DQ: Describe how the role of advanced registered nurse transformed over time

As a registered nurse, cultivating strong interpersonal skills is crucial to advance in the career, creating mentorship or other network opportunities.
The transition from registered nurse (RN) to advance practice nurse is a significant career role and also a stressful career transition. Besides that  these advanced practice nurse have nationally received increased attention in recent years. I am therefore willing to join formal orientations as recommended to benefit my transitional role. Orientations have been found to relieve stress and help promote a sense of confidence, competence, and satisfaction. Extensive  training will also be a structured support for me. This has been found to affect advance nurses role transition positively especially during the first year of practice. A successful transition is characterized by a subjective sense of well-being, increased confidence and competence, mastery of skills, and autonomous practice. Therefore am willing to work on all the above to advance my nursing degree to provide primary, acute, and specialty health care across the lifespan through assessment, diagnosis, and treatment of illnesses and injuries.


NUR 513 Topic 1 Discussion 1

DQ Describe how the role of advanced registered nurse transformed over time

Historically, when one spoke of advanced practice nursing, they meant one of four roles; certified registered nurse anesthetist (CRNA), certified nurse mid-wife (CNM), clinical nurse specialist (CNS), or certified nurse practitioner (CNP). In 2004, the American Association of Colleges of Nursing (AACN) defined advanced practice nursing as “Any form of nursing intervention that influences health care outcomes for individuals or populations, including direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy” (Denisco & Barker, 2016). Since this definition came out many other nursing roles, such as nurse administrators and public health nurses have also been thought of as advanced practice nursing roles. Whereas advanced practice nursing used to be mainly reserved for clinical practice, it is now branching out into non-clinical roles. With the ever-expanding role of nurses coupled with the push to expand access to and decrease costs of health care there will likely be many new roles developed for nursing practice. These roles will require advanced degrees even if they are not in clinical areas, therefore, they too should be thought of as advanced practice nursing.

Emotional intelligent is important in nursing practices because it helps to understand people better (Whitney, 2018). Self-awareness is one of the important elements in emotional intelligent and it is the capacity to notice and comprehend your own feelings. Being conscious of the impact of your actions, moods, and emotions on other people goes beyond simply being aware of your own feelings. Developing self-awareness as a leader will strengthen not only individual performance but organizational performance as well. Ultimately, the immense amount of understanding, trustworthiness and wisdom that self-aware leaders possess equips them with critical skills for success.

Denisco, S.M. and Barker, A.M. (2016). Advanced Practice Nursing: Essential Knowledge for the Profession. Jones and Bartlett Learning.


I agree with you that nursing practice is any form of nursing intervention that is meant to influence the care outcomes. The nurse practice has been evolving overtime especially with the transformation of the healthcare systems and healthcare policies. In the current healthcare industry where the focus is on the patient, what is commonly referred to as patient centered approach has ensured that the patient is given autonomy to choose on the best care practice that is appropriate and improves the patient’s health condition (American Association of Nurse Practitioners, 2019). This has called upon the nurse training institutions to shift and adapt to the new and emerging trends in healthcare. The advanced nursing role has been the significant part that the Affordable Care Act aims to enhance health promotion measures among the aging US population (Woo et al., 2017). The research findings reveal that the advanced nursing role would be one of the professions at a highest demand by the year 2022.


American Association of Nurse Practitioners. (2019). Scope of Practice for Nurse Practitioners. American Association of Nurse Practitioners; AANP Website.

Woo, B. F. Y., Lee, J. X. Y., & Tam, W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15(1).

