice act. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK559012/
Ohio. (2021, March 16). American Association of Nurse Practitioners. https://www.aanp.org/advocacy/ohio
Starting a nurse practitioner private practice. (2019, April 2). Ohio University. https://onlinemasters.ohio.edu/blog/nurse-practitioner-private-practice/
Wheeler, K. J., Miller, M., Pulcini, J., Gray, D., Ladd, E., & Rayens, M. K. (2022). Advanced practice nursing roles, regulation, education, and practice: A global study. Annals of Global Health, 88(1). https://doi.org/10.5334/aogh.3698
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