Guaranteeing that APRNs view the provision of healthcare from a nursing perspective has implications for graduate curricula. The American Association of Colleges of Nursing (AACN, 2006) includes nursing theory as a component of its document Essentials of Doctoral Education for Advanced Practice Nursing. Students also need assistance in utilizing this theoretical content in their practice. Faculty and preceptors who model this approach for advanced practice nursing students are critical for helping them inte- grate theory into practice and to build bridges over the theory-to-practice gap that currently exists.
APRNs provide healthcare to many individuals and populations in di- verse care environments and settings. APRNs have the opportunity to make major contributions to advance the nursing profession. By focusing on the nursing elements of healthcare, APRNs have the opportunity to demonstrate to the public and to policy makers the unique and signifi- cant contributions that nursing has on health outcomes. In using nursing frameworks rather than the medical model as the focus of practice, APRNs provide the public with a distinct and adjunctive model of care rather than a substitutive model (i.e., replacing physicians). APRNs may carry out ac- tivities that have traditionally been a part of medicine, but the manner, approach, style, and performance of these activities by APRNs need to be translated into the realm of nursing.
SUMMARY
Nursing practice is built on one’s philosophy and beliefs. The core of the APRN’s practice is the expansion of the professional nursing role. By re- taining the fundamental practice of nursing, transitioning from registered nurse to APRN gives the APRN role the “value added” that is separate from other healthcare providers. In order to survive in the current health- care system, the APRN must not lose sight of the “art of nursing,” which transcends the art of medical practice. The art of nursing is built on sci- ence, caring, and understanding human experience in health and illness.
Regardless of what theoretical framework or constructs are used by APRNs to formulate a model of practice, the key is to remain grounded in nursing.
To borrow a phrase from Hamlet by William Shakespeare, “This above all: to thine own self be true” (Hamlet Act I, scene 3).
ACKNOWLEDGMENT
The author acknowledges the contributions of Gail B. Katz to this chapter in the previous edition.
REFERENCES
Alligood , M. R ., & Marriner- Tomey , A . ( 2005 ). Nursing theory: Utilization and appli- cation. St. Louis, MO : Mosby .
American Association of Colleges of Nursing . ( 2006 ). Essentials of doctoral educa- tion for advanced practice nursing . Washington, DC : Author .
American Holistic Nurses Association/American Association of Nursing . ( 2013 ). Scope and standards of practice: Holistic nursing ( 2nd ed .). Silver Spring, MD : American Nurses Association .
American Nurses Association . ( 2004 ). Nursing: Scope and standards of practice.
Silver Spring, MD : Author .
American Nurses Association . ( 2010 ) Nursing’s social policy statement: The essence of the profession ( 3rd ed .). Silver Spring, MD : Author .
APRN Consensus Workgroup & APRN Joint Dialogue Group . ( 2008 ). Consensus model for APRN regulation: Licensure, accreditation, certification & education.
Retrieved from http://www.aacn.nche.edu/Education/pdf/APRNReport .pdf
Bahramnezhad , F ., Shiri , M ., Asgari , P ., & Afshar , P. F . ( 2015 ). A review of the nursing paradigm . Open Journal of Nursing, 5 , 17 – 23 . doi: 10.4236/
ojn.2015.51003
Benner , P . ( 1998 ). Nursing as a caring profession. Paper presented at the meeting of the American Academy of Nursing, Kansas City, MO .
Bulechek , G. M ., Butcher , H. K ., Dochterman , J. M ., & Wagner , C . (Eds.). ( 2013 ).
Nursing interventions classification (NIC) ( 6th ed .). St. Louis, MO : Elsevier . Burman , M. E ., Hart , A. M ., Conley , V ., Brown , J ., Sherard , P ., & Clarke , P. N .
( 2009 ). Reconceptualizing the core of nurse practitioner education and practice . Journal of the American Academy of Nurse Practitioners, 21 , 11 – 17 . doi: 10.1111/j.1745- 7599.2008.00365.x
Chism , L . ( 2013 ). The doctor of nursing practice: A guidebook for role development and professional issues ( 2 nd ed .). Burlington, MA : Jones & Bartlett .
Duffy , J . ( 2009 ). Quality caring in nursing: Applying theory to clinical practice, educa- tion and leadership. New York, NY : Springer Publishing .
Finkelman , A . ( 2013 ). Leadership in quality improvement . Clinical Nurse Specialist,
27 ( 1 ), 31 – 35 . doi:10.1097/NUR.0b013e3182776d8f
Fulton , J. S . ( 2011 ). Explaining clinical nurse specialist practice to the public .