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Re: Topic 1 DQ 1

The advanced practice registered nurse (APRN) has seemed to evolve based on shortages and demands of the population within our healthcare system. Deficits have expanded many nursing roles, leading to the need to define the nursing scope of practice and educational requirements. The traditional four roles of APRN, nurse practitioner (NP), certified nurse-midwife (CNM), certified

DQ Describe how the role of advanced registered nurse transformed over time
DQ Describe how the role of advanced registered nurse transformed over time

registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS); have all grown exponentially since the 20th century (DeNisco & Baker, 2016). These four roles all seemed to have stemmed from disparities in our healthcare system, whether it be a shortage of physicians, under-severed rural areas, vulnerable populations, or times of war. A great example of this is the advancements within the CRNA field. CRNAs were initially brought about during World War I due to a physician shortage during wartimes (DeNisco & Baker, 2016). The continuation of wars through United States history gave the CRNA field a strong foothold as a chief provider of anesthetics to the frontline. This expansion of the nursing scope of practice in anesthetics eventually led to credentialing and the American Association of Nurse Anesthetists (AANA) to monitor and regulate this growing field (DeNisco & Baker, 2016). Similarly, the growth and expansion of the other original APRN roles through the end of the 20th and 21st century required the nursing field to define graduate-level educational requirements and each specialty’s nursing role. The transformation of traditional APRN roles has now begun to open doorways for other nontraditional advanced practice nursing areas like public health nursing, clinical nurse leaders, nurse administrators, nursing research, and nurse educators.

DeNisco and Baker do a great job of laying out the ongoing evolution and need of the APRN role in the American healthcare system and the need for more advanced practice educators to sustain the APRN field’s continuous growth (2016). With a growing and aging population and a continuing shortage of physicians, the APRN roles offer a cost-effective solution that can also improve patient satisfaction (DeNisco & Baker, 2016). I will say that this week’s reading has made the decision to continue my education in nursing even more appealing and necessary.


DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 9781284072570


I agree with your statement that the advanced nurse practice numbers have soared high in the 21st century compared by the 20th century. The current Covid-19 pandemic has however, proved that health and wellness is a collective responsibility (Kovac, 2020). In this context both the patient and the nurse are at risk of contracting the disease regardless of age, gender or religious underpinnings hence adequate precautionary measures should be taken. The advanced nursing role has taken up active role in preventive measures of the disease by offering the routine guidelines of hygiene the emerging trends in the spread and severity of the disease. The concept of preventive care is one of the key pillars in the patient protection and well-being. The advanced nurse role requires the nurses to carry out educational programs, seminars and workshops that are meant to help the public on the need of maintaining our bodies for optimal health and reduced chances of hospitalization. The one situation where the advanced nurses’ practitioners have shown resilience is the tackling of the covid-19 pandemic. Countries that embraced strict, firm and taken early hard precautionary measures have known to be safer with very low reported cases in the country (Trnka et al., 2021)



Kovac, M. (2020). The Covid-19 pandemic: collective action and European public policy under stress. Central European Journal of Public Policy, 0(0).

Trnka, S., Long, N. J., Aikman, P. J., Appleton, N. S., Davies, S. G., Deckert, A., Fehoko, E., Holroyd, E., Jivraj, N., Laws, M., Martin-Anatias, N., Roguski, M., Simpson, N., Sterling, R., & Tunufa’i, L. (2021). Negotiating risks and responsibilities during lockdown: ethical reasoning and affective experience in Aotearoa New Zealand. Journal of the Royal Society of New Zealand, 1–20.

This week : CAT (150 WORDS)

This week : We will discuss how the role of advanced registered nurse transformed over time, considering various shifts in scope and expectations in the 20th and 21st centuries. We will also discuss different ways that will the advanced registered nurse role and responsibilities continue to evolve and emerge as the American health care system changes. Here is a CAT ( classroom assessment technique question for you to get additional participation points). Please respond in addition to your 2 main dbqs dq1 and dq2.

CAT #1

Explore the 4 APRN roles 🙂 of your personal interest.



