Future Scope, Role, and Professional Obligations Paper.

Advanced registered nursing graduates are entering the profession at dynamic time when roles and scope of practice are shifting based on developments in legislation and policy in response to the evolving needs of the health care system. Professional nursing organizations play an important role in making sure the perspectives of advanced registered nurses are heard, and in supporting nurse specialties in their efforts to expand their scope of practice and their full participation throughout the health care system. Future Scope, Role, and Professional Obligations Paper.

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For this assignment, you will conduct research on the current scope of practice for your specialty and efforts that are being made to expand that scope and the role of the advanced nurse in positively influencing the health care system. Write a 1,250-1,500-word paper that includes the following: 1. A discussion of the scope of your future role as an advanced registered nurse, including any regulatory, certification, or accreditation agencies that define that scope. 2. A discussion of three professional nursing organizations that you think are most influential in advancing the scope and influence of advanced nursing. Of these organizations, evaluate the one that you would most like to join. How do its goals and mission fit in with your worldview and philosophy of care? How might membership in this organization improve your practice? 3. A discussion of a controversial or evolving issue that is most likely to affect your scope of practice or role in the next few years. How do you think this issue could influence the profession and other stakeholders, and why does it matters to the advanced registered nurse? You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite.

Future Scope, Role, and Professional Obligations Paper.

Education, Future Scope, Role, Accreditation, Professional Obligations, and Membership of Professional Organizations of the Advanced Practice Certified Registered Nurse Anesthetist (CRNA)

According to the APRN Consensus Model, there are four recognized advanced practice registered nursing or APRN roles namely clinical nurse specialist (CNS), certified nurse midwife (CNM), certified nurse practitioner (CNP), and certified registered nurse anesthetist or CRNA (Sabo et al., 2017). To become a specialist in any of these roles, the registered nurse requires having at least a master’s postgraduate degree and training. Aside from the four roles, each APRN is expected to cater for a specific population focus that will benefit from their specialty.  But these roles are broad in a general sense of the word. Therefore, the APRN can actually study further to specialize even more in a sub-specialty. This paper looks at the certified registered nurse anesthetist or CRNA in terms of scope, future role, regulation, certification, accreditation, professional nursing organizations, and an evolving or controversial issue affecting their practice.Future Scope, Role, and Professional Obligations Paper.

The Scope and Future Role as a Certified Registered Nurse Anesthetist

The CRNA is an advanced practice registered nurse (APRN) whose scope of practice encompasses the provision of comprehensive anesthesiology care to patients who are both acutely ill in intensive care and undergoing surgery across the lifespan. Nurse specialists in this specialty role work alongside surgeons and physician intensivists to achieve this role. They are not only involved in the administration of anesthesia, but are also responsible for taking samples such as arterial blood for blood gas analysis and insertion of central lines in the intensive care unit or ICU. The CRNA is also involved in educating the surgical patient about prevention of post-operative complications (Sabo et al., 2017).Future Scope, Role, and Professional Obligations Paper.

Ten years ago, the Institute of Medicine (IOM) came up with a revolutionary report that addressed what the future of nursing would look like with concrete recommendations. The report was titled The Future of Nursing: Leading Change, Advancing Health (Hopper, 2016). The future role of the advanced practice CRNA is considered in the light of this report. Amongst others, the report recommended that:

• The present barriers to practice such as restricted and reduced practice in some of the states be removed for APRN nurses
• The number of nurses who hold a postgraduate doctorate degree be doubled by the year 2020 (this year)
• Nurses to be empowered to lead change in advancing health in all nursing specialties (Hooper, 2016).Future Scope, Role, and Professional Obligations Paper.

