The Healthcare system in the United States is complex and challenging to understand. Individuals interested in pursuing medicine have a wide range of opportunities not presented on a silver plate. The discussion in this paper shows nursing requirements in California based on education, licensure, and regulatory requirements. It also confirms whether California allows full, limited, or restricted NP practice. It also looks at Nurse Practitioner (NONPF) Core Competencies and leadership skills required by an individual to make a good nurse leader. In terms of an overview, the scope of practice, competencies, and leadership are related to the educational and developmental aspects of the healthcare system for nurses. The goal of this work is to examine nurse practice requirements, competences, and leadership abilities to construct a professional development program.
APN Scope of Practice
Advanced practice registered nurse (APRN) is responsible for ensuring that nurse practitioners provide good and acute healthcare across one’s lifespan by assessment, diagnosis, and treatment of illness. They attempt to guarantee that registered nurses provide exemplary healthcare services to their patients. I intend to join and develop my nursing career in California since the state offers an excellent opportunity for registered nurses as far as wages are concerned. Concerning educational, licensure, and regulatory requirements, nurse practitioners in California are regulated by the California Board of Registered Nursing to deliver medical services in several situations. This administrative organization establishes educational and regulatory requirements for nursing programs that support students in becoming certified nurses.
In addition, the state’s infrastructure is well-developed, with many hospitals of choice and other healthcare facilities that a nurse might need in their career lifespan. Getting a DEA in California is done through an online application at the United States department of justice website. It can also be done by submitting a completed requisition (DEA Form 222a) which is mailed to the registrant 30 days after each shipment of forms 222 to the DEA registration unit. Another option is to call the DEA headquarters registration unit on a free toll number and requests a physical copy of the order form which is mailed within ten working days; other requirements include taking and passing the NCLEX-RN examination.
The Association of California Nurse leaders introduced an initiative in 2010 that requires nurses to have a baccalaureate in nursing so that they may be hopeful of entering the practice as registered nurses. Educational requirements are highly needed in nursing compared to other health disciplines such as physiotherapy and pharmacy, among other fields. This has led to plans geared toward entry-level educational requirements for California nurses (Regan, 2019). This has been done to prevent the wide range between nursing and other disciplines as far as education is concerned. An increased level of education is argued to be creating a condition in which there will be strong relationships, cooperation, and interdisciplinary teamwork in delivering proper healthcare. This will also put nurses in equal educational standards and maintain equal status with other health practitioners, creating a room for partnership among these personnel.
Nursing licensure plays a vital role as a representative of nurses’ efforts to enhance their value in the nursing profession. Unsuccessful attempts during licensing affect graduates, pre-licensure nursing educational programmers, healthcare agencies, and most importantly, patients’ safety. All participants must submit their licensure application to the board and fingerprint through a hard card or live scan (Huynh & Haddad, 2020). The primary purpose of this activity is to investigate nursing students’ motivation and performance in licensure exams. During this procedure, nursing students must respond to questions related to reasons for learning as indicators of motivation type. Once all documents are received, it will take around 0 to 12 weeks for permanent licenses to come through.
It is recognized that nursing is a dynamic field that is currently growing so that it can include more complicated patient care activities. The nursing practice includes primary healthcare that helps individuals cope with daily living associated with their everyday problems and the requirement of some scientific knowledge that nurses provide. Nurses’ activities include direct and indirect patient care, skincare performance, immunization methods, withdrawal of blood from the human body, and observation of signs and symptoms, among other standardized procedures.
California is among other states of full practice authority (FPA), thus granting nurses full practice authority. California’s government through its representative, Gavin Newson, gave this authority which passed the bill AB-890 into the legislature in 2020. This has made nurses’ jobs in California easier since they can evaluate patients’ diagnosis orders, interpret diagnostic tests, and further initiate treatment by giving prescriptions on medications under the exclusive licensure authority of the state board of nursing (Poghosyan et al., 2022). The nurses in California and other more than half of the states in The United States permit NPs to operate independently as per their education and training.
