Rural communities throughout the US lack health care access. While 20% of Americans, equivalent to almost 50 million people, live in rural communities, only 9% of physicians practice there.
Healthcare workforce shortages in rural areas have persisted for many years. These shortages impact patient care access and increase costs, leading to decreased quality of care. Advanced nursing practices are one of the solutions to these issues.
What are advanced nursing practices?
Advanced practice nursing (APN) is an umbrella term for various nursing types and encompasses nurses acting in advanced and diverse roles. The conception of nurse practitioners (NPs), later called advanced practice nurses (APNs), goes back to the ’60s.
Today, there are different advanced nursing practices, including nurse practitioners, clinical nurse specialists, nurse anesthetists, and midwives. In the last two decades, advanced practice nurses have become an established group in the USA, Canada, Australia, Holland, and Great Britain.
Advanced nursing practices need additional training and education. This typically involves earning a master’s degree in nursing. Nurse practitioners, certified nursing midwives, and clinical nurse specialists must also obtain certification from a reputable certification board in their specialty areas.
APNs boost the competency to diagnose, assess, and treat normal or acute health situations and problems and give follow-up treatment and care for chronic conditions. Moreover, they can look at a patient’s history, identify and evaluate their need for healthcare, order tests, prescribe medications (rights vary from place to place), refer patients for further care, and discharge and admit patients from hospitals.
Types of advanced practice nurses
There are four main types of advanced practice nurses. These are nurse practitioners (NP), Clinical Nurse Specialists (CNS), Clinical Nurse Midwives (CNM), and Certified Registered Nurse Anesthetists (CRNA). These specializations have varying job duties, but the description generally includes soft and technical skills, which Baylor University’s nursing courses aim to equip students. The technical skills include certifications, education, and the tools used for treatment and diagnosis. On the other hand, soft skills include critical thinking, clear communication, and excellent decision-making.
Advanced practice nurse requires several years of studying regardless of the type. An advanced degree program such as a Master of Science or Doctor of Nursing Practice is required. After the competition for the degree, one goes for a certification exam in their specialization and then acquires the license requirements in a state before becoming an APN.
1. Nurse practitioners
The role of advanced practice nurses can vary depending on their certification. There are several types of advanced practice nurses:
- Neonatal nurse practitioner
- Pediatric nurse practitioner
- Family nurse practitioner
- Emergency nurse practitioner
- Adult-gerontology nurse practitioner
- Psychiatric-mental health nurse practitioner
2. Certified nurse midwives
Certified nurse midwives enhance the quality and access to women’s healthcare during pregnancy by educating them on family planning and nutrition. Their responsibilities include checkups, prenatal care, and giving consent during delivery and labor. They also provide healthcare and support throughout all the stages of pregnancy.
3. Clinical nurse specialist
Clinical nurse specialists have versatile skills, including treating patients and processing improvements. Also, like any other APNs, they diagnose and treat patients. These specialists often utilize analysis, consultation, and training skills. They commonly indirect care by participating in research and enhancing cost reduction and customer satisfaction in hospital stays and treatments.
4. Certified registered nurse anesthetists
These are some of the primary anesthesia providers in the US, especially in rural areas. They specialize in providing anesthesia to patients undergoing surgery or trauma. In these, they create an anesthesia plan for each patient.
How can these duties in advanced nursing practices address healthcare workforce shortages?
Advanced nursing practices are one of the solutions to address the healthcare workforce shortage. Below are some ways they can address deficiencies, especially in rural areas.
-
Expanded scope of practice
Advanced nursing practices allow nurses to expand their scope of practice and take on added responsibilities. APNs treat and diagnose illnesses, manage chronic conditions, advise the public on health matters, and engage in continuous education to stay ahead of any development in the medical industry. By expanding their scope of practice, these nurses can provide an array of services to patients. They can fill roles and take on responsibilities that would have necessitated an extra workforce.
-
Increased access to care
Advanced nursing practices can give increased access to care for patients. APNs can work in different settings, including clinics, hospitals, and community centers. They can also provide services to underserved communities through incentives to bring healthcare to remote communities. Consequently, they help improve the outcomes of patients and lower health disparities.
Some states allow nurses to have full practice authority. This means they can see patients prescribe medications and order tests without being supervised by a physician. Nurse practitioners tend to work in underserved areas in clinics, hospitals, and private practice. They provide healthcare at a more affordable rate than physicians, making it more appealing for those in rural areas to go for treatment. As such, they solve the shortage of e-services and providers in rural shortage areas.
-
Telemedicine
APNs are well-versed in the technological advancements in the medical field. They can easily utilize telemedicine to provide medical services to those in rural communities. This technology offers an upside since it does not require the nurses and patients to interact physically. Also, it allows the nurses to serve many patients. This, plus the added advantage that patients do not have to find transport to seek healthcare, makes the technology ideal for bridging the gap in healthcare provision in underserved areas.
-
Improving health literacy
Advanced nurse practitioners have a role in sensitizing underserved communities to different health aspects. Improving health literacy has a positive part on the rural population.
Better literacy levels assist patients in understanding how to navigate the system, from appointments to getting reimbursements from insurers. It can also help patients in complying with prescriptions and medical advice.
Enhancing rural healthcare
The stakes are high in rural communities. They suffer from hospital closures, shortage of providers, low incomes, and other barriers to healthcare. The difference in health outcomes between urban and rural areas is a big reminder of the inequities underserved communities face. Leaders in the sector must improve healthcare in these areas, and nurses should be at the forefront of service delivery.