In this context, the IOM suggested that the best and desirable entry level for APRNs such as CRNAs should be the doctorate level. This would ensure that the APRN is extensively educated and with enough practice to give them the ability to function as specialists who are at par in healthcare service delivery with physicians. They would be able to assess, order investigations such as BGAs, interpret the results of the investigations, perform critical procedures, and administer anesthesia. This is what the future role of the CRNA will look like. On the reduction to practice barriers, the future role of the advanced practice CRNA is expected to be that of a specialist with full practice authority and full prescriptive authority.Future Scope, Role, and Professional Obligations Paper. This means that the CRNA will be able to autonomously and without restrictions offer anesthesiology care as an able multidisciplinary team member. Full practice and full prescriptive authority will ensure that the CRNA promptly handles both surgical and critical care emergencies and other tasks without having to wait for supervision or authorization from a collaborating physician. This will save more lives and improve the health of communities benefitting from the services of the CRNA. Lastly but not least, empowering the CRNA to lead change in advancing health will mean accepting more and more CRNA specialists to work independently as APRNs with full practice and prescriptive authority at the primary health care level.Future Scope, Role, and Professional Obligations Paper. This is even more urgent given that many marginalized communities at the rural grassroots level still lack specialized anesthesiology care since the Patient Protection and Affordable Care Act (ACA) 2010 increased the number of those covered by health insurance (Kominski et al., 2017).Future Scope, Role, and Professional Obligations Paper.

Regulation, Certification, and Accreditation of the Cardiovascular Nurse Specialist

For any CRNA specialist to be recognized and given certification, they must have enrolled and acquired their postgraduate nursing education from accredited courses in the country. Accreditation of postgraduate courses for APRNs is done either regionally or nationally. An example of a regional accreditation body recognized by the US Department of Education is the Higher Learning Commission. The Northwest Commission on Colleges and Universities is another regional accreditation body.Future Scope, Role, and Professional Obligations Paper. National accrediting agencies accredit institutions and courses across the country.Future Scope, Role, and Professional Obligations Paper. An example of these bodies that offer both institutional and programmatic accreditation is the American Academy for Liberal Education (EDsmart, n.d.). For CRNs postgraduate courses, they must be accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs or COA, which is a national accreditation body for CRNA programs in the United States (AANA, 2020; MSNedu.org., 2020).

Regulatory framework for the practice of CRNAs as APRN specialists is in the hands of state boards of nursing for each state. These boards are governed by the existing legislation or Nursing Practice Acts that spell the scope of practice for all APRNs including CRNAs in each state. For instance, this means that in states that have full practice authority legislation such as Maryland and New Mexico the board will allow the CRNA to practice autonomously without supervision by a physician to the fullest extent of their education and training. Another CRNA specialist with the same training and experience but practicing in a reduced practice state such as Wisconsin and Ohio will have to practice under the supervision of a physician with whom they must have a collaborative agreement.Future Scope, Role, and Professional Obligations Paper.

Certification of the CRNA can be offered after the passing of special certification examinations. Specifically, this is the National Certification Examination or NCE given by the National Board of Certification and Recertification for Nurse Anesthetists or NBCRNA. This is what enables the CRNA to get state licensure for practice. The CRNA candidate is required to pay USD 725 for the NCE examination that consists of 100 to 170 questions done electronically. For instance, a total of 2,983 candidates did the examination in 2015 with a pass rate of 81 percent (MSNedu.org., 2020).

Three Professional Nursing Organizations

Professional nursing organizations are very important for not only APRNs but also all other nurses because they enable networking, facilitate continuous professional development in the form of conferences and publications, and engage in advocacy for the benefit of the members by providing a unified and collective voice. Three of the professional nursing organizations that the CRNA specialist may join are (AANA, 2020; ANA, 2020; IFNA, n.d.):Future Scope, Role, and Professional Obligations Paper.

1. American Association of Nurse Anesthetists (AANA)

This is the national professional organization for CRNAs that was founded in 1931 and caters for the interests of both qualified and student CRNAs countrywide. Its mission is to advance patient safety through excellence in practice. It represents about 54,000 nurse anesthetists (AANA, 2020).

1. American Nurses Association (ANA)

The ANA is the umbrella professional body for all nurses in the country regardless of specialty. It is engaged in advocacy on behalf of all nurses and its membership is open to all. Its mission statement is leadership to shape the future of the nursing profession and healthcare. It was founded in 1896 and boasts of members in all of the states and United States territories such as Puerto Rico (Nursingworld.org., n.d.). Future Scope, Role, and Professional Obligations Paper.

