Critical Analysis of the Nurse Practitioner Role in Healthcare

This report provides a comprehensive analysis of the Nurse Practitioner (NP) role, encompassing its description, national and international standards of practice, and impact on the healthcare system. The report delves into the specific duties and responsibilities of NPs, their evolving role in various specializations, and the registration standards set by organizations such as the Nursing and Midwifery Board of Australia, the American Association of Nurse Practitioners, and the Nursing Council of New Zealand. It also examines the influence of NPs on healthcare, including balancing doctor shortages, providing equal quality services, controlling costs, expanding urgent care facilities, and fostering team-based care. Furthermore, the report includes an appraisal of the literature, application of the NP role in the workplace, and independent thought on the role, offering a holistic understanding of the NP's significance in contemporary healthcare.

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Table of Contents
Introduction.................................................................................................................................................2
Main Context...............................................................................................................................................2
Description of Nurse Practitioner............................................................................................................2
National and International Standards of Practices Connected with NPs.................................................3
Impact of the Role of NP on the Healthcare System................................................................................4
Appraisal and Evaluation of the Literature..................................................................................................6
Application of the Role in the Workplace................................................................................................6
Independent Thought, Appraisal and Interpretation of the Role............................................................6
Conclusion...................................................................................................................................................8
References...................................................................................................................................................9

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Introduction
The nurse practitioners (NPs) are the registered nurses those who have higher education and
training in specific are like family practice or pediatrics. NP have master degree called Master of
Science in Nursing (MSN) and also certification from Board in their specialty. The paper will
describe the role of NP and discuss the national and international standards of practices
connected with the role of NP It will also provide a clear explanation of the effects of NP on the
health care systems. It will also critically analyze the application of NP in the place of work.
Moreover, it will evaluate the interpretation, appraisal and independent thought on the role of
NP.
Main Context
Description of Nurse Practitioner
The NPs were previously expected to act as doctors, basically to improve the health of the
children. Currently, the role of NPs has become broader than before, and NPs often concentrate
on different specialties, which include adult care nursing, women's health nursing and family
care nursing. Working with the patients directly, they could diagnose and manage several
common chronic illnesses. The role of NP is mainly recommended for those people who are
expected to be taken care of by others (Andregård & Jangland, 2015). Most of the NPs have the
ability for solving the complicated health issues and providing a compassionate approach to the
patients.
As NPs, they are responsible for the following duties:
 Writing prescriptions for specific medicines including the dosage and frequency
 Ordering and conducting diagnostic tests like electrocardiograms (ECGs) and x-rays
 Diagnosing and treating acute injuries, illnesses, and infections
 Providing education, counseling, guidance, and care to the patients while taking medicines
and also about the side effects and any interactions regarding the medicines which are
already taken by the patients (Barnes, 2015)
 Recording and examining the diagnoses, symptoms of the patients and medical history,
 Talking to the patients about managing their health effectively and also helping in making
proper treatment plans as well as suggesting further care

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The role of NP generally concentrates on holistic and preventative care with modified treatment
plans for each patient. As most of the NPs do their training in clinical MSN within a particular
specialized area, they could provide some degree of specialized knowledge along with their
regular responsibilities (Bush & Lowery, 2016). In a job, the role of NPs might differ broadly on
the basis of their specialized area, and generally, they may have to perform the following tasks:
 Detecting the conditions
 Treating the conditions and the illnesses
 Educating and counseling the patients
National and International Standards of Practices Connected with NPs
The registration standards for the NPs in Australia are set by the Nursing and Midwifery Board
of Australia (NMBA) under Section 95 of the National Law of Health Practitioner Regulation
enforceable in every territory. These standards are applicable to NPs those who are registered as
NP in Australia. These standards also demonstrate that while applying for NP, they must have
the following criteria:
 General registration as registered NP in Australia with np unprofessional or unsatisfactory
conduct (Nursing and Midwifery Board of Australia, 2019)
 Full-time experience of three years at the advanced level of nursing practices within the last
six years
 Successfully completing the program of study approved by NMBA or program equivalent of
study program approved by NMBA
 Comply with the Standards of Practice of NMBA
The registration standards are established by Australian Health Practitioner Regulation Agency
(AHPRA) for the NPs in Australia states that the NPs need to have recent practice in those
specialized areas where they want to work and continue the connection with their professions
adequately. The particular needs for current practices rely on the experience of the NPs, the
profession, and duration of absence from the specialized area (Australian Health Practitioner
Regulation Agency, 2019).
In the USA and Canada, the registration standards are set by the American Association of Nurse
Practitioners (AANP). It demonstrates that an NP has to be registered under the law and must

