The Core Competencies of Health Care Providers
Table of Contents
An advanced practice registered nurse (APRN) is a term that covers clinical nurse experts, nurse practitioners, midwives, and anesthetists. They play a vital role in providing crucial health care to patients and the public in general. In addition to their health care provision, they offer education to the trainees as a way of boosting their competence at work. APRNs are involved in the preventive care of patients through the provision of advice on how to curb and elude non-communicable diseases. They also come up with the policy strategies on primary care improvement in a bid to maintain public health. The paper compares and contrasts the core competencies between health care providers, educator’s role, advocacy, and research in the field of nursing.
Comparison of Core Competencies
A primary care nurse practitioner (NP) offers care for people of various age groups in a variety of settings. While initially NPs were concerned with childcare, with advancing years and more courses to equip them with the necessary to handle care in a wider perspective, the scope of practice for NPs expanded into dealing with adults, the aged, women, and families. They attend to a wide population of patients in acute, long-term and even community care settings. There is not much difference for the nurse educators who also provide care in different health care settings to yet different age groups. Apart from passing knowledge to students in classroom setting, nurse educators also must take their students through various areas of specialty, as they have to deal with populations in different settings. Since nurse educators must have knowledge in all these areas of specialty, their practice in the classroom and the field can be said to help them maintain a wide scope of knowledge and skills.
Currently, the minimum academic level to practice as an NP in the United States is master’s degree or higher. Furthermore, an NP must have enrolled for and passed a certification program that is recognized nationally in order to practice as Advanced Registered Nurse Practitioner (ARNP). Contrary to the belief of many, NPs have practiced in urban and rural areas for decades and given assistance to millions of patients annually. In contrast, these obligations do not apply for nurse educators who may wish to give a break to the competency certification test. Moreover, the level of education required of a nurse educator is primarily determined by the policies of a college in question.
Theoretically, the practice by NPs largely follows theories and models in nursing that emphasize a partnership nature between practitioner and patient, caring virtues as well as holism in primary care settings. Theories of nursing outline five domains that form NPs practice and these include 5Cs – change, consistency, community, connection, and commitment (in no particular order). These domains help NPs to negotiate through the health care continuum to ensure quality primary care for their patients. Their application is also multifaceted, and it does not mean that one domain is applied at one moment and not another. The organization that has been in charge of providing leadership to promote the education of nurse practitioners is the National Organization of Nurse Practitioner Faculties (NONPF) (NONPF, 2012). In addition to the five domains examined for NPs, NONPF provides seven more domains, each of which has up to 75 competencies under it (NONPF, 2006). These domains deal with the management of health status of patients, the relationship between NPs and their patients, the need to be a coach and a teacher, the negotiation of care continuum, quality monitoring and reporting, professional practice, and cultural competence.
On the other hand, the organization in charge of promotion of education and leadership among nurse educators is the National League for Nursing (NLN, n.d.). In contrast to NONPF, NLN identifies eight areas of core competencies for nurse educators. These include the facilitation of learning and learner’s development as well as socialization, participation in curriculum design and implementation, and the evaluation of resultant outcomes. Furthermore, among these competencies is the adoption of evaluation and assessment strategies in learning environment, change management leadership role, educator role in continuous quality improvement, and the engagement in scholarship. In comparison with physicians, NPs provide health advice on exercise and well-being to their patients in a bid of completing a comprehensive health pack. In this case, their patients become more aware of their medication, change of behavior, keeping and booking appointments than those who are attended by physicians.
Finally, NPs specialize in their practice in a given specialty area and this makes them experts in practice. However, in the case of nurse educators, much is expected from them, varying from their area of practice as educators to the expertise in different specialty areas. In practice, it is not possible for nurse educators to gain expertise in both areas as nurse practitioners and educators. As such, “competency” has been adopted as the most appropriate word to define what is expected of them.
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Contrast in Core Competencies
The similarities and differences between primary care NPs and nurse educators in terms of implementation of the core competencies can be uncovered by examining different dimensions of practice. For this paper, this comparison will be made based on the following dimensions: educator role, research, and advocacy.
NPs are educators themselves since among their core competencies NPs must have coaching and teaching skills. They use these skills in care settings to teach their patients, families, community members, and even colleagues. The implementation of these core competencies depends on individual self-reflection, the level of socialization or interaction, technical competence, and interpersonal skills. Similarly, nurse educators’ key role revolves around the educator role. In this role, they are expected to use their core competencies based on the teaching and coaching model to reach out to their students in the classroom and different specialty settings. NLN core competencies revolve around the ability of nurse educators to offer person-centered education to their students. To achieve this, they must be actively involved in curriculum development and implementation as well as the evaluation of program outcomes.
An advanced nurse practitioner must have research skills to foster evidence-based practice. Evidence-based practice has been envisioned as the most appropriate measure to ensure that quality care is delivered at all times. Using their knowledge and expertise as clinicians, advanced nurse practitioners incorporate their research skills into practice, identify benchmarks, and evaluate their practice against these benchmarks. Moreover, advanced nurse practitioners also collaborate with colleagues in organizational projects meant to establish evidence-based practices for their facilities. Similarly, nurse educators also require research skills in their core competencies. As opposed to advanced NPs, who use this skill in clinical settings, nurse educators must ensure that they adopt evidence-based teaching and instructional practices and even in their performance evaluation.
The Code of Ethics outlines advocacy as an integral aspect of nursing practice along with it is ethics. A nurse practitioner is required to have advocacy skills to protect health, rights, and safety of patients. This advocacy has now even been extended to the efforts to create a conducive environment for all nurse practitioners such as advocating private prescription by NPs in the absence of physicians in order to improve care delivery. Training in advocacy is seen as an important complement to the nursing core competencies and it assures NPs of a better future and improved public health.
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Advocacy skills are also required for nurse educators. As opposed to nurse practitioners, who are advocates of patients, nurse educators are advocates of both students and patients. The NLN (n.d.) has what is known as the hallmark of excellence indicators, among which advocacy skills are required as one of the strategies to enable students to be patient advocates in the future. The nursing profession has evolved over time depending on the needs of society and the patients concerned. The ever-changing challenges have given rise to the emerging roles of APRNs as a way of increasing the scope of work.
NPs make up the largest part of the nursing fraternity, which means the legal aspect comes up. The obligation and responsibilities of nurses are to ensure the safety of the public, and the legal framework is to protect the practice responsibilities. One of the limiting roles of nurses is the fact that one has to be employed and to work with the community centers. The specialty of nurses is based on the level of education and their experience. As for the patients, they have evolved from uninsured and low-income individuals to insurable and middle-income earners.
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Conclusively, NPs shift to serve a large population. Those NPs working the high-end economy together with physicians have been aided by the uptake of insurance covers by a large population of their clients. The newest invention is one where the NPs contract the patients and meet at a convenient location thereby achieving personal satisfaction. In the future, the nursing practitioners will play the most crucial task towards health care than ever before. Thus, passing of the (DNP) Doctor Nurse Practice degree will increase leadership of health facilities at the community level and initiate change to transform the health sector.