Nurses in California can order, administer, dispense and prescribe medication. The pursuit of these perspective authorities is a priority on the legislative agenda of nurses in California. There are legal avenues that nurses have used in California to obtain perspective authority. The perspective authority is state-regulated; hence a continuous outline is provided to guide the nurses through the legislative process from the beginning of the planning stages to when the bill was, and it becomes law.
Nurse Practitioner (NONPF) Core Competencies
Practice Inquiry (PI), which incorporates fixed procedures that indicate how PCPs might interact over time in teaching from their patients’ case-based medical uncertainty, is one of the competences of the student. It brings leadership in the transformation of new knowledge into practice. This knowledge includes clinical investigation methods that include identifying clinical practice problems, literature search methods that include the PICO Model to define clinical questions and search for the best clinical evidence, appraising evidence for application to practice, for example, tools and analysis (Chan et al., 2020). Knowledge encompasses evaluating therapeutic interventions, reviewing patient devices, considering potential risks and dispositions, leveraging data to enhance evidence-based changes in health management and template advancement using digital datasets. Furthermore, this skill results in project administration and implementation, which contains synthesis and supposition of research to specific communities, and assessment of project resources necessary and accessible. Moreover, it encompasses conflicting interests of patients, payers, practitioners, and suppliers, and analysis of why expected outcomes were or were not achieved, and lessons learned.
Another competency that is believed to be of student’s strength is Technology and Information Literacy Competencies. This competency makes a specialty of the capacity to research, collect, manage, transform, and exchange facts using technology like email, spreadsheet software, word processing, and web browsers. It incorporates appropriate knowledge administration technology to improve health care, including current-evidence-based treatment, application software used in medical practices, and digital products that assist diagnostic evaluation, algorithmic reasoning, and health record examination.
Some competency areas give nursing students a better chance for growth educationally. They enable students to fulfill their role as nurses. Scientific Foundation Competencies is one of the competencies that is geared toward student development since it significantly analyzes data and proofs for enhancing superior nursing practice and interpretation of research. Further, it details the forms of knowledge used in improving the practice strategies and outcomes. Research connectivity, concepts, knowledge practices and interoperability are all significant components of their methodologies. Their main focus is always on the humanities and nursing science incorporated into the sciences.
Leadership Competencies involve leadership skills and behaviors geared toward the excellent performance; organizations can better discover and improve their next generation of leaders by using a competency-based approach to leadership. Leadership competency provides leadership qualities that foster association with multiple stakeholders like patients, healthcare teams, and the community for improvement in healthcare provision (Waryold et al., 2021). In addition, leadership ability contributes to the advancement of the profession by designing and executing innovations that include change approaches.
Skills and knowledge are essential competencies when it comes to nursing. The first activity that I will do in the master’s program to help students achieve NP competencies is to engage students in inquisitive sessions that involve inquiry about wanting to learn more and grow both as a student and an individual (Chan, 2019). Since the fundamental job of nurses involves aiding patient care, disorder and sickness prevention, diagnosis, and management of diseases, I will make assessment more productive and time-efficient in measuring NP abilities.
Nurses play a vital role in hospitals, health institutions, and communities. Contemporary situations like increased competition among health institutions increased medical bills, and increased claims for quality medical services call for excellent and strategic leadership qualities in different healthcare institutions. Due to the nature of their duties and cooperation with patients, medical personnel, and multidisciplinary experts nurses is concerned, nurses are expected to practice leadership skills in various contexts to promote improved patient care.
Leadership is the ability to lead so that the institutions’ goals are achieved, fostering positive changes. The most important skill is expertise or knowledge, which is extremely important in raising awareness of professional and personal accountability and the dilemma of practice. Knowledge improves healthcare since if the nurse is aware of the best learning, they are better positioned to help a patient. Knowledge use is attached to their capability to get involved in and assess particular situations, and so is their ability to integrate situational reviews into their present knowledge framework. A knowledgeable leader is better positioned to advise the nurses effectively based on his comprehensive knowledge. Lack of knowledge is critical since it can harm both nurses and patients. It is then advisable for nurse leaders to identify community and clinical care knowledge gaps.
