Praxis- Family Nurse Practitioner (FNP)

Praxis- Family Nurse Practitioner (FNP)

Introduction

Praxis in nursing is concerned about thinking, feeling and doing. The practice of nursing requires the practitioners to use their mind and their education to performing responsibilities that they have been trained to perform (Seng, 1998).  Therefore, they have the duty of integrating the practice, theory and art, recognize, and put into correct use the value of different knowledge they have through reflection. The paper seeks to delineate on the ethical, ideological and theoretical influences that apply in the advanced nursing practice.

Overview of praxis and its benefit to the framework of discipline of nursing

Praxis has been found to be one of important pillar that underpins the construct of nursing.  It is therefore, advocated to be the route that allows nurses to be set free from the reified bureaucratic structures and regimes of truth (Cathrine & Denise, 2009).  It is also described as the road that will lead nurses to their quest of professionalism and professional growth in their profession as nurses.  The concept of praxis has therefore helped to revive the framework of nursing and how it is viewed. It has been the cornerstone of ensuring that nurses gain skills and knowledge to allow them expedite their roles with vigor and professionalism (Kilpatrick, 2008). Nursing is not about nursing actions but it is an ongoing reflective activity on the consequences and evaluation of nursing actions that enables refinement of knowledge and future nursing practices. Therefore, praxis has allowed expansive thinking and reflection about important aspects that concerns nursing. It has also helped nurses to be informed and to remain committed on their actions that have enabled them to provide quality services in their capacity as nurses.

Overview of advanced practice nursing role

Advanced practice nurse is a nurse that has attained a postgraduate education certification in nursing. Therefore, such an individual has adequate skills, knowledge and scope of practice in nursing.   Such individual is required to utilize these skills, and competencies in assessment, planning, implementation, diagnosis and in evaluation of the care that their clients require before prescription treatment.  Nurses practicing at this level may work as a generalist or as a specialist.

The advanced practice-nursing role that I will be practicing is that of Family nurse practitioner (FNP). FNP developed because of the higher and increasing demand for specialists that would help to provided clinical services to families in different settings (Oiler, 1993). The demand for these services was high prompting the need for specialist nurses to be trained to execute these duties. FNP usually assume the role of health care providers in different settings such as rural and remote clinics, joint practice with physicians, neighborhood health centers, private practitioners and outpatient departments (Frederickson 2003).  This capacity pervades all aspects of FNP and it influences how relationships are established between patients and their families in their work setting. As FNP, the focus is on the primary care settings and it involves screening and promotion of health and disease preventions across the span. As an FNP I will also handle issues relating to acute care and not deal with critical conditions, therefore, I am optimistic that in future this role will impact positively to the life’s and health of people.

Patients will benefit from education on prevention healthcare that they will receive.  This is because of the extensive training and education programs that are provided to patients and people on how to live healthy lifestyles. The rate of child mortality an women cases of stillbirth will also be reduced drastically. The future is going to be bright and the overall health of patients is also going to be improved. Nurses of this stature have advanced skills and knowledge owning to their extensive trainings and continued search of knowledge and skills through continuous research and studies. Therefore, these competencies will promote health living and foster good health.

Core competencies and skills for an FNP

An FNP should have the ability to carry out physical examination, have the ability to assess, evaluate, screen and conduct diagnostic tests. Strong communication skills are also required to express and relate well with the patients (Fitzpatric & Emerson, 2011).  FNP should have interest and ability and have the ability to work as a team as well as independent, have knowledge on acute and chronic conditions and excellent judgment ability when making prescriptions and referral.

Ideological influences

            The art of nursing is aimed at providing patient care that requires personal instinct and insight that is gained through practice and experience.  The ideological influences or philosophy as FNP is always to ensure that actions or decisions taken promote human good. The skilful connection that are carried out by the mind,  body , feelings and hands  and words and body languages should be aimed at provide better care and ensuring that the goals of nursing are achieved. Therefore, the values, and competent that are vivacity to personal and professional linkage will always be upheld to ensure that patients are well attended to and get the best of the healthcare services. It is not only skills and knowledge that an individual need to have to be an FNP, rather a coherent structure of work need to be integrated in guiding values and actions that are in consistent with the social mission of professionals, community awareness, and knowledge construction guided by the quest to promote and enhance human health. Therefore, the philosophical framework is to always yearn to promote human health by using the skills and knowledge acquired in the training. In so doing, the community, family members and all stakeholders will be useful in ensuring that this is achieved. Therefore, opening up communication and creating positive relationships will be part of the philosophies that will ensure that the objective is achieved.

