Advanced Practice Nursing: Roles, Responsibilities, and CNM Focus

This essay provides a detailed analysis of the Advanced Registered Nurse (ARN), with a specific focus on the Certified Nurse Midwife (CNM). It begins by defining the role of an ARN, highlighting the advanced education and responsibilities that distinguish them from Registered Nurses (RNs). The essay outlines the various roles of ARNs, including direct patient care, participation in nursing administration, and involvement in health policy formulation. It then delves into the specifics of CNMs, defining their unique expertise in nursing and midwifery, particularly in providing care during labor, treating STDs, and educating on family planning. The necessary education, skills, and personal attributes of CNMs, such as communication and critical thinking, are also discussed. This document is available on Desklib, a platform offering a range of study tools and resources for students.

Running head: ADVANCED PRACTICE NURSE 1
Advanced Practice Nurse
Name
Institution

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Advanced Practice Nurse
Introduction
Nursing is a big discipline where, for one to qualify as a nurse, one has to possess
excellent competencies on the theories, approaches, values, and practicalities of health care.
Nursing has therefore become one of the most prestigious disciplines because it gives everyone
an opportunity to advance the career. In Australia, for instance, as one has the right education
and meets other prerequisite qualifications, one can advance from the level of a Registered Nurse
(RN) to an Advanced Registered Nurse (ARN). Serving as an ARN is a bit demanding because it
comes with lots of duties, responsibilities, and challenges. However, it is what every other nurse
aspires for because it is prestigious and regarded as the apex of nursing career. The purpose of
this paper is to present a detailed and comprehensive analysis of ARN. It will later narrow down
to a Certified Nurse Midwife (CNM).
Who is an Advanced Registered Nurse (ARN)?
ARN is a registered nurse who, as its name suggests, is a more advanced nurse that is
allowed to perform the duties and responsibilities which were initially reserved for the
physicians. For one to be an ARN, one has to have a Master’s Degree in Nursing. That kind of
education is required because an ARN differs from the ordinary RNs who perform basic primary
healthcare roles such as the assessment and monitoring of the patient’s condition (Melnyk,
Gallagher‐Ford, Long & Fineout‐Overholt, 2014). In Australia, there are different kinds of ARNs
depending on the area of specialization. These include the Certified Nurse Midwives, Nurse
Practitioners, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists. Each of
these nurses has expertise training on their respective areas of specialization (Yee, Boukus, Cross

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& Samuel, 2013). Meaning, for one to serve in any of these capacities, one must have the
required education, experience, and competencies that can enable them to serve diligently and to
the satisfaction of the public.
Roles of ARN
ARNs differ from the RNs because they perform different tasks. Unlike their RN
counterparts, the ARNs are allowed to discharge more complex roles some of which were earlier
reserved for the doctors alone. However, with their expertise training, knowledge, and
experience, the ARNs can be relied upon to supplement the physicians (Kleinpell, 2013).
Although some operate under the supervision of physicians, others discharge their roles
autonomously, but in collaboration with the physicians. This means that, unlike the RNs, ARNs
have a deeper understanding of clinical competencies such as complex decision-making (Yee,
Boukus, Cross & Samuel, 2013). However, in terms of performance, the ARNs are obliged to
execute the following roles:
First, the ARNs are responsible for the delivery of direct care to the patients. Actually,
this is the basic function of a nurse. During their training, the ARNs are equipped with the skills
that they use in attending to individual patients who are brought under their care. Therefore,
whenever they get an opportunity to do this, the ARNs are required to perform a wide range of
activities including the assessment of the patient’s condition (Kleinpell, et al., 2014). The
assessment process which is the most essential component of treating can be done by analyzing
the medical history of the patient as well as the carrying out of a test to assess the vital signs such
as temperature, pulse rate, blood pressure, and breathing rates. Once this is done, the ARN nurse

