Roles of Advanced Practice Registered Nurses

Communication Civility and Conflict Resolution

In the same way that nurses are proficient in clinical skills, they should be proficient in communication skills. A patient’s optimal care requires that the specialized skills and knowledge of administrators, physicians, nurses and other professionals be integrated. The integration is only achievable through skilled, respectful interaction and frequent communication. Skilled communication uses a two-way information delivery model where people think and decide together (Johansen, 2012). Ineffective communication results in conflicts. Handling conflicts in an effective and efficient way improves staff morale, patient safety, and quality while limiting stress on caregiver workers.  

Effective management and resolution of a conflict entails clear communication and understanding of the perceived disagreement areas. Therefore, conflict resolution is an essential element in creating a healthy work environment because a breakdown in collaboration and communication leads to increased patient errors. According to the American Association of Critical-Care Nurses (2005), civility is one way used by nurses in conflict resolution as an attitude of showing respect to others demonstrated by one party to another. Therefore, civility “is the sum of the many sacrifices we are called to make for the sake of living together.” It requires that a nurse is mindful of others and aware of the impact that their behaviors have towards them.

Role of APN in Complementary Therapies

Globally, complementary therapies are gaining popularity and complement the conventional healthcare practices. They include a variety of treatment modalities that are not discipline-specific like herbal therapies and manual healing like acupuncture and reflexology. Every client has a right to make his/her decision regarding care and treatment, and the APN’s role is to respect the ethical values of a patient’s choice and well-being (College of Nurses of Ontario, 2014). Although clients may request the provision of complementary therapies, the APN should assess the appropriateness of the CAM therapy, and to have adequate knowledge of the effects and actions of therapy to assess the benefits and the risks for the particular patient. Therefore, before a nurse provides an individual treatment, it is crucial to ensure the intervention falls within the scope of nursing practice. 

Ways of Managing Cultural and Linguistic Challenges in Client Care

Today nurses are providing case management, education, and care to an increasingly diverse client population facing challenges in the form of health literacy, linguistic, and cultural barriers. In managing these barriers, nurses should continue developing their capability to practice cultural self-awareness so as to identify their personal linguistic and cultural biases and assumptions (Singleton, & Krause, 2009). APNs should stop relying on gut feelings in estimating the health literacy of clients and rely on patient assessment tools which efficiently collect a client’s health literacy information.

Ways in Which Ethics Influences APN Practice and Client Care

Every day, nurses face ethical dilemmas, irrespective of their practice. Ulrich, Zhou, Hanlon, Danis, and Grady (2014) explain that the Code of Ethics for Nurses developed by the American Nurses Association (ANA) guides nurses while carrying out their responsibilities in a consistent manner with professional ethical obligations and nursing care quality. In their day to day tasks, nurses face several ethical issues like empirical knowledge versus personal beliefs, distribution of resources, truth telling versus deception, freedom versus control, pro-choice versus pro-life, and quality versus quantity of life. In nursing, the moral thought is developed on four principles of justice, beneficence, non-maleficence, and autonomy.

Ways in which Reimbursement Affect APN Practice

In many health settings, APNs require a revenue stream to survive. The government’s Medicare covers health care cost and Medicaid programs, managed care organizations, self-insured institutions, and commercial insurers. APRNs receive reimbursements from third-party payers for supervising diagnostic studies and direct patient care. APRNs can be reimbursed under their provider number (JWOCN, 2012). They are also required to comply with physician service limitations, licensure requirements that they collaborate with physicians, and provision of practice within their scope. 


American Association of Critical-Care Nurses (2005) AACN standards for establishing and sustaining healthy work environments: a journey to excellence. American Journal of Critical Care, 14(3), 187-197.

College of Nurses of Ontario. (2014). Pratice Guidelines: Complementary Therapies. College Of Nurses Of Ontario. Retrieved from

Johansen, M. (2012). Keeping the peace. Nursing Management (Springhouse), 43(2), 50-54.

JWOCN. (2012). Reimbursement of Advanced Practice Registered Nurse Services. Journal Of Wound, Ostomy And Continence Nursing, 39, S7-S16.

Singleton, K., & Krause, E. (2009). Understanding Cultural and Linguistic Barriers to Health Literacy. Medscape, 13(3). Retrieved from

Ulrich, C., Zhou, Q., Hanlon, A., Danis, M., & Grady, C. (2014). The impact of ethics and work-related factors on nurse practitioners’ and physician assistants’ views on quality of primary healthcare in the United States. Applied Nursing Research, 27(3), 152-156.

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