• International Federation of Nurse Anesthetists (IFNA)

IFNA was founded by 11 countries but now has 11 member countries worldwide. It was started in 1989 and its mission is education of the nurse anesthetists to offer the best anesthesiology care for the best patient outcomes. It has as some of its objectives the promotion of networking and professional cooperation among nurse anesthetists across the world; and the promotion of continuous professional development in the specialty (IFNA, n.d.).Future Scope, Role, and Professional Obligations Paper.

Of these three organizations, the one the author is most likely to join is the American Association of Nurse Anesthetists (AANA). This is because its mission and goals fit in with the author’s worldview and philosophy of anesthesiology care. The author believes that the best strategy to anesthetic success is foreseeing complications and preventing the same. Its membership will therefore improve the author’s practice in that it will furnish the author with current research and other resources aimed at best practice in anesthesiology.Future Scope, Role, and Professional Obligations Paper.

An Evolving Issue Likely to Affect Practice in the Next Few Years

An evolving and controversial issue that is sure to affect the practice of the CRNA as an APRN in the future is the matter of full practice authority or FPA. Currently, nearly half of the states have legislation that allows for APRNS like CRNAs to practice independently. However, the other half still have either reduced or restricted practice that requires the APRNs in those states to practice under the supervision of a practicing physician with whom they must have a paid collaborative agreement. This state of affairs means that CRNAs in states without FPA will be limited in what they can do even though they are competent to autonomously do the same (AANP, 2018; Dillon & Gary, 2017; Duncan & Sheppard, 2015). This is in stark contrast to what the IOM recommended ten years ago in its The Future of Nursing: Leading Change, Advancing Health publication. Future Scope, Role, and Professional Obligations Paper.

Conclusion

The CRNA as an APRN role and specialty is one of the most fulfilling specialties that an APRN can pursue. It requires postgraduate education and training and provides the APRN with the best opportunity to perform critical care procedures and give anesthesia to patients undergoing surgical procedures and those in critical care. This is however only possible after certification and state licensure for practice, with the scope of practice being regulated by the various state boards of nursing. One of the professional organizations the CRNA specialist can join and benefit from is the American Association of Nurse Anesthetists or AANA. As one of the future thorny issues to free practice, FPA remains arguably the most controversial regulatory issue for the CRNA to date.

Education, Future Scope, Role, Accreditation, Professional Obligations, and Membership of Professional Organizations of the Advanced Practice Registered Cardiovascular Nurse Specialist

Education, Future Scope, Role, Accreditation, Professional Obligations, and Membership of Professional Organizations of the Advanced Practice Registered Cardiovascular Nurse Specialist

According to the APRN Consensus Model, there are four recognized advanced practice registered nursing or APRN roles namely clinical nurse specialist (CNS), certified nurse midwife (CNM), certified nurse practitioner (CNP), and certified registered nurse anesthetist or CRNA (Sabo et al., 2017). To become a specialist in any of these roles, the registered nurse requires to have at least a master’s postgraduate degree and training. Aside from the four roles, each APRN is expected to cater for a specific population focus that will benefit from their specialty.  But these roles are broad in a general sense of the word. Therefore, the APRN can actually study further to specialize even more in a sub-specialty. This is the case with the cardiovascular APRN nurse. This paper looks at this subspecialty of the cardiovascular nurse in terms of scope, future role, regulation, certification, accreditation, professional nursing organizations, and an evolving or controversial issue affecting their practice.Future Scope, Role, and Professional Obligations Paper.

