Patricia Kelly-Heidenthal
0-7668-2508-6
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company

Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company

Objectives
 Upon completion of this chapter, the reader should be able to:
• Discuss the many nursing opportunities available upon graduation.
• Discuss advanced nursing practice and other nontraditional nursing roles.
• Identify various opportunities for certification.
• Review hospital and nonhospital based nursing practice.
• Identify directions for the future.
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 3

Nontraditional Emerging Opportunities
 For nurses who remain in traditional settings, opportunities exist to receive certification in specialized areas.
 Certification is the process by which a nongovernmental agency or association certifies that an individual licensed to practice a profession has met certain predetermined standards specified by that profession for practice.
4 Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company

Sample List of Certifying Organizations


ANCC
• American Nurses Association Credentialing Center
NAPNAP
• National Association of Pediatric Nurse Associates and
Practitioners


ACCN
• Association of Critical Care Nurses
AWONN
• Association of Women's Health Obstetrics and Neonatal
Nurse
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 5

Sample List of Certifying Organizations
 NANN
• National Association of Neonatal Nurses
 WOCN
• Wound, Ostomy, and Continence Nurses Society
 AANA
• American Association of Nurse Anesthetists
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 6

Possible Areas of Specialization
 Neonatal
 Pediatric
 Adult medical/surgical
 Women's health
 Obstetrics/gynecology
 Psychiatry
 Dermatology
 Case management
Chapter 27
 Renal
 Critical care
 Emergency room
 Clinical nurse specialist
 Nurse practitioner
 Nurse anesthetist
 Nurse midwife
 Nursing informatics
Copyright © 2003 Delmar Learning, a Thomson Learning company 7

Traveling Nurse
 Travels to various locations throughout the United
States
 Usually works in 3-month assignments on the same unit
 May receive a similar or higher salary compared to salaries of fellow employees
 Needs to be aware of differing nursing methodologies and licensure requirements from state to state
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 8

Traveling Nurse
 Requires a license for each state in which he or she will practice
 Should ensure that contract says exactly what the assignment will be regarding expectations of the institution and agency
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 9

Representative for Pharmaceutical
Company, Home Care, or Nursing Agency
 Affords the nurse a perspective on corporate America and the workings of the business world
 Often involves salary enhancements or perks
 Allows for a certain level of independence
 May present difficulties in meeting sales quotas, providing for customers, or surviving the ups and downs of the business world
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 10

Case Manager
 This new delivery of care method includes providing and coordinating care across the continuum of prevention, wellness, acute care, rehabilitation, longterm, hospice, and respite care.
 The nurse case manager should have at least a baccalaureate degree and expert clinical skills; should possess knowledge of the health care system, health care finances, and legal issues; and should be an effective communicator.
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 11

Nurse Entrepreneur
 Many nurses are becoming entrepreneurs in a variety of consultative, educational, and technical areas.
 Advantages:
• Independence
• Job satisfaction
• Flexibility
• Choice
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 12

Nurse Entrepreneur
 Disadvantages:
• Competition
• Volatility
• Lack of provided benefits
• Must learn to develop and follow a business plan
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 13

Advanced Practice/Expanded Role
Emerging Opportunities


Advanced practice nursing builds on the foundation of professional nursing practice and responds to the developing health care needs of the United States.
In advanced practice nursing, the nurse may:
• Assess patients, synthesize and analyze data, and understand and apply nursing principles at an advanced level
• Provide expert guidance and teaching
• Work effectively with patients, families, and other members of the health care team
• Manage patient's physical and psychosocial health-illness status
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 14

Advanced Practice/Expanded Role
Emerging Opportunities
• Use research skills
• Analyze multiple sources of data, identify alternative possibilities as to the nature of a health care problem, and select appropriate treatment
• Make independent decisions in solving complex patient care problems
• Perform acts of diagnosis and prescribe therapeutic measures consistent with the area of practice
• Recognize limits of knowledge and experience, plan for situations beyond expertise, and consult with or refer patients to other health care providers as appropriate
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 15

Advanced Practice Nursing: Types of
Expanded Roles
 Wound, ostomy, continence nurse specialist
• Clinical expert in managing patients with ostomies, alterations in skin integrity, and wounds
 Flight nurse
• Provides care to infants, children, and adult patients while performing a variety of therapeutic interventions requiring independent decisions; also provides education to outlying communities and serves as a volunteer in emergency situations
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 16

Advanced Practice Nursing: Types of
Expanded Roles
 Nurse anesthetist: certified registered nurse anesthetist
(CRNA)
• Takes care of the patient’s anesthesia needs before, during, and after surgery and other procedures, either alone or in conjunction with other health care professionals
 Certified nurse midwife (CNM)
• Delivers newborns; also provides health education, including teaching of self-care skills and preparation for childbirth and childrearing
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 17

Advanced Practice Nursing: Types of
Expanded Roles
 Clinical nurse specialist (CNS)
• A registered nurse with an advanced nursing degree, master’s degree, or doctorate who is an expert in a specialized area of clinical practice
 Nurse practitioner (NP)
• An advanced practice nurse who has education beyond the bachelor’s degree in a clinical specialty area strongly focused on primary care, though some subspecialties are hospital-based
 Clinical nurse specialist/nurse practitioner (CNS/NP)
• Combines qualities of both specialties
Chapter 27 Copyright © 2003 Delmar Learning, a Thomson Learning company 18