Title: Core Competencies Necessary for the APN Role Development.
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Interview with an Advanced Practice Nurse
Introduction
Interview with APN/CNP, Diane John
Diane John, APN/CNP is a nurse practitioner at Health land, a Hawaii center for the public. She has devoted 30 years to her nursing career. She has worked as a nurse in a medical intensive care unit and as a research nurse in the study in the intensive care unit. She has been a Female Nurse Practitioner for the past 20 years where she started out as a midwife at wife care center, where she provided midwife services to women.

Rationale for an engaged interview process The reason for this interview is to find out Competencies necessary for APN role development and also to get some background information of a nurse leader on a one on one basis. This information will be important because it will help us to develop leadership skills in the field of nursing.
About the Diane John APN leader
Diane John, APN/CNP is an attendant specialist at Health land, a Hawaii community for the general population. She has dedicated 30 years to her nursing profession. She has filled in as an attendant in a restorative emergency unit as a examination nurture in the study in the emergency unit.

Interview
What is the CNS nurse?
The CNS is a practice for preparing advance practice nurses to be part of the clinical practice team where you work together with doctors to provide service to patients.Bringing knowledge into practice to improve health outcomes of patients as well as improvement of education of nurses. What is your role as a CNS?
I am a certified midwife nurse, certified registered nurse anesthetists (CRNA) and a certified nurse practitioner. Basically i am a registered nurse with a masters’ level education and certification. My role involves integration of care across the continuum through three spheres of influence; patient, nurse and the system. My primary goal is the improvement of patient outcomes and nursing care.

Describe how your previous work experience prepared you for the position you are in.
First my school attendance gave me an idea and much motivation to engage in the nursing practice. And, my previous work experience enabled me to understand the hospital operations and environment at large through exposure and time I have become a better nurse.
Where did you start your practice and where do you work currently
I am a nurse practitioner at Health land, a Hawaii center for the public. I have over 30 years experience in this nursing career. I have worked as a nurse in a medical intensive care unit and as a research nurse in the study in the intensive care unit. I have also been a Female Nurse Practitioner for the past 20 years where i started out as a midwife at wife care center, where I provided midwife services to women.
What is the current patient population in health land medical center?
We care for more than 43,000 patients per month and over 300,000 anually. We provide health care, mental care, care for the old and dental care to residents.
What are the competencies necessary for APN role development?
One is expert coaching and guidance that is demonstrated by knowledge expertise and ability to make evidence based education interventions and ability to use adult teaching principles.
The other is consultation that is demonstrated by utilizing the specialties of other disciplines such psychology, social work, medicine and other fields
Research skills are also core because it helps to design the evidence-based intervention content and delivering it according to the goals of the study.
And lastly, collaboration and ethical decision making skills help one to partner with others and makes them able to identify areas of ethical concerns during study implementation, reporting and administration.
Ok. What are some of the examples of ethical leadership by advance practice nurses?
Welcome. By nature of the APN part inevitably obliges all around sharpened correspondence and intervention abilities. Relational abilities are required for the exhaustive and suitable trade of data, and intercession abilities are expected to balance clashes created by individual identity and perspective contrasts inside of a gathering, particularly a multidisciplinary bunch.
What are the APN leadership expectations?
For nursing, all administration exercises have moral substance. They are coordinated toward a definitive objectives of ensuring what's more, advancing wellbeing and mitigating enduring utilizing nursing's points of view, whether at the individual level or at unit, center, or wellbeing strategy levels. They include: viable management of clinical consideration and [serves as] an asset individual, instructor and part model. The NP coaches different medical attendants, companions and interdisciplinary group individuals. He or she ought to have the capacity to clarify the subtleties and advantages of propelled practice parts to others including partnered health awareness suppliers.