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have an expert base of knowledge, nursing competencies, and decision-making skills. NPs need
to submit rigorous national certificates evaluations of clinical outcome, periodic review, and
follow the ethical code for practices (AANP | The American Association of Nurse Practitioners,
2019). Professional development and self-directed knowledge are also necessary to maintain
nursing competencies.
The registration standards set by the Nursing Council of New Zealand for NPs in New Zealand
must complete a master degree program approved by the Nursing Council. This degree enables
the NPs to acquire adequate clinical learning and theory for meeting the required skills, attitudes,
and knowledge (Nursing Council of New Zealand, 2019).
Impact of the Role of NP on the Healthcare System
In Australia, the development in the registered nursing profession has gone simultaneously with
development in the number of highly trained NPs. At present, there are almost 1,839 NPs in
Australia, and their influence on the healthcare system is also increasing (Carryer & Yarwood,
2015). They work in schools, workplaces, and public or private practices and might work
individually or collaboratively with the doctors. In several regions, NPs set the trend in new
practices of primary care delivery such as in nurse-managed health centers, urgent care facilities
in pharmacies and other stores (Xue, Ye, Brewer & Spetz, 2016). The impact of NPs on the
healthcare system are as follows:
 Helps to balance the low numbers of doctors selecting primary care - Very few medical
students are choosing a family practice, primary care or general internal medicine, but
Australia has an increasing number of elderly and chronically ill people. The training
programs for primary care for NPs are becoming popular and helping to balance the shortage
of primary care doctors in some areas (Cashin, Theophilos & Green, 2017). In some of the
regions, the training programs for primary care for the NPs have become so popular that
there are not adequate spaces for the nurses to register in them
 Provides equal quality services to their counterparts - It has been found that the efficiency
of NPs to deliver health-related services in terms of patient satisfaction, mortality, care, and
outcomes are equal to care and outcomes of the doctors (Faraz, 2016). It is specifically
welcome news for the primary care doctors those who want to grow their patient loads
without essentially recruiting more doctors

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 Helps to control the costs - A study focused on insurance claims that compared NP-
delivered care and doctor-delivered care found that low costs were connected with care
provided by the NPs. It has been found that the average cost for visiting an NP is 20%-35%
lower than the average cost of visiting a doctor (Stahlke, Rawson & Pituskin, 2017). It is
welcome news for the patients, clients and public and private insurers (Hupcey, 2016)
 Allows to expand the urgent care facilities - The urgent care facilities that provide urgent
care and other basic healthcare services on the same-day have expanded quickly in the past
few years. In Australia, the urgent care facilities have increased to 8100 in the year 2018
from 6,400 in the year 2014 with more 500-600 urgent care facilities to be opened in the year
2019 (Hurlock-Chorostecki et al., 2016). Most of these urgent care facilities are run by the
NPs and expand the access of basic healthcare services to those individuals who may not
have access to any other healthcare facilities
 Provides greater reach to the doctors within their practices - Every NP does not work
independently of the doctors. Wherever they are situated, they enable the doctors for
operating their practices more effectively and provide services to more patients. It is better
for preventing the patients from going elsewhere for treatment due to difficulty in getting
appointing with the doctor and also preventing unwanted emergency visits. Most of the times
NPs see the patients faster than the doctors, and the patients also appreciate it (Jennings,
Clifford, Fox, O’Connell & Gardner, 2015)
 A key factor in team-based care - The team-based health care is becoming popular since
the doctors are overwhelmed with the demanding healthcare services of the growing number
of chronically ill and elderly patients whereas every few students of medical select for
primary care practices (Lopatina et al., 2017). Several NPs prefer to work in a team-based
health care atmosphere more than working independently and assuming every business risk
connected with independent practices
 Popular and liked by the patients - NPs are popular and liked by the patients, and they also
express their satisfaction for their better treatment experiences. NPs, especially in primary
healthcare, adopt a holistic attitude towards health and might take time for discussing the
habits, lifestyles, and other clinical findings with the patients (MacLellan, Higgins & Levett‐
Jones, 2015). Some of the patients hesitate to ask questions to the doctors, specifically