The APRN roles which are the advanced roles include; certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM), clinical nurse specialist (CNS) and certified nurse practitioner CNP). The advanced nurse roles have been traditionally entailing focus on the clinical procedures, advocating for better patient care, being case managers (Hu & Forgeron, 2018). Additionally, ADP is also expected to work in consultation and collaboration with other healthcare professionals. The roles entail a wide scope of practice and ideally, the learning is meant for advancement on the already available information. However, in the current situation the healthcare industry is approaching a new era as emphasized in the affordable care act which we still don’t know what will happen. The affordable care act insists on offering medical care that built on patient centeredness and care that is preventive rather than curative (Courtemanche et al., 2018). This is meant to tackle the rising number of the elderly population that is battling serious chronic illnesses that are associated with old age

Transformation of the role of advanced registered nurses over time. 


According to DeNisco & Barker (2021), the advanced registered nurse role has evolved with time to assist the growing needs in the healthcare system. Such functions include Certified Registered Nurse Anesthetist, Clinical Nurse Specialist, Certified Nurse Midwife, and Nurse Practitioners. Since the 1960s, nurse practitioners have helped to supply the paucity of primary care physicians to underprivileged populations in urban and rural settings. Initially, the education process was less than one year; however, as the responsibilities expanded, so did the need for further education (Woodland, Foster, & Robertshaw,2022). Fast forward to the 1990s, and acquiring a master’s degree in nursing became the standard for practice. With the growing trend of increasing comorbidities, aging population, and the predicted physician shortage, the scope of nursing and transition from sole bedside care to more specialized nursing roles is evolving (DeNisco & Barker, 2021).


Shifts in scope and expectations in the 20th and 21st centuries. 


Health care has drastically expanded between the 20th and 21st centuries. Considering the national lifespan of the 21st century has lengthened in comparison to the early 1900s, more specialized services are available to meet individual health needs. For example, nursing in the 20th century was more generalized as one nurse was multifaceted, and primary nursing care and functional nursing care were practiced. However, as the 21st century advanced with complex healthcare needs, nursing has become more specialized. According to the International Council of Nurses (ICN), nursing responsibilities include a broad spectrum encompassing varied environments (Woodland, Foster, & Robertshaw,2022).


Ways in which the advanced registered nurse role changes 


Nursing is the most trusted profession in the United States (American Nurses Association, 2022). With trust comes obligations. The current healthcare system is complex and places more demands on healthcare providers, especially nurses. The complex healthcare system includes an aging population, a rise in chronic diseases, emerging infectious diseases, increasing health care costs, and an acute shortage of healthcare providers (DeNisco & Barker, 2021; Vos et al., 2020). The U.S. spends 18% of its GDP on healthcare costs, which is 3.35 trillion (WHO, 2022). The advanced registered nurses’ roles and responsibilities must continue to evolve to meet the challenges of our healthcare system. A unique and highly skilled workforce is necessary to meet these demands. One way to continue to grow is to advance the knowledge. According to the International Council of Nurses (ICN), advanced nurses hold a master’s degree and possess expert knowledge. The role also continues to evolve through expert coaching, research, specialized care, participation in evidence-based practice, nursing standards, the scope of practice, and professional leadership (Chau et al.,2022).




Chaum J. P., Lo, S.H., Lam, S.K., Saran, R., & Thompson, D. R. (2022). Critical elements in nursing graduates’ transition to advanced practice roles and their perceived impact on patient care: an exploratory, descriptive study of graduates and their managers’ perception. BMC Nursing, 21(1), 2-7.


DeNisco, S. M., & Barker, A. M. (Eds.). (2019). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124



Woodland, J., Foster, K., & Robertshaw, D. (2022). Nursing in the 21st century: results of a pilot survey on attitudes towards nurses and nursing. British Journal of Nursing (4). Vol 31.


Vos, T, Lim, S., Abbafati, Abbasi, & Abbasifard, et al., (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. (396). Pg. 204–22. 6736(20)30925-9


World Health Organization (WHO) (2022). than-half-a-billion-people-pushed-or-pushed-further-into-extreme-poverty-due-to-health-care- costs