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This is a reflection paper which gives the reflections and insights that were gained in the course of playing the role of  an advanced practice nurse particularly during a case study which was carried out   and generally in the course of the completing the course. The paper is structured into four sections with each section a different aspects of nursing.

In the recent past there has been an increase in the number of advanced practice nurses (APNs) roles which have included acute care nurse practitioners, clinical nurse specialist, advanced practice case managers. There has been a continuous increase in the roles of APNs especially in the acute care settings. It has been argued that the roles of the APNs are likely to keep on increasing in the ambulatory and community settings (Bryant- Lukosius, Dicenso, Brown and Pinelli, 2004). I believe that the APNs need to take active roles in community settings. This change I believe is a realistic one as the nurses will get to interact more with people. This interaction is likely to change the lifestyles of people to enhance their health. Apart from being in a position to instil healthy lifestyles in the society it will be possible to come up with a solution to healthy problems which affect the society.  Having more APNs working among the community will make it possible for the healthy practitioners to participate in policy making processes especially those policies which touch on communal health. With the APNs at the community level it will be easier to instil good and healthy lifestyles since the APNs will be deliver timely and resourceful information to the community. 


The issues that need to be championed in reference to APNs are issues which touch on the community service as explained above. APNs are in a good position to effect people in a community in a huge way if they can be actively involved in the community nursing. There is need to infiltrate more of the APNs in the community. This can be accomplished through organizations such as educational institutions, social networks and speciality organizations. The formation of networks such as the International Council of Nurses (ICN) will help a great deal in realizing the benefits of APNs. Such networks will be responsible for providing resources and evidence based information to support the development of the APN functions (Hamric, Spross and Hanson, 2005).

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Having the APNs at close levels to the day to day activities of people makes it easier for them to identify health care issues. For instance, a nurse working in company setting will be in a position to suggest useful physical exercise to the employees. Depending on the activities carried out by the individuals it might be necessary to advocate for different physical exercises for the people in question. The same will apply for the diets, depending on the calories of energy that are spent by the workers a nurses can propose different diets which will supply the appropriate amount of calories for them to work effectively. Through organizations working closely with the APNs it is possible to reduce to a great amount health issues such obesity which is growing in to being a big problem in the US. By reducing the number of obese people for instance will lead to increase production of goods or services by an organization. Arguing from the business point of view it will also act as a motivation to have a health practitioner checking over the health status of the employees. In learning institutions especially the lower learning levels, the APNs can easily pin point an healthy problem in a student before such can develop to an huge levels.

This section examines the ethical issues which are associated with the APNs. It was particularly agreed that the practitioners in the APN field should not be just centred on the treatment but rather should have a holistic approach and in their practice. It was generally agreed that the role of the APNs has narrowed down to a very limited responsibilities which make it possible for them not to fully and effectively utilize their skills (Fitzpatrick, Glasgow and Young, 2003). It was agreed that there is a need for the APN practitioners to engage more in non-clinical aspects of their role. These aspects when critically examined are the preventive measures which can be said to be equally important as any other. Another issue which was brought up was the competing nature time between the various roles that the APNs are often engaged in.

The case study exercise enabled my understanding of the broader roles of APNs. I have come to appreciate that these practitioners are in a position to influence the health status of a community. I have come to appreciate the fact that these practitioners are unnecessarily tied down to health institutions whereas they can be allowed to engage in various settings which can in fact allow them to effectively put into use their skills.  Their skills will be much appreciated if they are dispersed out to working institutions, learning institutions etc. When in such settings they are in a position to positively affect the health status of the people are therefore greatly reduce the occurrence of health issues such as obesity. It is important therefore that non clinical duties are given a priority as they will effectively act as measures of preventing occurrences of unnecessary health complications. By mixing up with the community away from the clinics it becomes possible for the community to get some advice on issues such as early detection of breast cancer among other complications.

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