Journal of Christian Nursing:
Department: Advanced Practicing Nursing
Kristene Diggins, DNP, RN, is a certified nurse practitioner in geriatrics and family practice, working with Wycliffe Bible Translators at a mission clinic as well as at an elderly health clinic. Kristene teaches online for the University of Phoenix/Axia College.
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I 've often thought about how refreshing it would be to have a place where Christian advanced practice nurses (APNs) could support one another. There are so many reasons we need this, but an important one is that the role of the APN is dynamic and often misunderstood. JCN is a perfect place for Christian APNs to connect with one another, share stories, discuss Christian practice, and offer support for the challenges we face.
Speaking of challenges, since I've become an APN I've experienced less recognition, understanding, and support than nurses do in general. Specifically, I've experienced a lot of confusion about the nurse practitioner (NP) role. Recently after explaining what an NP does, a patient told me, "I am so happy you are a nurse practitioner. My last doctor was a nurse practitioner too!" The patient was complementing me, but I was troubled by his equating my role with that of physicians. Although there is overlap, there are important distinctions.
As understood by the title, an APN is a nurse who practices in his or her field with an advanced degree beyond the BSN. The APN is equipped with more in-depth clinical knowledge, prepared to integrate theory with practice at a higher level to provide care as a nurse anesthetist, NP, nurse midwife, or clinical nurse specialist. An NP is a nurse who provides comprehensive care in management and treatment of health. The NP role was developed in 1965 by a nurse educator and a pediatrician to provide primary care in response to a shortage of primary care physicians. The first NP role was a pediatric NP (World of Nurse Practitioners, 2010).
Over the last 45 years, the NP role has grown and expanded. Currently the range of understanding and interpretation of the role varies greatly. The scope of practice, regulatory definitions, and educational preparation for NPs varies from state to state. As the shortage of healthcare providers in primary care becomes more severe, NPs must be ready to promote a unified understanding of this advanced practice role. One of the goals of Doctor of Nursing Practice education is to provide a more standardized description of the NP role.
Unfortunately, a cultural absolute permeates healthcare and society that creates a great barrier to understanding and acceptance of nursing roles. This is the belief that the only person qualified to examine, treat, educate, and prescribe is a physician; that MDs are the most qualified to care for patients, that they know and do everything all other healthcare professionals know and do. As a doctorally prepared practitioner, the distinction between my role and training and a physician's lies in the basic differences of nursing and medicine. In general, basic and advanced practice nursing focuses on health and educating individuals, families, and communities to promote, maintain, and restore optimal health; nurses empower clients to take ownership of their health. In general, medicine focuses on the diagnosis and treatment of disease and injury for individuals. In medicine, traditionally there is more emphasis on illness and pathology and less emphasis on education and empowerment.
Oftentimes, the barriers to gaining understanding of advanced practice nursing seem insurmountable. This confusion must be addressed on a many different levels. I decided to join my state NP legislative committee, meet regularly with state representatives, and seize every opportunity to explain APN roles. Because I believe so strongly in the NP approach to healthcare, no effort to promote an accurate understanding of my role is futile. Anything I can do to validate and promote APNs will, I hope, advance the cause of nursing practice.
All the confusion aside, I know I can rest my identity in the greater realm of who I am in Christ. No matter how long the dilemma of APN roles remains, I am first and foremost a Christian nurse. As a Christian nurse, I know who I am in Christ and can therefore claim my heritage in him. I know the privilege of serving Christ defines all I do professionally (Colossians 3:22–23). What a joy to know that while the confusion defining APNs may remain, there never will be any confusion that as Christian APNs we can follow Christ and serve him!