David R. Mandel, M.D.

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The role of the Advanced Practice Nurse (APN) is to provide preventative care and treatment and to participate in the management of acute and chronic illnesses using advanced clinical skills, diagnostic reasoning, and advanced therapeutic interventions. APNs demonstrate a high level of independence and clinical expertise in the management of rheumatic diseases. APNs integrate education, research, management, leadership, and consultation into their clinical roles.

What Does the APN Do?

The APN assesses patientsí' health status through comprehensive health histories, physical examinations, and interpretation of appropriate diagnostic tests. The APN formulates patient diagnoses and with the patient identifies outcomes in order to manage health problems, maximize functional abilities, prevent or minimize disabilities, and promote health maintenance. Collaborating with the patient and family, and other health care professionals as needed, the APN develops an appropriate plan of care to attain individualized expected outcomes, prioritizing multiple needs.

The APN prescribes, orders, and implements interventions and treatments identified in the plan of care, including: prescribing pharmacologic and nonpharmacologic interventions, in accordance with state law; providing patient/family education and counseling; and, initiating referrals to other health care providers.

The APN evaluates and documents patient/family progress toward attainment of expected outcomes and provides consultation to other providers to optimize the plan of care and affect system change. The APN provides comprehensive clinical coordination and case management and acts as an advocate for the patient and family within the health care facility, the community, and the legislative arena.

Where Does the APN Work?

The APN provides care in a variety of health care settings including hospital units, ambulatory clinics, managed care practice, private practice, rehabilitation centers, home health agencies, public health centers, and long-term care facilities. APNs may serve as primary care providers, specialty care providers, or consultants.

What Kind of Training Does the APN Have?

APN is an umbrella term given to a registered nurse who has met advanced educational and clinical practice requirements beyond that for basic registered nurse licensure. There are four types of APNs: clinical nurse specialists (CNS), nurse practitioners (NP), certified nurse midwives (CNM), and certified registered nurse anesthetists (CRNA). Since 1992, APNs have met the requirement of obtaining at least a Masterís degree. Regulated by both state and federal laws, APNs are licensed as registered nurses in the states in which they practice. Most states require APNs to be nationally certified in their specialty area by the APN specialtyís professional organization. National APN certification requires graduation from an accredited APN educational program and successful completion of a national certification examination. (1.)

(1.) Article courtesy of the Association of Rheumatology Health Professionals

For additional information, contact the Association of Rheumatology Health Professionals, 1800 Century Place, Suite 250, Atlanta, Georgia 30345, (404) 633-3777.

Revised 2001-2002 Professional Papers Task Force
Approved by ARHP Executive Committee, October 2002, New Orleans

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