Full Description
A comprehensive guide to the transition to clinical practice
Nurse Practitioners (NP) have become one of the most important parts of the medical profession. They provide direct patient care, bring a wealth of expertise, and in many clinical settings they are the primary guarantor of good patient outcomes. Nurse Practitioner: Transition Guide is a crucial resource designed to help guide a nurse practitioner through the challenging transition from academia to clinical practice. Covering all essential topics and enriched with real clinical experiences shared by practicing NPs, it's unlike any other work in addressing the needs of this growing group of indispensable medical professionals.
Readers of Nurse Practitioner: Transition Guide will also find:
Case studies, reflective exercises, and worksheets for goal setting
Detailed discussion of topics from board certification, job searching, and interview preparation to ethics, self-care, and communication
Essential information for the changing post-COVID landscape
Nurse Practitioner: Transition Guide is ideal for graduate students in their final semester of a Nurse Practitioner program who are taking a transition or capstone course. Additionally, preceptors preparing the next generation of Nurse Practitioners for the realities of clinical practice will find valuable insights and practical guidance throughout.
Contents
List of Contributors xvii
Foreword xix
Acknowledgments xxiii
Chapter 1 Introduction 1
Sara L. Gleasman-DeSimone PhD, ANP-C
1.1 Introduction 1
1.1.1 Transitions 1
1.1.2 Purpose 2
1.2 Intended Audience 2
1.3 Importance of Book 2
1.3.1 Growth of the Profession 2
1.4 Historical Background of Nurse Practitioner Practice 4
1.4.1 The Beginning 4
1.4.2 Definition and Growth of the Profession 4
1.4.3 Evolving Policy and Practice 5
1.5 What Do You Call a Nurse Practitioner? 6
1.6 Elevator Speech 6
1.7 Challenges Influencing Practice 7
1.8 Support of Practice 8
1.9 Setting Realistic Goals and Expectations 9
1.10 Introduction to the Nurse Practitioner Transitions to Practice Guidebook 10
1.11 Structure and Overview 10
1.11.1 Chapters 1-3: Building a Foundation for Nurse Practitioner Career Success 11
1.11.2 Chapter 4: Launching into Practice: The Inaugural Year 12
1.11.3 Chapter 5: Patient- Centered Care 12
1.11.4 Chapter 6: Self- Care 13
1.11.5 Chapter 7: Identifying Opportunities for Advancement 13
1.12 Learning Activities 14
1.13 Conclusion 15
References 16
Chapter 2 Certification and Career Preparation 19
Sara L. Gleasman-DeSimone PhD, ANP-C
2.1 Introduction 20
2.1.1 State Licensing and National Certification 22
2.1.1.1 State Forms 22
2.1.1.2 National Certification 24
2.1.1.3 Certification Review Courses 27
2.1.2 Job Preparation 30
2.1.2.1 Crafting the Resume: Essential Components 32
Summary 49
References 49
2.A Appendix A 50
2.B Appendix B 55
Chapter 3 Interview Mastery 57
Louise Dean-Kelly, PhD, DNS, FNP, RN
3.1 Introduction 59
3.2 What Is an Interview? 60
3.2.1 Types of Interviews 60
3.2.1.1 The Five Cs of Interviewing 63
3.3 Preparation for Interview 65
3.3.1 Patient Population 66
3.3.2 What to Wear 67
3.3.3 What Are You Looking For 68
3.3.4 Documents to Bring 68
3.3.5 Practice 69
3.4 Common Interview Questions 69
3.4.1 Strengths and Weaknesses 70
3.4.2 Questions About Past Experiences 72
3.4.3 The START Method for Behavioral Questions 73
3.4.4 Behavioral Questions 75
3.5 Mock Interview— Actual Practice for Interview 80
3.5.1 Choose Your Interviewer Carefully 80
3.5.2 The Setting for the Mock Interview 80
3.6 Post- Interview Strategies/Follow- Up Techniques 81
3.6.1 Positivity 83
3.6.2 Conclusion 83
3.7 START Worksheet for Behavioral Interview Questions 84
3.8 Assignment Mock Interview 86
References 94
Chapter 4 Understanding Contracts of Employment 97
Cynthia Grabski, DNS, FNP- BC
4.1 Introduction 98
4.1.1 Contracts 99
4.1.1.1 Employment Types 100
4.1.1.2 Boilerplate Language 101
4.1.1.3 Duties, Responsibilities, and Expectations 101
4.1.1.4 Extended Role Expectations 102
