NR 510 APN PROFESSIONAL DEVELOPMENT PLAN PAPER
Every Advanced Practice Registered Nurse (APRN) should develop a personal development plan (PDP). A PDP includes a written evaluation of the regulations and requirements needed to obtain licensure and practice in the APRNs designated geographical area. The PDP should also include a personal action plan that reflects the results of one's self-assessment, including one's strengths, weaknesses, goals, and objectives. In order to develop a PDP, the APRN should be aware of and understand the state in which they plan to practice educational, regulatory, and licensure requirements. This paper aims to describe the APRNs scope of practice in the state of Florida, a personal assessment using Benner’s self-assessment tool, tactics for marketing and networking, a Curriculum Vitae, and a summary of the information acquired for the PDP.
APN Scope of Practice
Every state decides the guidelines or requirements for licensure, accreditation, certification, and education, also known as LACE, by which an APRN must abide by to practice in that state. Unfortunately, not all states are equal when it comes to the requirements for LACE and how much autonomy the APRN is allowed. In Florida, the Nurse Practitioner (NP) applicant must have a valid RN license, a master's degree or a certificate in a nurse specialty area from a post master's program, have completed at least 500 clinical hours, and have a national advanced practice certification from an accepted nursing specialty board (FLBON, 2017).
Per the American Association of Nurse Practitioners (AANP) (2017), nursing regulations and practice laws are set by each state. There are three levels at which an NP can practice: Full practice, reduced practice, and restricted practice (AANP, 2017). Full practice means the NP works under the authority of the state board of nursing (AANP, 2017). An NP who works in a state that allows full practice can evaluate and assess patients, diagnose, set up a treatment plan and manage the treatment plan, order diagnostic testing and interpret diagnostic results, and prescribe medications (AANP, 2017). Full practice for NPs is the scope recommended by the National Council of State Boards of Nursing and by the Institute of Medicine (AANP, 2017). Reduced practice means the state reduces the NPs ability to practice by at least one element (AANP, 2017). In reduced practice states, NPs must have a collaborative agreement with a healthcare provider before they can practice (AANP, 2017). Restricted practice means the state restricts the NP in at least one element of practice and it requires the delegation, supervision, and/or team management by a healthcare provider (most often a physician) before the NP can practice (AANP, 2017).
Florida is a restricted practice state. Per Florida’s administrative code, Rule 64B9-4.010(1), an ARNP “shall only perform medical acts of diagnosis, treatment, and operation pursuant to a protocol between the ARNP and a Florida-licensed medical doctor, osteopathic physician, or dentist” (FLBON, 2016, para. 1). The protocol delineates the professional agreement between the physician and the ARNP. Protocols must include the ARNPs information, the physician’s information, the practice’s information, a description of the ARNPs duties such as procedures the NP can perform, conditions for which the ARNP is allowed to manage and treat, medications the ARNP may prescribe, and situations in which the NP must contact the physician (FLBON, 2016). Currently, NPs in Florida are also restricted from signing a Baker Act, signing a death certificate, certifying DNR orders, and are not recognized by Medicare and Medicaid as primary care providers (FLBON, 2016). In March 2017, bill HB 7011 was presented during the March legislative session; this bill recommended independent practice for ARNPs (FLANP, 2017). As of April 2017, the bill is in the House, specifically being evaluated by the Health and Human Services Committee (The Florida Senate, 2017).
One exciting landmark for NPs in Florida came in April of 2016; bill HB 423 passed, which allows NPs and PAs to prescribe schedule I, schedule II, and schedule III controlled substances (FLBON, 2016). As of January 2017, NPs were allowed to apply for a DEA license. However, there were some stipulations put in place with the passing of this bill. NPs must have an updated protocol filed with the Florida Board of Nursing (FLBON) stating the NP has the authority to prescribe controlled medication (FLANP, 2017). NPs must complete a minimum of three continuing education unit (CEU) hours relating to the safe and effective prescribing of controlled substances (FLBON, 2016). The NP must distinguish on their practitioner profile that they prescribe controlled medications. If the NP prescribes a schedule II medication, they are restricted to prescribing for a maximum of seven days (FLBON, 2016). Lastly, unless the NP is a certified psychiatric nurse, NPs cannot prescribe psychotropic medications to anyone under the age of 18 (FLBON, 2016).
Personal Assessment
Completing a personal assessment tool is beneficial for anyone; they can help determine one’s strengths, weaknesses, goals, and objectives. For NPs, personal assessment tools also allow them to explore their interests, discover passions, and to determine which areas of practice would suit them best. To care for others, one must have a true understanding of themselves, from what they want in life to what their strengths and weaknesses are.
Knowing one's strengths is the first step to having a true understanding of who they are. The strengths this author possesses are good communication skills, good listening skills, determination, and patience. These strengths, especially communication and listening, are important to anyone wanting to work in the healthcare industry. Effective communication and listening skills are vital to ensuring one accurately assesses, diagnoses, and treats the patient. Aside from diagnosing and treating the patient, patients want to feel as if their concerns have really been heard. How a patient perceives the provider will influence the message they receive and ultimately their care. If the patient feels the provider does not listen, cuts them off, or is too hasty in their diagnosis, it is likely the patient will not fully comply with the treatment options, lifestyle changes, and/or follow-up appointments ordered by the provider.
Just as everyone has their strengths, everyone also has weaknesses. The good thing about weakness is that it can be turned into a strength. If one is aware they are weak in certain areas, one can work on improving in these areas until they are no longer weaknesses. The weaknesses this author deals with are the fear of being an advanced beginner and time management skills. According to Benner’s Novice to Expert Model, the advanced beginner is one who has some clinical knowledge but they still require support and assistance, such as a mentor/preceptor who can help set priorities and give constructive feedback (Davis & Maisano, 2016). Luckily, time builds knowledge and confidence; the new NP should keep in mind that over time they will navigate through all of Benner’s stages. Time management skills are essential if one wants to provide quality care. New NPs often feel they must be the one to complete all tasks, which makes time management even more difficult. The new NP needs to learn that delegating certain tasks is actually beneficial to their patients because it allows the NP to spend more time with them.