What is the difference between model, theory, framework, and philosophy? How are they related?

Specialty nursing is described by Hamric, Hanson, Tracy, & O’Grady (2014, p. 112) as the focus of practice in a specific area in the field of professional nursing. “Advanced practice nursing reflects concentrated knowledge in a specialty that offers the opportunity for expanded and autonomous practice based on a broader practical and theoretical knowledge base” (Hamric et al., 2014, p. 113). The reason for such specialties and advanced degrees in nursing are related to changing patient needs. Once these needs are identified, educating professionals in caring for these specialized populations is initiated.

From the American Association of Colleges of Nursing (n.d.), advanced practice nursing includes more advanced education, knowledge base, and scope of practice as compared to specialty nursing. Advanced practice nursing is more firmly based in research, which encourages the use of critical thinking and analyzing data. The Commission on Collegiate Nursing Education (AACN, 2017.) accredits nursing schools at all levels including baccalaureate and graduate.

A registered nurse who is considered an expert in a specific area can obtain a “specialty” title. In order to become a specialist, certain education, experience, and examination must be met. Credentialing is available for many different areas of nursing, and can be acquired through examination and experience. Two organizations offer accreditation for specialized nursing and regulate their requirements; they are: American Board for Specialty Nursing Certification (ABSNC) and the National Commission for Certifying Agencies (NCCA). Not all specialty groups have chosen to be accredited, because it is a lengthy process. Some of the most popular areas for specialization include: cardiac, geriatric, and diabetic patients (CCNE, 2017).

Advanced practice nursing has four areas: certified nurse midwife, clinical nurse specialist, certified registered nurse anesthetists, and certified nurse practitioner. It is common, with nurse practitioners, to specialize in a certain area after an advanced practice nurse is achieved; for instance: family, acute care, pediatrics, and geriatrics. Unlike specialized nursing, advanced practice nursing does not require more hours of experience at the completion of school. The clinical hours that are obtained throughout school count towards hours of experience. Unlike specialists, advanced practice nurses have the ability to diagnose and treat patients as well as prescribe medications. Both specialists and advanced practice nurses are involved in direct patient care and responsible for educating patients and their families (CCNE, 2017).

Change takes a long time to occur. It took many years for the knowledge base, scope of practice, credentialing, and regulations to be agreed upon for the four different areas of advanced practice nursing. Having different nursing organizations agree upon something is a slow process. Many changes have occurred throughout the years and many more are to come, especially with the evolution of specialty nursing (Smolenski & Goudreau, 2013).

References

American Association of Colleges of Nursing (n.d.). The essentials of master’s education

for advanced practice nursing. Retrieved from

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