What is an Independent Nursing Practice

What is Independent Nursing Practice?



How would you like to hang at your gate or window a sign bearing your name and the words “Independent Nursing Practitioner?” As the term implies, “independent” means the nurse is self-employed and provides professional nursing services to clients/parents and their families. While some independent nursing practitioners set up their clinics near a hospital, most of them are community-based. These nurses reach out and offer theirs services rather than expect clients to seek their help. They perform both independent and collaborative roles. Health care assessment, formulating plans for health maintenance, prevention strategies, continuation of supportive activities in critical and complex health problems are all within the scope of nursing practice. They make referrals and collaborate with physicians and other disciplines as needed by the client or family.

Nurse Practice

Independent nurse practitioners are accountable for their decisions. Whether their role is independent or collaborative, it is based on the fact that each health care discipline offers an area of knowledge and expertise. Collaborative work is needed for effective, efficient, and economical care. It is essential therefore that independent nurse practitioners acquire working knowledge of the skills and expertise of other health workers.

Nurses at work


The growing interest in independent nursing practice is expected to very much contribute to the improvement of the existing health care delivery system. It is time that we asses our own resources to explore this new field of practice. But the initial preparation for this kind of practice should have been incorporated first in nursing programs before nurses can assume the role effectively.

Pros and Cons Concerning Institutional Nursing

Pros and Cons Concerning Institutional Nursing


Nursing in hospitals and related health facilities such as extended care facilities, nursing homes, and neighborhood clinics, comprises all of the basic components of comprehensive patient care and family health. The concept of the modern hospital as a community health center where in-patient and out-patient care are continuous describes the goal of medical care in most general hospitals.

Nursing Pros and Cons


The educational qualification for beginning practitioners is a Bachelor of Science in Nursing degree. The nurse, as member of the health care team, participates in all phases of patient care of the acutely ill, the convalescing and the ambulatory patient. The nurse cares for the patient in the hospital or in the out- patient department and plans for the nursing care needs of the patient about to be discharged.

Advantages of Staff Nursing in Hospitals

1. There is always a supervisor whom one can consult if a problem exists.
2. Nurses are updated with new trends in medicine and in the nursing care of patients.
3. They have a forty- hour week duty which provide for two days of rest away from duty.
4. More staff development programs are available in hospitals.
5. They undergo rotation to different units.

Disadvantages of Staff Nursing in Hospitals

1. There is a great possibility of under-staffing which may require nurses to put in overtime work and sacrifice some of their plans.
2. Because of the bulk of work, some staff nurses do not find time to improve their skills through continuing education programs.
3. Administrative problems and overwork may tend to dissatisfy the staff nurse.

What is a Clinical Nurse Specialist?

toolsWhat is a Clinical Nurse Specialist?



Educators first developed the clinical nurse specialist (CNS) role because of their concern for improving nursing care. They believed that improvement was dependent upon increasing expertise at the bedside, giving direct and indirect care, and incorporating role modeling and consultation


The role of a CNS has evolved to include many specialties particularly in psychiatric care. The impressive development of this masteral program helped to initiate the other CNS specialty courses. Thus, clinical specialization in graduate education increased tremendously. Graduates would provide a high level of specialized nursing care and serve as change agents in hospital settings.

A good portion of time is spent in the hospital, in both staff and patient/family education. A clinical nurse specialist is also into developing protocols, standards and pathways that will guide nursing practice. A CNS also serves as a direct care provider, educator/consultant, researcher and leader. Areas of focus can encompass adult, pediatric and obstetric patients. Different medical departments like oncology, the cardiopulmonary system, the pulmonary system and others are also included.

What are the competencies attributed to a CNS?

• In-depth knowledge expertise
• Demonstrating clinical expertise in a selected area of clinical practice.
• Can be emulated by others professionally and personally.
• Serving as practitioner/teacher, consultant and researcher.

The past years had seen the influx of the greatest percentage of APNs as clinical nurse specialists. In order to achieve this specialization, one should prepare for a graduate nursing education program. This is primarily hospital based and can be consultative in nature.

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