Advance Practice Nursing

Please provide a response to the  2 discussion post below.  Please provide 2 APA 7th edition references within 5 years.  Please do not be critical of the post just respond and add to what they said:
The major groups of  APNs are Nurse Practitioners, Nurse Anesthesiologist, Certified Midwife, and Certified Nurse Specialist (O. Grady, 2008). The four groups are feasible and inclusive in the current healthcare system. Each group consists of providing direct quality interventions that can dictate the outcome of a population (DeNisco, 2021). Advanced Registered Nurses can conduct a diagnostic testing, appropriate interventions which includes pharmacological methods, and has the assessment dexterity that’s comparable to a physician. 
             In 1991, MacDorman and Singh used regressional methods to display any disparity between CNM and Obstetrician’s delivery neonatal mortality rate (O. Grady, 2008). The objective focused on a subpopulation between the gestation age of 35-43 weeks. The result of the study concluded CNM were a safer practice compared to Obstetricians. Approximately 19% fewer infant mortalities after delivery, and low birth weight was 31% fewer compared to Obstetricians. The average baby weight the CNM delivered was 37 grams. (O. Grady, 2008). This example shows ADNs are feasible and inclusive in the healthcare system. 
              Unfortunately, Nurse Educators are excluded in the APN group. NE require a graduate degree but is a separate role from APNs. The reason NE are not considered a group within the APN is the competencies each role must complete. There are eight competencies a Nurse Educator which are facilitate learning; facilitate learner development and socialization; use assessment and evaluation strategies; anticipate in curriculum design and evaluation of program outcomes; functions as a change agent and leader; pursue continuous quality improvements in the nurse educator role; engage in scholarship; function within environment (DeNisco, 2021). The foundation of the Nurse Educator’s competencies is focused on pedagogy tactics, creating teachable plan and capacities. Even a PhD, or DNP, which are the highest nursing degree is unable to practice as a NE without satisfying the NE curriculum (DeNisco, 2021).  

DeNisco M. S, 2021. Advanced practice nursing essential knowledge for the profression, 4th edition. Jones & Bartlett Learning An ascend Learning Company. 
O. Grady T. E, 2008. Advanced practice registered nurses: the impact on patient safety and quality. In Hughes. RG (ed.). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (Chapter 43). https://www.ncbi.nlm.nih.gov/books/NBK2641/

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  In the USA, Advanced practice registered nurses (APRNs) are registered nurses who are certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), certified nurse practitioner (CRNP), or clinical nurse specialist (CNS).  APRNs are often primary care providers and are at the forefront of providing preventive care services to the public (ANA, n.d.).
        Nurse Practitioners provide primary, acute, and specialty health care across the lifespan. Certified Nurse-Midwives provide primary, gynecological, and reproductive health care. Clinical Nurse Specialists provide expertise and support to nurses caring for patients. Certified Registered Nurse Anesthetists provide a full range of anesthesia and pain management services (ANA, n.d.). 
       Nurse educators are individuals dedicated to teaching and mentoring the upcoming generation of nurses. They may teach in both clinical and classroom settings. A nurse educator primarily works in academic settings and may be responsible for staff development or continuing education (Norwich University online, 2019). Nurse educators are not part of the APRNs; I think they should be included they are nurses with an advanced degree usually a master’s degree.
 
ANA (n.d.). Advanced Practice Registered nurse (APRN). Retrieved from: https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/aprn/
Norwich University online (2019). Nurse Educator vs. Nurse Practitioner: Comparing Two Key Health Care Careers. Retrieved from: https://online.norwich.edu/academic-programs/resources/nurse-educator-vs-nurse-practitioner