Advanced Practice Registered Nurses - Essay Sample

Introduction

Advanced Practice Registered Nurses (APRNs) play vital roles in the health system as they are equipped with unique knowledge and experience which is gained through years of academic and occupational training. They are recognized and hold significant positions in health facilities since they can perform specific tasks such as the prescription of drugs whereas a registered nurse does not have the authority to do so. The privilege is prompted by the attainment of more advanced skills in one of the four primary APRN roles including clinical nurse specialist, nurse practitioner, nurse midwives, and nurse anesthetist. However, over recent years, there have been many issues of nurse turnover in the first year graduate which has been attributed to several factors. Such aspects include a reduced ratio of nurses to patients, little to no autonomy of nurses at the workplace and unfavorable working conditions. The turnover has adverse implications to the healthcare system in terms of financial losses and reduction of human resources offering services to patients at the facilities (Jones, & Gates, 2007). Therefore, there is the need to strategize a significant approach that would help in the reduction of nurse turnover of the first graduate as it will enhance the services provision at the medical institutions.

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As an Advanced Practice Registered Nurse-Midwife, first-year graduate's turnover is burdening the system in all aspects. The nurses are trained with the hope that they will join in as APRNs to ease the current difficult working conditions where only a few Certified Nurse-Midwives (CNM) are assigned to an enormous number of patients. It is a struggle to attend to a lot of clients and at the same time perform effectively or efficiently always because at some point the professional burn out, which is also one of the primary reason nurses are turning over, and is unable to conduct the tasks assigned as expected (Lindley & Cozad, 2016). It, thus, becomes an issue when nurses are quitting in their first year of employment only after arousing the existing practitioners' hope that at least responsibilities would be shared considerately (Antwi & Bowblis, 2016). As a professional, one is left wondering, if everyone comes in and later goes after some few months, then who will be left in the industry? Can the senior APRNs and the few left tackle all the work sufficiently? It, therefore, becomes a critical matter that the administrations ought to look in to and find meaningful solutions that would address the issue and to do this they have to tackle the roots first.

The grand and mid-range theories chosen earlier are Jean Watson's human caring and nurse intellectual capital theories respectively. The former entails that nurses are meant to be taking care of patients and attend to their needs efficiently. Watson demonstrates that by choosing to nurse as one's career, individuals possess certain unique qualities including human orientation, advanced experience, and knowledge of how to handle and interact with the sick, and multiple social processes about caring for others (Brewer & Watson, 2015). The nurses, therefore, become bonded to the patients as their primary objective is to ensure they are well taken care of and various issues concerning them are handled. Nursing intellectual capital, on the other hand, is a middle range theory that depicts that professionals in a health facility possess the essential skills, knowledge, and experience that determine patients' satisfactory, performance outcomes and the nature of the workplace environment (Covell, & Sidani, 2013). It implies that when the nursing practitioners are dedicated and committed such that they perform as expected, the organization's profitability is enhanced; hence, providing essential capital to provide a favorable working environment for the staff in the facility's premises. This way, they will be motivated to serve the clients satisfactorily as they will be reciprocating what is being done to them and that is caring for others.

Notably, the two theories are effective in reducing the rate of turnover of first-year graduates in nursing including CNM. When using the human caring approach, nurses are educated and trained on the essentiality of nursing and its role in caring for the sick during the initial stages of assessment in the hiring process. They are taught the value of their contribution to the growth of patients both physically and emotionally. Hence, they will understand the need for sticking to the professional and not quitting as they will have realized the importance of the role their play in patients' recovery. On its part, the nursing intellectual capital theory functions as an incentive to lure the practitioners and prevent them from leaving. It involves demonstrating to the nursing staff that the organization supports and rewards its workforce members (Sargent, & Olmedo, 2013). Hence, this way the nurses will work to improve their performance instead of quitting which will have reduced the rate of turnover.

Conclusion

In conclusion, the best ethical framework that would suitably support APN of CNM is autonomy with advocacy. Autonomy refers to respecting patients' decisions on how they would prefer being treated such as whether to give birth the natural way or through a caesarian. Advocacy implies when nurses are required to intervene for the clients such as ensuring the concerned practitioners grant their wishes in the facility. The objective of using this ethical framework is to ensure the patients are satisfied with which is then reciprocated to the nurses (Mills, Chamberlain-Salaun, Harrison, Yates, & O'Shea, 2016). One is always proud of themselves after achieving the intended results of which in this case it to please the clients. Therefore, it will be unlikely to push the nursing professionals to a turnover if they are satisfied with what they are doing at the health facility; instead, they will strive to perform better in the future.

References

Antwi, A.Y. &Bowblis, J.R. (2016). The impact of nurse turnover on quality of care and mortality in nursing homes: Evidence from the great recession. Upjohn Institute Working Paper 16-249.

Brewer, B. B.,& Watson, J. (2015). Evaluation of authentic human caring professional practices. The Journal of Nursing Administration, 45(12), 622-627.

Covell, C. L., & Sidani, S. (2013). Nursing intellectual capital theory: Testing selected propositions. Journal of Advanced Nursing,69(11), 2432-2445.

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S.& Drennan, V. (2017). Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews. The Open Nursing Journal, 11, 108-123.

Jones, C. B., & Gates, M. (2007). The cost and benefits of nurse turnover: A business case for

Lindley, L. C., & Cozad, M. J. (2016). Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care. The American Journal of Hospice & Palliative Care, 34(6), 577-583.

Mills, J., Chamberlain-Salaun, J., Harrison, H., Yates, K., & O'Shea, A. (2016). Retaining early career registered nurses: A case study. BMC Nurse, 15(57). doi.org/10.1186/s12912-016- 0177-z

Sargent, L., & Olmedo, M. (2013). Meeting the needs of new-graduate nurse practitioners: a model to support transition. Journal of Nursing Administration, 43(11), 603-610.