Analysis Of Advanced Registered Nurse

Analysis Of Advanced Registered Nurse

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Analysis Of Advanced Registered Nurse

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Analysis Of Advanced Registered Nurse

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Who is an Advanced Registered Nurse (ARN)?


Nursing is a big discipline where, for one to qualify as a nurse, one has to possess excellent competencies on the theories, approaches, values, and practicalities of health care. Nursing has therefore become one of the most prestigious disciplines because it gives everyone an opportunity to advance the career. In Australia, for instance, as one has the right education and meets other prerequisite qualifications, one can advance from the level of a Registered Nurse (RN) to an Advanced Registered Nurse (ARN). Serving as an ARN is a bit demanding because it comes with lots of duties, responsibilities, and challenges. However, it is what every other nurse aspires for because it is prestigious and regarded as the apex of nursing career. The purpose of this paper is to present a detailed and comprehensive analysis of ARN. It will later narrow down to a Certified Nurse Midwife (CNM).
Advanced Registered Nurse (ARN)?
ARN is a registered nurse who, as its name suggests, is a more advanced nurse that is allowed to perform the duties and responsibilities which were initially reserved for the physicians. For one to be an ARN, one has to have a Master’s Degree in Nursing. That kind of education is required because an ARN differs from the ordinary RNs who perform basic primary healthcare roles such as the assessment and monitoring of the patient’s condition (Melnyk, Gallagher?Ford, Long & Fineout?Overholt, 2014). In Australia, there are different kinds of ARNs depending on the area of specialization. These include the Certified Nurse Midwives, Nurse Practitioners, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists. Each of these nurses has expertise training on their respective areas of specialization (Yee, Boukus, Cross & Samuel, 2013). Meaning, for one to serve in any of these capacities, one must have the required education, experience, and competencies that can enable them to serve diligently and to the satisfaction of the public.
Roles of ARN
ARNs differ from the RNs because they perform different tasks. Unlike their RN counterparts, the ARNs are allowed to discharge more complex roles some of which were earlier reserved for the doctors alone. However, with their expertise training, knowledge, and experience, the ARNs can be relied upon to supplement the physicians (Kleinpell, 2013). Although some operate under the supervision of physicians, others discharge their roles autonomously, but in collaboration with the physicians. This means that, unlike the RNs, ARNs have a deeper understanding of clinical competencies such as complex decision-making (Yee, Boukus, Cross & Samuel, 2013). However, in terms of performance, the ARNs are obliged to execute the following roles:
First, the ARNs are responsible for the delivery of direct care to the patients.  Actually, this is the basic function of a nurse. During their training, the ARNs are equipped with the skills that they use in attending to individual patients who are brought under their care. Therefore, whenever they get an opportunity to do this, the ARNs are required to perform a wide range of activities including the assessment of the patient’s condition (Kleinpell, et al., 2014). The assessment process which is the most essential component of treating can be done by analyzing the medical history of the patient as well as the carrying out of a test to assess the vital signs such as temperature, pulse rate, blood pressure, and breathing rates. Once this is done, the ARN nurse then diagnoses the patient, before coming up with a treatment plan for the patient. Apart from offering such services, the ARN has a privilege of prescribing drugs to the patients. 
Secondly, the ARN has a responsibility to participate in the nursing administration process. The advanced training that the ARNs obtain not only prepares them to be directly involved in the caring of the patients. It also prepares them to serve as leaders in their respective healthcare organizations. Leadership is more challenging because it requires the ARNs to be in charge of other members of the nursing staff under them (Murphy, Staffileno & Foreman, 2017). Meaning, for this task to be effectively discharged, the ARN must possess basic competencies like effective interpersonal communication skills and must be ready to act as a role model whose actions can be emulated by the workers. At the same time, serving in a leadership position requires an ARN to be a team player who is always ready to collaborate and cooperate with everyone (Hain & Fleck, 2014). Further still, to succeed as a leader, the ARN must know how to apply the most appropriate leadership styles and strategies which suit the workers.
Last, but by no means the least, the ARN has a mandate to take part in the formulation and implementation of health and nursing policies in the country. Although most of the policies are made by the higher political authorities, they are always influenced by the involved professionals and other relevant stakeholders such as the nurses. This, therefore, implies that individual ARNs also have a role to play in the development of such policies (Begley, Elliott, Lalor, Coyne, Higgins & Comiskey, 2013). The first way through which ARNs contribute towards this course is by engaging in research and publication.  Besides, the ARN can participate in the advocacy process. Here, the ARNs can come together and use their association to petition the government and give suggestions regarding the new policies that the government needs to adopt as it strives to improve the welfare of the nurses and improve the quality of healthcare services offered to the people (Melnyk, Gallagher?Ford, Long & Fineout?Overholt, 2014). All the ARNs must take a challenge to voice their concern because each of them has a responsibility of advocating for change in the society.
Certified Nurse Midwives
