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Focus on Advanced Practice Nurses

Network - Spring 2011

Advanced practice nurses, also called mid-level providers, are the bridge between physicians and patients, says Jane Williams, advanced practice nurse and manager of mid-level providers in MD Anderson’s Department of Genitourinary Medical Oncology.

We asked her to give us the basics, including how they help improve patient care.

What is an advanced practice nurse?

Advanced practice nurses (APNs) are registered nurses who have advanced education and advanced knowledge, skills and scope of practice.  

There are several categories of APNs at MD Anderson. The two most common are nurse practitioners and clinical nurse specialists.

Nurse practitioners (NPs) are advanced practice nurses who provide high-quality health care services directly to patients, similar to those of a doctor. NPs diagnose and treat a wide range of health problems, and many are trained to perform advanced procedures. NPs also focus on health promotion, disease prevention, health education and counseling. 

Clinical nurse specialists (CNSs) focus on a specific patient population. Five general duties make up their daily routine: clinical practice, teaching, research, consulting and management. CNSs work primarily with other nurses to advance their nursing practices, improve outcomes, and provide clinical expertise to effect system-wide changes to improve programs of care. 

How does this advanced training and education improve patient care?

Unit-based clinical nurse specialists assist clinic nurses with clinical care at an advanced level of practice. They also serve as educators and consultants to improve clinical care.  

Nurse practitioners provide a blend of nursing and medical care. Whether clinic-based or hospital-based, they might: 

  • order, perform and interpret diagnostic tests such as lab work and diagnostic imaging; 
  • evaluate the effects of cancer treatment and help patients manage side effects; 
  • diagnose and treat acute and chronic conditions such as diabetes, high blood pressure, infections and injuries; 
  • prescribe medications and other treatments; and 
  • counsel patients on a variety of issues, including nutrition and physical activity, physical symptoms, coping strategies, sexuality and end-of-life decisions.

By having an extension of the usual physician-delegated services, patients may experience shorter wait times, receive comprehensive care and have time to discuss other issues that affect their overall health that the physician may not have time to offer.

What is the future for advanced practice nursing at MD Anderson and beyond? 

We have many clinics at MD Anderson that are APN-run, such as fatigue, coagulation, prevention and others.

As the demand on the health care delivery system increases, the numbers and types of APN-run clinics will increase. APNs will work closely with their physician colleagues to expand such key service areas. 

We are also expanding our 24-hour hospital coverage by staffing nurse practitioners who are skilled in internal medicine from 6 p.m. to 6 a.m. We will also see many more APNs acquiring doctoral degrees.


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