Curious about advanced practice skills

[traumasurgRN]

Hey there,

I was just curious if there are any particular skills that an APN ( NP or CNS) could perform that an RN could not. I know that some APNs can start central lines and such, but can an APN insert a chest tube or perform needle decompression? I am debating whether or not Advanced Practice Nursing is for me, or if I would be happier in an educational field. I guess I am asking about what skills are generally within the APN's scope of practice.

[zenman]

There are lot's of skills, including the ones you mentioned, that an APN can do that an RN cannot. However, those in my field (psych) are so highly skilled that we do not even have to touch a patient.

[CRF250Xpert]

A RN can't diagnose and generate RVUs for me. A RN can't sew, cut, debride, excise, reduce, biopsy - well a very few very specifc ones with specialty RN Certs can under my supervision. Remember, it's still a "I write the order and the appropriately skilled person can complete it if it is within his scope of practice and I am confortable delegating it" world. I have some staff that I don't allow to do much, and some I encourage to do more - all have the same license, but skills and trust vary.

[Corey Narry, MSN, RN, NP]

Echoing what CRF250Xpert just stated, skills are acquired with training and practice. As long as there's no Scope of Practice barrier, nurses who are not APN's could be taught many skills as easily as APN's. In the same vein, APN's can perform skills physicians routinely perform as long there is nothing stated in the Practice Acts prohibiting it.

NP's typically perform skills based on the type of practice they're involved in...i.e., primary care NP's would likely be doing office based procedures such as joint injections, simple suturing, extremity splinting; NP's working in Thoracic Surgery would likely be placing chest tubes; and Critical Care NP's like myself have been placing central lines, arterial lines, intubating, and providing conscious sedation.

To me, the bigger picture is that NP training focuses on being a provider who diagnoses and acts on the diagnosis using these skills while at the same time weighing the risk and benefits of the procedure itself. For example, various types of chest tube placements can easily be learned from simply doing a thoracentesis to placing large French, rigid chest tubes. The decision to choose one over the other requires training in diagnostics and clinical decision-making you wouldn't have if you didn't attend an NP program (or PA and MD+residency for that matter).

[kanzi monkey]

There are lot's of skills, including the ones you mentioned, that an APN can do that an RN cannot. However, those in my field (psych) are so highly skilled that we do not even have to touch a patient.

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