Certified Nurse Midwifery (CNM) is, as already hinted, one of the ARN specialties. CMN is a special group of ARNs which possess training on nursing and midwifery. Meaning, they are equipped with the skills that can prepare them to serve as nurses and midwife. A nurse has already been defined as a practitioner who specializes in delivering primary care services to the patients. However, a midwife is a special nurse whose mandate is to deal with pregnant women, unborn, and newborn children (Beal, Batzli & Hoyt, 2015). Meaning, a midwife is responsible for the delivery of antenatal and neonatal care both to the mother and the child. However, for a CMN to effectively discharge these roles, the nurse must possess the right competencies that are required of him or her as a nurse and a midwife. That is the only way through which he or she can handle the mothers and their newborn children.
Duties and Responsibilities and Scope of Practice for the Certified Nurse Midwifery
The first role of the CNM is to provide care during the labor process and also to the newborn children. When mother give birth, it is important for them to receive specialized support from the experts. That is actually one f the activities that the CNMs are trained to do. These specialists also have skills on genecology. Meaning, they can assist the pregnant mothers during pregnancy, administer genecology test, and support them during labor pain and birth (Peterson, Phillips, Puffer, Bazemore & Petterson, 2013). This assistance is not limited to the mother, but extends to the newborn who is supposed to be given a specialized care at this point of time. The CNM is able to offer this kind of service because they are trained to do it. That is why all the pregnant women and new mothers should work closer with them and always be ready to seek for their services as much as they can.The second function of a CNM is to treatment for the Sexually Transmitted Diseases (STDs) that affect the parents and children. There are different kinds of STDs which have been affecting people. Some of the common ones include the syphilis, gonorrhea, and Acquired Immune Deficiency Syndrome (AIDS). The expectant mothers or (new) mothers are supposed to be given sexual education by the CNMs because most of them do not know how to manage these conditions (Cox, Schlegel, Payne, Teaf & Albers, 2013). Lack of sexual knowledge has made many parents to infect their children with HIV/AIDS because they unknowingly transmit it to their children during birth and breastfeeding. Such avoidable infections do occur because many mothers are ignorant since they have not received adequate sexual education. Nevertheless, the good news is that all these can be eradicated if the CNMs effectively discharge their educative roles by effectively informing the mothers on such issues. The CNMs can also do this by prescribing the appropriate STI medications to their patients.The third role of the CNM is to provide education on family planning.  Family planning is one of the major issues f public health concernFamily planning has become an issue of concern to many governments today. The skyrocketing population has been posing a heavy burden on the governments because. Apart from causing economic burden, the high population piles a huge pressure on the natural resources. Hence, to overcome all these challenges, the CNMs can be used to teach people on the dangers of having many children as well as the benefits of birth control (Weitz, Taylor, Desai, Upadhyay, Waldman, Battistelli & Drey, 2013). At the same time, the nurses have a mandate to teach the mothers on the best strategies to use in controlling birth. The nurses must do this because many women are not aware of the effectiveness of birth control alternatives like the use of coils, condoms, vasectomy, tubal ligation, withdrawal, and all the other forms of Intra Uterine Devices (IUDs).
Education, Skills, and Personal Attributes of the Certified Nurse Midwives
For one to serve as a CNM, one must have what it takes to do so. It takes two things to realize that-education and experience. To reach this level of ARN, one must have served and successfully completed the service as an Enrolled Nurse (EN) and Registered Nurse (RN). Hence, when it comes to education, a CNM must have a master’s degree (Beal, Batzli & Hoyt, 2015). This is the best level of education that, according to the standards, qualifies one into this lucrative and competitive position. With this kind of education, CNMs is expected to have a number of competencies which can make them to effectively discharge their roles.
Topping the list of these competencies is communication skills. Communication is one of the most valuable assets in nursing. A nurse who cannot communicate can virtually not treat anyone. Whenever a patient comes to a hospital, he or she is looking forward to having a direct communication or conversation with the nurse unless he is incapacitated and cannot do so. It is only through communication that the nurse can assess the patient and get to know about the problems that need to be addressed (McDonnell, Goodwin, Kennedy, Hawley, Gerrish & Smith, 2015). Meaning, without communication, the nurse might not achieve anything. In this regard, it should be incumbent upon the individual CMNs to ensure that they have excellent interpersonal communication skills. Meaning, they should be critical listeners who create time to listen to the patients, give them enough time to speak, and respect their opinion no matter how diverse they might be.The other competency that all the CMNs must have is critical thinking skills. Serving as a CNM is challenging because it requires the nurse to make very tough and complex decisions that might not be properly made if one lacks decision-making skills.
Therefore, to address all sorts of clinical problems that a nurse has, the nurse has no choice, but to be a critical thinker (Hamric, Hanson, Tracy & O’Grady, 2013). A nurse who has this competency can make rational decisions because he has to reason out before making a decision. Critical thinking goes hand in hand with ethical compliance because a nurse who is committed to making ethical decisions must create enough time to meditate over it. A nurse who possesses this competency can, therefore, not face a challenge in dealing with whatever kind of problem that needs to be addressed (Beck, LoGiudice & Gable, 2015). Critical thinking can be instrumental in nurturing the culture of collaboration, team play and leadership.

