After a few years working as an intensive care unit nurse, Julie Tsirambidis, CNP, MSN, knew she wanted to expand her role in health care delivery. While attending graduate school to become a certified nurse practitioner, she encountered well-meaning friends and family members who really did not understand the degree she was pursuing. Later, after graduation, she faced new challenges as she integrated her role as an advanced practice provider (APP) into medical settings that had never hired an APP.
Tsirambidis was not alone. Advanced practice providers across the country have been charting a new course for health care delivery – by responding to increased demand for their services, particularly as resident physician hours decrease, and by bridging the gap between physician and nurse.
This charge has also led Tsirambidis to Akron Children’s Hospital where she is the director of the new Advanced Practice Center.
“The term advanced practice provider encompasses a number of specialties, including certified nurse practitioner (CNP), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA) and physician assistant (PA),” said Tsirambidis.
In general, advanced practice nurses work independently and in collaboration with physicians to:
- perform patient exams
- obtain medical histories
- order and interpret tests and procedures
- perform procedures within their scope of practice
- prescribe medication
- provide consultations
- coordinate care
- provide patient education
Physician assistants are licensed to practice medicine with physician supervision. They perform a range of duties from primary care to specialty procedures. Specific responsibilities depend on the type of practice, experience level, working relationships with physicians and other health care providers and state laws. PAs are often the primary health care providers in rural areas where there’s a shortage of physicians.
“Because advanced practice nurses and physician assistants fill a similar role in health care delivery and often have the same professional development needs, it made sense to include both groups within an Advanced Practice Center,” said Lisa Aurilio, MSN, RN, NEA-BC, vice president of Patient Services and chief nursing officer.
These providers are all credentialed as members of the hospital’s medical staff. Tsirambidis reports to both Aurilio and Michael Bird, MD, MPH, vice president of Medical Services.
“This demonstrates the strong support that Akron Children’s has for the advanced practice role and its unique place between nursing and medicine,” Tsirambidis said.