Another skill that is required to lead as an NP is interpersonal communication. This is the procedure of exchanging ideas, thoughts, knowledge, and information to fulfill the purpose or intention in the best viable manner. It makes it possible to communicate effectively in both speech and writing, making others think of you as trustworthy and enhancing your ability to motivate and lead (Jaworski et al., 2022). Most importantly, good communication skills result in more positive patient outcomes, increased employee satisfaction, and better healthcare.
Lastly, conflict resolution, combined with stress tolerance, is another leadership skill required to lead nurses effectively. This is a way of mediating between two or more parties to find a peaceful solution to a disagreement. Rather than solving conflicts peacefully, nurse leaders should improve ways of avoiding disputes. They should set up a workplace with minimal cases of conflict, hence improving patient outcomes through improved healthcare. Peaceful conflict resolution also enables nurses and patients to coexist mutually and understand each other.
For students to develop NP leadership skills, they require certain strategies, for example, total involvement. A fully-qualified leader should know when to lead and when to follow; hence an individual should take time and join professional organizations to learn from the best. Active membership in various factors provides a good leadership opportunity. This involves volunteering in these organizations to play specific roles, like serving on the committees of these organizations (Huynh, 2021). This also gives unique opportunities for networking since he can meet and build relationships with these individuals, some of whom are good leaders. Attending nursing conferences and events also enables an individual to meet great leaders, creating a room for knowledge sharing.
Enhancing communication skill also pave the way for one to become a good leader. One is capable of accomplishing more through effective communication. Effective communication involves exchanging ideas, thoughts, knowledge, and information to satisfy the reason or goal in the best possible manner. This is the essential skill of being a nurse leader. A nurse leader should be able to listen to patients, peers, and the administration actively. Listening is the first key to communication, followed by an accurate and polite response.
The scope of practice is related to the guidelines that specify what an advanced practiced nurse (APN) can legally perform within their profession. California is among the states that subject their nurses to full practice authority. Core Competencies for Nurse Practitioners (NONPF) provide standards and targets that indicate an awareness of policy and practice interconnectedness. They ensure that nursing programs provide aspiring NPs with the necessary training for the field. It is evident that substantial leadership qualities such as interpersonal communication are key factors for a nurse leader; hence, specialists should foster these qualities and act as positive role models to the students.
Chan, T. E. (2019). Determining Nurse Practitioner Core Competencies Utilizing a Delphi Approach (Doctoral dissertation, Duquesne University).
Chan, T. E., Lockhart, J. S., Schreiber, J. B., & Kronk, R. (2020). Determining nurse practitioner core competencies using a Delphi approach. Journal of the American Association of Nurse Practitioners, 32(3), 200-217.
Huynh, A. P., & Haddad, L. M. (2020). Nursing Practice Act. In StatPearls [Internet]. StatPearls Publishing.
Huynh, N. (2021). Exploring the use of simulation to develop leadership skills in undergraduate nursing students: A scoping review protocol. JBI Evidence Synthesis, 19(11), 3080-3087.
Jaworski, M., Panczyk, M., Leńczuk-Gruba, A., Nowacka, A., & Gotlib, J. (2022). The trend of authentic leadership skills in nursing education: the key role of perfectionism and self-efficacy. International Journal of Environmental Research and Public Health, 19(4), 1989.
Poghosyan, L., Kueakomoldej, S., Liu, J., & Martsolf, G. (2022). Advanced practice nurse work environments and job satisfaction and intent to leave: Six‐state cross-sectional and observational study. Journal of Advanced Nursing.
Regan Steel, M. (2019). The Provision of Abortion Services by California Advanced Practice Nurses (Doctoral dissertation, California State University-San Marcos).
Waryold, J. M., Holliday, K., & Rodriguez, E. (2021). Metacognition in nurse practitioner students: How nurse educators can best serve their students. Journal of Applied Social Psychology, 51(12), 1170-1175.