The creation of specialties like the ARN has made nursing has grown and become a fully-fledged discipline with its principles, strategies, ethics, theories, and scope of practice. Since its establishment, nursing has made tremendous contributions towards the delivery of quality, safe, and satisfactory healthcare services to the public. As a profession, nursing is manned by the nurses-professionals who have adequate training on what nursing entails. An ARN is, therefore, one of topmost levels in the nursing profession. ARN practitioners such as the CNM must have all it takes to effectively discharge their roles to the satisfaction of their patients. To help in serving the expectant women, new mothers, and the infants, the CNM must have the right educational and experiential qualifications as well as the fundamental competencies like critical thinking, communication, team play, and leadership.

Beal, M. W., Batzli, M. E., & Hoyt, A. (2015). Regulation of Certified Nurse?Midwife Scope of
Practice: Change in the Professional Practice Index, 2000 to 2015. Journal of Midwifery & Women’s Health, 60(5), 510-518.
Beck, C. T., LoGiudice, J., & Gable, R. K. (2015). A mixed?methods study of secondary
traumatic stress in certified nurse?midwives: shaken belief in the birth process. Journal of Midwifery & Women’s Health, 60(1), 16-23.
Begley, C., Elliott, N., Lalor, J., Coyne, I., Higgins, A., & Comiskey, C. M. (2013). Differences
between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study). Journal of advanced nursing, 69(6), 1323-1337.
Cox, K. J., Schlegel, R., Payne, P., Teaf, D., & Albers, L. (2013). Outcomes of Planned Home
Births Attended by Certified Nurse?Midwives in Southeastern Pennsylvania, 1983?2008. Journal of Midwifery & Women’s Health, 58(2), 145-149.
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare
redesign. OJIN: The Online Journal of Issues in Nursing, 19(2).
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2013). Advanced Practice
Nursing-E-Book: An Integrative Approach. Elsevier Health Sciences.
Kleinpell, R. M. (2013). Outcome assessment in advanced practice nursing. Springer Publishing
Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F., East, L., Fraser, D., … & Beauchesne, M.
(2014). Addressing issues impacting advanced nursing practice worldwide. Online journal of issues in nursing, 19(1).
McDonnell, A., Goodwin, E., Kennedy, F., Hawley, K., Gerrish, K., & Smith, C. (2015). An
evaluation of the implementation of Advanced Nurse Practitioner (ANP) roles in an acute hospital setting. Journal of advanced nursing, 71(4), 789-799.
Melnyk, B. M., Gallagher?Ford, L., Long, L. E., & Fineout?Overholt, E. (2014). The
establishment of evidence?based practice competencies for practicing registered nurses
and advanced practice nurses in real?world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence?Based Nursing, 11(1), 5-15.
Melnyk, B. M., Gallagher?Ford, L., Long, L. E., & Fineout?Overholt, E. (2014). The
establishment of evidence?based practice competencies for practicing registered nurses and advanced practice nurses in real?world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence?Based Nursing, 11(1), 5-15.
Murphy, M. P., Staffileno, B. A., & Foreman, M. D. (Eds.). (2017). Research for advanced
practice nurses: From evidence to practice. Springer Publishing Company.
Peterson, L. E., Phillips, R. L., Puffer, J. C., Bazemore, A., & Petterson, S. (2013). Most family
physicians work routinely with nurse practitioners, physician assistants, or certified nurse midwives. The Journal of the American Board of Family Medicine, 26(3), 244-245.
Weitz, T. A., Taylor, D., Desai, S., Upadhyay, U. D., Waldman, J., Battistelli, M. F., & Drey, E.

(2013). Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver. American journal of public health, 103(3), 454-461.

Yee, T., Boukus, E., Cross, D., & Samuel, D. (2013). Primary care workforce shortages: Nurse
practitioner scope-of-practice laws and payment policies. National Institute for Health Care Reform Research Brief, 13, 1-7.
Yee, T., Boukus, E., Cross, D., & Samuel, D. (2013). Primary care workforce shortages: Nurse
practitioner scope-of-practice laws and payment policies. National Institute for Health Care Reform Research Brief, 13, 1-7.

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