Analysis of the core competencies necessary for APN role development
The core competencies demonstrate knowledge expertise and enable one to tailor evidence based on educational interventions based on the patient’s and communities’ needs. It also makes use of team work to utilize the other health care skills to improve the nursing practice (Joel, 2013).
Nursing leaders play a major role in shaping the nursing profession and maintaining the health system. They can be either chief executives, middle wives, administrators, senior managers, professional practice or policy makers. Nurse leaders should advocate for quality care, collaboration, articulate communication, mentorship, risk taking and visionary role models.
An Advance practice Nurse (NPN) is a registered profession who has acquired the expert knowledge and decision making skills in nursing competencies through basic training in diagnosis and management of common practices. They should have at least a master’s degree and three years of practice in the chosen field of competences. They manage common medical conditions such as chronic diseases and other basic healthcare services in collaboration with doctors and other health professionals to provide complex nursing care to patients. Their activities promote the improvement of health care services through the development of evidence based and theoretical practice based knowledge at both local and national levels.
Advance practice nurses are expected to put into practice ethical and safe practices while handling patients and following of practice guidelines. They are based in the application of health care practice in any health care setting to provide mentorship to patients, provide education to peers, clinical leadership, translation and undertaking meaningful research to improve the nursing practice. Advance practice nurses are categorized into four specialties: * Acute care APNs who conduct practice in intensive care units and emergency departments; * Medical/surgical APNs conduct their practice in the theatre and other specialized clinical settings such as the neurology, cardiology, gerontology and oncology. * Community APNS care for patients with common acute conditions at the community level clinics and general hospitals where patients require less attention. * Mental health APNS conduct their practice in either inpatient or outpatient psychiatric settings (Joel, 2013).
Description of Non-PF Nurse Practitioners Competencies
The National Organization of Nurse Practitioner Faculties (NONPF) has specific core competencies for all Nurse Practitioners (NPs). This mark the entry of a qualified nurse into the field of practice after graduation forms the NP educational program. The competencies are nationally validated and set for all Nurse practitioners in order for them to start the practice. The competencies are frequently reviewed and renewed after a couple of years (Joel, 2013).
The Nurse Practitioner Core Competencies include: * Scientific foundation competencies that critically analyzes data and evidence for improving advanced nursing practice, integrates knowledge from the science of humanities, translate research to improve the practice process and develops new practice based on research (Gilbert-Palmer, 2005). * Leadership competencies that assumes advanced leadership roles to guide change, provides leadership to foster with other stakeholders, demonstrates leadership using critical and reflective thinking, advocates for quality and cost effective health care and advances practice through the development and implementation of principles of change (Gilbert-Palmer, 2005). * Quality competencies uses best available evidence to continuously improve clinical practice, evaluates relations between; cost, quality and safety and how they influence health care, evaluates the organization structure and how it affects clinical practice, promotes a culture of excellence and anticipates variations in practice and is proactive in implementing interventions to ensure quality (Gilbert-Palmer, 2005). * Practice inquiry competencies provides leadership in the translation of new knowledge into practice, generates knowledge to improve practice, applies clinical investigative skills to improve health outcomes, leads practice inquiry, individually or in partnership with others, conducts research through multiple modalities and analyzes clinical guidelines for individualized application into practice (Gilbert-Palmer, 2005). * Technology and information competency integrates appropriate technologies for knowledge management to improvement of the practice, translates scientific information for various users’ needs, demonstrates information literacy skills in complex decision making, uses technology systems that capture data on variables for nursing care, and contributes to the design of clinical information systems that promote safe and cost effective care. * Policy competencies analyzes ethical, legal and social factors influencing policy development and also demonstrates understanding of interdependence of policy and practice to contribute in the development of health policy. It also evaluates the impact of globalization on healthcare policies (Gilbert-Palmer, 2005). * Health delivery system competencies facilitate the development of health care systems that address the needs of cultural diversity in collaboration with the organization structure, functions and resources to improve the delivery of quality practice. * Ethics competencies integrates ethical principles in decision making, evaluating consequences and decisions and implements solutions to issues related to individuals, populations and systems of community care (Gilbert-Palmer, 2005). * Independent practice competencies is an independent licensed practitioner and provides assessment to differentiate between normal, variations of normal and abnormal findings, manages the health status of patient and families over time and prescribes medication within scope of practice. It also reorganizes cultural diversity and the patient or designee as a full partner in decision making. Works on the establishment of a relationship with the patient characterized by mutual respect and collaboration. It incorporates patient’s cultural and spiritual preferences, values and beliefs into the health care needs of a society. This is achieved through creation of a patient centered care that includes confidentiality, privacy, comfort and respect (Gilbert-Palmer, 2005).

Conclusion
The extent of routine of APN involves the intellectual, integrative and specialized capacities of the qualified medical caretaker to put into practice moral and safe acts, techniques, conventions and practice rules. The clinical routine of the APN is logically based and pertinent to human services rehearse in essential, optional and tertiary settings. The part additionally envelops the measurements of patient and associate instruction, mentorship, clinical administration, and incorporates the obligation to decipher, use and attempt significant examination to progress and enhance nursing practice. Contribution of various profession resources including the role dimension of consultant for advanced practice nursing. And lastly, identifying the core competencies that are necessary for the APN role development (Buppert, 2008).

References Joel, L. (2013). Advanced practice nursing. Philadelphia: F.A. Davis. Gilbert-Palmer, D. (2005). Advance practice nurses' perceptions of nurse educator core competencies. Buppert, C. (2008). Nurse practitioner's business practice and legal guide. Sudbury, Mass.: Jones and Bartlett.
Sredl, D. (2012). Evidence-based leadership success strategies for nurse administrators, Advance Practice Nurses (APN), and Doctors of Nursing Practice (DNP). New York: Nova S