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during busy times while the doctors serve huge numbers of patients, but the NPs could easily
develop a rapport with the patients, and this leads to the satisfaction of the patients
Appraisal and Evaluation of the Literature
Application of the Role in the Workplace
After completing my MSN, I work in Royal Prince Alfred Institute of Rheumatology &
Orthopedics as an NP. I have specialized in looking after the patient with orthopedics in the
hospital. My role is to carry on the orthopedic healthcare by supporting excellence in the nursing
practice, research, and education of orthopedic. Working along with the doctors and physical
therapists, as an orthopedic NP, I am able to help the patients from recovering from surgery,
rehabilitating from the injuries and returning to their painless and mobile lives after extreme
events. I mostly work from the specialized orthopedic unit of the hospital and deal with patients
who are recovering or preparing from orthopedic surgeries.
Orthopedic conditions which need treatment could take place at phase of life, so as an orthopedic
NP, I have to work with different types of patients. Most of the patients are older adults those
who need joint replacements or suffer from falls. As an orthopedic NP, I also see several children
and even babies those who need care bone cancers, for fractures and other needs of orthopedics. I
also have to perform some other duties, such as maintaining the records of the patient’s
conditions, provide compassionate and clear communications to the patients and their families,
and making patient rounds regularly. I also provide information and education to the families of
the injured patients, enable them to know about the recovery and follow-up care and help the
patients to return to their healthy lives after staying at the hospital.
Independent Thought, Appraisal and Interpretation of the Role
My thought about the NPs is that they are capable, versatile, and suitable to fill the gaps in the
healthcare systems. Although their scope of practice differs depending on the situations, they
usually manage the patient’s care, provide healthcare services, and in some of the cases give
specialty health-related services. They could be found in hospitals, public health facilities
physician practices and clinics and are always in high demand. They are liked by the patients,
and they also express their satisfaction with their better treatment experiences. NPs, especially in
primary healthcare, adopt a holistic attitude towards health and might take time for discussing
the habits, lifestyles and other clinical findings with the patients (MacLellan, Levett‐Jones &