The Scope and Future Role as Advanced Practice Registered Cardiovascular Nurse

The cardiovascular nurse is an advanced practice registered nurse (APRN) whose scope of practice encompasses the provision of comprehensive cardiovascular care to patients who have both acute and chronic cardiovascular illnesses across the lifespan. Nurse specialists in this subspecialty work alongside cardiologists to achieve this role. They are not only involved in the treatment of these various cardiovascular illnesses but are also involved in conducting cardiovascular tests such as electrocardiography, echocardiography, and stress exercises for the heart. The cardiovascular nurse specialist is also involved in educating the cardiac patient about prevention of cardiovascular conditions and illnesses. The most common primary specializations for cardiovascular nurse specialists are clinical nurse specialist (CNS) and certified nurse practitioner (CNP). It is worth noting that these two arepart of the four APRN roles in the Consensus Model referred to above (Graduate Nursing Education, 2020; Registered Nursing 2020; Sabo et al., 2017).Future Scope, Role, and Professional Obligations Paper.

Ten years ago, the Institute of Medicine (IOM) came up with a revolutionary report that addressed what the future of nursing would look like with concrete recommendations. The report was titled The Future of Nursing: Leading Change, Advancing Health (Hopper, 2016). The future role of the advanced practice cardiovascular nurse is considered in the light of this report. Amongst others, the report recommended that:Future Scope, Role, and Professional Obligations Paper.

• The present barriers to practice such as restricted and reduced practice in some of the states be removed for APRN nurses
• The number of nurses who hold a postgraduate doctorate degree be doubled by the year 2020 (this year)
• Nurses be empowered to lead change in advancing health in all nursing specialties (Hooper, 2016).Future Scope, Role, and Professional Obligations Paper.

In this context, the IOM suggested that the best and desirable entry level for APRNs such as cardiovascular nurses should be the doctorate level. This would ensure that the APRN is extensively educated and with enough practice to give them the ability to function as clinicians who are at par in healthcare service delivery with physicians. They would be able to assess, order complex investigations such as magnetic resonance imaging or MRIs, interpret the results of the investigations, diagnose, and treat. This is what the future role of the cardiovascular nurse will look like. On the reduction to practice barriers, the future role of the advanced practice cardiovascular nurse is expected to be that of a specialist with full practice authority and full prescriptive authority. This means that the cardiovascular nurse will be able to autonomously and without restrictions offer cardiovascular care as an able multidisciplinary team member. Full practice and full prescriptive authority will ensure that the cardiovascular nurse promptly handles cardiovascular emergencies and other taskswithout having to wait for supervision or authorization from a collaborating physician. This will save more lives and improve the health of communities benefitting from the services of the cardiovascular nurse.Future Scope, Role, and Professional Obligations Paper. Lastly but not least, empowering the cardiovascular nurse to lead change in advancing health will mean accepting more and more cardiovascular nurse specialists to work independently as APRNs with full practice and prescriptive authority at the primary health care level. This is even more urgent given that many marginalized communities at the rural grassroots level still lack specialized cardiovascular care since the Patient Protection and Affordable Care Act (ACA) 2010 increased the number of those covered by health insurance (Kominski et al., 2017).Future Scope, Role, and Professional Obligations Paper.

Regulation, Certification, and Accreditation of the Cardiovascular Nurse Specialist

For any cardiovascular nurse specialist to be recognized and given certification, they must have enrolled and acquired their postgraduate nursing education from accredited courses in the country. Accreditation of postgraduate courses for APRNs is done either regionally or nationally. An example of a regional accreditation body recognized by the US Department of Education is the Higher Learning Commission. The Northwest Commission on Colleges and Universities is another regional accreditation body. National accrediting agencies accredit institutions and courses across the country. An example of these bodies that offer both institutional and programmatic accreditation is the American Academy for Liberal Education (EDsmart, n.d.).

Regulatory framework for the practice of cardiovascular nurses as APRN specialists is in the hands of state boards of nursing for each state. These boards are governed by the existing legislation or Nursing Practice Acts that spell the scope of practice for all APRNs including cardiovascular nurses in the state. For instance, this means that in states that have full practice authority legislation such as Maryland and New Mexico the board will fully allow the cardiovascular nurse to practice autonomously without supervision by a physician of their education and training. Another cardiovascular nurse specialist with thesame training and experience but practicing in a reduced practice state such as Wisconsin and Ohio will have to practice under the supervision of a physician with whom they must have a collaborative agreement.Future Scope, Role, and Professional Obligations Paper.