Theoretical influences

The system theory proposed by Ludwig von Bertalanffy best fits my nursing practice as FNP. The theory was proposed in 1950 and it aspires to serve as framework between human beings and environment.  Health facility is considered as an organization or rather an open system, which is part of the larger supra-system of the society.  Therefore, it is considered as an integrated system that ensures information sharing between systems within the environment. Therefore, changes in the system are likely to affect the operations of the other subsystems, therefore, management process can be considered as series of integrated factors that interact within an organization environment. Therefore, such a system is essential in assessing the changes that are needed in the healthcare organization.  As FNP, this theory is applicable as it is going to help me to analyze the various trends in nursing that will help me to provide appropriate services to the patients (Ziegler 2005). The theory is also important in enhancing understanding of the functioning of the organization such as culture that are fundamental in enhancing  the work of a nurse.

Ethical influences

Ethics refers to issues pertaining to what is wrong or right. Heath practitioners are obliged to always uphold to ethics when providing their services to the patients. They are required to make rational decisions, which foster good health. According to Fry, Veatch and Taylor (2010), the ability to identify ethical and other value issues in nursing care and understanding or other moral authority is the foundation of understanding some of the ethical dilemmas that many nurses find themselves in. There are various principles of ethics that are applicable in FNP. This includes considering the value of life, justice or fairness, goodness or rightness, individual freedom and truth telling or honest (Burnard, Chapman & Smallman, 2004). Therefore, the appropriate theory that best benefits my practice as a nurse is deontological theory.  This theory is best exemplified by the concept that state that ‘the means should justice the end’. Therefore, in the service delivery any actions that are taken should be able to manifest a moral weight (Burnard, Chapman & Smallman, 2004).   In the service delivery, all acts or actions that tend to cause harm on other people should not be welcome as this will be going against the moral standards or obligations. Immanuel Kant proposed this theory, 1724-1804 and it is the biggest rival of utilitarianism. No human being should be treated as a means to an end.  Applying this theory, a nurse has a moral obligation to always endeavor to do right regardless of the consequences. By so doing, the nurse will avoid various conflicts that may arise between him and the patients or other stakeholders.

Utilization of Framework of Praxis

In the care of patients, process that facilitates and enhances continuous improvement is important especially in an environment that experiences changes in patient care that focuses on   patient and on evidence that aims at providing high quality health. For such initiative to succeed, it requires commitment and involvement of all stakeholders in order to change the practice. Two conceptual frameworks which include; promoting action on research implementation in health service model and appraisal of guidelines for research and evaluation can be combined with the system theory, ideologies and ethical influences or help in developing of praxis that can enhance the practice of nursing (Zaccagnini & white, 2011). These models function on three factors that include the nature of evidence, means of facilitating change and the context of the desired change.

The framework also requires application of system theory to ensure that the nurses relate well with other stakeholders. Therefore, communication is essential in provision of health care to the patients. In communication, feedback is essential in translating theories into practice. Sources of evidence are also important in ensuring that quality healthcare is provided.  Therefore, the FNP should be able to engage in continuous researches, refer from patient situations to provide nursing interventions that result in a quality healthcare.

Conclusion

            Even though FNP are considered as nurses that assume and handle manual nursing task by focusing on information dissemination and basic support to the physicians, they provide in-depth skills and knowledge to the overall health care system. Nevertheless, appreciating the fact that healthcare industry and nursing are growing and developing, hence efforts should be channeled on integrating theory into practice. Various sources of evidence such as researchers and studies should also be relied upon in acquiring additional skills that would help nurses to improve on their quality of healthcare.

 

References

Burnard, P., Chapman, C., & Smallman, S. (2004). Professional and Ethical Issues in Nursing, Elsevier Health Sciences.

Cathrine, F., & Denise, M. (2009). Chapter 4 praxis: Essential nursing construct. Retrieved from: http://www.irma-international.org/viewtitle/48921/

Ethical theories. Retrieved from: http://courses.cs.vt.edu/cs3604/lib/Ethics/notes.html

Fitzpatrick, J., & Emerson, E. (2011).  201 Careers in Nursing, Springer Publishing Company.

Frederickson, K. (2003). Opportunities in Nursing Careers, McGraw-Hill Professional.

Fry, S., Veatch, R., & Taylor, C. (2010). Case Studies in Nursing Ethics, Jones & Bartlett Learning.

Kilpatrick, K. (2008).  “Praxis and the role development of acute care nurse practitioner”, Nursing Inquiries, vol. 15, no. 2, pp. 116 – 126. The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice, Jones & Bartlett Publishers.

Zaccagnini, M and White, K W 2011,

Oiler, B. (1993). Toward a nursing practice research method, Adv Nur Sci., 16(2):9-25.

Seng, J. (1998). Praxis as a conceptual framework for participatory research in nursing, ANS Adv Nursing science, 20(4):37-48.

Ziegler, S. (2005). Theory-Directed Nursing Practice, Springer Publishing Company.

 

 

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