Competencies in Advanced Nursing Practice, Research Paper Example

Nurse-Client Relationship Competency in Advanced Nursing Practice

A competency of choice in this field of study is theNurse-Client Relationship that came into the forms of patient direct care paradigm. The impact of nurse-client therapy practicing in a climate environment is a creation of atmosphere that can produce a relationship-rapport with client or a patient.The expectations of advanced practice nurse are the abilities to demonstrate the practice independently and interdependently, in order to provide a broad range of health care services, including health promotion, assessment, diagnosis, and management of designated population (s) and actual health care problems in a variety of settings. Practicing nurse dealing with the role of ambiguity and the role of boundaries fluids would demonstrate an ability to communicate effectively to the individuals, families, and or communities, which is critical to foster professional growth and leadership growth.

Most importantly, preparing a graduate nursing student in an advanced nursing program is to build on temporal, expertise, and knowledge on all aspects of health care delivery system. In doing so, advanced nurse practicing students would demonstrate an ability to analyze, synthesize, and utilize knowledge in writing and communicate orally effectively. Managing nursing students and health-related supporting professionals on all types of communication styles require an established understanding of the environmental implications that may contribute to the medical situations and demonstrate an ability to resolve issues at hand.  In which, it is an opportunity for advanced nursing practicing student to master knowledge of health care problems, and apply these knowledge and skills in extensive clinical practice, prescribe therapeutic regimens, and be accountable for these decisions (American Association of Colleges of Nursing, 1996).

It is important for Advanced nurses practice their competencies by demonstratingaccordly to the standards of nurse interventions strategies.

Wedding (2008) An informed consent of confidentiality and information on key people to be notified in case of escalation or self-inflicted in a crisis before begin the relationship in the primary/tertiary  settings. In addition, that at anytime the written agreement is breached by a client would receive negative consequences and the informed consent form will not obligated. As it may occur in practice. The goal is to eliminate the inappropriate behaviors and is often combined with positive reinforcement for appropriate behavior as necessary. This will protect both parties in collaboration. A graduate-level of knowledge with the agency and legal processes are required of Advance Nurse Practitioner as indicated in the American Association of Colleges of Nursing Task Force.

The mutual understanding of client’s strengths and weakness and specify addressing client’s needs with the formation of healing commitment.  This stance would demonstrate an empathy and  maintaining being supportive and provide empowerment in promoting behavioral change and teach client self-efficacy style toward to a client or a patient; Providing informative information to where else to seek help and who to see in case of crisis may occur; Use an appropriate sense-of-humor behavior and speak unbiased tone would enable this advanced nurse to acknowledge that the client or a patient will feel less tense to express his/her feelings, emotions, and concerns relating to health.The last quality, empathic understanding has been one of the most widely used tools of the counseling relationship regardless of theoretical orientation and has been shown to be a critical factor in positive therapeutic outcomes, however, most preferable theories are the multiple intelligence theory and nurse theory (American Association of College of Nursing, 1995).

Empathy can be demonstrated in many ways, including accurately reflecting the client’s meaning and affect, using a metaphor, analogy, or visual image or simply nodding one’s head or gently touching the client during the client’s deepest moments of pain. This type of transference between a nurse and a client is clearly ethical and legal.

However, the implications of resistance-transference and counter transference may impede developing a good relationship due to the preferences  cultural differences, and customs biases. The analysis of transference approach is the key to treatment of a nurse intervention. The person’s central task is to say everything that occurs to them, no matter how silly, vulgar, or irrelevant it might seem. A quality of resilience is placed when necessary. The task of the client is very difficult– try spending 10 minutes some time speaking into a tape recorder really saying everything that comes into the client’s mind. APN will probably be amazed and horrified. Not surprisingly, the client finds himself/herself in a tough situation, and RESISTS the task, concealing things that would be shameful or inappropriate (McAuley, 2003).

In oppose of, countertransference approach are the feelings that emerge toward the patient. According to some countertransference relates to inadequacies or problems inside the Advanced Nurse Practitioner and reflects the APN imposing his/her own needs and wants onto the APN. For instance,  APN might find herself/himself behaving in paternal ways toward a patient (they have “hooked” his/her rescuer fantasies) and might avoid confronting them or pressing them on issues (McAuley, 2003).

In addition,it is a duty of  advanced nurse student to apply the principals of cognitive-behavioral therapy theory and enhances human dignity, caring attitude, sensitivity to a client. This would give an opportunity for this client to explore his/her own meaning . The meaning tocreate new goals or draw up existing goals.

A knowledge of variety of research methods to access relevant data and scientific evidence to the question of concern; Apply knowledge of nursing interventions and assess the implications of situations that may impose practice code of conduct and code of ethics discretions; A knowledge in computer science and its applications for health related information (e.g., medical records, legal, informed consent signatures) and formulate treatment plans for an individual of a population of interest.

In the CNS education programs, such as the practice-focused outcomes for all master’s-prepared nurses. Master’s level nursing practice builds upon the practice competencies delineated in the Essentials of Baccalaureate Education for Professional Nursing Practice (American Association of Colleges of Nursing, 2008).This core curriculum is delineated by the accrediting body likethe National Organization of Nurse Practitioner Faculties (NONPF). All of the accrediting bodies have standards, guidelines, and criterions for graduate advanced nursing students to accomplish the minimum requirements for specialty in Advanced Nurse Practitioner.

According to the National Organization of Nurse Practitioner Faculties’ published  Curriculum Guidelines and Program Standards for Nurse Practitioner Education (1995) stated that in the guideline for clinical experience in training foradvanced nursing student  is to successfully complete500 clinical hours. And, this is the minimum number required for nurse practitioner to function in both primary and tertiary care settings. Due to the complexity of the development of needed skills and the specialty content, itmay require more clinical hours of patient care focus. Depending on the quality and experience of a student has possessed adequate clinical exposures in practice. (American Nurse Association, 1995).

References

American Association of Colleges of Nursing. The Essentials of Master’s Education for Advanced Practice Nursing.  ED435321, p. 50. Washington, D.C. Retrieved July 12, 2011 from: EBSCOhost ERIC database.

American Association of College of Nursing. (1995) Role Differentiation of the Nurse Practitioner and Clinical Nurse Specialist: Reaching toward Consensus. Proceeding of the Master’s Education Conference. December 1994. Washington DC: Author. Retrieved July 12, 2011 from: EBSCOhost Eric Database

American Nurse Association (1995) Scope and Standards of Advanced Nurse Practice. Washington DC: Author. Document in Preparation.

Corsini, R.J. & Wedding, D. (2008) Current Psychotherapies 4th ed: Behavior Therapy. Belmont, CA: Thomson Brooks/Cole

McAuley, M.J. (2003) Transference, Countertransference, and Mentoring: The Ghost in Process. British Journal of Guidance& Counseling, 31(1) pp. 11-23. Retrieved July 12, 2011 from: EBSCOhost Database.

National Organization of Nurse Practitioner Faculties (1995). Advanced Nursing Practice: Curriculum Guidelines and Programs Standards for Nurse Practitioner Education. Washington, DC: Author.