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Higgins, 2015). Some of the patients hesitate to ask questions to the doctors, specifically during
busy times while the doctors serve vast numbers of patients, but the NPs could quickly develop a
rapport with the patients, and this leads to the satisfaction of the patients.
In nursing practice, NPs might face complicated cases of the patients as each patient have unique
medical history and conditions. The NPs need to utilize their diagnostic skills for solving the
cases. NPs have to consider the detailed medical history of the patients, carry thorough physical
tests and interpret the relevant imaging and lab tests. It has been found that the diagnostic skills
of the NPs are comparable with their doctor counterparts. After the diagnosis, NPs make their
personalized treatment plans for each patient that might consists of providing counseling and
prescribing medicines.
As an orthopedic NP, I have to work with different types of patients as orthopedic conditions
which need treatment could take place at the phase of life. Most of the patients are older adults
those who need joint replacements or suffer from falls. As an orthopedic NP, I also see several
children and even babies those who need care bone cancers, for fractures and other needs of
orthopedics. Being an orthopedic NP can be satisfying for the correct person. In several cases,
orthopedic NPs are able to take of the patients from the extremely low point when they might be
unable to move and in a state of tremendous pain till the bones are totally healed (McDonnell et
al., 2015). Witnessing this type of change and handling the patients’ care in this way may be
satisfying for several NPs. But there might be difficult situations when the complete recovery of
the patients become impossible. Orthopedic NP may have to deal with the consequences of
challenging surgeries and show hope and sympathy to the patients those might find themselves
severely limited flexibility or permanently disabled due to infection, accident or an injury
(Scanlon, Cashin, Bryce, Kelly & Buckely, 2016).
Reason for Choosing Nurse Practitioners
The role of NP has been chosen for this paper as I was always fascinated to become a nurse from
my childhood. All through my childhood, my mother was often hospitalized due to health
issues, and I spent countless nights beside her bed, observing the interactions between her and
the nurses. The nurses would help with my homework besides providing care to my mother.
Later at my youth, I did realize the extraordinary care the nurses provided during my family's
challenging times. I decided to become a nurse to give the same care and support given to my

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family by those nurses. With education and training from MSN, I felt that I could give the
opportunity for a healthy and long life to other families and dreamed of becoming NP. After one
year as an orthopedic NP, I am on my way to becoming one of those nurses who cared for my
mother to my patients. I am looking forward to further focus on my career as an NP
concentrating on health care and prevention and improving the overall health of the people
Conclusion
The paper described the role of NP and discussed the national and international standards of
practices connected associated with NP. It provided a clear explanation of the influence of NP on
the health care systems. It also critically analyzed the application of the role of NP in the
workplace. Moreover, it evaluated the interpretation, appraisal and independent thought on NP.
The future of healthcare depends on NPs for providing patient-centered care, and so the NPs
need to be skillful and well-qualified to work well with the multidisciplinary teams of health care
workers.

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References
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Andregård, A. C., & Jangland, E., (2015). The tortuous journey of introducing the Nurse
Practitioner as a new member of the healthcare team: A meta‐synthesis. Scandinavian
Journal of Caring Sciences, 29(1), 3-14.
Australian Health Practitioner Regulation Agency. (2019). Retrieved from
https://www.ahpra.gov.au/Registration.aspx
Barnes, H., (2015). Exploring the factors that influence nurse practitioner role transition. The
Journal for Nurse Practitioners, 11(2), 178-183.
Bush, C. T., & Lowery, B. (2016). Postgraduate nurse practitioner education: Impact on job
satisfaction. The Journal for Nurse Practitioners, 12(4), 226-234.
Carryer, J., & Yarwood, J., (2015). The nurse practitioner role: Solution or servant in improving
primary health care service delivery. Collegian, 22(2), 169-174.
Cashin, A., Theophilos, T., & Green, R. (2017). The internationally present perpetual policy
themes inhibiting the development of the nurse practitioner role in the primary care
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Faraz, A., (2016). Novice nurse practitioner workforce transition into primary care: a literature
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Hupcey, J. E., (2016). The socialization process of masters-level nurse practitioner students.
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Hurlock-Chorostecki, C., van Soeren, M., MacMillan, K., Sidani, S., Donald, F., & Reeves, S.
(2016). A qualitative study of nurse practitioner promotion of interprofessional care
across institutional settings: Perspectives from different healthcare
professionals. International journal of nursing sciences, 3(1), 3-10.

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Jennings, N., Clifford, S., Fox, A. R., O'Connell, J., & Gardner, G. (2015). The impact of nurse
practitioner services on cost, quality of care, satisfaction, and waiting times in the
emergency department: a systematic review. International journal of nursing
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Lopatina, E., Donald, F., DiCenso, A., Martin-Misener, R., Kilpatrick, K., Bryant-Lukosius, D.,
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