Certification of the cardiovascular nurse is offered by several bodies after the passing of special certification examinations. The American Board of Cardiovascular Medicine (ABCM) offers certification for acute cardiology care, non-acute cardiology care, and catheterization laboratory nurses. The American Association of Heart Failure Nurses gives certification as a certified heart failure nurse or CHFN. The American Association of Critical Care Nurses (AACN) gives the Adult Cardiac Surgery (CSC) and the Adult Cardiac Medicine (CMC) certifications. Lastly, the American Nurses Credentialing Center (ANCC) gives board certification for Cardiac-Vascular Nursing or RN-BC (Graduate Nursing Education, 2020).

Three Professional Nursing Organizations

Professional nursing organizations are very important for not only APRNs but also all other nurses because they enable networking, facilitate continuous professional development in the form of conferences and publications, and engage in advocacy for the benefit of the members by providing a unified and collective voice. Three of the professional nursing organizations that the cardiovascular nurse specialist may join are (Graduate Nursing Education, 2020):Future Scope, Role, and Professional Obligations Paper.

1. The Society of Pediatric Cardiology Nurses (SPCN)

This professional organization for cardiac nurses was founded in 1985 and caters for the interests of nurse specialists for pediatric cardiovascular illnesses. Its mission is to expand nursing knowledge and expertise in the area of pediatric cardiovascular care and treatment.

1. Preventive Cardiovascular Nurses Association (PCNA)

The PCNA has as its mission to disseminate and share knowledge and expertise on the management and prevention of cardiovascular disease to cardiovascular nurse specialists.It was originally founded in 1992 in California under a different name which was later changed to the current one.

1. American Heart Association, Council on Cardiovascular Nursing

This professional nursing organization is instrumental in the professional development of cardiovascular nurses in terms of current research and evidence-based practice of cardiovascular disorders.Future Scope, Role, and Professional Obligations Paper.

Of these three organizations, the one the author is most likely to join is the Preventive Cardiovascular Nurses Association or PCNA. This is because its mission and goals of prevention of cardiovascular conditions fit in with the author’s worldview and philosophy of care. The author believes that the best strategy to cardiovascular health is primary prevention. Its membership will therefore improve the author’s practice in that it will furnish the author with current research and other resources aimed at prevention of cardiovascular diseases.Future Scope, Role, and Professional Obligations Paper.

An Evolving Issue Likely to Affect Practice in the Next Few Years

An evolving and controversial issue that is sure to affect the practice of the cardiovascular nurse as an APRN in the future is the matter of full practice authority or FPA. Currently, nearly half of the states have legislation that allows for APRNS like cardiovascular nurses to practice independently. However, the other half still have either reduced or restricted practice that requires the APRNs in those states to practice under the supervision of a practicing physician with whom they must have a paid collaborative agreement. This state of affairs means that cardiovascular nurses in states without FPA will be limited in what they can do even though they are competent to autonomously do the same (AANP, 2018; Dillon & Gary, 2017; Duncan & Sheppard, 2015). This is in stark contrast to what the IOM recommended ten years ago in its The Future of Nursing: Leading Change, Advancing Health publication. Future Scope, Role, and Professional Obligations Paper.

Conclusion

Cardiovascular nursing is one of the most fulfilling subspecialties that an APRN can pursue. It requires postgraduate education and training ad provides the APRN with the primary specialization of CNS and CNP the opportunity to treat and care for persons with cardiovascular diseases. This is however only possible after certification, with scope of practice being regulated by the various state boards of nursing. One of the professional organizations the cardiovascular nurse specialist can join and benefit from is the Preventive Cardiovascular Nurses Association or PCNA. As one of the future thorny issues to free practice, FPA remains arguably the most controversial regulatory issue for the cardiovascular nurse. Future Scope, Role, and Professional Obligations Paper.