4.1.1.5 Compensation and Benefits 103
4.1.1.6 Contract Clauses 107
4.1.1.7 Breach of Contract 113
4.1.1.8 Recognizing Red Flags 113
4.2 Conclusion 126
References 126
Chapter 5 Launching Into Practice: The Inaugural Year 129
Sara L. Gleasman-DeSimone PhD, ANP-C
5.1 Introduction 130
5.2 Understanding the Transition Process 131
5.3 NP Transition to Practice Reflection 132
5.4 Clinical Competence 133
5.4.1 Benner's Model 134
5.4.1.1 Progression 134
5.4.1.2 NP Transitioning Through Benner's Framework 135
5.4.2 The Role of Experiential Learning and Reflection 136
5.4.2.1 NP Application 136
5.4.3 Embracing Challenges 137
5.4.3.1 Bridging Clinical Competence and Psychological Challenges 138
5.5 Imposter Syndrome 138
5.5.1 Prevalence and Impact 139
5.5.2 Contributing Factors 139
5.5.3 Application to New Nurse Practitioners 140
5.5.4 Overcoming Imposter Syndrome 141
5.5.4.1 Organizational Support/ Onboarding Programs 141
5.5.4.2 Workshop Strategies 142
5.5.4.3 Application to NP's 143
5.5.4.4 Mentorship and Guidance 144
5.6 Conclusion 144
5.7 Onboarding and Credentialing 153
5.7.1 Introduction 153
5.7.2 Credentialing Process 153
5.7.2.1 Practice Settings 154
5.7.2.2 Steps in Credentialing 154
5.7.2.3 Ensuring Excellence and Safety 155
5.7.2.4 Education and Licensing Verification 155
5.7.2.5 Competencies and Background Checks 156
5.7.2.6 Sample Credentialing Checklist 157
5.7.2.7 Obtaining a DEA Number 158
5.7.2.8 DEA Training Requirements for Nurse Practitioners 158
5.7.2.9 NPI Number 159
5.7.3 Privileging 160
5.7.3.1 Key Differences Between Credentialing and Privileging 161
5.7.4 Recredentialing 162
5.7.4.1 Documentation and Record- Keeping 162
5.8 Insurance 163
5.8.1 Medicare 163
5.8.2 Medicaid 164
5.8.3 Private Insurance 164
5.9 Billing for Nurse Practitioners 166
5.9.1 Understanding Reimbursement Models and Billing Codes 166
5.9.2 Reimbursement and Documentation 167
5.10 Conclusion 168
5.11 Time Management 168
5.11.1 Introduction 168
5.11.2 Definition and Problem 169
5.11.3 Origins of Time Management 169
5.11.4 Modern Challenges 170
5.11.5 Philosophy 171
5.11.6 Benefits of Time Management 172
5.11.6.1 Quality Healthcare 172
5.11.6.2 Increased Satisfaction and Overall Care 172
5.11.7 Impact of COVID- 19 on Time Management for NPs 173
5.11.8 Strategies for Nurse Practitioners 174
5.11.8.1 Automation 175
5.11.8.2 Electronic Health Records and Block Scheduling 175
5.11.9 Acceptance with Stoicism 177
5.11.9.1 Applying Stoicism to Time Management 178
5.11.9.2 Application to Nurse Practitioner Practice 178
5.11.10 Mere Urgency Effect 179
5.11.11 Work Smarter 180
5.11.12 Checklists 181
5.11.12.1 Steps for Checklists 182
5.11.13 The ABCD Method 182
5.11.14 Getting Things Done 183
5.11.14.1 Application of GTD to the NP 184
5.12 Conclusion 185
5.13 Legal and Regulatory Constraints 192
5.13.1 Introduction 192
5.13.2 Scope of Practice Definition 192
5.13.3 Legal Regulations 192
5.13.4 Influencing Factors 193
5.13.5 State Regulations and Examples 193
5.13.6 Practice and Prescriptive Authority 194
5.13.7 Malpractice Insurance 195
5.13.8 Collaboration and Referrals 196
5.13.9 Legislation 197
5.13.9.1 Pronouncing Death Example 197
5.14 Conclusion 200
References 200
Chapter 6 Patient- Centered Care 207
Sara L. Gleasman-DeSimone PhD, ANP-C
6.1 Introduction 208
6.2 Patient Communication 210
6.2.1 Patient Communication and Outcomes 210
6.2.1.1 Trust and Perceptions 211
6.2.1.2 Cost 211
6.2.2 Psychological Principles of Patient- Centered Care 212
6.2.2.1 Empathy 212
6.2.2.2 A Nurse Practitioner's Insight: Empathy and Trust in Patient- Centered Care 213
6.2.2.3 Self- Efficacy 214
6.2.2.4 Managing Challenging Patient Interactions 217
6.2.2.5 Enhancing Patient Engagement Through Therapeutic Communication 219
6.3 Conclusion 226
6.4 Professional Practice Guided by Evidence 226
6.4.1 Using Patient- Centered Evidence in Practice 227
6.4.2 Smooth Ways to Integrate Evidence 228
6.4.3 Evidence Summaries and Clinical Practice Guidelines 229
6.4.4 Systemic Reviews 230
