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Conceptual Frameworks for Advance Practice Nursing

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Week Two Discussion Board

May 27, 2010

Conceptual frameworks for advanced practice nursing play an integral role in the guiding of practice, formulating educational curricula, and the overall development of the specialty. The continued evolution of advanced practice nursing has seemingly sparked numerous conceptual models influencing practice. Many models share common similarities, while each maintains their own unique characteristics specific to their developers and contributors. Ann Hamric developed Hamric’s Integrative Model of Advanced Practice Nursing in 1996, that has undergone two subsequent revisions in response to research, variations in practice, and theoretical influence. The resiliency of Hamric’s Model is exemplified by its continued presence in advanced practice nursing literature (Hamric, Spross, & Hanson, 2009). Hamric’s model presents a foundational approach to advanced practice nursing that is generalizable among all specialties of advanced practice nursing. The structural basis for Hamric’s model shares many similarities with Abraham Maslow’s Theory of Self-Actualization. Hamric centralizes a foundation in education, certification, and experience that is built upon to develop central and core competencies. These competencies are patient focused and all encompassing of actions that take place in the healthcare setting. Like Maslow’s strive for self-actualization, where one must progressively satisfy personal needs that rang from the basic biological needs to those that stimulate our intellect, one must accomplish primary criteria before progressing to the central competency of patient care, and finally becoming proficient in core competencies of the healthcare environment (Simms, Irwin, & Drinnien, 1987). Hamric, however, goes one step further to include environmental factors that play influence to an APN’s role. The personal use of Hamric’s Model as a guide for one’s professional development is extremely practical. This structure was designed for all advanced practice nurses and has practical applications to their education, practice, and outside factors influencing their profession as a whole. As students, this model can be used as a template of professional goals. After completing a graduate program, one can turn their focus toward gaining licensure, then direct patient care. Calkin’s Model of Advanced Nursing Practice well defines advanced practice nursing using experience and education. This model brings to mind the work of Patricia Benner when she described the levels of competency in nursing based on amount of experience nurses acquired. Competence levels ranged from the novice to the expert nurse, with experience in the setting of care and patient interactions being the influencing factor (Toomey & Alligood, 2006). Calkin’s model proposes similar information, differing in the proclamation for the need for further advanced education. Advanced education provides for the acquisition of extensive knowledge in a particular subject area. In this instance, the field of nursing is the subject matter. While a more extensive knowledge base can help the advanced practice nurse better meet the needs of their patients (illustrating the model), the model can further be extrapolated to the expanded role of the advanced practice nurse in their work setting. As the advanced practice nurse gains experience he/she becomes more proficient and the gap between knowledge/skill level and population responses closes (Hamric, Spross, & Hanson, 2009). The application of this model will be used a guide for my practice. As a new nurse I actively sought out learning opportunities and courses for continuing education. This strive to be more knowledgeable has contributed to my proficiency in the clinical setting. As an advance practice nurse, I would enter my practice setting with the same hunger for knowledge as in previous clinical experiences. Through mentoring and collegial communication, I will strive to expand my knowledge base. The more knowledgeable one is, the better prepared they are to meet the needs of a patient in their critical time of need. Calkin’s Model does not specifically address the environment of care that many other models incorporate into their framework, however, Calkin’s principles can be applied to any environment of care or any environmental influence. Through experience and advanced knowledge, the advanced practice nurse can accomplish great tasks.
Hamric, A. B., Spross, J. A., & Hanson, A. M. (2009). Conceptualizations of advanced nursing practice. In S. Clark & C. Anerson(Eds.) Advanced practice nursing and integrative approach (pp. 33-70). St. Louis, MO: Saunders Elsevier.
Simms, J. A., Irvin, D. B., & Drinnien, B. A. (1987). Maslow’s hierarchy of needs. Retrieved May 24, 2010, from low.htm
Toomey, A. & Alligood, M. (2006). Patricia Benner. In Y. Alexopoulos & K Hebberd (Eds.) Nursing theorists and their work (pp. 140-159). St. Louis, MO: Mosby Elsevier.

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