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then diagnoses the patient, before coming up with a treatment plan for the patient. Apart from
offering such services, the ARN has a privilege of prescribing drugs to the patients.
Secondly, the ARN has a responsibility to participate in the nursing administration
process. The advanced training that the ARNs obtain not only prepares them to be directly
involved in the caring of the patients. It also prepares them to serve as leaders in their respective
healthcare organizations. Leadership is more challenging because it requires the ARNs to be in
charge of other members of the nursing staff under them (Murphy, Staffileno & Foreman, 2017).
Meaning, for this task to be effectively discharged, the ARN must possess basic competencies
like effective interpersonal communication skills and must be ready to act as a role model whose
actions can be emulated by the workers. At the same time, serving in a leadership position
requires an ARN to be a team player who is always ready to collaborate and cooperate with
everyone (Hain & Fleck, 2014). Further still, to succeed as a leader, the ARN must know how to
apply the most appropriate leadership styles and strategies which suit the workers.
Last, but by no means the least, the ARN has a mandate to take part in the formulation
and implementation of health and nursing policies in the country. Although most of the policies
are made by the higher political authorities, they are always influenced by the involved
professionals and other relevant stakeholders such as the nurses. This, therefore, implies that
individual ARNs also have a role to play in the development of such policies (Begley, Elliott,
Lalor, Coyne, Higgins & Comiskey, 2013). The first way through which ARNs contribute
towards this course is by engaging in research and publication. Besides, the ARN can participate
in the advocacy process. Here, the ARNs can come together and use their association to petition
the government and give suggestions regarding the new policies that the government needs to
adopt as it strives to improve the welfare of the nurses and improve the quality of healthcare

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services offered to the people (Melnyk, Gallagher‐Ford, Long & Fineout‐Overholt, 2014). All
the ARNs must take a challenge to voice their concern because each of them has a responsibility
of advocating for change in the society.
Certified Nurse Midwives
Certified Nurse Midwifery (CNM) is, as already hinted, one of the ARN specialties.
CMN is a special group of ARNs which possess training on nursing and midwifery. Meaning,
they are equipped with the skills that can prepare them to serve as nurses and midwife. A nurse
has already been defined as a practitioner who specializes in delivering primary care services to
the patients. However, a midwife is a special nurse whose mandate is to deal with pregnant
women, unborn, and newborn children (Beal, Batzli & Hoyt, 2015). Meaning, a midwife is
responsible for the delivery of antenatal and neonatal care both to the mother and the child.
However, for a CMN to effectively discharge these roles, the nurse must possess the right
competencies that are required of him or her as a nurse and a midwife. That is the only way
through which he or she can handle the mothers and their newborn children.
Duties and Responsibilities and Scope of Practice for the Certified Nurse Midwifery
The first role of the CNM is to provide care during the labor process and also to the
newborn children. When mother give birth, it is important for them to receive specialized support
from the experts. That is actually one f the activities that the CNMs are trained to do. These
specialists also have skills on genecology. Meaning, they can assist the pregnant mothers during
pregnancy, administer genecology test, and support them during labor pain and birth (Peterson,
Phillips, Puffer, Bazemore & Petterson, 2013). This assistance is not limited to the mother, but

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extends to the newborn who is supposed to be given a specialized care at this point of time. The
CNM is able to offer this kind of service because they are trained to do it. That is why all the
pregnant women and new mothers should work closer with them and always be ready to seek for
their services as much as they can.
The second function of a CNM is to treatment for the Sexually Transmitted Diseases
(STDs) that affect the parents and children. There are different kinds of STDs which have been
affecting people. Some of the common ones include the syphilis, gonorrhea, and Acquired
Immune Deficiency Syndrome (AIDS). The expectant mothers or (new) mothers are supposed to
be given sexual education by the CNMs because most of them do not know how to manage these
conditions (Cox, Schlegel, Payne, Teaf & Albers, 2013). Lack of sexual knowledge has made
many parents to infect their children with HIV/AIDS because they unknowingly transmit it to
their children during birth and breastfeeding. Such avoidable infections do occur because many
mothers are ignorant since they have not received adequate sexual education. Nevertheless, the
good news is that all these can be eradicated if the CNMs effectively discharge their educative
roles by effectively informing the mothers on such issues. The CNMs can also do this by
prescribing the appropriate STI medications to their patients.
The third role of the CNM is to provide education on family planning. Family planning
is one of the major issues f public health concern. Family planning has become an issue of
concern to many governments today. The skyrocketing population has been posing a heavy
burden on the governments because. Apart from causing economic burden, the high population
piles a huge pressure on the natural resources. Hence, to overcome all these challenges, the
CNMs can be used to teach people on the dangers of having many children as well as the

