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The American Nurses Association (ANA) definition of nursing practice is “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and population “(American Nurses Association, 2015). The four concepts of health, person, environment, and nursing in the nursing metaparadigm defines the discipline and practice of nursing. ANA’s definition of nursing incorporates all four concepts (Quinn & McDonough, 2019) . Thus, the concepts and actions necessary to address environmental factors that can affect the wellbeing of individuals and populations are within the scope of practice and definition of nursing defined by the ANA. The practice of nursing involves behaviors, attitudes and judgment, and physical competences in the application of knowledge and abilities to provide care and improve patient outcomes. (Ghahramanian, Rassouli, Zamanzadeh, Valizadeh, & Asghari, 2020).
In comparison, the definition of advanced practice nursing (APN) is a level of nursing practice that uses comprehensive skills, experience, and knowledge in nursing care. APN is concerned primarily with advancing the skills, knowledge, and role of the nurse beyond the traditional professional boundaries to increase their knowledge base. APN requires a nurse to have complex decision-making skills and clinical competencies for expanded practice (Gray, 2016). APN moves a step beyond nursing practice; it entails nurses to undertake further specialist skills, education, and competencies to enable them to provide skilled, competent nursing care in a chosen specialty. APN requires a higher-level nursing practice and academic skills through further education, which allows a nurse with advanced skills and knowledge to diagnose and treat medical conditions and prescribe medications, this is not seen in general nursing practice (Cooper, McDowell, & Raeside, 2019).
The primary purpose of a theory in the profession of nursing is to improve practice by positively impact the wellbeing and quality of life of individuals. The association between theory and practice is reciprocal. Advanced practice registered nurses (APRN) are encouraged to use nursing theories in their practice. Using only one theory to guide the APRN’s practice limits their vision and does not allow them to see the patient as a unique individual. APRN’s should choose the most appropriate nursing theory for each particular situation and interaction with their patients (Shireen, Asma, & Noureen. 2020). If the goal of care for the patient is health promotion, the APRN’s could use Nola’s Pender’s Health Promotion Model: She believed that the patient’s quality of life could be improved by the prevention of problems before they occurred (Nursing Theory, 2016). If the purpose of the APRN is caring, Jean Watson’s Theory of Human Caring can be used. The theory addresses how the APRN can express care towards their patients (Butts & Rich, 2014). When the patient’s culture and the cultural background needs to be taken into consideration when deciding on how to provide care, the APRN could implement Leininger’s Culture Care Diversity and Universality Theory (Nursing Theory, 2016). In her theory, she states that the nurse needs to understand the role of culture in the health of the patient and adapt their care accordingly to provide culturally competent care (Butts & Rich, 2014).
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