Clinical Nurse Specialist, 25 ( 3 ), 105 – 106 . doi: 10.1097/NUR.0b013e31821ada0b Gadow , S . ( 1980 ). Body and self: A dialectic . The Journal of Medicine and Philosophy,
5 , 172 – 184 . doi: 10.1093/jmp/5.3.172
Gordon , M . ( 2007 ). Nursing diagnosis. ( 11th ed .). Sudbury, MA : Jones & Bartlett . Greiner, A. C., & Knebel, E. (Eds.). ( 2003 ). Health professions education: A bridge to
quality . Washington, DC : National Academies Press .
Hagedorn , S ., & Quinn , A . ( 2004 ). Theory- based nursing practitioner prac- tice: Caring- in- action . Topics in Advanced Practice Nursing e- Journal, 4 ( 4 ), 1 – 7 . Hanson , M. D . ( 2015 ). Role of the clinical nurse specialist in the journey to
Magnet recognition . AANC Advanced Critical Care, 26 ( 1 ), 50 – 57 . doi: 10.1097/
NCI.0000000000000068
Henderson , V . ( 1966 ). Nature of nursing. New York, NY : Macmillan .
Institute of Medicine . ( 2011 ). The future of nursing: Leading change, advancing health.
Washington, DC : National Academies Press .
Jackson , J. I . ( 2015 ). Nursing paradigms and theories: A primer. Virginia Henderson Global Nursing e- Repository . Retrieved from http://www .nursinglibrary.org/vhl/handle/10755/338888
Jasemi , M ., Valizadeh , L ., Zamanzedeh , V ., & Keogh , B. ( 2017 ). A concept analysis of holistic care by hybrid model . Indian Journal of Palliative Care, 23 ( 1 ), 71 – 80 . doi:10.4103/0973-1075.197960
Johnson , D. E . ( 1980 ). The behavioral system model for nursing . In J. P . Riehl
& C . Roy (Eds.), Conceptual models for nursing practice ( 2nd ed ., pp. 207 – 216 ).
New York, NY : Appleton- Century- Crofts .
Johnson , D. E . ( 1959 ). The nature of a science of nursing . Nursing Outlook, 7 ( 4 ), 291 – 294 .
Johnson , M ., Bulechek , G ., Butcher , H ., McCloskey Dochterman , J ., Maas , M ., Moorehead , S . S ., & Swanson , E . ( 2005 ) NANDA, NOC and NIC linkages ( 2nd ed. ). St. Louis, MO : Mosby .
King , I. M . ( 1971 ). Toward a theory of nursing. New York, NY : John Wiley .
Leininger , M . ( 1990 ). Historic and epistemologic dimensions of care and caring with future directions . In J . Stevenson & T . Tripp- Reimer (Eds.), Knowledge about care and caring (pp. 19 – 31 ). Kansas City, MO : American Academy of Nursing . Levine , M . ( 1967 ). The four conservation principles of nursing . Nursing Forum,
6 ( 1 ), 45 – 59 . doi: 10.1111/j.1744- 6198.1967.tb01297.x
Marrs , J. A ., & Lowry , L. W . ( 2009 ). Nursing theory and practice: Connecting the dots . In P. G . Reed & N. C . Shearer (Eds.), Perspectives on nursing theory ( 5th ed. , pp. 3– 12). Philadelphia, PA : Lippincott Williams & Wilkins .
Mayo , A. M ., Ray , M. M ., Chamblee , T. B ., Urden , L. D ., & Moody , R. ( 2017 ). The advanced practice clinical nurse specialist . Nursing Administration Quarterly,
41 ( 1 ), 70 – 76 . doi: 10.1097/NAQ.0000000000000201
Meleis , A. I . ( 2011 ). Theoretical nursing: Development and progress ( 5th ed .).
Philadelphia, PA : Lippincott Williams & Wilkins .
Mishel , M. H . ( 1990 ). Reconceptualization of the uncertainty in illness theory .
Image: Journal of Nursing Scholarship, 22 , 256 – 262 . doi: 10.1111/j.1547- 5069.1990 .tb00225.x
Morley , G ., & Jackson , J . ( 2017 ). Is the art of nursing dying? A call for political ac- tion . Journal of Research in Nursing, 22 ( 5 ), 342 – 351 . doi: 10.1177/1744987117713043 Neuman , B . ( 1974 ). The Betty Neuman health care system model: A total person approach to individual problems . In J. P. Riehl & C . Roy (Eds.),
Conceptual approach to individual problems (pp. 99 – 114 ). New York, NY : Appleton- Century- Crofts .
