As medical care evolves, so does the role and scope of practice of the advanced practice nurse in acute care settings.

As medical care evolves, so does the role and scope of practice of the advanced practice nurse in acute care settings. When providing patient care, however, you, as an advanced practice nurse, must always ensure that you are working within the scope of practice outlined by your state’s laws and institution’s regulations. For this Discussion, you examine these laws and regulations and consider how they might affect your future clinical practice, consider the credentialing process for your area, and discuss negotiation techniques you may use in a job search.

To prepare:

• Locate a collaborative practice agreement. Based on this agreement, consider the scope of practice of an advanced practice nurse in your state.
• Locate and select at least two hospitals where you would be interested in working at once you obtain your licensure.
• Locate the hospitals’ credentialing documents and investigate the scope of practice at each hospital.

Note: All hospitals do not have the same scope of practice even if they are located within the same city and state.

• Consider how the laws and regulations of the state and hospitals might affect your practice with medical and surgical patients in acute care settings.
• Think about how you would negotiate your first Advanced Practice role. Consider issues such as salary range, Continueing Medical Education (CME), license and DEA costs, insurance, hours, on call requirements, etc.

By Day 3

Post an explanation of the scope of practice of advanced practice nurses, as outlined in the collaborative practice agreement. Then, identify the two hospitals of interest that you selected. Based on the credentialing documents, explain the scope of practice for acute care advanced practice nurses at each hospital. Explain how this might affect your practice in terms of caring for medical and surgical patients in acute care settings (i.e., medical treatments, procedures you can perform, interpreting diagnostics, etc.). Finally, describe job negotiation considerations.

ANSWER

Scope of Practice of Advanced Practice Nurses

Advanced Practice Nurses in New Jersey are required to work in close collaboration with certified physicians. In essence, collaboration refers to a continues arrangement by which a physician and an APN work as a team, in line with clearly stipulated parameters (Buppert, 2017). For APNs to prescribe medications and medical procedures, they must seek written shared protocol with the collaborating physician in charge. The scope of the joint protocol is determined by the parties involved. Typically, the protocol is quite personal to the APN’s experience and their relationship with the physician in question (APN White Paper, 2013). 

Hospitals Selected

1. Hackensack University Medical Center
2. Cooper University Hospital

At Hackensack University Medical Center, the scope of practice for acute care APN entails providing patient-centered care characterized by excellent leadership skills, effective collaboration, research-based practice and ethical decision making. They must provide culturally diverse and suitable health management education to their patients. Additionally, the hospital expects acute care APNs to coordinate the advancement of evidence-based practice standards and protocols of care that comprise treatment and interventions to accomplish set objectives.

At Cooper University Hospital, acute care APNs are expected to independently perform minor procedures such as interpreting x-rays and suturing. The nurse should also be able to assess acuity of patients, diagnose and manage mild conditions such as acute pain conditions. The scope of practice outlined by the state and the individual hospitals is likely to enhance my practice. Given the expansive scope of practice, I am likely to improve my skills in relation to medical and surgical cases, particularly in…