Advanced Nursing Education (page 3)
GRADUATE EDUCATION (master's and doctoral degrees) enables nurses to assume advanced roles in education, administration, research, and clinical practice. Advanced clinical practice nurses are nurse practitioners, clinical nurse specialists, nurse midwives, and nurse anesthetists. Nurses with graduate education bring new ideas and insights to nursing and the entire healthcare system, and they often influence the political system to effect change. Some of these roles developed because of change. Advanced practice nurses first evolved because of a shortage of physicians, then proliferated in response to managed care. Opportunities for nurses to redefine the role and practice of nursing continue to arise in these times when people demand change.
Master's Level Nursing Education
The number of master's level programs for advanced practice nursing increased dramatically in the 1990s and early twenty-first century. Most of the increase was in nurse practitioner programs in response to the demand for cost-effective care. However, schools continued to offer graduate degrees in nursing administration and education. Regardless of the role offered, the American Association of Colleges of Nursing (AACN) recommends that all master's level curricula share the same core content:
- critical thinking and clinical judgment
- primary healthcare, health promotion, patient education, self-care, rehabilitation, and alternative healthcare
- practice in multiple settings, including nontraditional settings (prisons, homeless shelters)
- outcome measures, quality indicators, case management, research methods, healthcare policy and economics, financial management, legislative advocacy, and management of data and technology
Master's curricula vary according to role and specialty; however, core content tends to be consistent in each program. Recommendations are that all master's programs have a core foundation curriculum that addresses theoretical foundations of nursing practice; research; policy, organization, and financing of healthcare; ethics; professional role development; human diversity and social issues; and health promotion and disease prevention. As with undergraduate programs, the content may be integrated into multiple courses or exist in stand-alone courses as in the following course examples.
Issues in Advanced Nursing
This course provides students with the opportunity to analyze contemporary issues and trends as they relate to advanced nursing, including professional role development, legal issues, healthcare policy, cultural diversity, and alternative healthcare practices.
This course explores ethical principles in U.S. healthcare and nursing. It utilizes the American Nurses Association's Code of Ethics for Nurses as a framework and familiarizes students in the healthcare decision making involving ethical principles.
Nursing Research I & II
Research I & II present the concepts and process of research, including problem formulation, rights of human subjects, research design, sampling, instrument evaluation, and data collection and analysis strategies. The courses provide students with the opportunity to analyze and critique various quantitative and qualitative nursing research studies, including their implications for utilization, and they emphasize the integration of theoretical and methodological elements in the development of research proposals. Finally, the courses examine research utilization, evidence-based practice, and the application of statistics.
While most advanced practice nurses now hold master's degrees, future advanced practice nurses and nurse administrators will most likely need to obtain a doctoral degree. The new requirement for these roles will be the Doctor of Nursing Practice, while the standard for the nurse educator will remain either master's level or doctoral level (PhD), depending on the nurse's educational role.
From AD to Geriatric NP, by Kathryn Ericksen
Becoming a geriatric nurse evolved over many years in my career as an RN. I first graduated 16 years ago with an associate's degree in nursing. I then ventured to hospital care floor nursing. It proved to be a great challenge with many rewards. The same story that you hear now applied back then as well, "short-staffed, overworked, underpaid." This is when I discovered that being a nurse came from my heart and soul. I wasn't in it for the money; I was in it for the love of it. The satisfaction I felt from helping others and witnessing most of them feeling better and going home was ultimately rewarding.
From hospital nursing I decided to slow the pace a bit and work at a nursing home. Well, the pace wasn't any slower, but the reward was even bigger for me. Still overworked, underpaid, and short-staffed, I was in my element. I had finally landed where I knew I wanted to grow into the role of a geriatric nurse. The passion of working with the geriatric population developed after having worked so closely with them. It helped me to develop emotionally and spiritually as well as clinically. Every day I left the nursing home with a better sense of being. I had developed true heartfelt warmth for the residents.
The residents in the nursing home opened my eyes to a whole new way of thinking about life. It is difficult to put into words, but the epiphany is profound. While working in the nursing home, I realized that most of the residents were not going back to their own homes. This was it, their last residence before they died. So, I tried even harder to make their stays meaningful and dignified. The geriatric patients also offered me so much in return—including their wisdom, strength, spirit, and generosity in sharing of life events.
The elderly population is growing exponentially. With this, I've also learned that geriatric patients are challenging in many ways regarding the chronicity and complexities of their diseases. There are many differences between adults and older adults with the same disease. Treatment and management proves to be much more complex and fragile. The physiological changes, their coexisting comorbidities, and multiple medications place them at a higher risk for complications. As a result of this realization, I felt being an RN on the floor was no longer enough for me. I wanted to contribute more to helping elders in their final weeks to years of life while delivering a high quality of care.
So, with the challenge of deciding to learn more about clinical decision making, holistic care, and prevention strategies (with the best interest of the geriatric patient in mind), I went back to school and succeeded in obtaining my bachelor's degree and have progressed to the master's GNP program. I will graduate with my master's in May and am looking forward to working with the geriatric population in a different capacity but with the same heart and soul.
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