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benefits of birth control (Weitz, Taylor, Desai, Upadhyay, Waldman, Battistelli & Drey, 2013).
At the same time, the nurses have a mandate to teach the mothers on the best strategies to use in
controlling birth. The nurses must do this because many women are not aware of the
effectiveness of birth control alternatives like the use of coils, condoms, vasectomy, tubal
ligation, withdrawal, and all the other forms of Intra Uterine Devices (IUDs).
Education, Skills, and Personal Attributes of the Certified Nurse Midwives
For one to serve as a CNM, one must have what it takes to do so. It takes two things to
realize that-education and experience. To reach this level of ARN, one must have served and
successfully completed the service as an Enrolled Nurse (EN) and Registered Nurse (RN).
Hence, when it comes to education, a CNM must have a master’s degree (Beal, Batzli & Hoyt,
2015). This is the best level of education that, according to the standards, qualifies one into this
lucrative and competitive position. With this kind of education, CNMs is expected to have a
number of competencies which can make them to effectively discharge their roles.
Topping the list of these competencies is communication skills. Communication is one of
the most valuable assets in nursing. A nurse who cannot communicate can virtually not treat
anyone. Whenever a patient comes to a hospital, he or she is looking forward to having a direct
communication or conversation with the nurse unless he is incapacitated and cannot do so. It is
only through communication that the nurse can assess the patient and get to know about the
problems that need to be addressed (McDonnell, Goodwin, Kennedy, Hawley, Gerrish & Smith,
2015). Meaning, without communication, the nurse might not achieve anything. In this regard, it
should be incumbent upon the individual CMNs to ensure that they have excellent interpersonal
communication skills. Meaning, they should be critical listeners who create time to listen to the

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patients, give them enough time to speak, and respect their opinion no matter how diverse they
might be.
The other competency that all the CMNs must have is critical thinking skills. Serving as a
CNM is challenging because it requires the nurse to make very tough and complex decisions that
might not be properly made if one lacks decision-making skills. Therefore, to address all sorts of
clinical problems that a nurse has, the nurse has no choice, but to be a critical thinker (Hamric,
Hanson, Tracy & O'Grady, 2013). A nurse who has this competency can make rational decisions
because he has to reason out before making a decision. Critical thinking goes hand in hand with
ethical compliance because a nurse who is committed to making ethical decisions must create
enough time to meditate over it. A nurse who possesses this competency can, therefore, not face
a challenge in dealing with whatever kind of problem that needs to be addressed (Beck,
LoGiudice & Gable, 2015). Critical thinking can be instrumental in nurturing the culture of
collaboration, team play and leadership.
Conclusion
The creation of specialties like the ARN has made nursing has grown and become a fully-
fledged discipline with its principles, strategies, ethics, theories, and scope of practice. Since its
establishment, nursing has made tremendous contributions towards the delivery of quality, safe,
and satisfactory healthcare services to the public. As a profession, nursing is manned by the
nurses-professionals who have adequate training on what nursing entails. An ARN is, therefore,
one of topmost levels in the nursing profession. ARN practitioners such as the CNM must have
all it takes to effectively discharge their roles to the satisfaction of their patients. To help in
serving the expectant women, new mothers, and the infants, the CNM must have the right

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educational and experiential qualifications as well as the fundamental competencies like critical
thinking, communication, team play, and leadership.

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