Advanced practice nurses (APNs) who seek to be employed in any hospital are often confronted by rules and regulations as outlined in an employment practice agreement drafted by the national nursing bodies. A collaborative practice agreement (CPA) is a formal written statement that provides a scope or definition of a joint working relationship and practice of both a physician and an advanced practice registered nurse. The rights and responsibilities of those involved as well as the mechanisms for legal protection of the advanced practice nurses are outlined in the CPA (APRN Consensus Group Work Group & NCSBN APRN Advisory Committee, 2008). This document contains the required qualification including education, conditions for licensing, minimum training, experience and any other certification that professional nurses should possess to be considered for employment. The agreement also states the rules and guiding principles which are the parameters within which nursing practice is done ("Advanced Practice Registered Nursing: Nurse Practitioners," 2017). It is mandatory for all advanced practice nurses, irrespective of practice setting to be well conversant with every aspect of collaborative practice agreements before committing to any by signature.
The Johns Hopkins University Student Health & Wellness Center (JHU SHWC)
In the State of Maryland, as a professional nurse, I would like to work in two hospitals: The Johns Hopkins University Student Health & Wellness Center (JHU SHWC) and the University of Maryland Medical Center. According to the credentialing and privilege policy of the JHU SHWC, all the qualifications about the practice of professional nursing are highlighted. The center determines all clinical procedures and treatments offered to patients and the grounds which enable a nurse to qualify for certain privileges. The JHU SHWC directors, the nurse manager, accreditation assistant as well as other relevant designees oversee the credentialing process that consists of assessing and validating a professional nurse to provide clinical services. In Maryland, it is a requirement that all nurses practice their services under registered physicians. On the contrary, a policy was passed that allows nurses to have the privilege of operating independently of a physician (Rubenfire, 2015). It is possible to also get other clinical privileges through application verified by the JHU SHWC committee and granted by the Maryland State board of nursing as per the laws of Maryland State (Kessler, 2006).
University of Maryland Medical Center (UMMC)
Acute care nurses only work with patients for a short period such as in the recovery process following surgery (Shapiro & Rosenberg, 2002). Nurse practitioners at the University of Maryland Medical Center (UMMC) employ expert knowledge from both nursing field and medical practice to enhance their patient care. The institution educates their health providers while at the same time uses research to improve and provide the best patient care. The advanced practice council is made up of diverse groups of physicians and nurse practitioners who collaborate to provide good healthcare (Improving Quality and Safety, 2011). Acute nurses in the UMMC enjoy a wide range of clinical privileges and service including acute pain management, medical intensive care, and emergency surgery among others. The credentialing process begins with an application by professionals from an appropriate school of medicine, in possession of a Maryland license, registration with federal Drug Enforcement Agency (DEA) as well as substance registration that is controlled by Maryland State. The attestation forms and the privilege forms are filled to get into UMMC ("Nurse Practitioners," n.d.).
The professional opportunities and privileges available in both UMMC and JHU SHWC, particularly the clinical privileges can positively affect my practice as a professional nurse due to the skills learned as well as full professional support from my colleagues. Diverse expertise can improve my skills of medical treatment, diagnostic procedures and interpretations in acute care settings. Being in possession of all the requirements such as education, certification, licensure, accreditation, competence, and experience would be the best route towards my job negotiations. The appropriate contract negotiations, for me, would be a collaborative, conversational approach that focuses on compensation. I would build on my skills and expertise as well as professional experience while at the same time being aware of the national and regional salary scale for nurse practitioners.
Advanced Practice Registered Nursing: Nurse Practitioners. (2017). Mbon.maryland.gov. Retrieved 28 August 2017, from http://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx
APRN Consensus Group Work Group & NCSBN APRN Advisory Committee. (2008).
Consensus model for APRN regulation: Licensure, accreditation, certification, and
education. Retrieved from http://www.nonpf.org/associations/10789/files/APRNConsensusModelFinal09.pdf
Improving Quality and Safety (2011). Despite some progress, the nation still faces an urgent need to build a less error-prone system that delivers better care. Health Affairs, 1-3. Retrieved from http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_45.pdf
Kessler, R. (2006). Johns Hopkins University Student Health & Wellness Center Policy & Guidelines Manual. Retrieved from https://studentaffairs.jhu.edu/wp-content/.../Credentialing-and-Privileging-Policy.pdf
Nurse Practitioners. University of Maryland Medical Center. Retrieved 28 August 2017, from http://www.umm.edu/professionals/nurse-practitioners
Rubenfire, A. (2015). Maryland allows nurse practitioners to practice independently of a physician. Modern Healthcare. Retrieved from http://www.modernhealthcare.com/article/20150514/NEWS/150519928
Shapiro, D., & Rosenberg, N. (2002). Acute Care Nurse Practitioner Collaborative Practice Negotiation. AACN Clinical Issues: Advanced Practice in Acute And Critical Care, 13(3), 470-478. http://dx.doi.org/10.1097/00044067-200208000-00011
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