Newman , M. A . ( 1984 ). Looking at the whole . American Journal of Nursing , 84 , 1496 – 1499 . doi: 10.1097/00000446- 198412000- 00068
Newman , M. A ., Sime , A. M ., & Corcoran- Perry , S. A . ( 1991 ). The focus of the discipline of nursing . Advances in Nursing Science, 14 ( 1 ), 1 – 6 . doi: 10.1097/00012272- 199109000- 00002
Nightingale , F . ( 1992 ). Notes on nursing. Philadelphia, PA : Lippincott . (Originally published 1859.)
Nojima , Y . ( 1989 , May). The structural formula of nursing practice: A bridge to new nursing. Paper presented at the19th Quadrennial Congress of the International Congress of Nurses, Seoul , Korea .
Nojima , Y ., Tomikana , T ., Makebe , S ., & Snyder , M . ( 2003 ). Defining character- istics of expertise in Japanese clinical nursing using the Delphi technique .
Nursing Health Science, 5 ( 1 ), 3 – 11 . doi: 10.1046/j.1442- 2018.2003.00129.x
North American Nursing Diagnosis Association International . ( 2015 ). Nursing diagnoses: Definitions and classification 2015- 2017 ( 10th ed. ). Ames, IA : Wiley Blackwell .
Olson , J ., & Hanchett , E . ( 1997 ). Nurse- expressed empathy, individual outcomes, and development of a middle- range theory . Image- The Journal of Nursing Scholarship , 29 , 71 – 76 .
Orem , D. E . ( 1980 ). Nursing: Concepts of practice. New York, NY : McGraw- Hill . Polk , L. V . ( 1997 ). Toward a middle- range theory of resilience . Advances in Nursing
Science, 19 ( 3 ), 1 – 13 . doi: 10.1097/00012272- 199703000- 00002
Reed , P. G . ( 1991 ). Toward a nursing theory of self- transcendence: Deductive reformulation using developmental theories . Advances in Nursing Science,
13 ( 4 ), 64 – 71 .
Riehl- Sisca , J . ( 1989 ). Conceptual models for nursing practice. Norwalk, CT : Appleton
& Lange .
Rogers , M . ( 1970 ). An introduction to the theoretical basis of nursing . Philadelphia, PA : F. A. Davis .
Rounds , L ., Zych , J ., & Mallary , L . ( 2013 ). The consensus model for regulation of APRNs: Implications for nurse practitioners . Journal of the American Associate of Nurse Practitioners, 25 ( 4 ), 180 – 185 . doi: 10.1111/j.1745- 7599.2013.00812.x Roy , C . ( 1984 ). Introduction to nursing: An adaptation model. Englewood Cliffs,
NJ : Prentice Hall .
Russell , G. E ., & Fawcett , J . ( 2005 ). The conceptual model for nursing and health policy revisited . Policy, Politics and Nursing Practice, 6 ( 4 ), 319 – 326 . doi: 10.1177/1527154405283304
Schoenhoefer , S. O ., & Boykin , A . ( 1993 ). Nursing as caring: An emerging general theory of nursing . In M. E . Parker (Ed.), Patterns of nursing theories in practice (pp. 82 – 92 ). New York, NY : National League for Nursing .
Smith , M. C . ( 1995 ). The core of advanced practice nursing . Nursing Science Quarterly, 8 ( 1 ), 2 – 3 . doi: 10.1177/089431849500800102
Stanley, J. M. (2012). Impact of new regulatory standards on advanced practice registered nursing. The APRN consensus model and LACE. Nursing Clinics of North America, 47(2), 241– 250. doi:10.1016/j.cnur.2012.02.001
Stanley , M. C . ( 2011 ). Advanced practice nursing. Emphasizing common roles ( 3rd ed .).
Philadelphia, PA : F. A. Davis .
Swanson , K. M . ( 1991 ). Empirical development of a middle- range theory of caring .
Nursing Research, 40 , 161 – 166 . doi: 10.1097/00006199- 199105000- 00008
Watson , J . ( 1988 ). Nursing: Human science and human care: A theory of nursing.
New York, NY : National League for Nursing .
Wiener , C. L ., & Dodd , M. J . ( 1993 ). Coping amid uncertainty: An illness trajec- tory . Scholarly Inquiry in Nursing Practice, 7 ( 1 ), 17 – 30 .
Younger , J. B. ( 1991 ). A theory of mastery . Advances in Nursing Science, 14 ( 1 ), 76 – 89 . doi: 10.1097/00012272- 199109000- 00009
Zaccagnini , M ., & Waud White , K . ( 2014 ). The doctor of nursing practice essentials and new model for advanced practice nursing ( 2 nd ed .). Burlington, MA : Jones &
Bartlett .