6.4.5 Meta- Analysis: Synthesizing Quantitative Results 231
6.4.6 Combining Systematic Reviews and Meta- Analyses 231
6.4.7 Digging Deeper on Complex Practice Approaches 232
6.5 Conclusion 233
6.6 Ethical Considerations 233
6.6.1 Introduction 233
6.6.2 Ethical Principles 234
6.7 Conclusion 239
6.8 Patient Education for Nurse Practitioners 239
6.8.1 Introduction 239
6.8.2 NP Foundation 240
6.8.3 Theory 240
6.8.3.1 Health Belief Model 241
6.8.3.2 Motivational Interviewing 243
6.8.3.3 Keller's Motivational Theory 249
6.9 Conclusion 250
6.10 Diversity, Equity, and Inclusion 251
6.10.1 Cultural Competence 252
6.10.2 DEI and Outcomes 253
6.10.2.1 Application to the NP 254
6.10.3 DEI Strategies 256
6.10.3.1 Workforce Diversity 256
6.10.3.2 Leadership, Mentoring, and Collaboration 257
6.10.3.3 Addressing Bias 259
6.11 Conclusion 264
References 264
Chapter 7 Self- Care 269
Mary Handley, PhD, LMHC, CRC
7.1 Introduction 270
7.2 Self- Care 271
7.2.1 Self- Care Assessment 272
7.3 Burnout 276
7.3.1 Burnout in Nurse Practitioners 276
7.3.1.1 Pandemic Effects on Burnout 277
7.3.1.2 Understanding Burnout Across Healthcare Settings 278
7.4 Compassion Fatigue 279
7.4.1 The Impact on Nurse Practitioners 280
7.5 Strength in the Storm: A Personal NP Story 280
7.5.1 Assessing and Addressing Compassion Fatigue 282
7.5.1.1 Workplace Support 283
7.6 Resilience 283
7.6.1 Case Study for Application 284
7.6.2 Strategies to Combat Burnout and Enhance Resilience 286
7.7 Emotional Intelligence 288
7.7.1 Components of Emotional Intelligence 289
7.7.2 Impact of Emotional Intelligence 289
7.7.3 Improving Emotional Intelligence 290
7.7.3.1 Self- Awareness 290
7.7.3.2 Self- Regulation 291
7.7.3.3 Empathy 291
7.7.3.4 Motivation 292
7.7.3.5 Social Skills 292
7.8 Conclusion 300
References 305
Chapter 8 Identifying Opportunities for Advancement 309
Sara L. Gleasman-DeSimone, PhD, ANP-C
8.1 Introduction 310
8.2 Elevating Practice 311
8.2.1 Continuing Education 311
8.2.1.1 Recertification 312
8.3 The Leap of Faith 316
8.3.1 Doctor of Nursing Practice Pathway 318
8.3.1.1 Future of the DNP 319
8.4 Entrepreneurship 320
8.4.1 Nurse Practitioners with Entrepreneurial Skills 321
8.4.2 Barriers 323
8.4.2.1 Laws and Policies 323
8.4.2.2 Lack of Business Skills 324
8.4.2.3 Commitment 324
8.4.3 Overview for Opening a Primary Care Practice 327
8.5 Entrepreneurship in Nursing 328
8.6 Outcome Measures 333
8.6.1 Relative Value Units 333
8.6.1.1 Three Components of RVUs 333
8.6.1.2 Compensation 334
8.6.1.3 Conversion Factor 334
8.6.1.4 Example of RVU Calculation 335
8.6.1.5 Quantity Vs. Quality 336
8.6.2 Clinical Performance Measures 337
8.6.2.1 HEDIS Measures 337
8.6.2.2 Application 338
8.6.2.3 HEDIS Measure Example 338
8.6.2.4 Balancing Quantity and Quality 341
8.7 Interprofessional Education 343
8.7.1 Overview 343
8.7.2 Effectiveness 343
8.7.3 Safety 344
8.7.4 Application to Nurse Practitioners 344
8.7.5 Opportunities for Future 345
8.8 Snapshot of AI in Healthcare 346
8.8.1 Introduction 346
8.9 Historical Foundations of AI 347
8.9.1 Natural Language Processing 347
8.9.2 The Turing Test and AI Verification 347
8.9.3 Advancements in Computing Power 348
8.9.4 Machine Learning and Transformers 348
8.10 AI Applications in Healthcare 349
8.10.1 Patient Engagement and Operations 349
8.10.2 Predictive Modeling 350
8.10.3 Improving Radiology and Healthcare with Advanced AI Technologies 350
8.10.4 Robots and Computer Vision in Surgical Training 351
8.10.5 Precision Medicine, Diagnostics, and Drug Discovery 352
8.11 Key Challenges 354
8.11.1 Transparency and Explainability 354
8.11.2 Bias 355
8.11.3 Ethics and Regulatory Compliance 355
8.11.4 Expanding AI Beyond Cognitive Domains 356
8.12 Artificial Intelligence and the Nurse Practitioner 356
8.12.1 Human Insights and Challenges 357
8.13 Conclusion 358
8.14 Fostering the Future 360
8.15 Growth of Nurse Practitioners 361
8.15.1 International Membership 362
8.15.2 Global Networking and Contributions to Healthcare 362
8.16 Conclusion 364
References 364
Index 371
